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: Cardiac complications are not the correct answer because they are not the main cause of the high infant mortality rate. Cardiac complications are problems that affect the heart or blood vessels of the newborn, such as congenital heart defects, arrhythmias, or heart failure. They can cause serious symptoms such as cyanosis, difficulty breathing, or poor feeding. However, they account for only about 5% of all infant deaths in the United States.

Choice B: Necrotizing enterocolitis is the correct answer because it is the main cause of the high infant mortality rate. Necrotizing enterocolitis is a condition that causes inflammation and death of the intestinal tissue of the newborn, leading to infection, perforation, or sepsis. It can cause symptoms such as abdominal distension, bloody stools, or shock. It is more common in premature or low birth weight infants and accounts for about 10% of all neonatal deaths.

Choice C: Viral infections are not the correct answer because they are not the main cause of the high infant mortality rate. Viral infections are diseases that are caused by viruses that invade the cells of the newborn, such as respiratory syncytial virus (RSV), cytomegalovirus (CMV), or herpes simplex virus (HSV). They can cause symptoms such as fever, cough, rash, or blisters. However, they account for only about 2% of all infant deaths in the United States.

Choice D: Prematurity is the correct answer because it is the main cause of the high infant mortality rate. Prematurity is a condition that occurs when a baby is born before 37 weeks of gestation, which is considered full-term. Premature babies are at risk of developing various complications such as respiratory distress syndrome, intraventricular hemorrhage, or retinopathy of prematurity. Prematurity accounts for about 35% of all infant deaths in the United States.

Choice E: Sudden infant death syndrome is the correct answer because it is the main cause of the high infant mortality rate. Sudden infant death syndrome is a condition that causes the unexpected and unexplained death of an apparently healthy baby during sleep. The exact cause of sudden infant death syndrome is unknown, but some risk factors include sleeping on the stomach, overheating, smoking exposure, or soft bedding. Sudden infant death syndrome accounts for about 15% of all infant deaths in the United States.

Choice F: Low birth weight is the correct answer because it is the main cause of the high infant mortality rate. Low birth weight is a condition that occurs when a baby is born weighing less than 2,500 grams (5 pounds 8 ounces). Low birth weight babies are at risk of developing various complications such as hypothermia, hypoglycemia, or jaundice. Low birth weight accounts for about 25% of all infant deaths in the United States.

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.