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 A

Explanation

A. The cervix is effacing and dilated to 2 cm. Cervical changes, including effacement and dilation, are the most definitive signs of preterm labor. Uterine contractions alone do not confirm preterm labor unless they result in cervical dilation, indicating that labor is progressing.

B. Irregular, mild uterine contractions are occurring every 15-30 minutes. Irregular contractions, known as Braxton Hicks contractions, can be common in pregnancy and do not necessarily indicate preterm labor. True preterm labor involves regular contractions that lead to cervical changes.

C. Estriol is not found in maternal saliva. The absence of estriol in maternal saliva does not confirm or rule out preterm labor. Salivary estriol testing is not a widely used or reliable diagnostic tool for determining the onset of preterm labor.

D. Fetal fibronectin is present in vaginal secretion. Fetal fibronectin (fFN) is a protein found in vaginal secretions between 22-34 weeks of pregnancy and can indicate a risk of preterm labor, but its presence alone does not confirm that labor is actively occurring. A positive fFN test means the patient may be at increased risk for preterm labor, but cervical changes remain the best indicator of actual labor.

A. Enteral nutrition (TPN) to correct nutritional deficits B. Small frequent meals C. Corticosteroids to reduce inflammation D. IV therapy to correct fluid and electrolyte imbalances

Correct Answer is D

Explanation

A. Enteral nutrition (TPN) to correct nutritional deficits. Total parenteral nutrition (TPN) is only considered in severe cases where oral and IV hydration fail. The initial treatment focuses on correcting dehydration and electrolyte imbalances before considering more invasive nutritional support.

B. Small frequent meals. While small, frequent meals may help manage nausea in mild cases of pregnancy-related nausea and vomiting, they are not sufficient for treating hyperemesis gravidarum, which involves severe, persistent vomiting leading to dehydration and electrolyte imbalances.

C. Corticosteroids to reduce inflammation. Corticosteroids are not the first-line treatment for hyperemesis gravidarum. They may be used in refractory cases where standard treatments fail, but IV fluids and antiemetics are prioritized initially.

D. IV therapy to correct fluid and electrolyte imbalances. The primary concern in hyperemesis gravidarum is severe dehydration and electrolyte disturbances due to excessive vomiting. IV fluids, often with electrolytes and thiamine, are the first step in stabilizing the patient before introducing oral intake.

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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

A woman at 26 weeks of gestation is being assessed to determine whether she is experiencing preterm labor. Which finding is most indicative that preterm labor is occurring?

Correct Answer is A

Explanation

The nurse caring for a woman hospitalized for hyperemesis gravidarum would expect that the initial treatment would involve:

Correct Answer is D

Explanation

A woman with preeclampsia gave birth vaginally 1 hour ago. She is still receiving a magnesium sulfate infusion at 1 gm/hr. A major concern regarding the administration of magnesium sulfate at this time would be:

During a vaginal delivery the midwife tells you that a shoulder dystocia has occurred. Which of the following initial nursing actions is appropriate at this time?

The nurse is assessing a patient who has severe preeclampsia. The assessment finding that should be reported to the physician is:

With regard to systemic analgesics administered during labor, nurses should be aware that:

A patient is being discharged from the hospital after the evacuation of a molar pregnancy. The nurse recognizes that additional discharge teaching is required when the patient makes which statement?

A patient has been admitted to the emergency department with a suspected diagnosis of ectopic pregnancy. How should the nurse explain this condition to the patient?

The nurse would include which of the following statements when describing the pathophysiology of gestational diabetes?