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Men Challenger - Womens Health Study Guide .Q/As with Rationales 2022
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  • NURS 630
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  • Maryville University Of St. Louis

Question 1 Report Question Stem & Answers A 23-year-old primiparous patient at 8 weeks' gestation reports abdominal cramping and moderate vaginal bleeding which has now stopped. Which of the following statements is most accurate?  The cervix should be gently probed with a small cotton swa...

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  • February 7, 2022
  • 240
  • 2021/2022
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  • question 1 report question stem amp answers a 23 year old primiparous patient at 8 weeks gestation reports abdominal cramping and moderate vaginal bleeding which has now stopped which of the fo

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  • Maryville University Of St. Louis
  • NURS 630
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MeD Challenger - Womens Health Study Guide .
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Question 1 I



Report IQuestion
Stem & Answers
I I



A 23-year-old primiparous patient at 8 weeks' gestation reports
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abdominal cramping and moderate vaginal bleeding which has now
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stopped. Which of the following statements is most accurate?
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•
The Icervix Ishould Ibe Igently Iprobed Iwith Ia Ismall Icotton Iswab Ito Idetermine Iif Ithe Iinternal Ios Iis Iclosed.
•
Almost Iall Ifirst Itrimester Imiscarriages Iarise Ifrom Ihigh Irisk Imaternal Ibehaviors.
•
First Itrimester Ivaginal Ibleeding Iwithout Ipain Iessentially Irules Iout Iectopic Ipregnancy.
•
The Ipresumptive Idiagnosis Iis Icompleted Imiscarriage.
•
Half Iof Iall Iwomen Iwith Ifirst Itrimester Ibleeding Iwill Iultimately Imiscarry.
Remediation
Correct!
It Iis Iwidely Iestimated Ithat Iapproximately I50% Iof Iall Ifemales Iwho Ihave Ibleeding Iduring Iearly
Ipregnancy Iwill Imiscarry, Ipossibly Ihigher Iin Ithe IED Ipopulation. IOf Igreatest Iconcern Iin Ithe

Idifferential Idiagnosis Iis Iectopic Ipregnancy, Iwhich Imay Ipresent Ias Ivaginal Ibleeding Iwith Ior

Iwithout Ipain. IMost Imiscarried Ifetuses Iare Inonviable Iup Ito I2 Iweeks Iprior Ito Iclinical Isigns Iof

Imiscarriage; Itherefore Imeasures Iaimed Iat Iprevention Iare Inot Iuseful. IModerate Idaily Iactivities

Ido Inot Iincrease Ithe Irisk Iof Imiscarriage. ICompleted Imiscarriage Ican Ionly Ibe Idiagnosed Iafter

Iexpulsion Iof Ian Iintact Igestational Isac Ior Iidentification Iof Iproducts Iof Iconception Iafter Idilation

Iand Icurettage, Ior Iby Iultimate Iconversion Iof Ithe Ipregnancy Itest Ito Inegative.



References: IMarx: IRosen’s IEmergency IMedicine, IConcepts Iand IClinical IPractice, I6th Ied.,
I2006, IChpt I177: IAcute IComplications Iof IPregnancy




Question 2 I



Report IQuestion
Stem & Answers
I I



Which of the following is the most accurate statement regarding Rh
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immunization?
I

, •
Ectopic Ipregnancy Idoes Inot Irequire Ianti-D Iimmune Iglobulin Itherapy.
•
Rh Isensitization Ican Ioccur Iduring Ithreatened Imiscarriage Ieven Iwithout Ifetal Iloss.
•
The IKleihauer-Betke Itest Iis Isensitive Ito Ias Ilittle Ias I0.1 Iml Iof Ifetal Iblood Iin Ithe Imaternal Icirculation.
•
Pregnant IRh-negative Ipatients Ishould Inot Ireceive Ianti-D Iimmune Iglobulin Iif Ithe Ifather's IRh Istatus Iis Iunknown.
•
The Istandard Idose Iof Ianti-D Iimmune Iglobulin Iis Ithe Isame Iregardless Iof Igestational Iage.
Remediation
Correct!
Anti-D Iimmune Iglobulin Iis Iindicated Iif Ithe Ipatient Iis IRh Inegative, Iunless Ithe Ifather Iis Iknown
Ito Ialso Ibe IRh Inegative. ISensitization Ioccurs Imost Icommonly Iat Idelivery, Ibut Ialso Ican Ioccur

Iduring Ithreatened Imiscarriage Iwith Ior Iwithout Ifetal Iloss, Iat Isurgery Ifor Iectopic Ipregnancy Iand

Iamniocentesis. IThe IKleihauer-Betke Itest Iof Imaternal Iblood Iis Ionly Isensitive Ienough Ito Idetect

I5 Iml Ior Imore Iof Ifetal Icells Iin Ithe Imaternal Icirculation, Iwhile Isensitization Imay Ioccur Iwith Ias

little Ias I0.1 Iml Iof Ifetal Iblood. IIn Igeneral, Ithe Idose Iof Ianti-D Iimmune Iglobulin Iis I50 I g IbeforeI12
Iweeks Igestation Iand I300 I g Ithereafter.


