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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.
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An adolescent is brought to the clinic by her mother because of abnormal uterine bleeding. The nurse should understand that the most likely cause of this dysfunctional bleeding pattern is what?
- A. Lack of ovulation
- B. Chronic vaginitis
- C. A sexually transmitted infection
- D. Ectopic pregnancy
Correct Answer: A
Rationale: Dysfunctional uterine bleeding is most common in adolescents due to anovulation (lack of ovulation), which disrupts normal hormonal cycles. Vaginitis, STIs, and ectopic pregnancy are less likely causes of abnormal bleeding in this age group.
A 17-year-old girl has come to the free clinic for her annual examination. She tells the nurse she uses tampons and asks how long she may safely leave her tampon in place. What is the nurses best response?
- A. You may leave the tampon in overnight.
- B. The tampon should be changed at least twice per day.
- C. Tampons are dangerous and, ideally, you should not be using them.
- D. Tampons need to be changed every 4 to 6 hours.
Correct Answer: D
Rationale: Tampons should not be used for more than 4 to 6 hours, nor should super-absorbent tampons be used because of the association with toxic shock syndrome. If used appropriately, it is acceptable and safe for the patient to use tampons. Changing twice daily or leaving overnight may exceed safe duration.
The nurse is utilizing the PLISSIT model of sexual health assessment during an interaction with a new patient. According to this model, the nurse should begin with what action?
- A. Conducting a preliminary assessment
- B. Addressing the patients psychosocial status
- C. Asking the patients permission to discuss sexuality
- D. Assessing for physiologic problems
Correct Answer: C
Rationale: The PLISSIT model of sexual assessment begins with permission, where the nurse seeks the patient's consent to discuss sexual health, fostering a safe environment. This is followed by limited information, specific suggestions, and intensive therapy if needed.
A premenopausal patient is complaining of vaginal spotting and sharp, colicky lower abdominal pain. She informs the nurse that her period is 2 weeks late. The nurse should recognize a need for this patient to be investigated for what health problem?
- A. Trichomonas vaginalis
- B. Ectopic pregnancy
- C. Cervical cancer
- D. Fibromyalgia
Correct Answer: B
Rationale: Clinical symptoms of an ectopic pregnancy include delay in menstruation of 1 to 2 weeks, vaginal spotting, and sharp, colicky pain. These symptoms align with the patient's presentation, warranting investigation for this condition. Trichomonas vaginalis causes vaginal infection, typically with discharge, not typically associated with delayed menstruation or colicky pain. Cervical cancer may cause abnormal bleeding but is less likely to present with acute colicky pain and delayed menstruation. Fibromyalgia is unrelated to menstrual irregularities or vaginal spotting.
A clinic nurse is meeting with a 38-year-old patient who states that she would like to resume using oral contraceptives, which she used for several years during her twenties. What assessment question is most likely to reveal a potential contraindication to oral contraceptive use?
- A. Have you ever had surgery?
- B. Have you ever had a sexually transmitted infection?
- C. When did you last have your blood sugar levels checked?
- D. Do you smoke?
Correct Answer: D
Rationale: Women who smoke and who are 35 years of age or older should not take oral contraceptives because of an increased risk for cardiac problems. Previous surgeries or STIs do not necessarily contraindicate use, and while blood sugar monitoring is relevant for diabetes management, smoking is the most significant risk factor in this context.