During a health assessment for a young adult female client's gynecological annual screening, the client reports amenorrhea. The nurse calculates the client's body mass index (BMI) as 16 kg/m2 (normal 18.0 to 24.9 kg/m2). Which finding should the nurse document in the electronic medical record that indicates an expected rationale for this condition?

Trains for competition and runs 12 miles every day.

Received an implanted intrauterine device (IUD) last month.

Reports a history of chronic urinary track infections.

Increased calcium intake with 3 glasses of non-fat milk daily.

Answer and Explanation

The Correct Answer is A

A.   Intense physical exercise, particularly when combined with a low body mass index, can lead to
amenorrhea. This condition, often referred to as "athletic amenorrhea," occurs due to the body’s response to excessive physical stress and insufficient fat stores. A low BMI combined with high levels of physical activity can disrupt the hormonal balance necessary for regular menstrual cycles.
B.   While certain types of IUDs (especially hormonal ones) can cause changes in menstrual patterns, they are not typically associated with the same degree of amenorrhea as seen with significant weight loss or low BMI. The timeline of one month after IUD insertion is relatively short for such significant changes to occur solely due to the device, making it a less likely cause of the client’s amenorrhea in this context.
C.   Chronic UTIs generally do not affect menstrual cycles or cause amenorrhea. They are more likely to result in symptoms related to the urinary system rather than hormonal imbalances that influence menstrual cycles.
D.   Increased calcium intake is generally associated with positive health benefits, including bone health, but it is not typically linked to amenorrhea. Calcium intake alone, especially if it is not accompanied by other significant dietary or lifestyle changes, is unlikely to be a contributing factor to amenorrhea.

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Correct Answer is D

Explanation

A. While a 24-hour diet history can provide valuable information about a person's dietary intake, it may not accurately reflect their long-term nutritional habits. Additionally, some individuals may underreport or overreport their food intake.
B. A person's current appetite can be affected by various factors, including illness, medication, and emotional state. It may not be a reliable indicator of long-term nutritional status.
C. While weight loss can be a sign of nutritional problems, it is not always indicative of a deficiency. Other factors, such as increased physical activity or illness, can also contribute to weight loss.
D. The condition of hair, nails, and skin can provide valuable clues about a person's nutritional status.
For example, dry, brittle hair and nails, as well as pale or scaly skin, can be signs of nutrient deficiencies such as iron, vitamin B12, or protein deficiency. These visible signs can be more indicative of long-term nutritional deficiencies than other factors.

A. Document the presence of nailbed clubbing. B. Consult with a podiatrist to trim the client's toenails. C. Determine the client's most recent hemoglobin level. D. Administer a PRN prescription for oxygen.

Correct Answer is A

Explanation

A. Nailbed clubbing is characterized by an increased angle between the nail and the nailbed, typically greater than 180 degrees. An angle of 200 degrees is consistent with clubbing, which can be a sign of chronic respiratory or cardiovascular conditions, such as chronic lung diseases, congenital heart defects, or other systemic conditions.
B. Consulting with a podiatrist to trim toenails is important for foot care but is not directly related to the finding of nailbed clubbing. The angle of the nailbed is more indicative of a systemic issue rather than a local foot care problem. Therefore, this action does not address the underlying concern suggested by the angle of 200 degrees.
C. While anemia or other blood conditions can affect the nails, the specific finding of a nailbed angle of 200 degrees is more indicative of clubbing rather than issues typically associated with hemoglobin levels. Therefore, while monitoring hemoglobin is important for overall health, it is not the immediate priority in response to the finding of nailbed clubbing.
D. Administering oxygen might be necessary if the client is experiencing symptoms of hypoxia or has a condition affecting oxygenation. However, the finding of nailbed clubbing itself does not immediately necessitate oxygen therapy. Oxygen administration should be based on specific symptoms or clinical indications of hypoxia rather than the nailbed angle alone.

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Naxlex Comprehensive Predictor Exams

The nurse is conducting a physical assessment of a young adult. Which information provides the best indication of the individual's nutritional status?

Correct Answer is D

Explanation

In assessing a client's nailbeds, the nurse notes that the angle between the nail and the nailbed is 200 degrees. Which action should the nurse take?

Correct Answer is A

Explanation

While performing a health history the nurse asks the client, "You don't use recreational drugs, do you?" This approach is most likely to elicit which response from the client?

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