A 20-year-old women arrives the clinic a complaint of lower abdominal pain (pain score 2/10) and light vaginal bleeding. In doing an initial intake history ,it is discovered that her last menstrual period was six weeks ago. A urine pregnancy test is performed with a positive result. Her vital signs are 110/68,982 84,18. Her b-HCG level is 1800 mlU/ml, and a transvaginal uitrasound shows no evidence of an intrauterine pregnancy. Upon bimanual examination, a small, irregular right adnexal mass was palpated.