A nurse is caring for a middle adult client who has just received the diagnosis of endometrial cancer. In taking a nursing history, which of the following manifestations is likely to be reported by this client?

Rationale: A. This manifestation is more commonly associated with vulvar cancer or a Bartholin gland cyst, not endometrial cancer. Endometrial cancer typically originates in the uterine lining and does not present with localized vulvar swelling. B. While dyspareunia (painful intercourse) can occur with certain gynecologic cancers, such as cervical cancer or pelvic inflammatory disease, it is not a hallmark symptom of endometrial cancer. C. Postmenopausal bleeding is the most common and classic symptom of endometrial cancer. Even a small amount of bleeding after menopause is abnormal and should be evaluated immediately. The bleeding results from the proliferation of malignant cells in the endometrial lining, which leads to tissue breakdown and spotting or bleeding. D. This symptom is most characteristic of vaginal infections, such as trichomoniasis, rather than malignancy. Endometrial cancer usually presents with watery or blood-tinged discharge, not green or foul-smelling secretions.