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. Cloudy discharge is more commonly associated with infections or discharge from the genital area rather than residual urinary symptoms. While urinary tract infections (UTIs) can cause cloudy urine, this is not typically associated with suprapubic tenderness or the sensation of residual pressure alone.
B. An overactive bladder is characterized by symptoms such as frequent urination, urgency, and sometimes incontinence. However, it does not typically cause suprapubic tenderness or a sensation of residual pressure after urination. The described symptoms are more consistent with bladder outlet obstruction or incomplete bladder emptying rather than an overactive bladder.

C. Black tarry stools indicate upper gastrointestinal bleeding and are unrelated to urinary symptoms. This finding would suggest a different issue entirely, such as gastrointestinal bleeding, rather than a problem with the urinary tract or bladder. This is not consistent with the client's reported symptoms of suprapubic tenderness and sensation of residual pressure after urination.
D. A weak urinary stream is a common symptom associated with bladder outlet obstruction or conditions affecting urinary flow, such as benign prostatic hyperplasia (BPH) in older men. This finding aligns with the client's reported symptoms of suprapubic tenderness and feeling of residual pressure after urination.

A. Ask the client to swallow while palpating along the sides of the trachea. B. Palpate deeply and firmly over the location of the thyroid gland. C. Document that thyroid gland size is normal with no visible goiter. D. Defer the thyroid exam and observe the client for signs of myxedema.

Correct Answer is A

Explanation

A. Asking the client to swallow while palpating along the sides of the trachea helps in assessing the thyroid gland's size and mobility. The thyroid gland is located just below the larynx, and during swallowing, it moves upward, which can make it easier to palpate and identify any enlargement or nodules.
B. Palpating deeply and firmly might not be necessary and could be uncomfortable for the client. Gentle palpation is usually adequate for assessing the thyroid gland. Excessive force is not recommended as it may not yield additional information and could cause discomfort.
C. If the thyroid gland is not visible, documenting that it is normal without further assessment may not be accurate. The gland could be enlarged (goiter) or have other abnormalities that are not apparent on visual inspection alone. Accurate documentation should include findings from palpation and other assessment techniques.
D. Deferring the thyroid exam and focusing on signs of myxedema is not ideal in this situation. Myxedema is a severe form of hypothyroidism that can have various signs, but the immediate need is to assess the thyroid gland directly for goiter or other abnormalities. It is essential to perform a thorough examination and not rely solely on observation of symptoms that might appear later.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is examining the abdomen of an older male client who expresses suprapubic tenderness on palpation. The client reports that it sometimes feels like there is still pressure in that area after urination. Which additional finding should the nurse expect with continued interview of the client?

Correct Answer is D

Explanation

The nurse is assessing a client for goiter and is unable to observe the thyroid gland. Which action should the nurse take?

Correct Answer is A

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?

During the admission assessment, the nurse observes that a client has a limping gait. Which assessment should the nurse complete next?

The nurse examines a client admitted with a deep, constant pain in the abdomen that radiates to the back. Which finding is most important for the nurse to report to the healthcare provider?

When inspecting a client's skin, the nurse observes an area of erythema on the arm. Which follow- up assessment should the nurse complete?

When assessing a client's skin, which finding should the nurse report to the healthcare provider?

The nurse examines a client's abdomen. Which finding indicates an abnormal response when palpating the spleen?

Patient Data Exhibits