The nurse has reviewed the Graphic Record and Diagnostic Results at 1030.
The nurse is collaborating with another nurse about the client's plan of care. For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
Repeat quantitative B-hCG level
Methotrexate IM
Blood typing
Cervical cerclage
Transvaginal ultrasound
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"A"},"D":{"answers":"B"},"E":{"answers":"A"}}
• Repeat quantitative B-hCG level: Monitoring the trend of quantitative beta-hCG levels is crucial in suspected ectopic pregnancy. Falling or plateauing hCG levels confirm the diagnosis and guide the management plan, especially if methotrexate is administered or surgical intervention is considered.
• Methotrexate IM: Methotrexate is an anticipated prescription for the medical management of a stable ectopic pregnancy. It works by stopping the growth of rapidly dividing cells and is appropriate when the client is hemodynamically stable and the ectopic pregnancy is unruptured.
• Blood typing: Blood typing is essential to determine Rh factor status. If the client is Rh-negative, Rh immune globulin should be administered to prevent isoimmunization, which could impact future pregnancies. This is a standard part of the care plan for any pregnancy loss or threatened pregnancy complication.
• Transvaginal ultrasound: A transvaginal ultrasound is needed to confirm the location of the pregnancy. In ectopic pregnancies, it helps visualize the presence or absence of an intrauterine gestational sac and may directly identify ectopic implantation, such as in the fallopian tube.
• Cervical cerclage: Cervical cerclage is contraindicated in this case. It is used to prevent preterm birth in clients with cervical insufficiency but is not appropriate in a non-viable pregnancy or suspected ectopic pregnancy. Placing a cerclage could worsen the clinical situation and delay necessary treatment.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. "Let's review hormonal contraceptives first": Redirecting the conversation to hormonal contraceptives ignores the client’s expressed preference. Effective communication involves respecting client choices and supporting informed decision-making rather than pushing alternative methods first.
B. "I will provide you with more information about this": This response supports the client’s autonomy by offering information tailored to their expressed interest. Providing education about natural family planning, including techniques and effectiveness, allows the client to make an informed and empowered decision.
C. "Have you considered other alternatives": While exploring options is sometimes appropriate, immediately questioning the client's choice may feel dismissive. It is important to first respect and address the client's initial interest before introducing other possibilities if needed.
D. "Natural family planning is not beneficial for everyone.": Although this statement may be true in some cases, it is not an appropriate initial response. It risks discouraging the client prematurely rather than fostering an open, supportive discussion about how to use natural family planning effectively.
Correct Answer is A
Explanation
A. Reviewing the results of the client's chlamydia screening with their parents, without the client's consent: Sexual health information, including STI screenings, is protected by confidentiality laws even for minors in many regions. Disclosing such sensitive information without the client's consent breaches confidentiality and can undermine trust between the adolescent and healthcare providers.
B. Reviewing the results of the client's celiac screening with their parents, without the client's consent: Celiac screening relates to general medical conditions and nutritional health, which are typically shared with parents of minors unless otherwise restricted. This does not generally breach confidentiality because it is not considered sensitive under adolescent health privacy laws.
C. Reviewing the results of the client's complete blood count (CBC) with their parents, without the client's consent: A CBC is a routine diagnostic test that checks general health indicators such as anemia or infection. Discussing these results with parents, especially for minors, is standard practice and does not usually violate confidentiality.
D. Reviewing the results of the client's urinalysis with their parents, without the client's consent: Urinalysis results typically assess general health or identify infections, which are standard to share with parents in the care of minors. This action would not be considered as a breach of confidentiality unless it revealed sensitive information like substance use without consent.
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