Ectopic Pregnancy Practice Exam

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1. A 39-year-old at 37 weeks gestation is admitted to the hospital with complaints of vaginal bleeding following the use of cocaine 1 hour earlier. Which complication is most likely causing the client’s complaint of vaginal bleeding?

  1. Placenta previa
  2. Abruptio placentae
  3. Ectopic pregnancy
  4. Spontaneous abortion

2.Which of the following is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage?

  1. Placenta previa
  2. Ectopic pregnancy
  3. Incompetent cervix
  4. Abruptio placentae

3.Maureen is admitted with a diagnosis of ectopic pregnancy. Which of the following would you anticipate?

  1. NPO
  2. Bed rest
  3. Immediate surgery
  4. Enema

4.Which of the following would be the priority nursing diagnosis for a client with an ectopic pregnancy?

  1. Risk for infection
  2. Pain
  3. Knowledge Deficit
  4. Anticipatory Grieving

5. Nurse Hazel is preparing to care for a client who is newly admitted to the hospital with a possible diagnosis of ectopic pregnancy. Nurse Hazel develops a plan of care for the client and determines that which of the following nursing actions is the priority?

  1. Monitoring weight
  2. Assessing for edema
  3. Monitoring apical pulse
  4. Monitoring temperature

6.Which of the following is caused by a B5deficiency?

  1. Ectopic pregnancy
  2. Nausea
  3. Dermatitis
  4. Fever

7.Which of the following are not treated with Methotrexate?

  1. Sarcomas
  2. Leukemias
  3. Ectopic pregnancy
  4. Rheumatic fever

8.Upon assessment the nurse found the following: fundus at 2 fingerbreadths above the umbilicus, last menstrual period (LMP) 5 months ago, fetal heart beat (FHB) not appreciated. Which of the following is the most possible diagnosis of this condition?

  1. Hydatidiform mole
  2. Missed abortion
  3. Pelvic inflammatory disease
  4. Ectopic pregnancy

9.Ectopic pregnancy can be reliably diagnosed by:

  1. US
  2. Laparoscopy
  3. Pregnancy test
  4. HSG

10.The most common cause of ectopic pregnancy:

  1. Congenital anomalies of the tube
  2. Inflammation of the tubes
  3. Uterine abnormalities
  4. Using OCPs
  5. Pelvic adhesions
Answers and Rationale
  1. Answer: B. Abruptio placentae. The major maternal adverse reactions from cocaine use in pregnancy include spontaneous abortion first, not third, trimester abortion and abruptio placentae.
  2. Answer D. Abruptio placentae. Abruptio placentae is described as premature separation of a normally implanted placenta during the second half of pregnancy, usually with severe hemorrhage. Placenta previa refers to implantation of the placenta in the lower uterine segment, causing painless bleeding in the third trimester of pregnancy. Ectopic pregnancy refers to the implantation of the products of conception in a site other than the endometrium. Incompetent cervix is a conduction characterized by painful dilation of the cervical os without uterine contractions.
  3.  Answer: C. Immediate surgery
  4. Answer: B . Pain. For the client with an ectopic pregnancy, lower abdominal pain, usually unilateral, is the primary symptom. Thus, pain is the priority. Although the potential for infection is always present, the risk is low in ectopic pregnancy because pathogenic microorganisms have not been introduced from external sources. The client may have a limited knowledge of the pathology and treatment of the condition and will most likely experience grieving, but this is not the priority at this time.
  5. Answer: C Monitoring apical pulse. Nursing care for the client with a possible ectopic pregnancy is focused on preventing or identifying hypovolemic shock and controlling pain. An elevated pulse rate is an indicator of shock.
  6. Answer: C. Dermatitis
  7. Answer: D. Rheumatic fever
  8. Answer: (A) Hydatidiform mole. Hydatidiform mole begins as a pregnancy but early in the development of the embryo degeneration occurs. The proliferation of the vesicle-like substances is rapid causing the uterus to enlarge bigger than the expected size based on ages of gestation (AOG). In the situation given, the pregnancy is only 5 months but the size of the uterus is already above the umbilicus which is compatible with 7 months AOG. Also, no fetal heart beat is appreciated because the pregnancy degenerated thus there is no appreciable fetal heart beat.
  9. Answer: B. Laparoscopy
  10. Answer B. Inflammation of the tubes.  Pelvic Inflammatory Disease (PID), which leads to scarring of the tubes, is the most common cause of ectopic pregnancy.