A nurse is caring for a client who is experiencing urinary incontinence. Which of the following recommendations should the nurse include in the teaching plan for this client?

Choice A rationale:

Multiparity, or having given birth to multiple children, is associated with a decreased risk of ovarian cancer, not an increased risk. The protective effect may be due to the repeated ovulatory cycles that occur during pregnancy.

Choice B rationale:

Endometriosis is a condition where endometrial tissue grows outside the uterus. It is associated with an increased risk of ovarian cancer. The exact link is not fully understood, but it is believed that the inflammatory and hormonal changes in endometriosis may contribute to cancer development.

Choice C rationale:

Being under 40 years of age does not increase the risk of ovarian cancer. Advanced age is a known risk factor for ovarian cancer, with the highest incidence occurring in women over 60.

Choice D rationale:

Use of contraceptive medications, particularly oral contraceptives, has been shown to reduce the risk of ovarian cancer. These medications suppress ovulation and decrease the exposure of the ovaries to potential carcinogens.

Choice A rationale:

Current guidelines recommend that women aged 21 to 29 have a Pap test every three years, and those aged 30 to 65 can either have a Pap test every three years or a Pap plus HPV (human papillomavirus) test every five years. After age 65, and with a history of normal results, Pap tests may be discontinued.

Choice B rationale:

The nurse should not include choice B, "Pap tests are discontinued following removal of the ovaries,” in the teaching. The presence or absence of ovaries does not affect the need for Pap testing. The Pap test is primarily used to screen for cervical cancer, and its necessity is determined based on age and previous screening results, not on ovarian status.

Choice C rationale:

Patients are advised to avoid sexual intercourse, douching, or using vaginal medications for 24 hours before the test to ensure accurate results.

Choice D rationale:

The nurse should not include choice D, "Viral infections can be detected by a Pap test,” in the teaching. The Pap test is not designed to detect viral infections. Instead, it is used to detect abnormal cervical cells, which may indicate pre-cancerous or cancerous changes.