A woman in her second trimester of pregnancy presents to the perinatal clinic with complaints of ...

ANS: B
This woman is displaying symptoms of a possible ruptured ectopic pregnancy (vaginal bleeding, abdominal pain, shoulder pain). Shoulder pain can occur from nerve irritation due to the presence of blood in the pelvic cavity. A -hCG test finding will be lower than expected for the gestational age. The woman will most likely need a pelvic exam. However, to facilitate a rapid diagnosis, the nurse should first obtain and send a blood sample for -hCG test. The nurse can then assess the woman for risk factors for ectopic pregnancy. However, preterm labor is not a risk factor. Methotrexate is used for uncomplicated, non-life-threatening ectopic pregnancies. It would not be indicated in this patient because she has manifestations of rupture.

Correct!