Chapter 5
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? chlamydia genital herpes syphilis gonorrhea
genital herpes -Besides AIDS, the five most common STIs are chlamydia, gonorrhea, syphilis, genital herpes, and genital warts. Of these, chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes recurs.
A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely? chancres at the vaginal site vesicles on the labia vaginal bleeding foul-smelling discharge
chancres at the vaginal site -Syphilis is divided into four stages: primary, secondary, latency, and tertiary. Primary syphilis is characterized by a chancre at the site of bacterial entry. Foul-smelling discharge would not be noted. Vesicles on the labia are not associated with syphilis. Bleeding from the vagina could be normal menses and does not correlate with syphilis.
A nurse is caring for a client undergoing treatment for bacterial vaginosis. Which instruction should the nurse give the client to prevent recurrence of bacterial vaginosis? Use oral contraceptive pills (OCPs). Practice monogamy. Avoid smoking. Undergo colposcopy tests frequently.
Practice monogamy. -Although the reasons for bacterial vaginosis are not yet fully understood, sex with multiple partners increases the risk, and therefore it should be avoided. Using OCPs and smoking have not been associated with bacterial vaginosis. A colposcopy test is recommended for clients with high-risk HPV, not for diagnosing bacterial vaginosis.
The nurse is caring for a client diagnosed with candida vaginitis. The nurse knows additional teaching is needed when the client makes which statement? "I should wear cotton underwear to prevent future infections." "Low blood sugar levels are a way to control vaginal infections." "Douching is an effective way to cleanse the vaginal area after intercourse." "Eating yogurt can may help limit future infections."
"Douching is an effective way to cleanse the vaginal area after intercourse." -An acidic environment helps protect against ascending infections in the vagina. Douching can alter the pH of the vagina, causing an alkaline environment where candida infections thrive. The client should be cautioned against using douches, hygiene sprays, or deodorants that might upset the acid balance. Cotton underwear promotes vaginal dryness, which will help prevent vaginal infections. Probiotics can help balance vaginal bacteria and limit infections. Foods such as yogurt and fermented foods contain probiotics. Infections also thrive when blood glucose levels are high; therefore, clients with diabetes must maintain balanced levels to promote healing and limit infections.
The nurse is teaching a client about sexually transmitted infections. The nurse determines the teaching was successful when the client makes which statement? "Genital ulcers are a sign of genital herpes simplex." "People with trichomoniasis will have burning when they urinate." "Gonorrhea can be prevented with a vaccine." "Chlamydia remains localized if not treated."
"Genital ulcers are a sign of genital herpes simplex." -The nurse knows the teaching was effective when the client states genital herpes simplex is a sexually transmitted infection associated with genital ulcers. Gonorrhea cannot be prevented with a vaccine. It must be treated with an antibiotic if contracted. Chlamydia can spread to other areas of the body if not treated and lead to long-term health complications. Most people with trichomoniasis have no symptoms. If symptoms are experienced, burning with or after urination may be present.
A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? "STIs can't be transmitted through oral sexual intercourse." "At least antibiotics will cure a sexually transmitted infection." "Human papillomavirus is the cause of essentially all cases of cervical cancer." "Gonorrhea and syphilis are infections seen only in men."
"Human papillomavirus is the cause of essentially all cases of cervical cancer." -Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer, which is the fourth most common cancer in women in the United States. Up to 95% of cervical squamous cell carcinomas and nearly all preinvasive cervical neoplasms are caused by the HPV. Antibiotics will only cure those STIs caused by bacterial infections. A viral STI infection is a lifetime infection. Gonorrhea and syphilis affect both men and women. Sexually transmitted infections are infections of the reproductive tract caused by microorganisms transmitted through oral sexual intercourse.
A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? "I should rub rather than scratch in response to itching." "I can pour hydrogen peroxide and water over my lesions." "I will apply a water-based lubricant to my lesions." "I will wear loose cotton underwear."
"I will wear loose cotton underwear." -Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. Lesions should not be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. The use of hydrogen peroxide and water on lesions is not recommended.
