Care Manager Certification Practice Exam

Which client should the nurse assess first on the obstetrics-gynecology unit?

1. A client who is 1 day postpartum after a late-term miscarriage.

2. A client who had a bilateral tubal ligation 12 hr previously.

3. A client who is 4 days postpartum and has mastitis.

4. A client who was admitted 1 hr ago for an ectopic pregnancy.

The correct answer is: A client who was admitted 1 hr ago for an ectopic pregnancy.

The client who was admitted 1 hour ago for an ectopic pregnancy should be assessed first due to the potential for life-threatening complications associated with this condition. An ectopic pregnancy occurs when a fertilized egg implants outside the uterus, most commonly in the fallopian tube. It can cause severe internal bleeding if it ruptures, leading to significant morbidity or mortality. Therefore, the urgency of assessing this client is paramount to evaluate for any signs of rupture, such as abdominal pain, signs of shock (like hypotension or tachycardia), and to initiate any necessary interventions promptly. The other clients, although they may present their own concerns, generally have stable conditions that are less immediately life-threatening. For instance, the client postpartum after a late-term miscarriage might require evaluation, but the risk of immediate medical crisis is lower compared to the ectopic pregnancy. The client who had a bilateral tubal ligation 12 hours ago generally requires routine assessment as complications are less common, and the client with mastitis is also in a stable but concerning situation that can be managed after addressing more critical cases. Hence, prioritizing the client with the ectopic pregnancy reflects the need for timely intervention in high-risk situations.