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 C
Explanation
A. While some guidelines suggest that alternating days can reduce gastrointestinal side effects and improve absorption for certain formulations, the primary recommendation for iron absorption focuses on enhancers and inhibitors of absorption, not timing. Therefore, this is not the most important instruction for effectiveness.
B. Calcium in milk inhibits iron absorption, making it less effective when taken together. Iron supplements should not be taken with dairy products.
C. Vitamin C (ascorbic acid), found in orange juice, enhances the absorption of non-heme iron, which is the type found in most oral iron supplements. Taking iron with vitamin C–rich fluids significantly improves the effectiveness of supplementation.
D. Tea contains tannins, which inhibit iron absorption, reducing the effectiveness of the supplement. It is recommended to avoid tea, coffee, and high-calcium foods near the time of taking iron supplements.
Correct Answer is D
Explanation
A. Suggesting that further testing is needed implies that the score is abnormal or inconclusive. A BPP score of 8 out of 10 is generally considered normal, indicating that the fetus is well-oxygenated and not showing signs of compromise, so immediate further testing is not indicated.
B. While an obstetric specialist may review BPP results as part of routine care, the nurse should first provide accurate, reassuring information about the score. This response could cause unnecessary anxiety.
C. Immediate delivery by cesarean is not indicated for a BPP score of 8. Cesarean delivery is usually considered for scores of 4 or less, which indicate significant fetal compromise.
D. The test results are within normal limits is correct. A BPP evaluates fetal breathing movements, body movements, muscle tone, amniotic fluid volume, and nonstress test results, each scored 0–2. A total of 8–10 indicates a healthy fetus with no evidence of acute distress. This response reassures the client and accurately reflects the meaning of her BPP score.
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