NURS 535 Practice Exam Questions with
Verified Answers
What is PMS? - ✔✔the cyclic recurrence (in the luteal phase of the menstrual cycle) of
distressing physical, psychologic, or behavioral changes that impair interpersonal relationships
or interfere with usual activities.
When does PMS occur? - ✔✔Always occurs cyclically before the onset of menstruation, not
present at other times of the month
What are s/s of PMS? - ✔✔extremely variable even from one cycle to another, breast
tenderness, edema, bloating, binge eating, headache, dizziness, mood swings
What is primary dysmenorrhea? - ✔✔painful menstruation associated with the release of
prostaglandins in ovulatory cycles, but not with pelvic disease.
What is the incidence of primary dysmenorrhea? - ✔✔Approximately 50% of all women
experience dysmenorrhea, 10% of whom are incapacitated for 1 to 3 days because of pain
severity.
When does primary dysmenorrhea occur? - ✔✔usually begins with the onset of ovulatory
cycles, around age 15 or 16 years with prevalence highest during adolescence.
What is secondary dysmenorrhea? - ✔✔related to pelvic pathology (i.e., ovarian cysts,
endometriosis) which manifests in later reproductive years and may occur any time in the
menstrual cycle.
What are s/s of primary dysmenorrhea? - ✔✔starts 12-24 hrs before menses, rarely lasts more
than 2 days, lower abd pain radiating to lower back/upper thighs, nausea, diarrhea, fatigue,
headache
,What is the epidemiology of secondary dysmenorrhea? - ✔✔begins age 30-40 after previous
pain-free menses
What are s/s of secondary dysmenorrhea? - ✔✔unilateral, constant pain that lasts longer than
2 days, can have painful intercourse, painful defecation, or irregular bleeding
What is the pathophysiology of primary dysmenorrhea? - ✔✔Women w/ painful periods
produce 10x as much PGF2α, a potent myometrial stimulant & vasoconstrictor, as
asymptomatic women. Elevated levels of PGs cause uterine hypercontractility, dec bf to the
uterus, & inc nerve hypersensitivity, thus resulting in pain. Women may have up-regulated COX
enzyme activity, which contributes to inc synthesis of PGs. leukotriene production is elevated
further contributing to inc levels of pain. PGs are primarily released during the first 48 hrs of
menstruation, when symptoms are the most intense.
What is the pathophysiology of secondary dysmenorrhea? - ✔✔results from disorders such as
endometriosis, endometritis, PID, obstructive uterine or vaginal anomalies, uterine fibroids,
polyps, tumors, ovarian cysts, pelvic congestion syndrome, or non-hormonal IUDs.
What are diff causes of abnormal bleeding across ages? - ✔✔Young - SAB, ectopic pregnancy,
clotting disorders. 30s/40s - leiomyomas (fibroids), endometrial polyps. Old - endometrial
cancer
What is amenorrhea? - ✔✔lack of menstruation
What is the etiology of amenorrhea? - ✔✔the most common causes are hypothalamic
dysfunction, PCOS, hyperprolactinemia, and ovarian failure.
What is primary amenorrhea? - ✔✔the failure of menarche & the absence of menstruation by
age 13 years w/o the development of secondary sex characteristics or by age 15 regardless of
the presence of secondary sex characteristics
,What is secondary amenorrhea? - ✔✔the absence of menstruation for a time equivalent to 3 or
more cycles in women who have previously menstruated
How often does the endometrial lining need to shed? - ✔✔4-6 times/yr
What are compartment IV disorders of primary amenorrhea? - ✔✔include CNS disorders, in
particular hypothalamic disorders. In some of the congenital syndromes, the HPO axis is
dysfunctional. The hypothalamus is unable to synthesize GnRH, so the pituitary fails to secrete
LH & FSH. Therefore, the ovary does not receive the hormonal signals required to stimulate
estrogen production, & ovulation & menstruation do not occur. B/c the ovarian hormones are
absent, estrogen-dependent sex characteristics do not develop.
What are compartment III disorders of primary amenorrhea? - ✔✔disorders of the anterior
pituitary, including tumors. Some anatomic defects of the CNS, whether congenital or acquired,
impinge on the hypothalamic- pituitary unit so as to interfere w/or interrupt the secretion of
GnRH or FSH & LH. Ex of such defects include hydro- cephalus, craniopharyngiomas, & other
space-occupying lesions of the CNS. the ovary does not receive the necessary signals, &
ovulation & menstruation do not occur. In some cases these lesions develop b/t the onset &
conclusion of puberty. skeletal growth may occur & secondary sex characteristics may develop,
but sexual maturation is interrupted before menarche.
What are compartment II disorders of primary amenorrhea? - ✔✔involve the ovary & are often
linked w/genetic abnormalities. These include gonadal dysgenesis (Turner syndrome), &
androgen insensitivity syndrome. Turner syndrome results in the ovaries lacking gametes &
ovarian failure. W/o primitive gametes & follicles, follicular development & estrogen secretion
cannot occur. Lack of estrogen accounts for failure of secondary sex characteristic development
& amenorrhea, although there are high levels of circulating FSH and LH.