The clinic nurse is treating a client diagnosed with HIV. Which statement made by the client indicates the teaching was successful? "Right now I have HIV, but eventually it will develop into AIDS." "If I do not take my medications as prescribed, my red blood cell count will fall." "I will not spread HIV to others during intercourse if I take my medication." "If my CD4 T-cell count drops below 200 cells/mm3 (0.2 × 109/l), my HIV has progressed to AIDS."
"If my CD4 T-cell count drops below 200 cells/mm3 (0.2 × 109/l), my HIV has progressed to AIDS." -The client indicates an understanding of the diagnosis when reporting a CD4 T-cell count at or below 200 cells/mm3 (0.2 × 109/l) indicates the development of AIDS. Not all persons with HIV will develop AIDS. There are medications available to help slow the process within the body and limit the development of AIDS. Although intercourse can lead to the spread of HIV or AIDS, clients are still able to be sexually active if appropriate measures are taken such as using barrier protection. The client should notify any partners before intercourse occurs and use a condom. Taking the prescribed medication may help prevent the spread but is not a definitive measure. Not taking medications as prescribed will lead to a decrease in white blood cell counts initially, not red blood cells.
A client at 32 weeks' gestation has recently been diagnosed with acute herpes type 2. The client asks what can happen to the baby as a result of this infection. How should the nurse bestrespond? "Your infant is protected from this infection during pregnancy." "There is a chance your baby may have a form of intellectual disability." "There may be a chance your baby will be a heavier birth weight." "You may carry the pregnancy beyond your due date."
"There is a chance your baby may have a form of intellectual disability." -Herpes type 2 (genital herpes) contamination can occur during birth. The infant is susceptible to intellectual disability, premature birth, low birth weight, blindness, or even death as a result of this infection. The infant is not protected from the infection as it is contaminated during vaginal birth. Premature birth is a risk, not postdate birth.
A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infections. What is the nurse's best response? "This STI is characterized by an infection of your cervix." "This STI is an infection that will cause itching in the genital area." "This STI is an infection that results in ulcers in the genital area." "This STI is an infection that will result in the formation of genital warts."
"This STI is characterized by an infection of your cervix." -STIs like chlamydia result in cervicitis, which implies the presence of inflammation or infection of the cervix. It produces quantities of purulent discharge. Cervicitis is usually caused by gonorrhea or chlamydia. Chlamydia will not produce ulcers or warts and is not an STI that has itching associated with it.
A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching? "This drug will help reduce my risk for a recurrence after discontinuing it." "If I use this drug, I will be cured of the infection." "The severity of future attacks will be much less after using this drug." "This drug will help to suppress any symptoms of the infection."
"This drug will help to suppress any symptoms of the infection." -No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. Advances in treatment with acyclovir 400 mg orally three times daily for 7 to 10 days, famciclovir 250 mg orally three times daily for 7 to 10 days, or valacyclovir 1 g orally twice daily for 7 to 10 days have resulted in an improved quality of life for those infected with herpes simplex virus (HSV). However, according to the CDC, these drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued.
A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply. "Transmission is through contact of infected mucous membranes." "Your baby is protected from this infection by the placenta." "Infections may be transmitted by individuals unaware that they have it." "Many recognize they have the infection and seek treatment immediately." "The virus remains quiet until a stressful event occurs to reactivate it."
"Transmission is through contact of infected mucous membranes." "Infections may be transmitted by individuals unaware that they have it." "The virus remains quiet until a stressful event occurs to reactivate it." -Genital herpes simplex is transmitted by contact of mucous membranes or breaks in the skin with visible or nonvisible lesions. Most genital herpes infections are transmitted by individuals unaware that they have an infection. Kissing, sexual contact (including oral sex), and vaginal birth are means of transmission. The virus remains latent until stimuli such as fever, stress, ultraviolet radiation, or immunosuppression occurs and reactivates it.
A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student? "Use only petroleum-based lubricants, such as body lotion or massage oil." "It is important to put the condom on just before the penis is erect." "Withdraw the penis erect, holding the condom firmly against the penis." "Ensure your condom is always available, so store condoms in your wallet."
