A woman arrives at the clinic for her annual examination. She tells the nurse that she thinks she has a vaginal infection and has been using an over-the-counter cream for the past 2 days to treat it. The nurse's initial response should be to:

Choice A reason: Intranasal spray is not a correct option, as urofollitropin is not available in this form. Intranasal spray is a method of delivering some medications through the nose, where they can be absorbed by the mucous membranes. However, urofollitropin is a protein hormone that would be degraded by the enzymes in the nasal cavity and would not reach the bloodstream effectively.

Choice B reason: Intramuscular injection is the correct option, as urofollitropin is available in this form. Intramuscular injection is a method of delivering medications into the muscle tissue, where they can be absorbed by the blood vessels. Urofollitropin is a protein hormone that needs to be injected into the body to bypass the digestive system and avoid being broken down by the stomach acids and enzymes. Urofollitropin is usually injected into the thigh or buttock muscles once a day for several days, depending on the dosage and the response².

Choice C reason: Vaginal suppository is not a correct option, as urofollitropin is not available in this form. Vaginal suppository is a method of delivering medications into the vagina, where they can be absorbed by the vaginal walls or act locally. Urofollitropin is a protein hormone that would not be absorbed well by the vaginal mucosa and would not reach the ovaries, where it is supposed to stimulate the development of the follicles (eggs).

Choice D reason: Tablet is not a correct option, as urofollitropin is not available in this form. Tablet is a method of delivering medications orally, where they can be swallowed and absorbed by the gastrointestinal tract. Urofollitropin is a protein hormone that would be destroyed by the stomach acids and enzymes and would not reach the bloodstream or the ovaries.

Choice A reason: HSV-2 is a viral infection that causes genital herpes. It is transmitted through sexual contact and can cause painful blisters and ulcers in the genital area. The primary infection is usually the most severe and lasts for several weeks. After the primary infection, the virus remains dormant in the nerve cells and can reactivate periodically, causing recurrent episodes of genital herpes. The frequency and severity of the recurrences vary from person to person.

Choice B reason: HPV is a viral infection that causes genital warts and cervical cancer. It is transmitted through sexual contact and can infect the skin and mucous membranes of the genital area. The primary infection is often asymptomatic and may clear spontaneously or persist for years. HPV does not cause recurrent episodes of genital warts or cervical cancer, but it can increase the risk of developing these conditions over time.

Choice C reason: CMV is a viral infection that causes flu-like symptoms and can affect various organs. It is transmitted through bodily fluids such as saliva, urine, blood, and semen. The primary infection is usually mild and may go unnoticed. After the primary infection, the virus remains latent in the body and can reactivate in people with weakened immune systems, causing serious complications. CMV does not cause recurrent episodes of flu-like symptoms or organ damage, but it can worsen the condition of people with HIV or AIDS.

Choice D reason: HIV is a viral infection that causes acquired immunodeficiency syndrome (AIDS). It is transmitted through sexual contact, blood transfusion, or sharing of needles. The primary infection is often accompanied by flu-like symptoms and lasts for a few weeks. After the primary infection, the virus gradually destroys the immune system and makes the person vulnerable to opportunistic infections and cancers. HIV does not cause recurrent episodes of flu-like symptoms or AIDS, but it can progress to AIDS over time.