Question 1

Which of the following are structural causes of abnormal uterine bleeding? (Select all that apply.)

Accepted Answer

Leiomyoma, endometrial polyp, and malignancy are all structural causes of abnormal uterine bleeding.

Question 2

During the menstrual cycle, if conception does not occur, which of the following events take place following ovulation? (Select all that apply.)

Accepted Answer

If conception does not occur following ovulation, the corpus luteum degenerates (B), leading to a decrease in progesterone levels (E), which contributes to the onset of withdrawal bleeding (D). The blastocyst implanting on the uterine wall (A) would only occur if conception had taken place, and estrogen levels typically rise leading up to ovulation, not after it in the absence of conception (C).

Question 3

Tanya is a 21-year-old African American woman with a body mass index (BMI) of 32. She is sedentary and smokes. Which of the following are factors that increase Tanya's risk for developing abnormal uterine bleeding? (Select all that apply.)

Accepted Answer

A, C

Question 4

Which of the following are symptoms of abnormal uterine bleeding? (Select all that apply.)

Accepted Answer

Abnormal uterine bleeding (AUB) can manifest in various ways, including bleeding between periods (B, E), bleeding after sex (C), and bleeding after menopause (D). Soaking through a menstrual pad in 4 hours on a heavy day (A) can be within the range of normal menstruation for some individuals and does not necessarily indicate AUB without other symptoms.

Question 5

Indigo is a 25-year-old client who arrives at the office complaining of a high fever and heavy menstrual bleeding. When the nurse inquires about her menstrual cycle, Indigo says that it is highly regular and that this is the normal time of the month for her to have her period, but that she has never bled this heavily before. Based on this information, which of the following should the nurse deduce as the most likely cause of the abnormal uterine bleeding?

Accepted Answer

Given the symptoms of high fever and heavy menstrual bleeding, the most likely cause is endometritis, an inflammation of the inner lining of the uterus, often associated with infection, which can present with these symptoms.

Question 6

Angie is a 33-year-old client who is experiencing abnormal uterine bleeding. The nurse would like to evaluate Angie's endometrium to determine whether she should undergo an endometrial sampling procedure. Which diagnostic test would be most appropriate for this purpose?

Accepted Answer

Transvaginal ultrasonography is the most appropriate diagnostic test to evaluate the endometrium for abnormal uterine bleeding, as it provides detailed images of the uterine lining.

Question 7

On what days of the menstrual cycle should a transvaginal ultrasound be scheduled in premenopausal women?

Accepted Answer

The answer of On what days of the menstrual cycle...

Question 8

Malorie is a 15-year-old client who is concerned because she still has not had her first period. Malorie is short for her age and appears to be prepubertal. She enjoys playing softball on a community recreation league team and has a body mass index (BMI) index of 22. Which cause of amenorrhea should the nurse suspect most in Malorie's case?

Accepted Answer

Turner syndrome is the most likely cause of amenorrhea in Malorie's case, given her description. It is characterized by short stature and delayed or absent puberty, which aligns with Malorie being short for her age and appearing prepubertal. The other options do not fit as well with the provided information.

Question 9

Beatrice is a 35-year-old client who has been experiencing lighter periods for the past few months and even missed a period of 1 month. On ultrasound, the nurse observes that Beatrice's ovaries are enlarged. Laboratory tests indicate an elevated luteinizing hormone level but normal estrogen and follicle-stimulating hormone levels. Which cause of amenorrhea should the nurse suspect most in Beatrice's case?

Accepted Answer

Polycystic ovary syndrome (PCOS) is characterized by symptoms such as irregular or light periods, and it can lead to enlarged ovaries as observed in Beatrice's ultrasound. Elevated luteinizing hormone levels are also commonly seen in PCOS, while estrogen and follicle-stimulating hormone levels can remain within the normal range.

Question 10

Jenny is an 18-year-old client who has been diagnosed with female athlete triad. What interventions should the nurse make to treat Jenny? (Select all that apply.)

Accepted Answer

The female athlete triad consists of three interrelated conditions: disordered eating, amenorrhea, and osteoporosis. To address these issues, interventions should focus on nutritional support and psychological help. Increasing calcium intake (A) is important for bone health. Recommending a balanced diet with plenty of calories (C) addresses the energy deficit and nutritional imbalances. Referring the client to a therapist (D) can help address underlying psychological issues, including disordered eating behaviors. Encouraging weight loss (B) is not appropriate as it could exacerbate the condition, and prescribing antidiabetic medication (E) is not relevant unless there is a specific diagnosis of diabetes or insulin resistance as part of her medical condition.

Question 11

Maria is a 38-year-old client who experiences depression, mood swings, and abdominal cramps each month right before her period. Her symptoms are so severe that she has had to miss many days of work in the past year. Which of the following conditions would best explain Maria's symptoms?

Accepted Answer

Maria's symptoms align with Premenstrual Dysphoric Disorder (PMDD), which is characterized by severe depression, irritability, and tension before menstruation. PMDD is a more severe form of premenstrual syndrome (PMS) and can significantly impact daily functioning.

Question 12

Trudy is a 36-year-old client who has just been diagnosed with premenstrual dysphoric disorder. Which of the following self-management measures should the nurse recommend to Trudy? (Select all that apply.)

Accepted Answer

Calcium supplements can help alleviate symptoms. Cognitive behavioral therapy is effective for mood disorders. Aerobic exercise can reduce symptoms. Spironolactone may help with bloating and fluid retention. Caffeine intake should be reduced, not increased.

Question 13

Chloe has been experiencing migraine headaches lately, which she believes may be related to her menstrual cycle. Which of the following symptoms are associated with menstrual migraine headaches? (Select all that apply.)

Accepted Answer

Menstrual migraines are often associated with nausea and vomiting (B), sensitivity to light and sound (D), and can be preceded by visual disturbances such as flickering lights, known as aura (E). Bilateral presentation (A) and mild, steady pain (C) are not typically characteristic of migraines, which are more often unilateral and moderate to severe in intensity.

Question 14

Oma is a 20-year-old client who regularly experiences menstrual migraines with aura just before her period. Which medication should the nurse recommend to Oma to take 2 to 3 days before her period as a short-term prophylactic treatment?

Accepted Answer

Triptans are effective for the short-term prophylaxis of menstrual migraines, especially when taken a few days before the expected onset of the migraine, which often coincides with the menstrual cycle.

Question 15

Which of the following are characteristics of primary dysmenorrhea, as opposed to secondary dysmenorrhea? (Select all that apply.)

Accepted Answer

Primary dysmenorrhea is characterized by pain that follows a predictable pattern, usually starting at the onset of menstruation and often being worst on the first day. It is not typically associated with conditions like endometriosis or heavy menstrual bleeding, which are more characteristic of secondary dysmenorrhea.

Quiz 28: Perimenstrual and Pelvic Symptoms and Syndromes