A client comes to the primary healthcare clinic and reports that her current sexual partner was recently diagnosed with gonorrhea.
Which treatment would you expect the client and her partner to receive?

Choice A rationale

Fluid retention in chronic renal failure (CRF) is primarily managed by restricting sodium and fluid intake, not by a low-protein diet. Protein intake primarily impacts nitrogenous waste production, not the homeostatic mechanisms of antidiuretic hormone and aldosterone that regulate fluid volume retention.

Choice B rationale

Protein breakdown yields nitrogenous waste products, primarily in the form of urea. In chronic renal failure, the damaged nephrons lose their capacity to efficiently filter and excrete these wastes, causing them to build up in the bloodstream, leading to symptoms of uremia and an increased BUN.

Choice C rationale

Protein does not impair potassium storage. Hyperkalemia (high potassium) is a common, life-threatening complication of chronic renal failure, often resulting from the kidney's inability to excrete potassium, especially when coupled with certain medications or high dietary intake of potassium.

Choice D rationale

High protein intake, particularly from animal sources, can contribute to calcium loss by increasing the body's acid load. The body then buffers this acid by releasing calcium from the bones, a process unrelated to calcium retention, which is often impaired in renal failure due to Vitamin D metabolism issues.

Choice A rationale

This statement is judgmental and uses a potentially shaming tone ("improve your habits"), which can inhibit open communication and a trusting therapeutic relationship. A nonjudgmental, open-ended approach is essential for obtaining an accurate sexual health history, as the client may withhold information if they feel judged, potentially leading to unmet health needs. The nurse should use neutral language to promote a comfortable environment.

Choice B rationale

Sexual health is an integral part of overall health and wellness, encompassing physical, emotional, mental, and social well-being, according to the World Health Organization. Screening for sexual activity, risk factors, and concerns is a fundamental component of a comprehensive annual wellness exam, even if the client doesn't initially volunteer specific concerns, ensuring holistic care.

Choice C rationale

This is an example of making an assumption or a closed-ended question, which limits the client's response and may lead to inaccurate data collection. Assuming a client is not sexually active can result in missed opportunities for preventative counseling, screening for sexually transmitted infections (STIs), and discussion of contraception. Open-ended questions are preferred for history taking.

Choice D rationale

This statement is an open-ended question that encourages the client to provide detailed, relevant information in a nonjudgmental manner, which is crucial for a complete sexual health history. It demonstrates an inclusive approach to sexual health, covering both partners and practices, allowing the nurse to assess risk factors, counsel on safe practices, and screen for STIs effectively.