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Nursing Test bank:Lowdermilk 12 edition.ch-6

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The document covers key topics such as Amenorrhea, dysmnorrhoea, hormonal imbalances and patient counseling strategies offering clear rationales ideal for exam prep and nursing study review

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Nursing Test bank:Lowdermilk 12
edition.ch-6
1. Which condition is the least likely cause of amenorrhea in a 17-year-old client?
a. Anatomic abnormalities
b. Type 1 diabetes mellitus
c. Obesity
d. Pregnancy - ANS>>ANS: C
A moderately obese adolescent (20% to 30% above ideal weight) may have early onset
menstruation. Girls who regularly exercise before menarche can have delayed onset of
menstruation to age 18 years. Anatomic abnormalities are a possible cause of
amenorrhea. Type 1 diabetes mellitus is a possible cause of amenorrhea. Pregnancy is
the most common cause of amenorrhea.

2. When a nurse is counseling a woman experiencing primary dysmenorrhea, which
nonpharmacologic intervention might be recommended?
a. Increasing the intake of red meat to replace blood loss b. Reducing the intake of
diuretic foods, such as peaches and asparagus
c. Temporarily substituting physical activity for a sedentary lifestyle
d. Using a heating pad on the abdomen to relieve cramping - ANS>>ANS: D
Heat minimizes cramping by increasing vasodilation and muscle relaxation and
minimizing uterine ischemia. Dietary changes such as a low-fat vegetarian diet may be
recommended for women experiencing dysmenorrhea. Increasing the intake of
diuretics, including natural diuretics such as asparagus, cranberry juice, peaches,
parsley, and watermelon, may help ease the symptoms associated with dysmenorrhea.
Exercise has been found to help relieve menstrual discomfort through increased
vasodilation and subsequent decreased ischemia

3. Nafarelin is used to treat mild-to-severe endometriosis. What instruction or
information should the nurse provide to a client regarding nafarelin administration?
a. Nafarelin stimulates the secretion of gonadotropin-releasing hormone (GnRH),
thereby stimulating ovarian activity.
b. It should be administered by intramuscular (IM) injection.
c. Nafarelin should be administered by a subcutaneous implant.
d. It can cause the client to experience some hot flashes and vaginal dryness. -
ANS>>ANS: D
Nafarelin is a GnRH agonist, and its side effects are similar to those of menopause. The
hypoestrogenism effect results in hot flashes and vaginal dryness. Nafarelin is a GnRH
agonist that suppresses the secretion of GnRH. Nafarelin is administered twice daily by
nasal spray and can be intranasally administered. Leuprolide is given once per month
by IM injection. Goserelin is administered by subcutaneous implant.

, 4. While interviewing a 31-year-old woman before her routine gynecologic examination,
the nurse collects data about the client's recent menstrual cycles. Which statement by
the client should prompt the nurse to collect further information?
a. "My menstrual flow lasts 5 to 6 days."
b. "My flow is very heavy."
c. "I have had a small amount of spotting midway between my periods for the past 2
months."
d. "The length of my menstrual cycles varies from 26 to 29 days." - ANS>>ANS: B
Menorrhagia is defined as excessive menstrual bleeding, either in duration or in
amount. Heavy bleeding can have many causes. The amount of bleeding and its effect
on daily activities should be evaluated. A menstrual flow that lasts 5 to 6 days is a
normal finding. Mittlestaining, a small amount of bleeding or spotting that occurs at the
time of ovulation (14 days before the onset of the next menses), is considered normal.
During her reproductive years, a woman may have physiologic variations in her
menstrual cycle. Variations in the length of a menstrual cycle are considered normal

5. A 21-year-old client reports experiencing severe pain immediately after the
commencement of her menses. Which gynecologic condition is the most likely cause of
this client's presenting symptoms?
a. Primary dysmenorrhea
b. Secondary dysmenorrhea
c. Dyspareunia
d. Endometriosis - ANS>>ANS: A
Primary dysmenorrhea, or pain during or shortly before menstruation, has a biochemical
basis and arises from the release of prostaglandins with menses. Secondary
dysmenorrhea develops after the age of 25 years and is usually associated with a pelvic
pathologic condition. Dyspareunia, or painful intercourse, is commonly associated with
endometriosis. Endometriosis is characterized by endometrial glands and stoma outside
of the uterus.

6. Which symptom described by a client is characteristic of premenstrual syndrome
(PMS)?
a. "I feel irritable and moody a week before my period is supposed to start."
b. "I have lower abdominal pain beginning on the third day of my menstrual period."
c. "I have nausea and headaches after my period starts, and they last 2 to 3 days."
d. "I have abdominal bloating and breast pain after a couple days of my period." -
ANS>>ANS: A
PMS is a cluster of physical, psychologic, and behavioral symptoms that begin in the
luteal phase of the menstrual cycle and resolve within a couple of days of the onset of
menses. Complaints of lower abdominal pain, nausea and headaches, and abdominal
bloating all are associated with PMS; however, the timing reflected is inaccurate.

7. 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 and has tried unsuccessfully to become pregnant
for the past 18 months. To which condition are these symptoms most likely related?
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