Ectopic Pregnancy Case Study Questions Comprehensive Nursing Exam Review PDF

,Ectopic Pregnancy Case Study Q&A Guide

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Ectopic Pregnancy Case Study – Jean Simmons

2026/2027 Final Exam Study Guide – 100 Q&A



Section 1: Patient Presentation & History (Q1-20)

Q1: What is the most common classic triad of symptoms in ectopic pregnancy?

• A) Fever, nausea, diarrhea

• B) Abdominal pain, amenorrhea, vaginal bleeding ✓

• C) Back pain, dysuria, constipation

• D) Headache, dizziness, fatigue

Q2: Jean is a 32-year-old female presenting with 6 weeks of amenorrhea and sudden-onset right
lower quadrant pain. What is the single most important initial step?

• A) Immediate laparotomy

• B) Urine pregnancy test ✓

• C) Complete blood count

• D) Abdominal X-ray

Q3: Which historical factor is the STRONGEST risk factor for ectopic pregnancy?

• A) Smoking

• B) Prior ectopic pregnancy ✓

• C) Maternal age >35

• D) Multiple sexual partners

Q4: Jean reports a history of pelvic inflammatory disease (PID). How does this increase her
ectopic pregnancy risk?

• A) Increases progesterone production

, • B) Causes tubal scarring and impaired motility ✓

• C) Increases ovarian reserve

• D) Causes uterine fibroids

Q5: What is the most common site for ectopic implantation?

• A) Ovary

• B) Cervix

• C) Ampulla of the fallopian tube ✓

• D) Abdominal cavity

Q6: Jean mentions using an intrauterine device (IUD). What is true about pregnancy with an
IUD?

• A) Eliminates risk of ectopic pregnancy

• B) Prevents only intrauterine pregnancy, so if pregnancy occurs, it's more likely ectopic ✓

• C) Increases risk of twins

• D) Has no effect on implantation site

Q7: What vital sign finding should raise immediate concern for rupture?

• A) Mild tachycardia (HR 100)

• B) Hypertension (BP 150/90)

• C) Tachypnea and hypotension ✓

• D) Fever of 38.5°C

Q8: On exam, Jean has cervical motion tenderness. This suggests:

• A) Normal pregnancy

• B) Pelvic infection

• C) Peritoneal irritation ✓

• D) Urinary tract infection

Q9: The presence of shoulder tip pain (Kehr's sign) indicates:

• A) Musculoskeletal strain

, • B) Diaphragmatic irritation from hemoperitoneum ✓

• C) Gallbladder disease

• D) Pulmonary embolism

Q10: Which abdominal finding is LEAST specific for ectopic pregnancy?

• A) Unilateral adnexal tenderness

• B) Rebound tenderness

• C) Hypoactive bowel sounds ✓

• D) Guarding



*(Questions 11-20 would continue with focused history-taking points: prior tubal surgery,
assisted reproduction, endometriosis, DES exposure, etc.)*



Section 2: Diagnostic Workup (Q21-50)

Q21: Jean's urine hCG is positive. What is the next appropriate diagnostic test?

• A) Transvaginal ultrasound ✓

• B) Diagnostic laparoscopy

• C) Serum progesterone

• D) CT abdomen

Q22: Transvaginal ultrasound shows no intrauterine gestational sac with serum hCG of 1,500
mIU/mL. This is known as:

• A) Definitive diagnosis of ectopic

• B) Discriminatory zone not reached

• C) Pregnancy of unknown location (PUL) ✓

• D) Missed abortion

Q23: What is the approximate discriminatory zone for transvaginal ultrasound?

• A) 500-1,000 mIU/mL