Ch 5: Sexually Transmitted Infections

A nurse is preparing for a class discussion on sexually transmitted infections (STIs) to be given at a local high school. Which would the nurse include as a discussion priority? A) Adolescents and young adults are the largest age group diagnosed with an STI. B) Adults aged 21 to 30 years are at greater risk of contracting an STI. C) College students are more likely to engage in risky sexual behaviors leading to an STI. D) More single mothers are diagnosed with an STI causing sterility.

A) Adolescents and young adults are the largest age group diagnosed with an STI. Individuals aged 15 to 24 years represent almost half of all cases of new STIs. Four in ten sexually active teen girls, not single mothers, have an STI that can cause infertility. In the United States, teens who are sexually active, not college-aged students, experience high rates of STIs.

A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? A) Avoiding alcohol consumption B) Using a sunscreen when outside C) Reporting signs of an oral yeast infection D) Taking the drug on an empty stomach

A) Avoiding alcohol consumption If alcohol is ingested when taking ceftriaxone, the client can experience a disulfiram-like reaction. Therefore the nurse would need to emphasize avoiding alcohol consumption. Taking the drug on an empty stomach may be appropriate but not the most important consideration. Using a sunscreen would be appropriate if the client was receiving doxycycline or tetracycline. Reporting the appearance of an oral yeast infection would be appropriate for a client receiving tetracycline.

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms? A) an azole antifungal agent B) a penicillin antibiotic C) an antiviral agent D) a quinolone antibiotic

A) an azole antifungal agent The character of the discharge and the lack of recent sexual activity suggest infection with Candida, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, diabetes, or oral contraceptive use, enable the fungus to proliferate. Candidiasis responds well to treatment with azole antifungal agents.

A client with a family history of cervical cancer is to undergo a Pap test. During the client education, what group should the nurse include as at risk for cervical cancer? A) clients who have genital warts B) clients who have not had babies C) clients with irregular menstrual cycles D) clients with fibrocystic breast disease

A) clients who have genital warts The presence of genital warts (condyloma) increases the risk of developing cervical cancer. Women with metrorrhagia or irregular menstrual cycles are at an increased risk of developing breast cancer, not cervical cancer. Clients who have never had a baby or those with a history of fibrocystic breast disease have an increased risk of developing breast cancer, but not cervical cancer.

The nurse at a community drop-in clinic is completing a sexual health history on a 15-year-old female client requesting oral contraceptives. Which factor in the client's history would indicate to the nurse the client may be susceptible for contracting a sexually transmitted infection (STI)? A) uses a female condom B) admits to sexual activity C) has a long-term boyfriend D) adolescent female

D) adolescent female Female adolescents are more susceptible to STIs due to their anatomy. During adolescence and young adulthood, women's columnar epithelial cells are especially sensitive to the invasion of sexually transmitted organisms. These cells recede to a more protected location as women age. Sexual activity places the client at risk, but the fact that she is very young is a greater risk factor. A female condom would protect the client from an STI as well as having a long-term boyfriend whom she would know well.

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? A) gonorrhea B) Gardnerella vaginalis vaginitis C) candidiasis D) trichomoniasis

D) trichomoniasis The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery, and frothy or purulent. The discharge associated with candidiasis is thick, white, and resembles cottage cheese in appearance while that associated with infection due to G. vaginalis is thin and grayish white, with a marked fishy odor. With gonorrhea, vaginal discharge is purulent when present but, in many women, gonorrhea produces no symptoms.

The nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection (STI). What would the nurse expect to assess if the adolescent has trichomoniasis? A) lesions on the vulva B) flu-like symptoms C) green vaginal discharge D) urinary incontinence

C) green vaginal discharge Symptoms of trichomoniasis include a yellow, green, or gray vaginal discharge with a foul odor. Urinary incontinence is not indicative of trichomoniasis, but dysuria is. Syphilis is associated with flu-like symptoms. Lesions on the vulva are a sign of venereal warts.

Which factor in a client's history indicates she is at risk for candidiasis? A) menopause B) nulliparity C) use of corticosteroids D) use of spermicidal jelly

C) use of corticosteroids Small numbers of the fungus Candida albicans are commonly in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. Pregnancy, not nulliparity, increases the risk of candidiasis. Candidiasis is rare before menarche and after menopause. The use of hormonal contraceptives, not spermicidal jelly, increases the risk of candidiasis.

Which medication is the most effective treatment for trichomoniasis? A) doxycycline B) penicillin G benzathine C) azithromycin D) metronidazole

D) metronidazole The most effective treatment for trichomoniasis is metronidazole and tinidazole. Penicillin G benzathine is used for syphilis. Doxycycline and azithromycin are used in the treatment of chlamydia.

Clients who have had PID are prone to which complication? A) ovarian cancer B) multiple gestation C) inguinal lymphadenopathy D) ectopic pregnancy

D) ectopic pregnancy All clients who have had PID need to be informed of the signs and symptoms of ectopic pregnancy because they are prone to this complication.