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?

An ectopic pregnancy does not need major treatment and can be delivered vaginally."

"An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus."

"An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube."

"An ectopic pregnancy involves a fertilized ovum in the vagina

Answer and Explanation

The Correct Answer is B

A. "An ectopic pregnancy does not need major treatment and can be delivered vaginally." This statement is incorrect. An ectopic pregnancy involves the fertilized ovum implanting outside the uterus, most commonly in a fallopian tube, which poses serious risks to the mother. The pregnancy cannot be carried to term, and it requires prompt medical intervention, such as medication or surgery, to prevent life-threatening complications.
B. "An ectopic pregnancy involves a fertilized ovum outside the uterus that cannot be transferred to the uterus." This is an accurate explanation of an ectopic pregnancy. The fertilized egg implants outside the uterus, most commonly in the fallopian tubes, and cannot develop into a viable pregnancy. The condition requires immediate treatment to prevent tube rupture and internal bleeding.
C. "An ectopic pregnancy involves a cancerous fertilized ovum in either fallopian tube." This is incorrect. An ectopic pregnancy is not cancerous. It refers to a pregnancy where the fertilized ovum implants in an abnormal location outside the uterus, most commonly the fallopian tubes, not involving cancerous growth.
D. "An ectopic pregnancy involves a fertilized ovum in the vagina." This statement is incorrect. An ectopic pregnancy occurs when the fertilized ovum implants outside the uterus, but it does not implant in the vagina. The condition most commonly involves the fallopian tubes but can also occur in other locations such as the cervix, ovary, or abdominal cavity.

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Correct Answer is D

Explanation

A. Apply oxygen. While oxygen may be administered if fetal distress is present, it does not directly resolve shoulder dystocia, which is a mechanical issue requiring immediate positional maneuvers to free the impacted shoulder.

B. Increase IV Pitocin. Increasing oxytocin (Pitocin) is contraindicated in shoulder dystocia because it can cause stronger contractions, worsening the impaction and increasing the risk of fetal injury or uterine rupture.

C. Apply downward pressure on the woman's fundus. Fundal pressure should never be applied in shoulder dystocia, as it can further wedge the fetal shoulder against the pubic bone, increasing the risk of brachial plexus injury and fetal distress.

D. Flex the woman's thighs sharply toward her abdomen. The McRoberts maneuver, which involves sharply flexing the mother’s thighs to widen the pelvic outlet, is the first-line intervention for shoulder dystocia. This maneuver helps rotate the pelvis and reposition the fetal shoulder, increasing the chances of a successful vaginal delivery.

A. Internal fetal monitoring B. Amniocentesis for fetal lung maturity C. Contraction stress test D. Ultrasound for placenta location

Correct Answer is D

Explanation

A. Internal fetal monitoring. Internal fetal monitoring is contraindicated when placenta previa is suspected because it involves inserting a catheter or electrode into the uterus, which can increase the risk of hemorrhage if the placenta is covering the cervix.

B. Amniocentesis for fetal lung maturity. While fetal lung maturity assessment may be relevant if early delivery is being considered, it is not an immediate diagnostic procedure for evaluating the cause of vaginal bleeding. The priority is to determine placenta location and rule out placenta previa.

C. Contraction stress test. A contraction stress test evaluates fetal response to contractions but is not the appropriate initial diagnostic test in a patient with vaginal bleeding. Stimulating contractions could worsen bleeding if placenta previa or another placental abnormality is present.

D. Ultrasound for placenta location. The first-line diagnostic test for painless, bright red vaginal bleeding in the third trimester is an ultrasound. It helps determine whether the bleeding is due to placenta previa, a condition where the placenta partially or completely covers the cervix, which requires careful management to prevent complications.

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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?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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?

Correct Answer is D

Explanation

A 26-year old having her first baby is 28 weeks pregnant. She experiences bright red, painless vaginal bleeding, soaking one pad. Upon her arrival at the hospital, after placing her on the FHR Monitor, what would be an expected diagnostic procedure?

Correct Answer is D

Explanation

When working with a woman who has just experienced a fetal demise you should offer supportive care, give her the opportunity to grieve, and provide for a chaplain to come in if the patient wants one. You know that the Chaplain is non-denominational and can also provide comforting words.

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