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 D

Explanation

The correct answer is choice D: “This test is used to identify fetal abnormalities.” Alpha-fetoprotein (AFP) is a protein produced by the fetus that can be measured in the mother’s blood.

Abnormal levels of AFP may indicate a problem with the development of the baby’s brain, spine, or other organs.

This test is usually done between 15 and 20 weeks of gestation.

Choice A is wrong because AFP does not measure the baby’s maturity.

It is not related to the gestational age or the lung development of the fetus.

Choice B is wrong because AFP is not a routine test for all pregnant women over thirty years of age.

It is an optional screening test that may be offered to women who have a higher risk of having a baby with a birth defect, such as those who have a family history, a previous affected pregnancy, or certain ethnic backgrounds.

Choice C is wrong because AFP is not recommended for people with a history of infertility.

It does not assess the fertility status of the mother or the father.

It only measures the level of a fetal protein in the mother’s blood.

A. Obtain a full history. B. Examine the cervix for dilation C. Examine the cervix for dilation. D. Palpate for uterine contraction frequency

Correct Answer is C

Explanation

This is because the first priority for a pregnant woman with acute abdominal pain is to assess the fetal well-being and rule out any obstetric complications such as placental abruption, uterine rupture, or preterm labor.Fetal heart tones can indicate the presence and viability of the fetus and alert the nurse to any signs of fetal distress or hypoxia.

Choice A: Obtain a full history is wrong because it is not the most urgent action.

A full history can provide valuable information about the possible causes of abdominal pain, but it should not delay the assessment of fetal status and maternal vital signs.

Choice B: Examine the cervix for dilation is wrong because it can be harmful in some cases.A digital cervical examination should be avoided until placenta previa is ruled out by ultrasound, as it can cause bleeding and worsen the condition.

Moreover, cervical dilation alone does not indicate the cause or severity of abdominal pain.

Choice D: Palpate for uterine contraction frequency is wrong because it is not the most reliable method to assess labor.Uterine contractions can be measured by external tocodynamometry or internal intrauterine pressure catheter, which can provide more accurate and objective data than manual palpation.

Furthermore, uterine contractions do not necessarily indicate labor, as they can also be caused by other conditions such as dehydration, infection, or irritable uterus.

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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

A 38-year-old primigravida returns to the clinic at 16 weeks gestation for an alpha-fetoprotein test.She asks a nurse, "Why do lI need this test?".Which response would be most appropriate for the nurse to make?

Correct Answer is D

Explanation

A 23-year-old primigravida who appears to be in her third trimester of pregnancy comes to the labor and delivery unit reporting acute abdominal pain. She has had no prenatal care. Which assessment should the nurse do first?

Correct Answer is C

Explanation

The fetal monitor indicates that a patient is having contractions every three to four minutes with late fetal decelerations.Which action should the nurse take first?

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A patient is receiving magnesium sulfate.Which side effect should the nurse monitor for with this patient?

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A patient had a cesarean delivery due to placenta previa.Which statement by the patient would indicate that she understands why she had the cesarean delivery?

A nurse is caring for a newborn of a diabetic mother (IDM). What should the nurse monitor for during care of the newborn?

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