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.

Nursing Test Bank

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. This open-ended question allows the client to describe the reason for their visit in their own words, which can provide a broad range of information about their current concerns or symptoms. It encourages the client to share specific issues or problems they are experiencing since the surgery, which could include pain, complications, or other concerns.
B. While this question is important for assessing one aspect of the client’s postoperative condition, it is somewhat narrow. It focuses specifically on pain, which is only one possible postoperative issue. This question does not capture other potential concerns such as functional problems, wound healing, or systemic symptoms.
C. Knowing the type of surgery is important for understanding the client’s medical background and specific postoperative considerations. However, this question may not provide immediate information about the client’s current condition or why they are seeking follow-up care.
D. This question helps establish a timeline and can be useful for understanding the postoperative phase and assessing healing progress. However, it does not directly address the client's current symptoms or concerns. Knowing the timing of the surgery alone does not provide comprehensive information about the client's present condition or reasons for the visit.

A. Dyspnea. B. Peripheral edema. C. Intercostal retractions. D. Headaches. E. Jugular venous distension.

Correct Answer is ["A","B","E"]

Explanation

A. Dyspnea, or shortness of breath, is a common symptom of heart failure exacerbation. It occurs because the heart is unable to effectively pump blood, leading to pulmonary congestion and fluid accumulation in the lungs. This symptom is significant in confirming an exacerbation of heart failure.
B. Peripheral edema, or swelling of the legs and ankles, is another common sign of heart failure exacerbation. It results from fluid buildup due to the heart's decreased ability to manage blood volume effectively. This finding is indicative of fluid retention and can confirm an exacerbation of heart failure.
C. Intercostal retractions are typically seen in respiratory distress, especially in conditions affecting the lungs or severe respiratory conditions. While they can occur with severe pulmonary congestion in heart failure, they are more directly associated with respiratory issues rather than specifically confirming heart failure exacerbation.
D. Headaches are not a typical or primary symptom of heart failure exacerbation. They can be associated with various conditions but are not specific to heart failure. This symptom is less relevant in confirming an exacerbation of heart failure.
E. Jugular venous distension is a classic sign of right-sided heart failure or fluid overload. It occurs when there is increased pressure in the venous system due to the heart's inability to handle blood volume effectively.

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Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who recently underwent a routine surgical procedure made a dinic appointment. To elicit the most information, which question is best for the nurse to ask this client?

Correct Answer is A

Explanation

An older adult client with a history of heart failure (HF) is brought to the clinic by a family member. Which finding(s) confirm to the nurse that the client is experiencing an exacerbation of the HP? Select all that apply.

Correct Answer is ["A","B","E"]

Explanation

The nurse is assessing an ulcer on a client's lower extremity, which is likely the result of either venous or arterial insufficiency. Which assessment technique should the nurse use to differentiate the pathophysiology causing the ulcer?

During a routine health screening of an adult female, the nurse notes several changes that have occurred over the past year. Which change indicates the need for a bone density screening?

The nurse assesses a male client who is brought to the emergency department (ED) by his family who believes he is having a heart attack. Which finding is the best indicator that a client is experiencing an acute myocardial infarction (AMI)?

Which finding should raise the greatest concern for a nurse who is performing an ear nose and throat (ENT) examination?

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?

The nurse is assessing older clients in a community health clinic. Which assessment finding is an indicator for immediate medical follow-up?

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?