A 52-year-old woman with a history of a bilateral oophorectomy presents to the nurse practitioner with complaints of vaginal bleeding and pelvic pain for 2 weeks. What is the best next step?
Refer to a gynecologic oncologist
CA-125 blood test
Pap smear
Endometrial biopsy
The Correct Answer is D
Choice A reason: Referral to an oncologist is premature without diagnostic confirmation of malignancy.
Choice B reason: CA-125 is mainly used for ovarian cancer, which is unlikely after bilateral oophorectomy.
Choice C reason: Pap smear screens for cervical cancer and is not indicated for evaluating postmenopausal or post-oophorectomy bleeding.
Choice D reason: Correct. Endometrial biopsy or transvaginal ultrasound helps evaluate uterine pathology, including endometrial cancer, and is the most appropriate initial diagnostic step.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: Trichotillomania involves hair pulling often due to tension or boredom without a preoccupation with symmetry. In this case, the pulling is driven by a compulsion for symmetry, making this diagnosis less appropriate.
Choice B reason: BDD involves distress over perceived physical flaws. While the patient is concerned about asymmetry, the hair pulling is specifically performed to alleviate compulsive distress, consistent with OCD rather than BDD.
Choice C reason: Delusional disorder, somatic type, involves a fixed false belief about bodily functions or appearance. The patient acknowledges the asymmetry is "all in her head," indicating insight, which rules out delusional disorder.
Choice D reason: OCD is characterized by obsessions (distressing thoughts) and compulsions (ritualized behaviors to alleviate distress). The patient’s repetitive eyebrow tweezing to achieve symmetry despite knowing it is unnecessary reflects a compulsion, confirming OCD.
Correct Answer is D
Explanation
Choice A reason: EMDR is effective for PTSD broadly but is not the first-line treatment specifically for nightmares.
Choice B reason: Hypnosis has limited evidence and is not considered a first-line treatment for PTSD-related nightmares.
Choice C reason: Progressive muscle relaxation may reduce general anxiety but has limited efficacy for nightmare-specific symptoms.
Choice D reason: This is correct. Image rehearsal therapy has the highest level of evidence for reducing the frequency and intensity of PTSD-related nightmares. It involves rescripting the nightmare during wakefulness to alter its content and emotional impact.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.
