39. An emergency department nurse assess a client, who is gravida 2, para 0 at 8 weeks' gestation, with a history of pelvic inflammatory disease. The nurse suspects a diagnosis of ectopic pregnancy. Which signs or symptoms would be consistent with this diagnosis?
. Positive pregnancy test, shoulder pain, and copious vaginal bleeding.
. Hyperemesis, hypertension, and moderate vaginal bleeding.
. Amenorrhea, abdominal pain, and hypotension.
. Copious vaginal discharge, weight loss, and positive pregnancy test.
Test-Taking Tip
Ectopic pregnancy symptoms also include signs of shock due to internal bleeding with decreased blood pressure and increased heart rate.
Content Area: Maternity, Antepartum; Integrated Process: Nursing Process, Assessment; Cognitive Level: Application; Client Need/Subneed: Physiological Integrity/Physiological Adaptation/Alterations in Body Systems
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Answer 1 is incorrect because, although a positive pregnancy test and shoulder pain would be consistent with ectopic pregnancy, copious vaginal bleeding would not be a sign of ectopic pregnancy; it would be a sign of spontaneous abortion. Answer 2 is incorrect because hyperemesis, hypertension, and moderate vaginal bleeding would be signs of a hydatidiform mole, not ectopic pregnancy. Answer 3 is correct because amenorrhea is a possible sign of pregnancy, abdominal pain can be a sign of tubal pregnancy, and hypotension can be a sign of internal bleeding as a result of a ruptured ectopic pregnancy. Answer 4 is incorrect because copious vaginal discharge, weight loss, and positive pregnancy test would be consistent with first-trimester pregnancy, not ectopic pregnancy.