A young woman experienced signs of secondary sexual development (puberty) beginning at age 12. She is now approaching her 17th birthday but has not yet begun menstruating. What is the clinic nurse’s best response?

Correct Answer: C

Rationale: The correct answer is C. Given the young woman's delayed menarche despite signs of secondary sexual development, further assessment is warranted to rule out any underlying medical conditions affecting her menstrual cycle. This approach ensures appropriate evaluation and potential intervention if necessary. A: Incorrect. While reassuring, it overlooks the need for a thorough assessment in this scenario. B: Incorrect. Prematurely alarming the individual about future fertility issues without proper evaluation is unwarranted. D: Incorrect. While some young women may be "late bloomers," it is essential to verify this through a professional assessment to rule out any underlying issues.

Correct Answer: B

Rationale: The correct answer is B: Progesterone. On the 15th day of the menstrual cycle, the woman would have ovulated, leading to the release of the egg and the formation of the corpus luteum. The corpus luteum produces progesterone, which causes an increase in basal body temperature. FSH (A) is responsible for stimulating the growth of ovarian follicles, not the temperature increase. Estrogen (C) levels peak before ovulation but do not cause the post-ovulation temperature rise. Prostaglandin (D) is involved in various physiological processes but not directly related to the basal temperature increase post-ovulation.

Correct Answer: B

Rationale: The correct answer is B: dysmenorrhea. Dysmenorrhea refers to painful menstrual cramps that can be severe enough to interfere with daily activities like work. This condition is common and can be caused by increased prostaglandin levels leading to uterine contractions. Amenorrhea (A) is the absence of menstruation, not painful cramps. Premenstrual syndrome (C) involves a variety of physical and emotional symptoms before menstruation, but not necessarily severe cramps. Abnormal uterine bleeding (D) refers to irregular or excessive bleeding, not specifically related to cramps.

Correct Answer: A

Rationale: The correct answer is A: oral contraceptives. Oral contraceptives are commonly prescribed for managing endometriosis by regulating the menstrual cycle and reducing symptoms. They help control estrogen levels, which can alleviate pain and inflammation associated with endometriosis. Selective serotonin inhibitors (B) are used for treating depression and anxiety, not endometriosis. Dopamine agonists (C) are used for conditions like Parkinson's disease and hyperprolactinemia, not endometriosis. Bisphosphonates (D) are used to treat osteoporosis, not endometriosis. Therefore, oral contraceptives are the most appropriate medication to discuss with a patient diagnosed with endometriosis.

Correct Answer: D

Rationale: The correct answer is D: bladder fistula. A bladder fistula is an abnormal connection between the bladder and another organ, leading to urine leakage into the vagina. In this case, the continuous wet sensation and urine leakage observed in the vagina indicate a communication between the bladder and the vagina. Pelvic floor prolapse (choice A) can cause urinary incontinence but does not involve direct leakage of urine into the vagina. DES exposure (choice B) is associated with reproductive tract abnormalities but not specifically with urinary incontinence. A vaginal septum (choice C) is a congenital condition where the vagina is divided by a septum, which would not directly cause urine leakage into the vagina.