National Board of Chiropractic Examiners (NBCE) Practice Test

A multiparous female who experiences urination upon coughing or sneezing should be evaluated for which condition?

1. Uterine prolapse

2. Pelvic inflammatory disease

3. Stress urinary incontinence

4. Endometriosis

The correct answer is: Uterine prolapse

The scenario describes a multiparous female who experiences involuntary urination when coughing or sneezing, which is a classic symptom of stress urinary incontinence. This condition is characterized by the involuntary leakage of urine in situations that increase abdominal pressure, such as physical activity, laughter, or sneezing. Stress urinary incontinence is often associated with childbirth, particularly in women who have had multiple pregnancies (multiparous) and deliveries. The pelvic floor muscles and connective tissue can become weakened due to the strain of pregnancy and childbirth, leading to a decrease in the bladder's support and subsequent leakage. While uterine prolapse, pelvic inflammatory disease, and endometriosis are relevant gynecological conditions, they do not primarily present with the symptom of involuntary urination upon coughing or sneezing. Uterine prolapse may lead to urinary symptoms but is typically characterized by a sensation of heaviness in the pelvic area. Pelvic inflammatory disease often presents with pain and fever rather than incontinence. Endometriosis primarily causes pain and is associated with menstrual irregularities rather than urinary symptoms alone. Thus, the best evaluation for the described scenario is for stress urinary incontinence due to its direct correlation with childbirth and the specific symptom of urinary leakage during physical exert