A client diagnosed with a vaginal fistula is at risk for low self-esteem. Which of the following would be an appropriate recommendation for the client?

Correct Answer: A

Rationale: In the context of a client diagnosed with a vaginal fistula, the correct recommendation of wearing disposable, absorbent incontinence briefs (Option A) is crucial for maintaining their dignity and promoting self-esteem. Vaginal fistulas can cause involuntary leakage of urine or feces, leading to embarrassment and social isolation. By wearing absorbent briefs, the client can manage the leakage discreetly, thus preserving their self-esteem. Option B, avoiding the use of commercial deodorizers at home, is incorrect as it is not directly related to managing the symptoms of a vaginal fistula. Deodorizers may help mask odors but do not address the primary issue of urinary or fecal incontinence. Option C, abstaining from sexual intercourse, is not necessarily a universal recommendation for all clients with vaginal fistulas. While sexual activity may need to be temporarily restricted based on individual circumstances, it is not the primary intervention to address low self-esteem in this case. Option D, avoiding frequent douches, is also not directly related to managing a vaginal fistula. Douching can disrupt the natural vaginal flora and exacerbate any existing vaginal infections but does not directly address the issue of incontinence associated with a fistula. In an educational context, it is essential for healthcare providers to understand the holistic care needs of clients with conditions like vaginal fistulas. Providing appropriate recommendations that prioritize the client's physical and emotional well-being is crucial in promoting optimal outcomes and quality of life for these individuals.

Correct Answer: D

Rationale: The correct answer is D) Syphilis. Treponema pallidum is the bacterium responsible for causing syphilis, a sexually transmitted infection. Syphilis has distinct stages and can lead to serious health complications if left untreated. Option A) Herpes is caused by the herpes simplex virus, not Treponema pallidum. Herpes presents as painful blisters on the genitals and can recur periodically. Option B) Venereal warts are caused by the human papillomavirus (HPV), not Treponema pallidum. HPV infections can lead to the development of warts in the genital area and increase the risk of certain cancers. Option C) Gonorrhea is caused by the bacterium Neisseria gonorrhoeae, not Treponema pallidum. Gonorrhea can result in genital discharge, pain, and complications if untreated. Understanding the specific pathogens responsible for different sexually transmitted infections is crucial for accurate diagnosis, treatment, and prevention. By knowing the causative agents, healthcare providers can recommend appropriate interventions, including testing, treatment, and education on safe sexual practices. This knowledge is essential for healthcare professionals working in reproductive health and for individuals seeking to protect themselves from sexually transmitted infections.

Correct Answer: B

Rationale: The correct answer is B: Through age 65. This is because current guidelines recommend that women continue to have Pap tests every 3-5 years until age 65, assuming previous tests have been normal. This age cutoff is based on the decreasing risk of cervical cancer with age and the low likelihood of developing new HPV infections after this age. Choices A, C, and D are incorrect because they do not align with the most up-to-date screening recommendations and may lead to unnecessary testing or missed opportunities for appropriate screening.

Correct Answer: A

Rationale: Step 1: Human papilloma virus (HPV) infection and cigarette smoking are major risk factors for cervical cancer. Step 2: The patient is 50 years old, which puts her at risk for cervical cancer. Step 3: HPV infection and smoking increase the risk of cervical cancer. Step 4: Therefore, the appropriate response by the nurse is A. Summary: B: Endometrial cancer risk factors include obesity, not age 40, and infertility is not a primary risk factor. C: Ovarian cancer can occur in women under 50 and family history of breast cancer is not a definitive protective factor. D: Menstrual irregularities do not necessarily lower the risk of reproductive system cancers.

Correct Answer: C

Rationale: The correct answer is C: Waking from sleep to urinate. This symptom, known as nocturia, is common in patients with an enlarged prostate due to increased pressure on the bladder causing frequent urination at night. This is a classic sign of benign prostatic hyperplasia (BPH). Painful urination (choice A) is more indicative of a urinary tract infection. Blood in the urine (choice B) could suggest other conditions like bladder cancer. Incontinence throughout the day (choice D) is more commonly associated with other urinary issues such as overactive bladder or pelvic floor dysfunction.