The nurse is preparing to administer methotrexate to the patient. This drug is most often used for which obstetric complication?

Preterm labor

Abruptio placentae

Pre-eclampsia

Unruptured ectopic pregnancy

Answer and Explanation

The Correct Answer is D

A. Preterm labor. Methotrexate is not used for preterm labor. Medications such as tocolytics (e.g., nifedipine, magnesium sulfate, or terbutaline) are typically used to delay labor and improve neonatal outcomes, but methotrexate does not serve this purpose.

B. Abruptio placentae. Methotrexate is not indicated for abruptio placentae, which is the premature separation of the placenta from the uterine wall. Management of abruptio placentae focuses on stabilizing the mother, monitoring fetal well-being, and delivering the baby if necessary.

C. Pre-eclampsia. Methotrexate does not treat pre-eclampsia. The management of pre-eclampsia includes antihypertensive medications, magnesium sulfate for seizure prevention, and delivery of the baby when indicated.

D. Unruptured ectopic pregnancy. Methotrexate is the first-line treatment for an unruptured ectopic pregnancy. It works by inhibiting rapidly dividing trophoblastic cells, stopping the growth of the ectopic pregnancy while preserving the fallopian tube. It is only used in stable patients with small, unruptured ectopic pregnancies and no signs of internal bleeding.

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Correct Answer is B

Explanation

A. Induction of labor with intravenous oxytocin. Induction is contraindicated in cases of abruptio placentae with a Category III fetal heart rate tracing, as labor induction can worsen fetal distress and maternal bleeding. An immediate cesarean section is the safest intervention to prevent fetal and maternal complications.

B. An emergency cesarean section. A Category III fetal heart rate tracing with minimal variability and a prolonged deceleration indicates severe fetal distress, requiring immediate delivery. Partial abruptio placentae can cause fetal hypoxia, maternal hemorrhage, and potential fetal demise. The priority is an emergency cesarean section to ensure the best outcome for both mother and baby.

C. In-hospital fetal monitoring for 48 hours. Continuous monitoring is essential in cases of mild abruptio placentae without fetal distress, but in this case, a Category III tracing indicates an immediate threat to the fetus, making waiting inappropriate.

D. Discharge home on strict bed rest. Abruptio placentae is a serious obstetric emergency, and home management is never appropriate when fetal distress is present. Immediate intervention is necessary to prevent fetal and maternal complications.

A. Treat opportunistic infections B. Supplement radiation and chemotherapy C. Decrease viral loads in the blood D. Cure acute HIV/AIDS infections

Correct Answer is C

Explanation

A. Treat opportunistic infections. Antiretroviral drugs do not directly treat opportunistic infections. They help suppress the HIV virus, which in turn strengthens the immune system, reducing the risk of opportunistic infections, but specific infections require separate antimicrobial treatment.

B. Supplement radiation and chemotherapy. Antiretroviral therapy (ART) is not used as a supplement to radiation or chemotherapy. While HIV-positive patients can develop certain cancers like Kaposi’s sarcoma, ART is aimed at controlling HIV rather than being a direct cancer treatment.

C. Decrease viral loads in the blood. Antiretroviral drugs work by suppressing HIV replication, thereby decreasing viral load in the bloodstream. This helps maintain immune function, reduces the risk of perinatal transmission, and improves overall health outcomes. Consistent use of ART can even lower viral loads to undetectable levels, significantly reducing transmission risk.

D. Cure acute HIV/AIDS infections. There is no cure for HIV/AIDS. Antiretroviral therapy helps manage the disease by reducing viral replication and preventing progression to AIDS, but it does not eradicate the virus from the body. Lifelong adherence to ART is necessary for disease control.

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The nurse is preparing to administer methotrexate to the patient. This drug is most often used for which obstetric complication?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is B

Explanation

The nurse is caring for a pregnant woman who is HIV positive. While teaching her about the use of antiretroviral drugs, the nurse explains that these medications will

Correct Answer is C

Explanation

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