A woman complains of severe abdominal and pelvic pain around the time of menstruation that has gotten worse over the last 5 years. She also complains of pain during intercourse and has tried unsuccessfully to get pregnant for the past 18 months. These symptoms are most likely related to:
primary dysmenorrhea.
endometriosis.
secondary dysmenorrhea.
PMS.
The Correct Answer is B
Choice A reason: This is incorrect because primary dysmenorrhea is menstrual pain that is not associated with any underlying condition. It usually begins with the onset of menstruation and lasts for a few days. It does not cause pain during intercourse or infertility.
Choice B reason: This is correct because endometriosis is a condition where the endometrial tissue that normally lines the uterus grows outside the uterus, such as on the ovaries, fallopian tubes, or pelvic organs. It causes chronic inflammation, scarring, and adhesions that can result in severe pain during menstruation and intercourse, as well as infertility.
Choice C reason: This is incorrect because secondary dysmenorrhea is menstrual pain that is caused by an underlying condition, such as fibroids, pelvic inflammatory disease, or adenomyosis. It usually develops later in life and lasts longer than primary dysmenorrhea. It may or may not cause pain during intercourse or infertility, depending on the condition.
Choice D reason: This is incorrect because PMS stands for premenstrual syndrome, which is a group of physical and emotional symptoms that occur before menstruation. It may include mood swings, irritability, bloating, headaches, or breast tenderness. It does not cause severe pain during menstruation or intercourse, or infertility.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is not a good intervention, as it may worsen the symptoms of faintness, dizziness, and agitation. Standing up can cause a sudden drop in blood pressure (orthostatic hypotension), which can reduce the blood flow to the brain and the fetus. This can cause lightheadedness, blurred vision, and loss of consciousness in the woman, as well as fetal distress or hypoxia.
Choice B reason: This is not a good intervention, as it may also worsen the symptoms of faintness, dizziness, and agitation. Lying supine can cause compression of the inferior vena cava (a large vein that returns blood to the heart) by the gravid uterus, which can reduce the cardiac output (the amount of blood pumped by the heart) and the blood pressure. This can cause nausea, sweating, and visual disturbances in the woman, as well as fetal distress or hypoxia.
Choice C reason: This is not a good intervention, as it may not improve the symptoms of faintness, dizziness, and agitation. Sitting down and holding the arm in a dependent position can lower the blood pressure in the arm, but not in the rest of the body. This can cause inaccurate readings of the blood pressure and delay the detection of hypotension or hypertension. This can also cause discomfort and pain in the arm due to impaired circulation.
Choice D reason: This is the best intervention, as it can relieve the symptoms of faintness, dizziness, and agitation by improving the blood flow to the brain and the fetus. Turning to the left side can reduce the pressure of the uterus on the inferior vena cava and increase the cardiac output and the blood pressure. This can also optimize the placental perfusion (the blood flow to the placenta) and the fetal oxygenation.
Correct Answer is D
Explanation
Choice A reason: Cramping is a common symptom of pregnancy, especially in the third trimester, due to the stretching of the ligaments and muscles that support the uterus. It is not a specific sign of abruptio placentae, which is the premature separation of the placenta from the uterine wall.
Choice B reason: Uterine activity is a normal phenomenon of pregnancy, as the uterus contracts and relaxes periodically. It is not a specific sign of abruptio placentae, which is associated with increased uterine tone and tenderness.
Choice C reason: Bleeding is a possible sign of both abruptio placentae and placenta previa, which is the implantation of the placenta over or near the cervical os. However, bleeding is more common and severe in placenta previa than in abruptio placentae, as the latter can have concealed hemorrhage.
Choice D reason: Intense abdominal pain is the most prevalent clinical manifestation of abruptio placentae, as the blood accumulates behind the placenta and causes pressure and irritation of the uterine nerves. It is a distinguishing sign from placenta previa, which is usually painless.
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