"Withdraw the penis erect, holding the condom firmly against the penis." -The teaching guidelines for proper condom use include: ensure the condom has been stored in a cool, dry place away from direct sunlight. Do not store condoms in wallet; put the condom on before any genital contact; put the condom on when penis is erect; ensure adequate lubrication during intercourse. If external lubricants are used, use only water-based lubricants. Oil-based or petroleum-based lubricants, such as body lotion or massage oil, can weaken latex condoms. Withdraw while penis is still erect, and hold condom firmly against base of penis. Remove carefully to ensure no semen spills out.
A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement? "Women are diagnosed with two thirds of the new cases of STIs annually." "After only a single exposure, women are twice as likely as men to acquire STIs." "Certain infections can be transmitted to the newborn." "All individuals are susceptible if exposed to the infectious organism." "Women are equally diagnosed over men as they will seek treatment first."
"Women are diagnosed with two thirds of the new cases of STIs annually." "After only a single exposure, women are twice as likely as men to acquire STIs." "Certain infections can be transmitted to the newborn." -STIs are biologically sexist, presenting greater risk and causing more complications among women than among men. Women are diagnosed with two thirds of the new cases of STIs annually in the United States. After only a single exposure, women are twice as likely as men to acquire infections from pathogens. Certain infections can be transmitted in utero to the fetus or during childbirth to the newborn.
A school health nurse is presenting information on sexually transmitted infections (STIs) to a high school class. The nurse feels confident that learning has taken place when the students report: genital cancer is associated with the STI genital herpes. most adolescents will seek early treatment to cure the STI. adolescent females make up more than three-quarters of HIV diagnosis. female adolescents are more susceptible to STIs due to their anatomy.
"female adolescents are more susceptible to STIs due to their anatomy. -STIs may cause chronic liver diseases and cancer due to hepatitis B (HBV) and C (HCV) infections. Genital cancer is associated with papillomavirus (HPV), and is AIDS caused by HIV. Adolescent males make up more than three-quarters of HIV diagnoses. Many health care providers fail to assess adolescent sexual behavior and STI risks or to screen for asymptomatic infection during clinic visits thus delaying treatments. STIs are not curable. Many female adolescents are more susceptible to STIs due to their anatomy.
The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age? 25 28 32 40
25 -The CDC (2015) recommends yearly chlamydia testing of all sexually active women aged 25 or younger, older women with risk factors for chlamydial infections (those who have a new sex partner or multiple sex partners), and all pregnant women).
A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia? 30% 50% 90% 70%
70% -Asymptomatic infection is common among both men and women, affecting 50% and 70%, respectively.
The nurse is providing education on the prevention of sexually transmitted infections (STIs) to clients. The nurse understands which client is at the highest risk of contracting an STI? A 30-year-old client who consumes alcohol multiple times per week, uses cocaine, and has a history of prostitution. A 17-year-old client who is in a monogamous relationship with a 25-year-old partner and engages in unprotected sex. A 20-year-old client who reports having protected sexual intercourse with three others, male and female, over the past five years. A 25-year-old client who refused to receive the human papillomavirus vaccine and whose parents both have HIV.
A 30-year-old client who consumes alcohol multiple times per week, uses cocaine, and has a history of prostitution. -The nurse will look for the client with the most risk factors for contracting an STI. The 30-year-old client is at the highest risk due to the use of alcohol and drugs and a history of forced sexual activity (3 risk factors). Other risk factors include age of 24 years or less, multiple partners, unprotected intercourse, and a history of STIs. Although the 17-year-old client is young and having unprotected intercourse, the client is in a monogamous relationship, indicating only 2 risk factors. The 20-year-old client is young and has protected intercourse with multiple partners (2 risk factors). The 25-year-old has no risk factors.
A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem? Explain the cause of the sexually transmitted infection (STI). Affirm the client's good judgment in seeking treatment. Schedule an appointment for follow-up care. Provide the client with a telephone number for obtaining accurate information.
