A female client reports green-yellow vaginal discharge, vaginal itching, and foul-smelling genitals.
She has been sexually active for six months in a monogamous relationship with her boyfriend.
Both were tested for sexually transmitted diseases when she received a hormonal implant five months ago.
The couple broke up a month ago, and since then, she has had unprotected sex with two partners.
The client's symptoms are most consistent with which of the following conditions?

Urinary tract infection.

Trichomoniasis.

Herpes simplex.

Human papillomavirus.

Answer and Explanation

The Correct Answer is B

Choice A rationale

Urinary tract infections primarily involve the urinary system, causing symptoms like dysuria, frequency, and urgency. While some overlap in symptoms might occur, the green-yellow vaginal discharge, itching, and foul odor are not typical of a UTI.

Choice B rationale

Trichomoniasis, caused by the parasite *Trichomonas vaginalis*, is a sexually transmitted infection that commonly presents with a frothy, green-yellow vaginal discharge, vulvar itching, and a distinct, often foul, odor. The client's recent unprotected sexual activity with new partners supports this possibility.

Choice C rationale

Herpes simplex virus typically causes painful vesicular lesions on the genitals, perineum, or cervix. While there might be some discomfort, the primary symptoms are the characteristic blisters, not typically a green-yellow discharge and foul odor.

Choice D rationale

Human papillomavirus (HPV) is a sexually transmitted infection that can cause genital warts or lead to cervical cancer. However, it typically does not present with a green-yellow vaginal discharge, itching, or a foul odor. Many HPV infections are asymptomatic. .

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Correct Answer is ["A","D","E"]

Explanation

The correct answer is Choice A, Choice D, Choice E.

Choice A rationale

Pain during intercourse, also known as dyspareunia, is a common symptom of endometriosis. Endometrial tissue growing outside the uterus can infiltrate the pelvic organs and ligaments, causing pain and discomfort during sexual activity due to pressure and inflammation in these areas.

Choice B rationale

Painless heavy menstrual bleeding is not typically associated with endometriosis. Endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, which responds to hormonal fluctuations of the menstrual cycle, often leading to painful periods (dysmenorrhea) and potentially heavy bleeding accompanied by pain.

Choice C rationale

Unexplained weight gain is not a typical symptom directly linked to endometriosis. While hormonal imbalances can occur with endometriosis, they do not usually manifest as unexplained weight gain. Other factors are more likely to contribute to weight changes.

Choice D rationale

Infertility is a significant concern for many individuals with endometriosis. The presence of endometrial implants, adhesions, and scarring in the pelvic cavity can distort the anatomy of the reproductive organs, interfering with ovulation, fertilization, and implantation of a fertilized egg.

Choice E rationale

Pain during the menstrual period, known as dysmenorrhea, is a hallmark symptom of endometriosis. The ectopic endometrial tissue undergoes cyclical bleeding and shedding, similar to the uterine lining, but this occurs outside the uterus, causing inflammation, pain, and potentially the formation of scar tissue and adhesions.

B. Bright red vaginal bleeding. C. Closed cervix upon examination. M. Mild to moderate lower abdominal cramping.

Correct Answer is ["B","C","E"]

Explanation

Choice A rationale

Severe cramping and pelvic pain are more indicative of an inevitable or incomplete abortion, where the pregnancy is no longer viable and the body is actively trying to expel the uterine contents. In a threatened abortion, the symptoms are typically milder.

Choice B rationale

A closed cervix upon examination is a key finding in a threatened abortion. It indicates that the uterus is not yet dilating or effacing, suggesting that the pregnancy might still be maintained. Cervical dilation signifies progression towards abortion.

Choice C rationale

Mild to moderate lower abdominal cramping is a common symptom of a threatened abortion. These cramps result from uterine irritability and contractions as the body reacts to potential pregnancy loss. The intensity is less severe than in later stages of abortion.

Choice D rationale

Passage of fetal tissue is a definitive sign of an incomplete or complete abortion, meaning the pregnancy has already been lost and the products of conception are being expelled. This would not be expected in a threatened abortion.

Choice E rationale

Bright red vaginal bleeding is a common symptom of a threatened abortion, indicating disruption at the decidual-trophoblastic interface. The bleeding can range from spotting to light bleeding and suggests a potential threat to the pregnancy.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which assessment findings might raise the nurse's suspicion of endometriosis in the client they are evaluating?

Correct Answer is ["A","D","E"]

Explanation

Correct Answer is ["B","C","E"]

Explanation

For each medication below, click to select the appropriate nursing action. (Each category can have zero or more response options selected)

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A 56-year-old menopausal woman reports to the registered nurse that she has been experiencing vaginal itching, burning, and an increase in vaginal infections over the past 3 years. What important factor should the nurse consider before responding to the client's concerns?