Which of the following female clients has the greatest risk for uterine fibroids?
  1. A 30-year-old Chinese American who has a BMI of 30 and smokes 2 packs of cigarettes a day.
  2. A 43-year-old Caucasian who has a BMI of 32 and smokes 2 packs of cigarettes daily.
  3. A 25-year-old Black American who has a BMI of 32; cigarette smoking is denied.
  4. A 25-year-old of Meditteranean descent who has a BMI of 30; cigarette smoking is denied.
Explanation
Answer: C - The 25-year-old Black American who has a BMI of 32 and denies cigarette smoking has the greatest risk for uterine fibroids. The risk factors for uterine fibroids include: obesity, pregnancy, race (Black women are more likely to have fibroids) and heredity. Research has revealed that smoking is associated with low occurrence of uterine fibroids. This is most likely due to the lowering effect of smoking on the bioavailability of estrogen.
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