A female client reports green-yellow vaginal discharge, vaginal itching, and foul-smelling genitals.
She has been sexually active for six months in a monogamous relationship with her boyfriend.
Both were tested for sexually transmitted diseases when she received a hormonal implant five months ago.
The couple broke up a month ago, and since then, she has had unprotected sex with two partners.
The client's symptoms are most consistent with which of the following conditions?

Choice A rationale

Betamethasone does not directly increase the fetal heart rate. Factors influencing fetal heart rate include fetal oxygenation, maternal hydration, and medications affecting the maternal or fetal autonomic nervous system. Normal fetal heart rate ranges from 110 to 160 beats per minute.

Choice B rationale

Betamethasone is a corticosteroid administered to pregnant women at risk of preterm delivery to accelerate fetal lung maturity. It stimulates the production of surfactant, a lipoprotein that reduces surface tension in the alveoli, preventing collapse upon expiration and improving the neonate's ability to breathe independently.

Choice C rationale

Betamethasone does not halt cervical dilation. Cervical dilation is primarily influenced by uterine contractions and the presenting fetal part. Medications like tocolytics, such as terbutaline or magnesium sulfate, are used to inhibit uterine contractions in preterm labor.

Choice D rationale

Betamethasone is not used to stop preterm labor contractions. Its primary purpose is to enhance fetal lung maturation. Tocolytic medications are the class of drugs used to attempt to delay or stop preterm labor contractions, allowing time for corticosteroids to be administered.

Choice A rationale

During menopause, estrogen levels significantly decline. Estrogen plays a crucial role in maintaining the acidic environment of the vagina, which inhibits the growth of pathogenic bacteria and yeast. A decrease in estrogen leads to a rise in vaginal pH (normal premenopausal pH is 3.8 to 4.5), making the vaginal environment less acidic and more susceptible to infections, including bacterial vaginosis and yeast infections, thus explaining the client's symptoms.

Choice B rationale

While dietary habits and fluid intake can influence overall health, they are not the primary factors directly causing the increased risk of vaginal itching, burning, and infections in a menopausal woman. Hormonal changes are the most significant contributing factor.

Choice C rationale

A history of sexually transmitted infections (STIs) is important to consider, but the onset of these symptoms three years into menopause suggests that hormonal changes related to estrogen deficiency are a more likely primary cause for the recurrent vaginal issues. While past STIs can sometimes have long-term effects, the timing aligns with menopausal changes.

Choice D rationale

The client's genitourinary disorder (specifically, the vaginal changes due to estrogen deficiency) will not alleviate over time without intervention. The decrease in estrogen is a permanent physiological change associated with menopause, and the associated symptoms often persist or worsen without treatment such as hormone therapy or other local treatments to restore vaginal health.