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 B
Explanation
Rationale:
A. Metabolic acidosis may cause rapid breathing or lethargy but is not primarily indicated by fever.
B. In infants younger than 3 months, a temperature greater than 100.4°F (38°C) is concerning for a serious bacterial or viral infection due to their immature immune systems. Even mild fevers in this age group warrant prompt evaluation for sepsis, urinary tract infections, or meningitis.
C. Renal artery disease does not typically present with isolated fever in young infants.
D. Congenital heart defects may cause cyanosis, tachypnea, or poor feeding, but fever is not a primary sign.
Correct Answer is A
Explanation
Rationale:
A. Ranitidine HCl (Zantac), a histamine-2 receptor antagonist, is considered safe for use in pregnancy for treating dyspepsia and gastroesophageal reflux, particularly when antacids alone are insufficient. It reduces gastric acid production without significant risk to the fetus.
B. Sodium bicarbonate is generally avoided in pregnancy due to the risk of systemic alkalosis and fluid overload.
C. Sodium citrate and citric acid (Bicitra) are typically used to alkalinize urine or prevent aspiration during anesthesia, not for routine dyspepsia management in pregnancy.
D. Aluminum, magnesium, and simethicone (Gelusil) are generally safe in moderation, but they are less effective than H2 blockers for persistent symptoms and may cause constipation or diarrhea depending on the formulation.
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