Correct Answer: D

Rationale: Self-care management for this client includes instructions to dilate the new vagina several times a day for months after the procedure, using water-based lubricant. The client also needs to douche regularly, especially after intercourse, to avoid infections. Sexual intercourse is another way to keep the vagina dilated.

Correct Answer: C

Rationale: A red, swollen calf could be a manifestation of a deep vein thrombosis, a known side effect of estrogen. The nurse reports this finding immediately. The other manifestations are also side effects of estrogen, but do not need to be reported as a priority.

Correct Answer: A

Rationale: Ice is applied to the perineum to reduce pain and discomfort. Elevating the legs on pillows is not recommended after a lengthy procedure in the lithotomy position, which predisposes the client to venous thromboembolism.

Correct Answer: A,B,C

Rationale: Gender dysphoria is emotional distress caused by the incongruence between natal sex (sex assigned at birth) and gender identity. Gender queer is a label sometimes used by people whose gender identity does not fit within the binary of male or female. Natal sex refers to the sex assigned at birth. The term 'transition' in the provided options is incorrect as it refers to the process of changing one's gender presentation or physical characteristics to align with gender identity, not establishing a sexual identity. Gender fluid is a valid term for a gender identity that can shift over time, but it was not part of the original options.

Correct Answer: C

Rationale: Spironolactone is a potassium-sparing diuretic, and hyperkalemia can cause cardiac dysrhythmias. The nurse's priority is to obtain an ECG, then to facilitate a serum potassium level being drawn. Having the client sit down and obtaining vital signs are also important care measures, but do not take priority.