Affirm the client's good judgment in seeking treatment. -The nurse should affirm the client's good judgment in seeking treatment. Acknowledging positive action helps increase the client's self-esteem. Explaining the cause of the STI and how to avoid potential consequences or complications dispels inaccurate beliefs and misconceptions and helps the client to acquire realistic information. It does not help the client's self-esteem to be positive. Providing the client with a telephone number for obtaining objective and authoritative information helps the client to ask more questions about an STI and its treatment. Medical follow-up promotes compliance with therapeutic regimen and does not help the client's self-esteem to be positive.
A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? Avoid alcohol consumption. Use a sunscreen when outside. Report signs of an oral yeast infection. Take the drug on an empty stomach.
Avoid 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.
Which instruction should the nurse give to a client with genital herpes to help control the infection? Apply antibacterial medication. Apply imiquimod cream. Avoid people with upper respiratory infections. Avoid sexual contact until sores heal.
Avoid sexual contact until sores heal. -The nurse should instruct the client to avoid sexual contact until sores heal completely and new skin forms. Application of antibacterial medication is suggested for wounds in case of lymphedema. Clients with HIV are advised to avoid people with upper respiratory infections. Application of imiquimod cream is suggested for clients infected with human papillomavirus.
A client is being discharged from the gynecological unit after treatment for acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include? Discuss the necessity of completing the antibiotic therapy. Refer the client to the women's sexual health clinic. Provide the client with brochures on sexually transmitted infection prevention. Arrange for follow-up visits to her health care provider.
Discuss the necessity of completing the antibiotic therapy. -It is the priority that the client understands the need to finish the antibiotic therapy required to treat PID in order to eradicate the offending bacterial infection. The STI brochures may be appropriate, but they are not the priority and neither is arranging for follow-up health care provider visits. If the client can access the women's health clinic, a referral can be made, but it is not the priority.
A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby? Instill a prophylactic agent in the eyes of the newborn. Perform cesarean birth to prevent infection. Administer cephalosporins to mother during pregnancy. Administer an antiretroviral syrup to the newborn.
Instill a prophylactic agent in the eyes of the newborn. -To prevent gonococcal ophthalmia neonatorum in the baby, the nurse should instill a prophylactic agent in the eyes of the newborn. Cephalosporins are administered to the mother during pregnancy to treat gonorrhea but not to prevent infection in the newborn. Performing a cesarean birth will not prevent gonococcal ophthalmia neonatorum in the newborn. An antiretroviral syrup is administered to the newborn only if the mother is HIV positive and will not help prevent gonococcal ophthalmia neonatorum in the baby.
When describing sexually transmitted infections and testing, the nurse explains that a client is typically tested for chlamydia, gonorrhea, and syphilis at the same time for which reason? The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client. It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI). The infecting bacterium in all cases is the same, and therefore clients have concurrent infections. The infections spread through the same medium, and therefore clients have concurrent infections.
It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI). -It is common practice to test clients for chlamydia, gonorrhea, and syphilis because it is not unusual for clients to have concurrent infections with more than one STI. For chlamydia, the causative microorganism is a bacterium named Chlamydia trachomatis. For gonorrhea, the infection is caused by a bacterium named Neisseria gonorrhoeae. The spirochete Treponema pallidum is the causative microorganism of syphilis. The symptoms of these conditions are not identical. The causative microorganisms do not spread through the same medium.
A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response? It is recommended to formula-feed your newborn as it is transmitted through your breast milk." "It is not transmitted to your newborn as it is protected in the uterus." "It is only transmitted through the birth canal so a cesarean birth will be scheduled." "The risk of your newborn being infected with HIV infection is about 1%."
It is recommended to formula-feed your newborn as it is transmitted through your breast milk." -An infected mother can transmit HIV infection to her newborn before or during birth and through breastfeeding. The risk of perinatal transmission of HIV from an infected mother to her newborn is about 25%. This risk falls to less than 1% if the mother receives antiretroviral therapy during pregnancy. HIV can be spread to the infant through breastfeeding. HIV-infected mothers should be counseled to avoid breastfeeding and use formula instead.