What are compartment I disorders of primary amenorrhea? - ✔✔anatomic defects of the
outflow tract associated w/ primary amenorrhea. They include congenital absence of the vagina
& uterus & congenital uterine hypoplasia (infantile uterus). Genetically normal females w/o a
uterus or vagina usually have normal ovarian function. skeletal growth occurs & secondary sex
characteristics develop in the proper sequence, but menstruation does not occur b/c the uterus
is too small or malformed to produce substantial endometrium.
, What is etiology of secondary amenorrhea? - ✔✔triggered by dramatic wt loss, thyroid
disorders, hyperprolactinemia, HPO interruption secondary to excessive exercise, stress, wt
loss, and PCOS
When does secondary amenorrhea occur? - ✔✔common during early adolescence and the
perimenopausal period, pregnancy, and lactation.
What are clinical manifestations of secondary amenorrhea? - ✔✔the absence of menses after
previous menstrual periods. Infertility, vasomotor flushes, vaginal atrophy, acne, osteopenia,
and hirsutism (abnormal hairiness) also may be present.
What is the pathophysiology of secondary amenorrhea? - ✔✔In women w/normal ovarian
steroid hormone levels, may be caused by structural abnormalities (müllerian anomalies),
Asherman syndrome (removal of the endometrial decidua basalis), or removal of the uterus. In
women w/elevated ovarian steroid hormone levels, inhibited ovulation leads to amenorrhea.
What are clinical manifestations of abnormal bleeding? - ✔✔unpredictable & variable bleeding.
Especially during perimenopause, abnormal bleeding also may involve greatly inc menstrual
flow & the passage of large clots, leading to excessive blood loss. Excessive bleeding can lead to
iron deficiency anemia & associated symptoms (fatigue, shortness of breath).
What is the incidence of abnormal bleeding? - ✔✔may occur at any time during the
reproductive years, 20% of cases occur in adolescents, & more than 50% of cases occur in
perimenopausal women ages 40 to 50 years b/c women at the edges of the reproductive years
are more likely to ovulate irregularly
What is the pathophysiology of abnormal bleeding? - ✔✔Due to lack of bleeding. Disruptions in
the reproductive cycle can affect the amount & structure of the uterine endometrium, causing
it to shed irregularly or heavily.
Verified Answers
What is PMS? - ✔✔the cyclic recurrence (in the luteal phase of the menstrual cycle) of
distressing physical, psychologic, or behavioral changes that impair interpersonal relationships
or interfere with usual activities.
When does PMS occur? - ✔✔Always occurs cyclically before the onset of menstruation, not
present at other times of the month
What are s/s of PMS? - ✔✔extremely variable even from one cycle to another, breast
tenderness, edema, bloating, binge eating, headache, dizziness, mood swings
What is primary dysmenorrhea? - ✔✔painful menstruation associated with the release of
prostaglandins in ovulatory cycles, but not with pelvic disease.
What is the incidence of primary dysmenorrhea? - ✔✔Approximately 50% of all women
experience dysmenorrhea, 10% of whom are incapacitated for 1 to 3 days because of pain
severity.
When does primary dysmenorrhea occur? - ✔✔usually begins with the onset of ovulatory
cycles, around age 15 or 16 years with prevalence highest during adolescence.
What is secondary dysmenorrhea? - ✔✔related to pelvic pathology (i.e., ovarian cysts,
endometriosis) which manifests in later reproductive years and may occur any time in the
menstrual cycle.
What are s/s of primary dysmenorrhea? - ✔✔starts 12-24 hrs before menses, rarely lasts more
than 2 days, lower abd pain radiating to lower back/upper thighs, nausea, diarrhea, fatigue,
headache
,What is the epidemiology of secondary dysmenorrhea? - ✔✔begins age 30-40 after previous
pain-free menses
What are s/s of secondary dysmenorrhea? - ✔✔unilateral, constant pain that lasts longer than
2 days, can have painful intercourse, painful defecation, or irregular bleeding
What is the pathophysiology of primary dysmenorrhea? - ✔✔Women w/ painful periods
produce 10x as much PGF2α, a potent myometrial stimulant & vasoconstrictor, as
asymptomatic women. Elevated levels of PGs cause uterine hypercontractility, dec bf to the
uterus, & inc nerve hypersensitivity, thus resulting in pain. Women may have up-regulated COX
enzyme activity, which contributes to inc synthesis of PGs. leukotriene production is elevated
further contributing to inc levels of pain. PGs are primarily released during the first 48 hrs of
menstruation, when symptoms are the most intense.
What is the pathophysiology of secondary dysmenorrhea? - ✔✔results from disorders such as
endometriosis, endometritis, PID, obstructive uterine or vaginal anomalies, uterine fibroids,
polyps, tumors, ovarian cysts, pelvic congestion syndrome, or non-hormonal IUDs.
