A 16-year-old adolescent female reports amenorrhea for 8 weeks. The most appropriate intervention by the nurse practitioner would be to:
ask the adolescent if she is sexually active.
order a urine pregnancy test.
order a serum human chorionic gonadotropin (HCG), test.
order a pelvic ultrasound.
The Correct Answer is B
Rationale:
A. Asking about sexual activity is important for history-taking but does not directly confirm or rule out pregnancy.
B. Ordering a urine pregnancy test is the most appropriate first step in evaluating secondary amenorrhea in a sexually active adolescent, as pregnancy is the most common cause.
C. A serum HCG test is more sensitive than a urine test and may be ordered if the urine test is inconclusive, but initial evaluation typically starts with the less invasive urine test.
D. Pelvic ultrasound is not the first-line evaluation for amenorrhea and is reserved for cases where structural abnormalities are suspected or pregnancy is confirmed and further assessment is needed.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Rationale:
A. By age 3, children typically begin to distinguish between reality and make-believe, showing emerging imaginative play and understanding of fantasy versus real events.
B. Cooperation with other children develops gradually and is more consistently observed around ages 4–5.
C. Taking turns when playing structured games generally emerges closer to 4–5 years of age as social and cognitive skills mature.
D. Preferring to play with others rather than alone is more characteristic of children around 4 years old; 3-year-olds often engage in parallel play, playing alongside rather than directly with peers.
Correct Answer is B
Explanation
Rationale:
A. Recent fluid intake provides context for overall hydration but does not directly determine the safety of adding potassium.
B. Urinary output must be assessed before adding potassium to IV fluids because adequate renal function is essential for potassium excretion. Administering potassium to a patient with low or absent urine output can lead to hyperkalemia, which can cause life-threatening cardiac arrhythmias.
C. Capillary refill helps assess perfusion and dehydration but does not indicate the patient’s ability to excrete potassium.
D. Last bowel movement is not relevant to potassium administration in IV fluids, as potassium is primarily excreted via the kidneys rather than the gastrointestinal tract.
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