Which instruction should be given to a woman newly diagnosed with genital herpes? Have your partner use a condom when lesions are present. Limit stress and emotional upset as much as possible. Obtain a Papanicolaou test every 3 years. Use a water-soluble lubricant for relief of pruritus.
Limit stress and emotional upset as much as possible. -Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it is not known whether the virus can be transmitted at this time. During an outbreak, creams and lubricants should be avoided because they may prolong healing. Because a relationship has been found between genital herpes and cervical cancer, a Papanicolaou test is recommended every year.
A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis? Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism. Antifungal medications are effective against the anovulation and risk for HIV that accompany the infection. Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy.
Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. -The treatment of choice for Trichomonas vaginalis is oral metronidazole or tinidazole, medications that are effective against anaerobic protozoans. Antifungals are not a relevant treatment and eradication of the infection is possible with treatment.
Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection? Participate in early prenatal care. Take tub baths regularly. Have regular cancer screening examinations. Pat or blot the skin dry.
Participate in early prenatal care. -The nurse should recommend that a pregnant client with a sexually transmitted infection who is at risk for infection transmission receive early prenatal care because some STIs can be transmitted during birth. Patting or blotting the skin dry is helpful in reducing friction and the itch-scratch-itch cycle. The nurse should recommend clients infected with carcinogenic viruses to have regular cancer screening examinations to facilitate early diagnosis and optimistic prognosis. Taking tub baths regularly would have no effect on infection transmission.
An HIV-positive client who is on antiretroviral therapy reports anorexia, nausea, and vomiting. Which suggestion should the nurse offer the client to cope with this condition? Limit number of meals to three a day. Use high-protein supplements. Eat dry crackers after meals. Constantly drink fluids while eating.
Use high-protein supplements. -The nurse should instruct the client to use high-protein supplements to provide quick and easy protein and calories. The nurse should also instruct the client to eat dry crackers upon arising, not after every meal, and to eat six small meals a day, not three. Drinking fluids constantly while eating is not recommended. The nurse should instruct the client to separate the intake of food and fluids.
The nurse is caring for a male client diagnosed with gonorrhea and chlamydia. Which health care provider order will the nurse question? rapid serum HIV test avoidance of sexual activity until treatment is complete notification of all recent sexual partners acyclovir 400 mg orally BID
acyclovir 400 mg orally BID -The nurse would question an order for acyclovir because this is an anti-viral medication used to treat genital herpes. Clients with gonorrhea and chlamydia are treated with antibiotics such as levofloxacin, erythromycin, azithromycin, or tetracycline. The client should notify recent sexual partners to allow them to be tested and treated as needed. The client would be informed to avoid sexual activity until the treatment is complete and to use condoms once sexual activity resumes to prevent future infections. It is recommended for clients with sexually transmitted infections (STIs) be tested for other STIs because risk factors for contracting an STI include a history of STIs.
A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity? educating about HPV testing in women over age 30 encouraging treatment for genital warts administering HPV vaccine teaching about the importance of regular Papanicolaou test
administering HPV vaccine -Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be a primary prevention activity. If the woman does not receive primary prevention with the vaccine, then secondary prevention would focus on education about the importance of receiving regular Papanicolaou tests and, for women over age 30, including an HPV test to determine whether the woman has a latent high-risk virus that could lead to precancerous cervical changes.
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)? uses a female condom has a long-term boyfriend adolescent female admits to sexual activity
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.
The nurse cares for a client recently diagnosed with syphilis who has no known drug allergies. Which medication will the nurse expect the health care provider to prescribe? miconazole benzathine penicillin G doxycycline metronidazole
benzathine penicillin G -Current guidelines recommend benzathine penicillin G injection (long-acting penicillin) as the preferred treatment for syphilis. If the client is allergic to penicillin, other medications (e.g., doxycycline, tetracycline, or ceftriaxone) may be used; however, data to support the use of these medications to treat syphilis are limited. Metronidazole is the treatment for trichomoniasis, and miconazole is the treatment for candidiasis.
