Assessment of a female client reveals a thick, white vaginal discharge. She also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has:

Choice A: Fluid balance is not the most likely priority because it is not directly affected by the mastectomy. Fluid balance is the state of equilibrium between the intake and output of fluids in the body. It can be influenced by various factors such as hydration, nutrition, medication, or illness. It can be monitored by measuring vital signs, weight, urine output, or laboratory values. Fluid balance is important for maintaining homeostasis and preventing dehydration or edema, but it is not a specific concern for a client undergoing a mastectomy.

Choice B: Body image is the most likely priority because it is directly affected by the mastectomy. Body image is the perception and attitude that one has toward one's own physical appearance and function. It can be influenced by various factors such as culture, media, self-esteem, or feedback from others. It can be assessed by observing verbal and nonverbal cues, asking open-ended questions, or using standardized tools. Body image is a major psychosocial issue for a client undergoing a mastectomy, as it can affect one's sense of identity, femininity, sexuality, or attractiveness. The nurse should address body image by providing information, support, and referral to appropriate resources.

Choice C: Urinary elimination is not the most likely priority because it is not directly affected by the mastectomy. Urinary elimination is the process of expelling urine from the bladder through the urethra. It can be influenced by various factors such as fluid intake, kidney function, medication, or infection. It can be assessed by measuring urine volume, color, odor, or specific gravity. Urinary elimination is important for maintaining fluid balance and preventing urinary tract infection or retention, but it is not a specific concern for a client undergoing a mastectomy.

Choice D: Activity is not the most likely priority because it is not directly affected by the mastectomy. Activity is the level of physical movement and exercise that one engages in on a daily basis. It can be influenced by various factors such as age, health status, motivation, or environment. It can be assessed by observing mobility, endurance, strength, or coordination. Activity is important for maintaining muscle tone, joint range of motion, circulation, or metabolism, but it is not a specific concern for a client undergoing a mastectomy.

Choice A: "Information about a client can be disclosed to family members at any time." This statement indicates a need for further teaching because it is false and violates HIPAA. HIPAA protects the privacy and security of clients' health information and limits who can access or share it without their consent. Information about a client can only be disclosed to family members if they are involved in the client's care or payment, or if the client gives permission.

Choice B: "HIPAA established regulations of individually identifiable health information in verbal, electronic, or written form." This statement does not indicate a need for further teaching because it is true and reflects HIPAA. HIPAA defines individually identifiable health information as any information that relates to the past, present, or future physical or mental health or condition of an individual; the provision of health care to an individual; or the past, present, or future payment for the provision of health care to an individual; and that identifies the individual or for which there is a reasonable basis to believe it can be used to identify the individual.

Choice C: "HIPAA is a federal law, not a state law." This statement does not indicate a need for further teaching because it is true and reflects HIPAA. HIPAA is a federal law that was enacted in 1996 by Congress and signed by President Clinton. It applies to all states and territories of the United States. However, some states may have additional or stricter laws that protect clients' health information.

Choice D: "A client's address would be an example of personally identifiable information." This statement does not indicate a need for further teaching because it is true and reflects HIPAA. HIPAA lists 18 identifiers that can be used to identify an individual, such as name, address, phone number, email address, social security number, medical record number, or biometric identifiers. A client's address is one of these identifiers and must be protected under HIPAA.