A 32-year-old woman who is 36 hours postpartum experiences lower abdominal pain, fever, flu-like symptoms, a tender uterus that is subinvoluted, and foul-smelling discharge. Which of the following is most consistent with this presentation?
Trichomonas
Urinary tract infection
Endometriosis
Endometritis
The Correct Answer is D
Choice A reason: Trichomonas is a sexually transmitted infection that typically causes vaginal discharge, itching, and irritation. It does not cause uterine tenderness or systemic symptoms like fever and flu-like illness in the postpartum period.
Choice B reason: A urinary tract infection may cause fever and abdominal discomfort, but it does not typically result in a tender, subinvoluted uterus or foul-smelling lochia. The symptoms described are more consistent with a uterine infection.
Choice C reason: Endometriosis is a chronic condition involving ectopic endometrial tissue, causing pelvic pain and infertility. It is not an acute postpartum infection and does not present with fever or foul-smelling discharge.
Choice D reason: Endometritis is an infection of the uterine lining, commonly occurring postpartum, especially after prolonged labor or cesarean delivery. Symptoms include uterine tenderness, fever, subinvolution, and malodorous lochia. This diagnosis best fits the clinical presentation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Telmisartan is an angiotensin II receptor blocker (ARB), which prevents angiotensin II from binding to its receptors but does not inhibit its formation. ARBs are less likely to cause a dry cough because they do not increase bradykinin levels.
Choice B reason: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor. It blocks the conversion of angiotensin I to angiotensin II, reducing vasoconstriction and aldosterone secretion. A common side effect is a persistent dry cough due to increased bradykinin levels, making it the correct answer.
Choice C reason: Amlodipine is a calcium channel blocker that works by relaxing vascular smooth muscle to lower blood pressure. It does not affect the renin-angiotensin system and is not associated with dry cough.
Choice D reason: Furosemide is a loop diuretic that inhibits sodium and chloride reabsorption in the loop of Henle. It is used to manage fluid overload in heart failure and hypertension but does not act on the renin-angiotensin system or cause dry cough.
Correct Answer is C
Explanation
Choice A reason: The L1 nerve root primarily innervates the groin and upper thigh region. Damage to L1 may cause pain or sensory changes in these areas but does not typically affect heel walking or toe extension, which are controlled by more distal nerve roots.
Choice B reason: The L3 nerve root contributes to thigh adduction and knee extension. Symptoms of L3 involvement include anterior thigh pain and weakness in quadriceps muscles, not the dorsiflexion of the foot or toe extension.
Choice C reason: The L5 nerve root innervates muscles responsible for dorsiflexion of the foot and extension of the big toe, such as the extensor hallucis longus and tibialis anterior. Difficulty walking on heels and weakness in toe extension are hallmark signs of L5 radiculopathy. This nerve also contributes to sensation on the dorsum of the foot, aligning with the patient's symptoms.
Choice D reason: There is no L7 nerve root in the human lumbar spine. The lumbar spine consists of five vertebrae (L1–L5), followed by the sacral region. Therefore, this option is anatomically incorrect.
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