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? painless chancre burning on urination diffuse skin rash dry, hacking cough
burning on urination -Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the organisms enter the body, such as on the genitalia, anus, or lips.
A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge? syphilis chlamydia candidiasis gonorrhea
candidiasis -Although vaginal discharge can occur with any STI, genital/vulvovaginal candidiasis is one of the most common causes of vaginal discharge. It is also referred to as yeast, monilial, and a fungal infection. It is not considered an STI because candida is a normal constituent in the vagina and becomes pathogenic only when the vaginal environment becomes altered.
A nurse is required to assess a client reporting unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess? heavy yellow discharge characteristic "stale fish" odor erythema in the vulvovaginal area dysfunctional uterine bleeding
characteristic "stale fish" odor -Symptoms of bacterial vaginosis include a characteristic "stale fish" odor and thin, white homogeneous vaginal discharge, not heavy yellow discharge. Dysfunctional uterine bleeding is a sign of chlamydia, not bacterial vaginosis. Erythema in the vulvovaginal area is a symptom of vulvovaginal candidiasis, not bacterial vaginosis.
A nurse is conducting a presentation for a local community group on sexually transmitted infections. The nurse determines that the group has understood the information when they identify which infection as the most commonly reported bacterial STI in the United States? chlamydia candidiasis syphilis gonorrhea
chlamydia -Chlamydia is the most commonly reported bacterial STI in the United States. The CDC estimates that over 3 million new cases occur each year.
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common bacterial STI in the United States would the nurse expect to include? genital herpes gonorrhea chlamydia syphilis
chlamydia -Chlamydia is the most commonly reported bacterial STI in the United States. The CDC estimates that over 3 million new cases occur each year.
A client has presented reporting symptoms that suggest a gonorrheal infection. After laboratory testing confirms this diagnosis, the nurse anticipates that the client will also be treated for which infection? HPV candidiasis syphilis chlamydia
chlamydia -The CDC recommends that any client being treated for gonorrhea should also be treated for chlamydia due to the common occurrence of co-infection of these two organisms.
A client with a family history of cervical cancer is to undergo a Papanicolaou test. During the client education, what group should the nurse include as at risk for cervical cancer? clients who have genital warts clients with fibrocystic breast disease clients who have not had babies clients with irregular menstrual cycles
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.
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? painful ejaculation erectile dysfunction dysuria hematuria
dysuria -A male with the diagnosis of chlamydia will first experience dysuria as the primary symptom. The other symptoms listed do not correlate to men with the diagnosis of chlamydia.
Clients who have had PID are prone to which complication? inguinal lymphadenopathy multiple gestation ovarian cancer ectopic pregnancy
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.
When developing a program for STI prevention, which action would need to be done first? educating on how to promote sexual health increasing the availability of resources interfering with the mode of transmission getting individuals to change their behaviors
educating on how to promote sexual health -The key to successful treatment and prevention of STIs is education to promote sexual health. Behavior changes, increasing the availability of resources, and interfering with modes of transmission are important, but all of these require education.
A nurse is conducting a class for high school students on preventing sexually transmitted infections (STIs). Which information would the nurse emphasize as the sole method for not contracting STIs? engaging in abstinence limiting sexual partners using condoms urinating immediately after intercourse
engaging in abstinence -Although limiting sexual partners and using condoms can help in preventing STIs, abstinence is the only way to completely avoid contracting STIs. Urinating immediately after intercourse would be ineffective.
A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment? acyclovir fluconazole tetracycline clindamycin
fluconazole -Treatment of candidiasis includes miconazole cream or suppository, clotrimazole tablet or cream, terconazole cream or intravaginal suppository, or fluconazole oral tablet. Most of these medications are used intravaginally in the form of a cream, tablet, or suppositories for 3 to 7 days. If fluconazole is prescribed, a 150-mg oral tablet is taken as a single dose. The other medications would not be appropriate.
