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: Refusing to look at the dressing or surgical incision is the correct answer because it is a behavior that may indicate difficulty adjusting to the loss of her breast. Refusing to look at the dressing or surgical incision may reflect denial, avoidance, or fear of facing the reality of the surgery and its consequences. It may also indicate low self-esteem, body image disturbance, or depression. The nurse should assess the client's emotional state and provide support and education.

Choice B: Asking questions about the information on her postoperative care pamphlet is not the correct answer because it is a behavior that may indicate a positive adjustment to the loss of her breast. Asking questions about the information on her postoperative care pamphlet may reflect acceptance, curiosity, or motivation to learn about her condition and treatment. It may also indicate high self-efficacy, coping skills, or optimism. The nurse should encourage the client's involvement and provide clear and accurate information.

Choice C: Performing arm exercises once or twice a day is not the correct answer because it is a behavior that may indicate a positive adjustment to the loss of her breast. Performing arm exercises once or twice a day may reflect compliance, responsibility, or self-care. It may also indicate physical recovery, functional ability, or quality of life. The nurse should reinforce the client's efforts and provide feedback and guidance.

Choice D: Asking for pain medication every 3 hours is not the correct answer because it is a behavior that may indicate a normal response to the loss of her breast. Asking for pain medication every 3 hours may reflect pain management, comfort, or relief. It may also indicate trust, communication, or satisfaction with care. The nurse should assess the client's pain level and provide adequate and timely pain relief.

Choice A: The social worker is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The social worker is a professional who provides psychosocial support and advocacy for clients and families, such as counseling, referrals, or discharge planning.

Choice B: The nurse is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The nurse is a professional who provides direct care and education for clients and families, such as assessment, medication administration, or teaching. However, the nurse can assist the physician in obtaining informed consent by witnessing the client's signature, verifying the client's understanding, or documenting the process.

Choice C: The physician is the correct answer because they are legally responsible for obtaining informed consent for an invasive procedure. The physician is a professional who diagnoses and treats clients and families, such as performing surgery, prescribing medication, or ordering tests. The physician must explain the purpose, benefits, risks, alternatives, and consequences of the procedure to the client and obtain their voluntary agreement before proceeding.

Choice D: The unit secretary is not the correct answer because they are not legally responsible for obtaining informed consent for an invasive procedure. The unit secretary is a staff member who performs clerical and administrative tasks for the unit, such as answering phones, filing records, or scheduling appointments.