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.

Answer and Explanation

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.

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Correct Answer is B

Explanation

The correct answer is choice B. A multipara is a woman who has given birth more than once.

After delivery, the uterus contracts to return to its normal size and position.

However, in multiparas, the uterine muscles may be weaker and less able to contract effectively.

This can lead to a condition called uterine atony, where the uterus does not contract enough to prevent bleeding.

Uterine atony can also cause the uterus to descend into the vagina, which is called a prolapsed uterus.

Therefore, multiparas need frequent uterine fundal assessments to monitor the tone and position of the uterus and prevent complications.

Choice A is wrong because breast care teaching is important for all postpartum women, regardless of parity.

Mastitis is an inflammation of the breast tissue that can occur in any woman who is breastfeeding or not.

It is not more common in multiparas.

Choice C is wrong because a strict toileting schedule is not necessary for multiparas.

Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract, usually from the urethra.

UTIs are not more common in multiparas, unless they have other risk factors such as catheterization, diabetes, or sexual activity.

Choice D is wrong because an “as needed” order for an analgesic may not be adequate for multiparas.

Pain after delivery can vary depending on the type and duration of labor, the size and position of the baby, and the use of anesthesia or episiotomy.

Multiparas may experience more pain due to stretching of the pelvic muscles and ligaments, or due to afterpains, which are contractions of the uterus that occur after delivery.

Therefore, multiparas may need regular doses of analgesics to manage their pain effectively.

A. Maintain the newborn in a reverse Trendelenburg position. B. Encourage family members to gently stroke the newborn’s face and head. C. Swaddle the newborn in a flexed position. D. Provide the newborn with visual stimulation.

Correct Answer is C

Explanation

The correct answer is choice C. Swaddle the newborn in a flexed position.This helps to reduce the symptoms of neonatal abstinence syndrome, which is what happens when babies are exposed to drugs in the womb before birth and go through drug withdrawal after birth.Swaddling can provide comfort, warmth, and security to the newborn and decrease their stress response.

Choice A is wrong because maintaining the newborn in a reverse Trendelenburg position does not help with drug withdrawal symptoms and may increase the risk of aspiration or reflux.

Choice B is wrong because gently stroking the newborn’s face and head may overstimulate the newborn and worsen their irritability and tremors.

Choice D is wrong because providing the newborn with visual stimulation may also overstimulate the newborn and increase their discomfort and agitation.

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The nurse at the antepartal clinic reviews four patients’ charts. Which patient is at increased risk for an ectopic pregnancy?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

In planning the postpartum care of a multipara who had a normal pregnancy, labor, and delivery, which factor should be considered? The client needs to have:

Correct Answer is B

Explanation

The newborn of a patient suspected to have used drugs during the prenatal period is admitted to the nursery.The nurse caring for the newborn notes that the infant is beginning to exhibit signs of drug withdrawal.Which action should the nurse take?

Correct Answer is C

Explanation

The nurse instructs a postpartum patient in the use of a sitz bath. Which action by the patient indicates that the teaching was effective?

A 14-year-old patient visits the antepartal clinic because she has missed three menstrual periods.The patient is to have a pelvic examination. In addition to explaining the procedure, which measure would best help reduce the patient’s anxiety?

A mother of a 3-hour-old infant requests information concerning breastfeeding. The mother has tested positive for human immunodeficiency virus (HIV).A nurse’s response should be based on which fact?

A patient is scheduled for an amniocentesis when she is 18 weeks pregnant. Which instruction concerning amniocentesis should the nurse give to the patient?

A nurse is caring for a patient who is receiving oxytocin injection intravenously for labor induction.The nurse should monitor this patient for which adverse effect of oxytocin?

A patient comes to the family planning clinic requesting information.Which information should the nurse obtain initially to determine the patient’s knowledge base?.

The nurse provides a 16-year-old client with information concerning expected and possible changes during pregnancy. Which statement, if made by the client, would indicate that she understands the information?

A client is at the antepartal clinic for a pregnancy test.Which finding, if present, would be considered a positive sign of pregnancy?

The nurse at the antepartal clinic reviews four patients’ charts.
Which patient is at increased risk for an ectopic pregnancy?