Nokea
A 15-year-old girl is brought to the clinic by her mother to see her primary care provider. The mother states that her daughter has not started to develop sexually. The physical examination shows that the patient has no indication of secondary sexual characteristics. What diagnosis should the nurse suspect?
- A. Primary amenorrhea
- B. Dyspareunia
- C. Vaginal atrophy
- D. Secondary dysmenorrhea
Correct Answer: A
Rationale: Primary amenorrhea is suspected when a young woman over 14 years has not begun menstruating and shows no secondary sexual characteristics, as described. Dyspareunia is painful intercourse, vaginal atrophy is unrelated to puberty onset, and secondary dysmenorrhea involves painful periods due to pathology, none of which fit the scenario.
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A nurse presenting an educational event for a local community group is addressing premenstrual syndrome (PMS). What treatment guideline should the nurse teach this group?
- A. Avoid excessive fluid intake.
- B. Increase the frequency and intensity of exercise.
- C. Limit psychosocial stressors in order to reduce symptoms.
- D. Take opioid analgesics as ordered.
Correct Answer: B
Rationale: In general, the patient is encouraged to increase or initiate an exercise program to help relieve symptoms of PMS. Increased fluid intake is recommended, not avoidance. Opioids are not used to treat PMS, and while stress reduction has general benefits, it is not specifically noted to alleviate PMS symptoms.
A woman presents at the ED with sharp, colicky pain in her right abdomen that radiates to her right shoulder. She tells the nurse that she has been spotting lightly for the past few days. The patient is subsequently diagnosed with an ectopic pregnancy. What major nursing diagnosis most likely relates to this patients needs?
- A. Anxiety related to potential treatment options and health outcomes
- B. Chronic sorrow related to spontaneous abortion
- C. Chronic pain related to genitourinary trauma
- D. Impaired tissue integrity related to keloid scarring
Correct Answer: A
Rationale: A diagnosis of ectopic pregnancy is likely to cause significant anxiety due to treatment uncertainties and health risks. Chronic sorrow, chronic pain, and impaired tissue integrity (keloid scarring) are less applicable to the acute presentation of ectopic pregnancy.
A 21-year-old woman has sought care because of heavy periods and has subsequently been diagnosed with menorrhagia. The nurse should recognize which of the following as the most likely cause of the patients health problem?
- A. Hormonal disturbances
- B. Cervical or uterine cancer
- C. Pelvic inflammatory disease
- D. A sexually transmitted infection (STI)
Correct Answer: A
Rationale: Menorrhagia in young women is most commonly caused by hormonal disturbances, which disrupt normal menstrual regulation. Cervical or uterine cancer, pelvic inflammatory disease, and STIs are less likely causes in this age group.
A patient in her late fifties has expressed to the nurse her desire to explore hormone replacement therapy (HRT). Based on what aspect of the patients health history is HRT contraindicated?
- A. History of vaginal dryness
- B. History of hot flashes and night sweats
- C. History of vascular thrombosis
- D. Family history of osteoporosis
Correct Answer: C
Rationale: The use of HRT is contraindicated in women with a history of vascular thrombosis, active liver disease, some cases of uterine cancer, and undiagnosed vaginal bleeding. HRT is beneficial in women with a risk for osteoporosis and can relieve symptoms like vaginal dryness, hot flashes, and night sweats. A history of vascular thrombosis is a clear contraindication.
The nurse is working with a couple who have been unable to conceive despite more than 2 years of trying to get pregnant. The couple has just learned that in vitro fertilization (IVF) was unsuccessful and they are both tearful. What nursing diagnosis is most likely to apply to this couple?
- A. Hopelessness related to failed IVF
- B. Acute confusion related to reasons for failed IVF
- C. Compromised family coping related to unsuccessful IVF
- D. Moral distress related to unsuccessful IVF
Correct Answer: A
Rationale: The couple's tearful response to a failed IVF suggests hopelessness, a likely emotional reaction to the loss of a promising intervention. Acute confusion implies cognitive impairment, compromised coping is less specific, and moral distress is unrelated to the scenario.