A 50-year-old woman calls the clinic because she has noticed some changes in her body and breasts and wonders if these changes could be attributable to the hormone replacement therapy (HRT) she started 3 months earlier. The nurse should tell her:

Correct Answer: B

Rationale: The correct answer is B because hormone replacement therapy (HRT) commonly causes side effects such as fluid retention, breast tenderness, and vaginal bleeding. This information is important for the nurse to communicate to the patient, as it aligns with the symptoms the woman is experiencing. Choice A is incorrect as even low doses of HRT can still result in side effects. Choice C is incorrect because vaginal bleeding with HRT is not very unusual and does not necessitate immediate evaluation unless it is severe. Choice D is incorrect as adjusting the dose without proper evaluation could be dangerous and is not the appropriate first step in addressing the patient's concerns.

Correct Answer: B

Rationale: The correct answer is B, placing the girl in a frog-leg position on the examining table. This position provides optimal access and visualization of the external genitalia while ensuring the child's comfort and privacy. Placing the child in the parent's lap (A) may hinder the nurse's ability to perform the examination effectively. The lithotomy position (C) with feet in stirrups is typically used for pelvic exams in older females and may not be necessary for a school-age girl. Lying flat with legs extended (D) would also not provide the necessary access and visibility required for the examination.

Correct Answer: D

Rationale: The correct answer is D because it follows the current guidelines for cervical cancer screening. Starting at age 30, if a woman has had three consecutive normal Pap tests, she can be screened every 2 to 3 years. This is based on the evidence that the risk of cervical cancer is low in women with a history of normal Pap tests. Option A is incorrect as smoking status does not determine Pap test frequency. Option B is incorrect as annual Pap tests are no longer recommended for all women. Option C is incorrect as waiting 5 years between tests is not the standard recommendation based on guidelines.

Correct Answer: C

Rationale: The correct answer is C: Ovarian cysts. Ovarian cysts can cause dysmenorrhea by disrupting the normal menstrual cycle and causing pain. Endometriosis (B) is another common cause of dysmenorrhea, but it involves the abnormal growth of endometrial tissue outside the uterus. Uterine contractions (A) are a normal part of menstruation and may cause cramping but are not the primary cause of dysmenorrhea. PCOS (D) is a hormonal disorder that can cause irregular periods and pain, but it is not the most likely cause of dysmenorrhea in this case.

Correct Answer: B

Rationale: The correct answer is B: Painful urination and frequent bladder infections. Interstitial cystitis is characterized by chronic bladder inflammation causing pain and discomfort during urination. This leads to painful urination and an increased risk of developing frequent bladder infections due to the compromised bladder lining. Severe abdominal cramping (A) is not a common symptom of interstitial cystitis. Frequent urination and pelvic pressure (C) are also common symptoms but not specific to interstitial cystitis. Dysuria and urinary retention (D) are not typically associated with interstitial cystitis.