Question 1

A patient has received methotrexate therapy for treatment of an ectopic pregnancy. What information will the provider include when teaching this patient about this therapy? (Select all that apply.)&#10;A) Avoid sexual intercourse for 3 months&#10;B) Do not consume alcohol for at least 3 months&#10;C) Long-term effects include lower fertility&#10;D) Pregnancy should be avoided in the future&#10;E) Refrain from taking vitamins containing folic acid

Accepted Answer

A, B, E

Question 2

A patient is determined to have a nonruptured ectopic pregnancy within 1 week of a missed period. Which treatment will the specialist order?&#10;A) Laparoscopy&#10;B) Leucovorin rescue&#10;C) Methotrexate&#10;D) Mifepristone

Accepted Answer

Methotrexate is the standard treatment for nonruptured ectopic pregnancies that are diagnosed early on, usually within the first few weeks of pregnancy. It is a medication that stops the growth of the pregnancy and allows the body to absorb it. Laparoscopy may be necessary if the ectopic pregnancy has ruptured or if there is heavy bleeding, but it is not the first-line treatment for early, nonruptured ectopic pregnancies. Leucovorin rescue and mifepristone are not indicated for the treatment of ectopic pregnancies.

Question 3

A female patient has lower abdominal pain, nausea, and vomiting and reports missing a period 3 weeks prior. The patient reports using an intrauterine device for contraception. A serum $\beta$ -hCG is 1500 mIU/mL. What will the provider do, based on these findings?

A) Perform a transvaginal ultrasound
B) Recheck the

\beta

-hCG level in 4 to 6 weeks
C) Refer for a diagnostic laparoscopy
D) Tell the patient that a viable pregnancy is likely

Perform a transvaginal ultrasound

Accepted Answer

The patient's symptoms along with a positive pregnancy test and history of an IUD increase the concern for an ectopic pregnancy. A transvaginal ultrasound can help determine if the pregnancy is intrauterine or ectopic. Waiting 4 to 6 weeks to recheck the hCG level would delay diagnosis and treatment if it is an ectopic pregnancy. Referring for diagnostic laparoscopy would be a more invasive and expensive option compared to an ultrasound. Telling the patient that a viable pregnancy is likely is not appropriate given the symptoms and history.

Deck 144: Ectopic Pregnancy