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2022 NAMS Nursing Diagnosis Certification Exam With Answers (114 Solved Questions)

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    NAMS Certification Exam 2022 1. Early Menopause FMP before age 45 2. Late Menopause FMP after age 54 3. Bilateral oophorectomy prior to age 45 increases risks for: - All cause mortality - Coronary heart disease - CVD - Menopause symptoms - Worsening mood symptoms - Higher incidence of Parkinson Disease - Associated with cognitive impairment 4. Early Menopause Transition (-2) 7 or more days persistent difference in cycle length from previous normal cycle - Results of increased follicular aging and depletion - Inhibin B decreases - FSH increases (Variable) 5. LOOP Cycles Explains elevation of Estradiol in perimenopause - Rising FSH levels recruit 2nd follicle during luteal phase which leads to overproduction of Estradiol - This causes menstrual changes in future cycles 6. Decreased AMH in Early Menopause Tran- sition More frequent anovulatory cycles 7. Decreased Inhib- in B in Early Menopause Tran- sition - Skipped menstrual cycles - Mastalgia - Migraine - Menorrhagia (with LOOP cycles) - Endometrial Hyperplasia 8. Late Menopause Transition (-1) 60 or more days of amenorrhea for women aged 45 years or older - Women 40-44 years with recurrent episodes of amenor- rhea of 60 day for longer within a year improves prediction of entry into late menopause transition 1 / 13

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    9. Late Menopause Transition (-1) Duration 1-3 years 10. Late Menopause Transition (-1) Symptoms VMS likely 11. STRAW Stage where FSH > 25 Late Menopause Transition (-1) 12. Elevated FSH symptoms in Late Menopause Transition - VMS - Sleep disturbance - Changes in weight distribution - Increased variability in cycle length 13. Decreased Inhib- in B in Late Menopause Tran- sition - Mood changes - Cognitive complaints - Changes in sexual functioning - Increased prevalence of anovulation 14. Decreased AMH in Late Menopause Tran- sition - GSM - Bone loss - CVD issues - Interval of amenorrhea > 60 days 15. POI Menopause before age 40 16. POI diagnosis - Oligomenorrhea or amenorrhea x 4 months - FSH > 25 on two occasions at least 4 weeks apart 17. POI Symptoms - Hot flashes - Mood changes - depression - Insomnia - Vaginal dryness, dyspareunia 18. POI Management HT until average of menopause 19. 2 / 13

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    Early Menopause Risks (natural or surgical) - CVD - Low bone density - Memory for verbal information compromised - Low libido due to decreased testosterone - Depression due to fertility 20. Ovarian Reserve Lab - Antral follicle count & AMH 21. Secondary Amenorrhea differential with low FSH - Pregnancy - Hypothalamic amenorrhea (e.g., Diabetes, celiac dis- ease, excessive exercise/caloric restriction, stress, le- sions of hypothalamus/pituitary) - Hyperprolactinemia - Thyroid disease - PCOS 22. Adrenal Insuffi- ciency - Hypofunction of adrenal gland and pituitary gland - Diagnosed by low cortisol at baseline - Treatment includes glucocorticoid replacement 23. Female Pattern Hair Loss (FPHL) - Gradual hair thinning on crown of scalp - Occurs due to altered estrogen-to-androgen ratio - Sometimes seen with discontinuation of HT 24. Telogen Effluvi- um (TE) - Sudden hair shedding - Patchy hair loss - Occurs after a major life stressor, chronic illness, or medication (beta blocker, anticoagulant) 25. Hair Loss Treat- ment Goal: Prevent progression of hair loss - Minoxidil is FDA approved - Commonly used with Finasteride or Spironolactone 26. Window of Vul- nerability Idea that women are exposed to hormone-related mood symptoms (e.g., PMS, PPD) 27. HT and Mood - Consider if VMS and mood changes - Only consider if in perimenopause or early post- menopausal 3 / 13

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