A client reports experiencing severe abdominal and pelvic pain around the time of menstruation. This pain has become progressively worse over the last 5 years. She also experiences pain during intercourse, irregular vaginal bleeding, and has been unsuccessful in becoming pregnant for the past 18 months. To which condition are these symptoms most likely related?
Genital warts
Pregnancy
Endometriosis
Premenstrual syndrome (PMS)
The Correct Answer is C
A. Genital warts are caused by human papillomavirus (HPV) infection. They usually present as painless, cauliflower-like lesions on the external genitalia. Genital warts do not cause cyclical pelvic pain, progressively worsening dysmenorrhea, dyspareunia, irregular bleeding, or infertility, making this an unlikely cause of the client’s symptoms.
B. Pregnancy does not account for chronic, long-term pelvic pain or progressive worsening over several years. Additionally, pregnancy is not a chronic condition and cannot explain the client’s secondary infertility or irregular vaginal bleeding over multiple menstrual cycles.
C. Endometriosis occurs when endometrial tissue grows outside the uterine cavity, most commonly on the ovaries, fallopian tubes, or peritoneum. It is characterized by progressive dysmenorrhea with pain during menstruation that worsens over time, persistent or cyclic pelvic pain often severe, dyspareunia or pain during sexual intercourse, irregular bleeding such as spotting or heavy periods, and infertility due to adhesions and altered pelvic anatomy that can impede conception. The client’s long history of progressively worsening pain, dyspareunia, irregular bleeding, and difficulty conceiving strongly supports endometriosis as the most likely diagnosis.
D. Premenstrual syndrome (PMS) involves physical and emotional symptoms, such as mood swings, bloating, breast tenderness, and mild cramps, that occur 1–2 weeks before menstruation. PMS does not cause severe, progressively worsening pelvic pain, dyspareunia, chronic irregular bleeding, or infertility.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Fluid intake should not be limited during phototherapy. In fact, maintaining adequate hydration is important because phototherapy can increase insensible fluid losses through the skin. Limiting fluids could worsen dehydration and hyperbilirubinemia.
B. Applying eye shields is essential during phototherapy to protect the newborn’s eyes from the harmful effects of light exposure, including retinal damage. The shields should be positioned correctly and checked frequently to ensure proper fit and safety. This is a primary nursing intervention during phototherapy.
C. Oil-based lotions should be avoided during phototherapy because they can absorb heat and cause skin burns. Newborn skin should be kept clean and dry; mild, water-based moisturizers may be used if necessary after phototherapy.
D. The newborn’s position should be changed frequently, usually every 2–3 hours, not every 12 hours. Frequent repositioning ensures that all areas of the body are exposed to the light, maximizing bilirubin breakdown and preventing pressure sores.
Correct Answer is D
Explanation
A. Caput succedaneum is a diffuse edema of the scalp caused by pressure during delivery. It is soft, may feel puffy, and crosses suture lines. It is usually present at birth and resolves within a few days, making this option inconsistent with the findings described.
B. Molding refers to the temporary shaping of the newborn’s head due to overlapping cranial bones during passage through the birth canal. It affects the overall head shape rather than causing a localized, raised, bruised area and does not present as a firm mass.
C. The anterior fontanelle is a normal anatomical structure located at the junction of the frontal and parietal bones. It is soft and flat or slightly sunken, not raised or bruised, and is not a pathological finding.
D. A cephalhematoma is a collection of blood between the skull and periosteum caused by birth trauma. It is typically firm, localized, appears within the first 24 hours after birth, and does not cross suture lines, which precisely matches the assessment findings described.
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