Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

Choice A: The social worker is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The social worker is a professional who provides psychosocial support and advocacy for clients and families, such as counseling, referrals, or discharge planning.

Choice B: The nurse is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The nurse is a professional who provides direct care and education for clients and families, such as assessment, medication administration, or teaching. However, the nurse can assist the physician in obtaining informed consent by witnessing the client's signature, verifying the client's understanding, or documenting the process.

Choice C: The physician is the correct answer because they are legally responsible for obtaining informed consent for an invasive procedure. The physician is a professional who diagnoses and treats clients and families, such as performing surgery, prescribing medication, or ordering tests. The physician must explain the purpose, benefits, risks, alternatives, and consequences of the procedure to the client and obtain their voluntary agreement before proceeding.

Choice D: The unit secretary is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The unit secretary is a staff member who performs clerical and administrative tasks for the unit, such as answering phones, filing records, or scheduling appointments.

Choice A: Growth spurt is not the correct answer because it is not the first event that occurs in female puberty. The growth spurt is a period of rapid increase in height and weight that usually occurs between 10 and 14 years of age in girls. It is influenced by various factors such as genetics, nutrition, and hormones. Growth spurt usually follows the development of breast buds and pubic hair by about 6 to 12 months.

Choice B: Evidence of pubic hair is not the correct answer because it is not the first event that occurs in female puberty. Evidence of pubic hair is the appearance of coarse, curly, and pigmented hair on the pubic area and around the genitals. It usually occurs between 8 and 13 years of age in girls. It is caused by the increased production of androgens (male hormones) by the adrenal glands and ovaries. Evidence of pubic hair usually follows the development of breast buds by about 3 to 6 months.

Choice C: Onset of menses is not the correct answer because it is not the first event that occurs in female puberty. The onset of menses is the beginning of menstrual cycles, which are regular changes in the female reproductive system that prepare the body for pregnancy. It usually occurs between 10 and 15 years of age in girls. It is caused by the maturation of the hypothalamus, pituitary gland, ovaries, and uterus, which regulate the levels of estrogen and progesterone (female hormones). The onset of menses usually follows the development of breast buds and pubic hair by about 2 to 3 years.

Choice D: Development of breast buds is the correct answer because it is the first event that occurs in female puberty. Development of breast buds is the enlargement and elevation of the nipples and areolas (dark circles around the nipples), which indicate the beginning of breast growth. It usually occurs between 8 and 12 years of age in girls. It is caused by the increased production of estrogen (female hormone) by the ovaries, which stimulates the growth of ducts (tubes) and lobules (glands) in the breast tissue. The development of breast buds is also called thelarche or breast stage 2.