References: IMarx: IRosen’s IEmergency IMedicine, IConcepts Iand IClinical IPractice, I6th Ied.,
I2006, IChpt I177: IAcute IComplications Iof IPregnancy




Question 3 I



Report IQuestion
Stem & Answers
I I



A patient early in her first trimester complains of severe lower abdominal
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pain. Which of the following most significantly decreases the likelihood of
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ectopic pregnancy?
I I




•
A Iprevious Ihistory Iof Ipelvic Iinflammatory Idisease Ior Iother ISTD
•
A Ihistory Iof Iprior Itubal Isterilization
•
Doubling Iof Ithe Iquantitative IHCG Iin I72 Ihours

, •
Blood Ivisible Iat Ithe Icervical Ios
•
An Iintrauterine Igestational Isac Iwith Ia Idouble Idecidual Isac Isign Ivisible Ion Itransvaginal
Isonography

Remediation
Identification Iof Ian Iintrauterine Igestational Isac Iwith Ia Idouble Idecidual Isac Isign Isignificantly
Ireduces Ithe Ilikelihood Iof Ian Iectopic Ipregnancy I(though Iit Idoes INOT Irule Iit Iout!). IHCG Ilevels

Inormally Idouble Ievery I1.8 Ito I3 Idays Ifor Ithe Ifirst I6 Ito I7 Iweeks. IThe Iectopic Ipregnancy

Isometimes Iresults Iin Iabnormally Ilow IHCG Iproduction, Ihowever, Inormally Irising IHCG Ilevels

Iare Icommonly Iseen Iduring Iearly Iectopic Ipregnancy. ISlow Ileakage Iof Iblood Ior Iabrupt Irupture

Iof Ithe Ipregnancy Imay Ilead Ito Ivaginal Ibleeding Ior Iblood Iin Ithe Iperitoneum Ior Ipelvis. IFactors

Ipredisposing Ito Iectopic Ipregnancy Iinclude Iprevious Itubal Iinfections Ior Isurgeries, Iuse Iof Ian

IIUD, Ismoking Ior Iolder Imaternal Iage.




Reference:

Marx: IRosen’s IEmergency IMedicine, IConcepts Iand IClinical IPractice, I6th Ied., I2006, IChpt
I177: IAcute IComplications I of IPregnancy




Question 4 I


Report IQuestion
Stem & Answers
I I

, Which of the following statements is most accurate regarding ectopic
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pregnancy?
I




•
Methotrexate Iis Iused Ito Itreat Iearly Iectopic Ipregnancies Iless Ithan I4 Icm Iin Idiameter.
•
A Inormally Irising IHCG Ilevel Irules Iout Iectopic Ipregnancy.
•
Direct Isonographic Ievidence Iof Iectopic Ipregnancy, Isuch Ias Ian Iadnexal Imass, Iis Iusually Ivisible.
•
Peritoneal Isigns Iand Icervical Imotion Itenderness Idecrease Ithe Ilikelihood Iof Iectopic Ipregnancy.
•
The Irate Iof Iheterotopic Ipregnancy Iamong Ipatients Iundergoing Iembryonic Itransfer Itechniques Iis Iabout I1 Iin I4000.
Remediation
Correct!
Methotrexate Icauses Idestruction Iof Irapidly Idividing Ifetal Icells Iand Iinvolution Iof Ithe
Ipregnancy. IThe Ipresence Iof Iperitoneal Isigns, Icervical Imotion Itenderness Ior Ilateral Ior

Ibilateral Iabdominal Ior Ipelvic Itenderness Igreatly Iincreases Ithe Ilikelihood Iof Iectopic

Ipregnancy. IPelvic Isonography Irarely Idemonstrates Idirect Ievidence Iof Iectopic Ipregnancy Iin

Ithe Iadnexa. IAbout Ihalf Ithe Isonographic Istudies Iare Iindeterminate. IEarly Iectopic Ipregnancies

Imay Idemonstrate Ia Inormal Idoubling Iof IHCG Iapproximately Ievery I48 Ito I72 Ihours. IThe

Ireported Irate Ifor Iheterotopic Ipregnancy Iis Iundergoing Ichange Iin Ithe Iliterature Ias Iclinicians

Iare Irealizing Ithat Ithe Icondition Imay Ibe Imore Icommon Ithat Ionce Isuspected. IIn Ithe Igeneral

Ipopulation, Ithe Irate Iis Ireported Ito Ibe Ianywhere Ifrom I1 Iin I30,000 Ito Iabout I1 Iin I4000. ISeveral

Iauthors Ireport Ithis Irate Ito Irise Ito Iabout I1 Iin I100 Ior I1 Iin I500 I(depending Ion Iauthor) Iwith

Ipatients Iundergoing Iembryo Iimplantation Ior Iother Iin Ivitro Iproecdures. IThe Irate Iis Ialso

Ielevated Ifrom Ithe Ithat Iof Ithe Igeneral Ipopulation Iin Ipatients Iwith Ifallopian Itube Idamage.



References:
Marx: IRosen's IEmergency IMedicine, IConcepts Iand IClinical IPractice, I6th Ied., I2006, IChpt
I177: IAcute IComplications I of IPregnancy

Barnhart IKT. IEctopic Ipregnancy. IN IEngl IJ IMed. IJuly I2009;361(4):379-387.
Hassani IKIM; IHeterotopic Ipregnancy: IA Idiagnosis Iwe Ishould Isuspect Imore Ioften. IJ IEmerg
ITrauma IShock. I2010 IJul-Sep; I3(3): I304.




Question 5 I



Report IQuestion
Stem & Answers
I I



A patient at 12 weeks' gestation presents with prolonged nausea and
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vomiting. A diagnosis of hyperemesis gravidarum was made on a prior
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