The nurse at the antepartal clinic reviews four patients’ charts.
Which patient is at increased risk for an ectopic pregnancy?

A 23-year-old primigravida with a history of endometriosis.

A 40-year-old multigravida with a history of condyloma acuminata.

A 27-year-old primigravida with a bicornuate uterus.

A 36-year-old multigravida who has had two previous cesarean deliveries.

Answer and Explanation

The Correct Answer is A

The correct answer is choice A. A 23-year-old primigravida with a history of endometriosis.Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, sometimes affecting the fallopian tubes. This can cause scarring and damage to the tubes, which can increase the risk of ectopic pregnancy.

Choice B is wrong because condyloma acuminata, also known as genital warts, are caused by human papillomavirus (HPV) infection. HPV infection does not directly increase the risk of ectopic pregnancy, although it may be associated with other sexually transmitted infections (STIs) that can cause pelvic inflammatory disease (PID), which is a risk factor.

Choice C is wrong because a bicornuate uterus is a congenital anomaly where the uterus has two horns or chambers instead of one. This does not affect the fallopian tubes or the implantation of the fertilized egg in the uterus.

Choice D is wrong because previous cesarean deliveries do not increase the risk of ectopic pregnancy. However, previous tubal surgery, such as tubal ligation or salpingectomy, can damage the fallopian tubes and increase the risk.

Other risk factors for ectopic pregnancy include previous ectopic pregnancy, smoking, age older than 35 years, history of infertility, and use of assisted reproductive technology.

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Correct Answer is B

Explanation

The correct answer is choice B. Apply ice to her perineal area.This is because ice can help reduce swelling and pain in the episiotomy wound, which is a cut made in the tissue between the vagina and anus during childbirth.Ice should be applied for the first 24 to 48 hours after delivery.

Choice A is wrong because Kegel exercises, which involve contracting and relaxing the pelvic floor muscles, are not recommended for the first 12 hours after an episiotomy.They can increase blood flow and inflammation in the area, and may interfere with healing.

Choice C is wrong because keeping her hips slightly elevated can cause pressure on the episiotomy wound and increase discomfort.It can also affect blood circulation and drainage in the area.

Choice D is wrong because observing her perineal area for signs of infection is not a nursing action that should be included in her plan of care for the first 12 hours.Infection is rare in episiotomy wounds, and signs of infection usually appear after 24 hours or later.However, the nurse should teach the patient how to keep the area clean and dry, and when to report any signs of infection, such as fever, pus, or foul-smelling discharge.

Normal ranges for episiotomy healing are:

• Stitches dissolve within 2 to 4 weeks

• Pain and swelling subside within a few days to a week

• Wound heals completely within 4 to 6 weeks

A. A symptom of an endocrine disorder. B. In response to the need for chromosomal determination of gender identity. C. Related to the influence of maternal hormones. D. A symptom of an abnormal proliferation of mammary alveoli.

Correct Answer is C

Explanation

The correct answer is choice C: Related to the influence of maternal hormones.This is because breast milk contains many hormones that pass into it from the mother’s body, such as prolactin, thyroid hormones, and estrogen.

These hormones can affect the baby’s growth and development, and sometimes cause temporary breast enlargement and milk secretion in newborns of both sexes.This is called neonatal galactorrhea or “witch’s milk” and it is harmless and usually resolves within a few weeks

Choice A is wrong because neonatal galactorrhea is not a symptom of an endocrine disorder.It is a normal physiological response to maternal hormones that cross the placenta during pregnancy and are present in breast milk

Choice B is wrong because neonatal galactorrhea is not related to the need for chromosomal determination of gender identity.Gender identity is determined by a complex interaction of genetic, hormonal, and environmental factors, and it is not influenced by breast milk production in newborns

Choice D is wrong because neonatal galactorrhea is not a symptom of an abnormal proliferation of mammary alveoli.

Mammary alveoli are the milk-producing cells in the breast, and they are stimulated by prolactin to secrete milk.Neonatal galactorrhea does not indicate any abnormality in the structure or function of the mammary glands

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The nurse at the antepartal clinic reviews four patients’ charts. Which patient is at increased risk for an ectopic pregnancy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A patient had an episiotomy during her delivery. Which nursing action should be included in her plan of care for the first 12 hours?

Correct Answer is B

Explanation

The mother of a 4-hour-old newborn reports to a nurse, “My son is producing breast milk.” The nurse’s response should be based on which understanding about newborn physiology? This is:.

Correct Answer is C

Explanation

When a pregnant patient has genital herpes, for which complication is the patient at higher risk than the general population?

A client in preterm labor is managed with terbutaline. Which will a nurse need to consider in planning care for this client?

The nurse provides a 16-year-old client with information concerning expected and possible changes during pregnancy. Which statement, if made by the client, would indicate that she understands the information?

When a client reports using cocaine during her current pregnancy, which laboratory study should a nurse anticipate?

A nurse is caring for a client with gestational diabetes.Which guideline should the nurse use when providing nutritional counseling to this client?

A client in preterm labor tells the nurse, “It’s okay that I am in labor.I’m not worried. My sister’s baby was born this early, and he is doing great.” How should the nurse interpret this statement by the client? The client is:.

A nurse is providing information to a patient regarding contraception methods. Which statement by the patient indicates a need for further teaching regarding use of copper intrauterine device (IUD)?

A client who is 22 weeks pregnant with a twin gestation comes to the clinic. The nurse instructs the client in self-care for the third trimester of pregnancy. Which statement made by the client would indicate the need for further teaching?

The nurse at the antepartal clinic reviews four patients’ charts.
Which patient is at increased risk for an ectopic pregnancy?