chapter 46

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate the client by making which statement?

"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."

A female client is diagnosed with chlamydia during a routine pelvic examination. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?

"My partner will need to take antibiotics at the same time I do."

In a client suspected of having gonorrhea with active symptoms, what does the nurse tell the client about confirming the diagnosis?

"Since you have discharge, we can perform a culture."

A client is diagnosed with trichomoniasis. Which information is appropriate for the nurse to tell the client?

"We need to contact your sexual partners."

After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?

6 weeks to 8 months

It is important to test anyone who has had sex with an individual tests positive for gonorrhea within how many days of the diagnosis?

60 days

Which client is at highest risk of developing trichomoniasis?

A client who is sexually active

Which information is essential for a nurse to include in the teaching plan for a client receiving metronidazole for trichomoniasis?

Abstinence is recommended until the therapy is completed.

A nurse is caring for a client being treated for chlamydial infection. Which medication would the nurse anticipate being prescribed?

Azithromycin

Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has:

C. albicans

When screening for a sexually transmitted disease (STD), a microscopic evaluation of a discharge culture reveals hyphae and a pH level of 4.2. Which conditions are not likely to present based on these findings? Select all that apply.

C. trachomatis N. gonorrhoeae T. vaginalis

A female receives a Papanicolaou (Pap) test result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse would emphasize the need for continued follow-up to monitor for which potential complication?

Cervical dysplasia

Which sexually transmitted infection exists in two morphologically distinct forms, elementary and reticulate bodies?

Chlamydia

The nurse is reviewing the uses and side effects of azithromycin. For which infection is azithromycin the antibiotic of choice?

Chlamydial

A couple presents to an infertility clinic. The health care provider will focus testing on which sexually transmitted infection (STI) that is very damaging to the reproductive system but rarely exhibits symptoms of infection?

Chlamydial infection

A client has been diagnosed with condylomata acuminata. The nurse recognizes that which treatment may be prescribed to removal visible warts?

Cryotherapy

A female client is found to have genital warts during a routine pelvic examination. Which sexually transmitted infection will the nurse prepare to test for?

Human papillomavirus

Which assessment finding is most clearly suggestive of initial genital herpes (herpes simplex virus, HSV) in a male client?

Itching, pain, and the emergence of pustules on the penis

Select the treatment of choice for syphilis.

Long-acting penicillin in a single injection

For which STI should the nurse anticipate a prescription for antibiotics such as erythromycin or doxycycline since this infection will respond to antibiotic treatment?

Lymphogranuloma venereum (LGV)

Select the most common symptom a female diagnosed with chlamydial infection will develop.

Mucopurulent cervical discharge

A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in.

Secondary

A woman asks "Why do I have to tell my sexual partner about chlamydia? I thought this was a "female" disease." What is the nurse's best response?

"The condition is transmittable to men and may cause infertility."

A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which sexually transmitted infection?

Syphilis

A client asks why his partners need to know that he was diagnosed with syphilis. What is the nurse's best response?

"They will have to be treated prophylactically."

Which instruction is essential for the nurse to include in the care plan for a client with herpes simplex virus-1 (HSV-1)?

"This disease is transmitted by oral secretions."

A young woman has contracted the human papillomavirus (HPV) and has developed genital warts. The client is eager to receive an HPV vaccine, citing the large number of television advertisements she has seen. How should the nurse best respond?

"Unfortunately, these vaccines are not effective once you have HPV."

There is no known cure for genital herpes, and methods of treatment are often symptomatic. Pharmacologic management of genital herpes includes which drugs?

Acyclovir

A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice.

Azithromycin

Select the condition that contributes to the risk of infertility in males.

Trichomoniasis

Select the correct statement regarding herpes simplex virus.

Only two strains of the virus are considered sexually transmittable.

A client is diagnosed with granuloma inguinale. Which question should the nurse ask the client?

"Have you traveled outside of the country recently?"

A client presents with a rash on the palms of his hands, mucous membranes, and stomach. He is reporting a sore throat and nausea. Which conditions is the nurse concerned about?

