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. The patient’s uterine contraction pattern is enhanced.Prostaglandin E2 gel is used to induce labor by ripening and dilating the cervix and stimulating uterine contractions.The effectiveness of the gel can be measured by the frequency, duration and intensity of the contractions.

A stronger and more regular contraction pattern indicates that the gel is working and labor is progressing.

Choice A is wrong because cervical dilation is not the only indicator of labor induction.Cervical dilation can occur without contractions or with weak and irregular contractions, which means that labor is not established yet.

Choice C is wrong because cervical softening (or effacement) is a prerequisite for cervical dilation, but it does not necessarily mean that labor has started.Cervical softening can occur weeks before labor or even during pregnancy.

Choice D is wrong because uterine softening (or relaxation) is the opposite of what prostaglandin E2 gel is supposed to do.Uterine softening reduces the contractility and tone of the uterus, which can lead to prolonged labor or fetal distress.

A. “You don’t need to breastfeed now if you would rather wait for your milk to come in.”. B. “It is good practice for you to breastfeed now so that you will be skilled when your milk comes in.”. C. “The earlier you begin to breastfeed your baby, the closer you and your baby may become.”. D. “The fluid you have in your breasts now is just what the baby needs.”.

Correct Answer is D

Explanation

The correct answer is choice D. The fluid that the mother has in her breasts before the milk comes in is called colostrum, which is rich in antibodies and nutrients that the baby needs.

It also helps to prevent jaundice by stimulating the baby’s bowel movements.

Therefore, the nurse should encourage the mother to breastfeed as soon as possible after birth and explain the benefits of colostrum.

Choice A is wrong because it discourages breastfeeding and may interfere with milk production and bonding.

Choice B is wrong because it implies that breastfeeding is only a skill and not a natural process that benefits both the mother and the baby.

Choice C is wrong because it focuses on the emotional aspect of breastfeeding and not the physiological one.

While breastfeeding may enhance the closeness between the mother and the baby, it is not the only reason to breastfeed.

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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

The physician prescribes prostaglandin (PGE2) gel for a patient being admitted for induction of labor. Which finding would best indicate that the prostaglandin gel is effective?

Correct Answer is B

Explanation

During the first postpartum day, a new mother is breastfeeding her infant.The client asks, “Since I don’t have any milk yet, why am I breastfeeding?” Which response by the nurse is most appropriate?

Correct Answer is D

Explanation

The newborn of a patient suspected to have used drugs during the prenatal period is admitted to the nursery.The nurse caring for the newborn notes that the infant is beginning to exhibit signs of drug withdrawal.Which action should the nurse take?

A patient who is 26 weeks pregnant has gestational diabetes and is to begin insulin management. When discussing the patient’s insulin needs, which information should the nurse include?

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 instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

A nurse is caring for a client with postpartum hemorrhage. The provider has ordered Methylergonovine 200 mcg intravenously to be administered stat. The nurse should perform which priority assessment prior to administering this medication?

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

A client who had pregnancy-induced hypertension (PIH) is now postpartum. A nurse should closely monitor this client for which complication?

A nurse is observing the internal fetal monitor readings of a laboring client.The fetal heart rate is between 130 and 138 beats per minute, with moderate beat-to-beat variability. How should the nurse interpret this finding?

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