A 22-year-old tells the nurse that she has not had a menstrual ...

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A 22-year-old tells the nurse that she has not had a menstrual period for the last 2 months. Which action is most important for the nurse to take?
 
  a. Obtain a urine specimen for a pregnancy test.
  b. Ask about any recent stressful lifestyle changes.
  c. Measure the patient's current height and weight.
  d. Question the patient about prescribed medications.

Question 2

The nurse has just received change-of-shift report about the following four patients. Which patient should be assessed first?
 
  a. A patient with a cervical radium implant in place who is crying in her room
  b. A patient who is complaining of 5/10 pain after an abdominal hysterectomy
  c. A patient with a possible ectopic pregnancy who is complaining of shoulder pain
  d. A patient in the fifteenth week of gestation who has uterine cramping and spotting

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Answer to Question 1

ANS: A
Pregnancy should always be considered a possible cause of amenorrhea in women of childbearing age. The other actions are also appropriate, but it is important to check for pregnancy in this patient because pregnancy will require rapid implementation of actions to promote normal fetal development such as changes in lifestyle, folic acid intake, etc.

Answer to Question 2

ANS: C
The patient with the ectopic pregnancy has symptoms consistent with rupture and needs immediate assessment for signs of hemorrhage and possible transfer to surgery. The other patients should also be assessed as quickly as possible but do not have symptoms of life-threatening complications.