A nurse is caring for an adolescent client who has pelvic inflammatory disease as a consequence of a sexually transmitted infection and will need intravenous antibiotic therapy. The client tells the nurse, "My parents think I am a virgin. I don't think I can tell them I have this kind of an infection." Which of the following responses should the nurse make?

Choice A: Menstrual is not the correct answer because it is the phase when estrogen levels are lowest. The menstrual phase occurs when the endometrium (the lining of the uterus) is shed along with blood and mucus through the vagina.

Choice B: Ischemic is not the correct answer because it is the phase when estrogen levels are decreasing. The ischemic phase occurs when the blood supply to the endometrium is reduced due to vasoconstriction (narrowing of blood vessels). This phase prepares the endometrium for shedding if fertilization does not occur.

Choice C: Secretory is not the correct answer because it is the phase when progesterone levels are highest. The secretory phase occurs when the endometrium becomes thick and spongy due to increased secretion of mucus and glycogen (a form of sugar). This phase provides a suitable environment for implantation if fertilization occurs.

Choice D: Proliferative is the correct answer because it is the phase when estrogen levels are highest. The proliferative phase occurs when the endometrium regenerates and grows due to increased stimulation by estrogen. This phase prepares the endometrium for implantation if fertilization occurs.

Choice A: Call the surgeon to perform a femoral puncture. This action is not appropriate because it is unnecessary and invasive. A femoral puncture is a procedure that involves inserting a needle into the femoral vein in the groin area to obtain a blood sample. It is usually reserved for situations where other veins are inaccessible or unsuitable, such as in trauma or shock. It is not indicated for a routine CBC test.

Choice B: Assist in holding the client's arm still. This action is not appropriate because it is harmful and contraindicated. Holding the client's arm still may cause injury or infection to the arm that has undergone surgery and lymph node removal. It may also increase the risk of lymphedema, which is a condition that causes swelling and pain in the arm due to fluid accumulation and impaired lymphatic drainage.

Choice C: Tell the technician to obtain the blood sample from the client's left arm. This action is appropriate because it is safe and recommended. Obtaining the blood sample from the client's left arm can avoid complications such as injury, infection, or lymphedema in the right arm that has undergone surgery and lymph node removal. The technician can use a different site than the antecubital space, such as the hand or wrist, to avoid interfering with the intravenous line.

Choice D: Suggest a finger stick be done on one of the client's left fingers. This action is not appropriate because it is unreliable and inaccurate. A finger stick is a procedure that involves pricking the finger with a lancet to obtain a small amount of blood for testing. It is usually used for point-of-care testing, such as glucose or hemoglobin levels, but not for a CBC test. A CBC test requires a larger volume of blood and a venous sample for accurate results.