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 D

Explanation

The correct answer is choice D. Apply petrolatum to the patient’s perineum.This is because petrolatum can help soothe and protect the perineal area, which may be swollen, bruised, or have stitches after a vaginal delivery.Applying petrolatum can also prevent the pad from sticking to the wound and causing more pain.

Choice A is wrong because observing the patient for vaginal discharge of bright red blood is not a specific action for perineal care.Bright red blood may indicate postpartum hemorrhage, which requires immediate medical attention.

Choice B is wrong because assessing the patient’s vaginal tone is not a priority action for perineal care.Vaginal tone may be reduced after childbirth due to stretching of the pelvic floor muscles, but this can improve with time and exercises.

Choice C is wrong because massaging the patient’s perineum is not recommended for perineal care.Massaging the perineum may cause more trauma and discomfort to the area, especially if there are stitches or hemorrhoids.Massaging the fundus (the top of the uterus) may be done to help it contract and prevent bleeding, but this is different from massaging the perineum.

A. Abdominal distention. B. High-pitched cry. C. Jitteriness. D. Excessive drooling.

Correct Answer is C

Explanation

Answer and explanation..

The correct answer is choice C. Jitteriness.Jitteriness is a sign of low blood sugar (hypoglycemia) which is common in infants of diabetic mothers (IDM) because they have high levels of insulin in their blood that lower their glucose levels after birth.Hypoglycemia can also cause other symptoms such as seizures, lethargy, poor feeding, sweating, trembling, and pale complexion.

Choice A is wrong because abdominal distention is not a typical symptom of IDM.

It can be caused by other conditions such as intestinal obstruction or infection.

Choice B is wrong because high-pitched cry is not a specific symptom of IDM.

It can be caused by many factors such as pain, hunger, or neurological problems.

Choice D is wrong because excessive drooling is not a common symptom of IDM.

It can be a sign of oral problems such as teething or infection.

Normal ranges for blood glucose in newborns are 40 to 150 mg/dL (2.2 to 8.3 mmol/L).

IDM should be monitored closely for hypoglycemia and treated promptly with glucose if needed.

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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

During the postpartal admission assessment, the nurse notes that a patient’s perineum appears edematous and ecchymotic. Based on this finding, which action should the nurse take?

Correct Answer is D

Explanation

A nurse is caring for a newborn of a diabetic mother (IDM). What should the nurse monitor for during care of the newborn?

Correct Answer is C

Explanation

On her second postpartum day, the mother of a newborn says, “The doctor says the baby has physiologic jaundice. Even though it is supposed to be normal, I don’t understand why it occurs.” Which fact regarding physiologic jaundice should form the basis of the nurse’s response?

A nurse is caring for a patient who is 40 weeks pregnant. Which finding would indicate the need for a cesarean delivery?

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?

During a regular clinic visit, a patient who is 28 weeks pregnant reports leg cramps. The nurse teaches the patient measures to relieve the cramps. Which statement would indicate that the patient understands the teaching?

A nurse is caring for a patient who is receiving oxytocin injection intravenously for labor induction.The nurse should monitor this patient for which adverse effect of oxytocin?

The nurse suspects drug abuse in a patient admitted with no prenatal care and a diagnosis of abruptio placentae.Which question would elicit the most information from the patient concerning the suspected drug use?

A woman gives birth to twin girls, one of whom is stillborn. Which nursing action would be least helpful in supporting the woman as she copes with her loss?

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