The patient is at 6 weeks' gestation, and is spotting. The patient had an ectopic pregnancy 1 year ago, so the nurse anticipates that the physician will order:
1. A urine pregnancy test.
2. The patient to be seen next week for a full examination.
3. A serum pregnancy test.
4. An ultrasound to be done.
3
Rationale 1: Urine pregnancy tests are not quantifiable.
Rationale 2: It is not appropriate to wait until next week to see the patient.
Rationale 3: A patient with a history of an ectopic pregnancy is at risk for another ectopic pregnancy, and spotting is a common symptom of ectopic pregnancy. A serum quantitative beta hCG test will be performed. The enzyme-linked immunosorbent assay may also be used, as it can detect hCG very early.
Rationale 4: An ultrasound may be used to diagnose an ectopic pregnancy, but would not be needed now.
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