The nurse is palpating a female patient's adnexa. The findings include a firm, smooth uterine wall; the ovaries are palpable and feel smooth and firm. The fallopian tube is firm and pulsating. The nurse's most appropriate course of action would be to:

Correct Answer: B

Rationale: The correct answer is B because the findings of a firm, smooth uterine wall, palpable ovaries, and a firm, pulsating fallopian tube are concerning for possible gynecological issues such as ovarian cancer or pelvic inflammatory disease. A prompt referral to a gynecologist is necessary for further evaluation, which may include imaging studies or biopsies to rule out serious conditions. Choice A is incorrect as the findings are not normal. Choice C delays necessary evaluation, potentially leading to a progression of any underlying condition. Choice D assumes the presence of an ovarian cyst without further investigation, which is not appropriate given the pulsating fallopian tube and the need for a comprehensive assessment by a specialist.

Correct Answer: A

Rationale: The correct answer is A because fibroids typically present as an enlarged, irregular uterus that may be tender to palpation. Fibroids are non-cancerous growths in the uterus that can cause abnormal bleeding and pelvic pain. The irregular shape and tenderness are characteristic findings of fibroids. Option B is incorrect because fibroids are not typically smooth and do not have smooth contours. Option C is incorrect because fibroids are not usually smooth and tender. Option D is incorrect because fibroids are not soft or mobile; they are usually firm and fixed in place within the uterus.

Correct Answer: B

Rationale: The correct answer is B: Pelvic pain that worsens during menstruation. This is because endometriosis is characterized by the presence of endometrial-like tissue outside the uterus, leading to inflammation and pain in the pelvic region. The pain typically worsens during menstruation due to the shedding of this tissue, causing irritation and further inflammation. A: Pain during menstruation is a common symptom, but what distinguishes endometriosis is the worsening of pain during menstruation. C: Pain during ovulation is not a typical symptom of endometriosis. While some individuals may experience pain during ovulation, it is not the most common symptom. D: Heavy bleeding during menstruation can occur in endometriosis, but it is not the most common symptom. Pelvic pain that worsens during menstruation is the hallmark symptom of endometriosis.

Correct Answer: B

Rationale: The correct answer is B: Creatinine. Creatinine is a waste product produced by muscle metabolism and is filtered by the nephrons in the kidneys. It is then secreted into the filtrate and eventually excreted in the urine. A: Amino Acids are reabsorbed by the nephrons, not secreted. C: Sodium is primarily reabsorbed by the nephrons to maintain electrolyte balance. D: Glucose is normally completely reabsorbed by the nephrons unless there is a medical condition such as diabetes where it may be found in the urine.

Correct Answer: A

Rationale: The correct answer is A: Renal pelvis. The upper expanded region of the ureter is called the renal pelvis, which is where the major calyces converge to collect urine before it travels down the ureter. The other choices are incorrect: B) Renal papilla is the tip of the renal pyramid where urine is collected before entering the minor calyx, C) Renal pyramids are the conical structures in the renal medulla that contain the nephrons, and D) Renal cortex is the outer region of the kidney where the nephrons are located.