What are diff causes of abnormal bleeding across ages? - ✔✔Young - SAB, ectopic pregnancy,
clotting disorders. 30s/40s - leiomyomas (fibroids), endometrial polyps. Old - endometrial
cancer
What is amenorrhea? - ✔✔lack of menstruation
What is the etiology of amenorrhea? - ✔✔the most common causes are hypothalamic
dysfunction, PCOS, hyperprolactinemia, and ovarian failure.
What is primary amenorrhea? - ✔✔the failure of menarche & the absence of menstruation by
age 13 years w/o the development of secondary sex characteristics or by age 15 regardless of
the presence of secondary sex characteristics
,What is secondary amenorrhea? - ✔✔the absence of menstruation for a time equivalent to 3 or
more cycles in women who have previously menstruated
How often does the endometrial lining need to shed? - ✔✔4-6 times/yr
What are compartment IV disorders of primary amenorrhea? - ✔✔include CNS disorders, in
particular hypothalamic disorders. In some of the congenital syndromes, the HPO axis is
dysfunctional. The hypothalamus is unable to synthesize GnRH, so the pituitary fails to secrete
LH & FSH. Therefore, the ovary does not receive the hormonal signals required to stimulate
estrogen production, & ovulation & menstruation do not occur. B/c the ovarian hormones are
absent, estrogen-dependent sex characteristics do not develop.
What are compartment III disorders of primary amenorrhea? - ✔✔disorders of the anterior
pituitary, including tumors. Some anatomic defects of the CNS, whether congenital or acquired,
impinge on the hypothalamic- pituitary unit so as to interfere w/or interrupt the secretion of
GnRH or FSH & LH. Ex of such defects include hydro- cephalus, craniopharyngiomas, & other
space-occupying lesions of the CNS. the ovary does not receive the necessary signals, &
ovulation & menstruation do not occur. In some cases these lesions develop b/t the onset &
conclusion of puberty. skeletal growth may occur & secondary sex characteristics may develop,
but sexual maturation is interrupted before menarche.
What are compartment II disorders of primary amenorrhea? - ✔✔involve the ovary & are often
linked w/genetic abnormalities. These include gonadal dysgenesis (Turner syndrome), &
androgen insensitivity syndrome. Turner syndrome results in the ovaries lacking gametes &
ovarian failure. W/o primitive gametes & follicles, follicular development & estrogen secretion
cannot occur. Lack of estrogen accounts for failure of secondary sex characteristic development
& amenorrhea, although there are high levels of circulating FSH and LH.
What are compartment I disorders of primary amenorrhea? - ✔✔anatomic defects of the
outflow tract associated w/ primary amenorrhea. They include congenital absence of the vagina
& uterus & congenital uterine hypoplasia (infantile uterus). Genetically normal females w/o a
uterus or vagina usually have normal ovarian function. skeletal growth occurs & secondary sex
characteristics develop in the proper sequence, but menstruation does not occur b/c the uterus
is too small or malformed to produce substantial endometrium.
, What is etiology of secondary amenorrhea? - ✔✔triggered by dramatic wt loss, thyroid
disorders, hyperprolactinemia, HPO interruption secondary to excessive exercise, stress, wt
loss, and PCOS
When does secondary amenorrhea occur? - ✔✔common during early adolescence and the
perimenopausal period, pregnancy, and lactation.
What are clinical manifestations of secondary amenorrhea? - ✔✔the absence of menses after
previous menstrual periods. Infertility, vasomotor flushes, vaginal atrophy, acne, osteopenia,
and hirsutism (abnormal hairiness) also may be present.
What is the pathophysiology of secondary amenorrhea? - ✔✔In women w/normal ovarian
steroid hormone levels, may be caused by structural abnormalities (müllerian anomalies),
Asherman syndrome (removal of the endometrial decidua basalis), or removal of the uterus. In
women w/elevated ovarian steroid hormone levels, inhibited ovulation leads to amenorrhea.
What are clinical manifestations of abnormal bleeding? - ✔✔unpredictable & variable bleeding.
Especially during perimenopause, abnormal bleeding also may involve greatly inc menstrual
flow & the passage of large clots, leading to excessive blood loss. Excessive bleeding can lead to
iron deficiency anemia & associated symptoms (fatigue, shortness of breath).
What is the incidence of abnormal bleeding? - ✔✔may occur at any time during the
reproductive years, 20% of cases occur in adolescents, & more than 50% of cases occur in
perimenopausal women ages 40 to 50 years b/c women at the edges of the reproductive years
are more likely to ovulate irregularly
What is the pathophysiology of abnormal bleeding? - ✔✔Due to lack of bleeding. Disruptions in
the reproductive cycle can affect the amount & structure of the uterine endometrium, causing
it to shed irregularly or heavily.
