A 49-year-old woman tells the nurse that she is postmenopausal but has occasional spotting. Which initial response by the nurse is most appropriate?
a. "A frequent cause of spotting is endometrial cancer."
b. "How long has it been since your last menstrual period?"
c. "Breakthrough bleeding is not unusual in women your age."
d. "Are you using prescription hormone replacement therapy?"
ANS: D
In postmenopausal women, a common cause of spotting is hormone therapy (HT). Because breakthrough bleeding may be a sign of problems such as cancer or infection, the nurse would not imply that this is normal. The length of time since the last menstrual period is not relevant to the patient's symptoms. Although endometrial cancer may cause spotting, this information is not appropriate as an initial response.
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