A postmenopausal woman with uterine prolapse is being fitted with a pessary. The nurse would be most alert for which side effect?

Choice A: Fecal incontinence is not the correct answer because it is not a disorder of pelvic organ prolapse. Fecal incontinence is a condition that causes the loss of bowel control, resulting in involuntary leakage of stool or gas. It can be caused by various factors such as nerve damage, muscle weakness, or diarrhea. It is not related to the displacement or descent of pelvic organs.

Choice B: Rectocele is the correct answer because it is a disorder of pelvic organ prolapse. Rectocele is a condition that occurs when the rectum bulges or sags into the vagina, creating a pouch or hernia. It can cause symptoms such as constipation, difficulty with bowel movements, or a feeling of pressure or fullness in the vagina. It is caused by the weakening or stretching of the pelvic floor muscles and connective tissue that support the rectum and vagina.

Choice C: Urinary incontinence is the correct answer because it is a disorder of pelvic organ prolapse. Urinary incontinence is a condition that causes the loss of bladder control, resulting in involuntary leakage of urine or urge to urinate. It can be caused by various factors such as stress, infection, or medication. It is also related to the displacement or descent of pelvic organs, such as the bladder or urethra, which can affect the function and closure of the urinary sphincter.

Choice D: Cystocele is the correct answer because it is a disorder of pelvic organ prolapse. Cystocele is a condition that occurs when the bladder protrudes or drops into the vagina, creating a pouch or hernia. It can cause symptoms such as urinary frequency, urgency, or retention, or a feeling of pressure or fullness in the vagina. It is caused by the weakening or stretching of the pelvic floor muscles and connective tissue that support the bladder and vagina.

Choice E: Enterocele is the correct answer because it is a disorder of pelvic organ prolapse. Enterocele is a condition that occurs when the small intestine bulges or descends into the vagina, creating a pouch or hernia. It can cause symptoms such as lower back pain, pelvic pressure, or difficulty with bowel movements. It is caused by the weakening or stretching of the pelvic floor muscles and connective tissue that support the small intestine and vagina.

Choice A: "Don't worry, I will be with you during the exam." This response is not appropriate because it does not address the client's feelings or concerns. It also may sound dismissive or patronizing to the client, who may have valid reasons to be nervous.

Choice B: "What part of the exam makes you most nervous?" This response is appropriate because it shows empathy and interest in the client's perspective. It also invites the client to express her fears or questions and allows the nurse to provide information and reassurance.

Choice C: "All you need to do is relax." This response is not appropriate because it does not acknowledge the client's feelings or concerns. It also may sound unrealistic or insensitive to the client, who may find it hard to relax in a stressful situation.

Choice D: "A pelvic exam is required if you want birth control pills." This response is not appropriate because it does not address the client's feelings or concerns. It also may sound coercive or threatening to the client, who may feel pressured or intimidated by the requirement.