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: Fluid balance is not the most likely priority because it is not directly affected by the mastectomy. Fluid balance is the state of equilibrium between the intake and output of fluids in the body. It can be influenced by various factors such as hydration, nutrition, medication, or illness. It can be monitored by measuring vital signs, weight, urine output, or laboratory values. Fluid balance is important for maintaining homeostasis and preventing dehydration or edema, but it is not a specific concern for a client undergoing a mastectomy.

Choice B: Body image is the most likely priority because it is directly affected by the mastectomy. Body image is the perception and attitude that one has toward one's own physical appearance and function. It can be influenced by various factors such as culture, media, self-esteem, or feedback from others. It can be assessed by observing verbal and nonverbal cues, asking open-ended questions, or using standardized tools. Body image is a major psychosocial issue for a client undergoing a mastectomy, as it can affect one's sense of identity, femininity, sexuality, or attractiveness. The nurse should address body image by providing information, support, and referral to appropriate resources.

Choice C: Urinary elimination is not the most likely priority because it is not directly affected by the mastectomy. Urinary elimination is the process of expelling urine from the bladder through the urethra. It can be influenced by various factors such as fluid intake, kidney function, medication, or infection. It can be assessed by measuring urine volume, color, odor, or specific gravity. Urinary elimination is important for maintaining fluid balance and preventing urinary tract infection or retention, but it is not a specific concern for a client undergoing a mastectomy.

Choice D: Activity is not the most likely priority because it is not directly affected by the mastectomy. Activity is the level of physical movement and exercise that one engages in on a daily basis. It can be influenced by various factors such as age, health status, motivation, or environment. It can be assessed by observing mobility, endurance, strength, or coordination. Activity is important for maintaining muscle tone, joint range of motion, circulation, or metabolism, but it is not a specific concern for a client undergoing a mastectomy.

Choice A reason: Baby oil is not an acceptable lubricant, as it can damage the condom and reduce its effectiveness. The students should use water-based or silicone-based lubricants instead.

Choice B reason: Ensuring a tight fit of the condom is not advisable, as it can cause discomfort and increase the risk of breakage. The students should leave some space at the tip of the condom to collect semen and prevent spillage.

Choice C reason: Only using latex condoms is correct, as they are more effective than other materials in preventing pregnancy and sexually transmitted infections. The students should avoid using condoms made of natural skin or lambskin, as they are porous and can allow viruses to pass through.

Choice D reason: Placing the condom on an erect penis is correct, as it ensures proper application and prevents slippage. The students should unroll the condom over the entire length of the penis before any sexual contact.

Choice E reason: Storing the condoms in a cool dry place is correct, as it prevents exposure to heat, moisture, sunlight, or sharp objects that can damage the condom. The students should check the expiration date and integrity of the condom before use.