A nurse in a prenatal clinic is caring for a client. Using Leopold's maneuvers, the nurse palpates a round, firm, movable part in the fundus of the uterus and a long smooth surface on the client's right side. In which abdominal quadrant should the nurse expect to auscultate fetal heart tones?

Choice A reason:

While vaginal bleeding can be associated with ectopic pregnancy, it is not typically characterized by a large amount. The bleeding is often described as spotting or light bleeding. A large amount of vaginal bleeding is more indicative of other conditions, such as a miscarriage or placental issues.

Choice B reason:

Unilateral, cramp-like abdominal pain is one of the hallmark signs of an ectopic pregnancy. This pain is usually felt on one side of the abdomen and can vary from mild to severe. It occurs due to the embryo implanting outside the uterus, most commonly in one of the fallopian tubes, which can cause irritation and discomfort as it grows.

Choice C reason:

Uterine enlargement greater than expected for gestational age is not a symptom of ectopic pregnancy. In fact, the uterus may not enlarge as much as expected because the embryo is not growing inside it. Ectopic pregnancies are often associated with a smaller-than-expected uterus for the gestational age.

Choice D reason:

Severe nausea and vomiting are not specific to ectopic pregnancy and can occur with any pregnancy. However, if these symptoms are accompanied by other signs of ectopic pregnancy, such as abdominal pain and vaginal bleeding, they may support the diagnosis.

Choice A Reason:
Using a cotton-tipped swab to clean a newborn's nares can be dangerous. It can push debris further into the nose, cause mucosal damage, bleeding, or even introduce germs. Instead, the nurse should advise the mother to use a bulb syringe for gentle suction if necessary.

Choice B Reason:
Leaving the yellow exudate on the circumcision site is actually recommended. This exudate is part of the normal healing process and does not need to be removed. It acts as a natural barrier to infection and will clear up as the circumcision heals.

Choice C Reason:
Cleaning the umbilical cord with tap water is generally considered safe and can help keep the area clean. However, the nurse should ensure that the mother dries the area thoroughly afterward to prevent moisture from promoting bacterial growth.

Choice D Reason:
Cleaning the newborn's eyes from the inner canthus outwards is the correct technique. It prevents contamination from the outer part of the eye to the inner part and helps to clear any discharge or debris effectively.