UPUMS Nsg.Officer-2024
Obstetrics & Gynaecology
Easy
Premenstrual syndrome (PMS) has a constellation of possible symptoms. Which of the following would NOT be expected?
Appeared in: UPUMS Nsg.Officer-2024
Explanation
- Weight loss is not a characteristic symptom of Premenstrual Syndrome (PMS).
- Conversely, weight gain is a common complaint due to fluid retention, which is triggered by hormonal fluctuations during the luteal phase.
- The interaction of sex steroids with the renin-angiotensin-aldosterone system leads to increased fluid and salt retention, causing bloating and weight gain.
- Therefore, weight loss is the symptom that would NOT be expected in a patient with PMS.
Why Other Options Were Wrong
- Option B: Breast tenderness is a classic somatic (physical) symptom of PMS, directly linked to hormonal fluctuations and fluid retention in breast tissue.
- Option C: Abdominal bloating is one of the most frequently reported physical symptoms of PMS, caused by systemic fluid retention.
- Option D: Anxiety is a common affective (psychological) symptom of PMS. Hormonal shifts can alter levels of neurotransmitters like serotonin and GABA, leading to increased anxiety, irritability, and mood swings.
Related Visual
Clinical Relevance
- Nursing practice connection: Use the key finding related to Clinical manifestations of Premenstrual Syndrome (PMS) to guide bedside assessment, documentation, and the next nursing action.
- Accurate identification of PMS symptoms is crucial for nurses to provide appropriate patient education on management strategies, such as dietary changes (reducing salt to minimize fluid retention), regular exercise, and stress management.
- Recognizing the typical symptom cluster helps differentiate PMS from more severe conditions like Premenstrual Dysphoric Disorder (PMDD) or other underlying psychiatric or medical issues that require different interventions.
- What if? If a patient with suspected PMS reports significant, unintentional weight loss instead of gain, the nurse should recognize this as a red flag. This warrants a recommendation for further medical evaluation to rule out other conditions such as hyperthyroidism, an eating disorder, or malignancy.
How to Approach the Question
- First, identify the core concept of the question, which is the symptoms of Premenstrual Syndrome (PMS).
- Pay close attention to the negative keyword 'NOT'. This indicates you must find the option that is inconsistent with a PMS diagnosis.
- Recall the common physical and psychological symptoms of PMS. The underlying pathophysiology involves hormonal fluctuations leading to fluid retention and mood changes.
- Systematically evaluate each option against your knowledge of PMS. Breast tenderness, abdominal bloating, and anxiety are all well-documented symptoms.
- Analyze the 'Weight loss' option. Since fluid retention is a key feature of PMS, it typically causes weight gain, not loss.
- Conclude that weight loss is the outlier and therefore the correct answer to this 'NOT' question.
Concept Tested & Keywords
- Concept Tested: Clinical manifestations of Premenstrual Syndrome (PMS)
- Stem keywords: Premenstrual syndrome, PMS, symptoms
- Lead-in keywords: NOT
- Negative lead-in flag: Question asks for an exception (NOT expected symptom).
Question ID
Q60t9TI72AgX-z0JARNis
Reference Book
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 8416-8418
E6 Gynecology Williams p. 321-394
Practise the full UPUMS Nsg.Officer-2024
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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