Syphilis

A client has been diagnosed with candidiasis. Which symptom was present to diagnose this condition?

Thick white secretions

What is the primary reason that the nurse urges clients to be seen by their health care provider when they have genital warts?

To be informed of the risk of premalignant and malignant changes

A nurse is attempting to culture a lesion to determine if a client has genital herpes. What is the nurse's best action?

Attempt to culture a lesion as soon as it develops.

The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of:

Blindness

A sexually active female presents to the clinic with white copious vaginal discharge, itch, swelling, and dysuria. The nurse anticipates the client will be treated for the overgrowth of which organism?

Candida albicans

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.

Dementia Blindness Ataxia

While in its dormant state, what structure provides residence for herpes simplex virus to allow for replication?

Dorsal root ganglia

An male client presents with urethral itching, burning, pain, and a creamy, yellow discharge following unprotected sex with a new partner 3 days ago. The nurse anticipates the client to be diagnosed with which sexually transmitted infection?

Neisseria gonorrhoeae

A client develops Reiter's syndrome. Which symptoms will the nurse assess? Select all that apply.

Pain in the joints Conjunctivitis

A 30-year-old male has contracted an STI caused by Treponema pallidum. Which symptom did he most likely notice first?

Painless chancres on the man's scrotum

A nurse is assessing a male who is reporting nonspecific symptoms of prostate and periurethral gland pain. Which characteristic discharge makes the nurse suspect gonorrhea?

Purulent exudates

The nurse caring for a client with syphilis notes the Venereal Disease Research Laboratory (VDRL) test result is elevated. Which stage of syphilis is this client likely experiencing?

Secondary

A client asks the nurse how he will know if he has syphilis after sexual contact. What is the nurse's best response?

"You will develop a sore on your penis or scrotum."

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has:

Trichomoniasis

A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women?

Trichomoniasis

Which assessment question is most likely to address the causation of a woman's new case of candidiasis?

"Have you been on antibiotics recently?"

A client asks how his condition, Condylomata acuminata, is caused. What is the nurse's best response?

"Human papillomavirus (HPV) is the cause of your condition."

A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?

"I will take the acyclovir every 8 hours for the next week."

In teaching a client about genital warts, which statement is correct for the nurse to say?

"The incubation period is 6 weeks to 3 months."

A client has been diagnosed with syphilis after seeking care for a penile lesion. The nurse should anticipate which intervention?

Administration of injectable penicillin

A nurse notes that the incidence of sexually transmitted infections (STIs) are increasing. To which reason does the nurse attribute this?

Advanced technology to screen for infections

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 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of medication is most likely to resolve her symptoms?

An azole antifungal agent

In assessing a client, the nurse notes a grayish discharge from the vaginal area accompanied by a foul odor. What is the nurse's best action?

Asking about other symptoms

A client presents to the outpatient clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of:

Bacterial vaginosis

Which assessment finding correlates to advanced (tertiary) syphilis?

Dementia

When is syphilis highly contagious?

During its primary stage

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation?

Fallopian tube damage

A client presents to an STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI?

Gonorrhea

Which statement about gonorrhea is correct?

Gonorrhea is a reportable sexually transmitted infection.

Bacterial vaginosis is the most common vaginal infection seen by health care providers. What is the predominant symptom of bacterial vaginosis?

Grayish white discharge with a fishy odor

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

A client with herpes simplex virus (HSV) states, "I can stop taking my drugs because I'm cured. My lesions are gone." Knowing the pathophysiology behind the disappearance of HSV symptoms, the health care provider suspects the client is experiencing which phase of infection?

Periods of latency in the nervous system

Select the most reliable test to diagnose syphilis.

Serology

The nurse should assess a client with a history of untreated chlamydia for which potential disease process?

Reiter syndrome

An older adult female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms?

Tertiary syphilis

Which clients would the nurse determine are at increased risk of infection with gonorrhea? Select all that apply.

The client who is younger than 25 years of age The client who does not use condoms The client with multiple sexual partners

Which client will the nurse determine is a candidate for continuous antiviral suppressive therapy for genital herpes?

The client with more than six outbreaks this year