The nurse at the antepartal clinic reviews four patients’ charts.
Which patient is at increased risk for an ectopic pregnancy?
A 23-year-old primigravida with a history of endometriosis.
A 40-year-old multigravida with a history of condyloma acuminata.
A 27-year-old primigravida with a bicornuate uterus.
A 36-year-old multigravida who has had two previous cesarean deliveries.
The Correct Answer is A
The correct answer is choice A. A 23-year-old primigravida with a history of endometriosis.Endometriosis is a condition where the tissue that normally lines the uterus grows outside of it, sometimes affecting the fallopian tubes. This can cause scarring and damage to the tubes, which can increase the risk of ectopic pregnancy.
Choice B is wrong because condyloma acuminata, also known as genital warts, are caused by human papillomavirus (HPV) infection. HPV infection does not directly increase the risk of ectopic pregnancy, although it may be associated with other sexually transmitted infections (STIs) that can cause pelvic inflammatory disease (PID), which is a risk factor.
Choice C is wrong because a bicornuate uterus is a congenital anomaly where the uterus has two horns or chambers instead of one. This does not affect the fallopian tubes or the implantation of the fertilized egg in the uterus.
Choice D is wrong because previous cesarean deliveries do not increase the risk of ectopic pregnancy. However, previous tubal surgery, such as tubal ligation or salpingectomy, can damage the fallopian tubes and increase the risk.
Other risk factors for ectopic pregnancy include previous ectopic pregnancy, smoking, age older than 35 years, history of infertility, and use of assisted reproductive technology.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
This is because epidural anesthesia can cause hypotension (low blood pressure) which can affect the placental blood flow and fetal oxygenation.
The nurse should monitor the patient’s blood pressure frequently and intervene if it drops below the baseline.
Choice A is wrong because assessing the patient’s urine for acetone is not relevant to the side effects of epidural anesthesia.Acetone in urine can indicate diabetic ketoacidosis, a complication of diabetes that occurs when the body breaks down fat for energy due to lack of insulin.
However, this is not related to epidural anesthesia.
Choice B is wrong because monitoring the patient’s deep tendon reflexes is not relevant to the side effects of epidural anesthesia.Deep tendon reflexes can be affected by magnesium sulfate, a medication used to prevent seizures in patients with preeclampsia (a condition characterized by high blood pressure and proteinuria in pregnancy).
However, this is not related to epidural anesthesia.
Choice C is wrong because assessing the patient’s pupillary accommodation is not relevant to the side effects of epidural anesthesia.
Pupillary accommodation is the ability of the eye to adjust its focus from distant to near objects.It can be impaired by drugs that affect the nervous system, such as opioids or anticholinergics.
Correct Answer is C
Explanation
The correct answer is choice C. Arrange for her to meet the staff who will be caring for her during labor and delivery.This measure can help reduce the anxiety and fear of the unknown that a primigravida may have in the last month of pregnancy.Meeting the staff can also help establish rapport and trust, which are essential for a positive birth experience.
Choice A is wrong because an increase in fetal activity does not necessarily require an increase in the need to rest.
Fetal activity is normal and expected, and the mother should monitor it regularly.Resting may help with some discomforts of pregnancy, but it is not directly related to fetal activity.
Choice B is wrong because back labor is not likely for a primigravida with an uncomplicated pregnancy.
Back labor occurs when the fetus is in an occiput posterior position, which puts pressure on the mother’s spine and causes intense pain in the lower back.This position is more common in multiparous women than primigravidas.
Choice D is wrong because testing urine for glucose is not a routine measure for a primigravida with an uncomplicated pregnancy.
Urine glucose testing is done for women who have gestational diabetes or are at risk of developing it.It is not necessary for women who have normal blood glucose levels.
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