A nurse is conducting a review class for a group of perinatal nurses working at the local clinic. The clinic sees a high population of women who are HIV positive. After discussing the recommendations for antiretroviral therapy with the group, the nurse determines that the teaching was successful when the group identifies which rationale as the underlying principle for the therapy?

A. Fatigue - Fatigue is a common side effect of chemotherapy and can significantly impact a patient's quality of life. While it can be debilitating and affect daily activities, it is not typically considered as serious as myelosuppression. Fatigue usually improves over time after completion of chemotherapy treatment.

B. Hair loss - Hair loss, or alopecia, is another common side effect of chemotherapy. It can be distressing for many patients, but it is generally not considered medically serious. Hair typically grows back after the completion of chemotherapy treatment.

C. Vomiting - Nausea and vomiting are common side effects of chemotherapy, known as chemotherapy-induced nausea and vomiting (CINV). While they can cause discomfort and affect a patient's well-being, they are usually manageable with antiemetic medications. In severe cases, dehydration and electrolyte imbalances may occur, but they are generally reversible and not as serious as myelosuppression.

D. Myelosuppression - Myelosuppression, also known as bone marrow suppression, is a serious side effect of chemotherapy. It can lead to a decrease in the production of blood cells (white blood cells, red blood cells, and platelets) by the bone marrow. This can increase the risk of infections, anemia, and bleeding, which can be life-threatening if not managed promptly. Myelosuppression requires close monitoring and may necessitate treatment adjustments or supportive care measures to prevent complications.

A. Ask, "Have you ever been physically hurt by your partner?":

This approach involves directly asking the client about their experience with intimate partner violence. While it's crucial to address the issue openly and directly, some clients may feel uncomfortable or unsafe disclosing abuse, especially during an initial encounter. However, for many clients, this direct approach can be empowering and may facilitate disclosure.

B. Offer the client a pamphlet about the local shelter for victims of intimate partner violence:

Providing informational resources about local shelters and support services can be a supportive and non-confrontational way to offer assistance to a client who may be experiencing intimate partner violence. It allows the client to access resources privately and at their own pace. However, it may not lead to immediate disclosure or intervention.

C. Call the client at home to ask some questions about the marriage:

Calling the client at home to inquire about their relationship may inadvertently escalate the situation and put the client at risk if the abusive partner overhears the conversation. It can also violate the client's privacy and autonomy, as they may not be comfortable discussing sensitive issues over the phone, especially if the abusive partner is present.

D. Wait until the client comes in a few more times to make a better assessment:

Delaying assessment and intervention can potentially prolong the client's exposure to abuse and increase their risk of harm. Intimate partner violence often escalates over time, so it's essential to address suspected abuse as soon as possible to ensure the client's safety and well-being.