A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports: dysuria and lymphadenopathy. genital pruritus and paresthesia. vaginal and urethral discharge. headache and fever.
genital pruritus and paresthesia. -Pruritus and paresthesia as well as redness of the genital area are prodromal symptoms of recurrent herpes infection. These symptoms occur 30 minutes to 48 hours before the lesions appear. Headache and fever are symptoms of viremia associated with the primary infection. Vaginal and urethral discharge is also a local sign of primary infection. Dysuria and lymphadenopathy are local symptoms of primary infection that may also occur with recurrent infection.
A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition? genital herpes syphilis gonorrhea genital warts
gonorrhea -Gonococcal infections can be completely eliminated by drug therapy. Genital warts are not curable and are identified by appearance, not culture. Genital herpes is not curable and is identified by the appearance of the lesions or cytologic studies. The diagnosis of syphilis is done using dark-field microscopy or serologic tests.
A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit? ulcerated chancre, aortic valve insufficiency, lymphadenopathy fever, malaise, sore throat heart disease and inflammation of the aorta, eyes, brain, central nervous system, and skin papular lesion, rash, headache
heart disease and inflammation of the aorta, eyes, brain, central nervous system, and skin -The client with late or tertiary syphilis is noninfectious because the microorganism has invaded the central nervous system (CNS) as well as other organs of the body. Symptoms of tertiary syphilis include heart disease and neurologic disease that slowly destroys the heart, with inflammation of the aorta, eyes, brain, central nervous system, and skin. Symptoms of secondary syphilis include fever, malaise, rash, headache, sore throat, and lymph node enlargement. Ulcerated chancre occurs in the primary stage.
The nurse in the sexual health clinic is obtaining a health history of a client who suffers from heroin use disorder. The client reports chronic flu-like symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection does the nurse suspect? hepatitis A syphilis herpes simplex trichomoniasis
hepatitis A -Hepatitis A produces flu-like symptoms with malaise, skin rashes, fatigue, anorexia, nausea, pruritus, fever, and upper right quadrant pain. In addition, illicit drug use is a known risk factor for hepatitis A. Symptoms of hepatitis B are similar to those of hepatitis A, but with less fever and skin rash involvement. Syphilis, herpes simplex, and trichomoniasis do not present with these types of symptoms.
The nurse in the sexual health clinic is obtaining a health history of a client who suffers from heroin use disorder. The client reports chronic flu-like symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection does the nurse suspect? trichomoniasis hepatitis A herpes simplex syphilis
hepatitis A -Hepatitis A produces flu-like symptoms with malaise, skin rashes, fatigue, anorexia, nausea, pruritus, fever, and upper right quadrant pain. In addition, illicit drug use is a known risk factor for hepatitis A. Symptoms of hepatitis B are similar to those of hepatitis A, but with less fever and skin rash involvement. Syphilis, herpes simplex, and trichomoniasis do not present with these types of symptoms.
A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata? Treponema pallidum human papillomavirus herpes virus Haemophilus ducreyi bacillus
human papillomavirus -Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Haemophilus ducreyi bacillus is the cause of chancroid.
What is the most common viral infection? gonorrhea chlamydia trichomoniasis human papillomavirus (HPV)
human papillomavirus (HPV) -HPV infection is the most common viral infection. Millions of Americans are infected with HPV, many unaware that they carry the virus.
A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply. multiple sex partners 29 years of age vaginal douching approximately once a week intrauterine contraceptive device inserted 3 weeks ago residence in a suburban area
multiple sex partners vaginal douching approximately once a week intrauterine contraceptive device inserted 3 weeks ago -All sexually active women are at risk of PID, but common risk factors include age less than 25 years old, residence in an inner city, multiple sexual partners, sex with a new partner, insertion of an intrauterine contraceptive (IUC) within the past 6 weeks, vaginal douching, history of STI in the woman or her partner, lack of barrier contraceptive use, and a previous episode of PID.
An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported? hepatitis B syphilis condylomata acuminata genital herpes
syphilis -The law mandates reporting of syphilis, chlamydia, gonorrhea, chancroid, and HIV/AIDS. Genital herpes, hepatitis B, anogenital warts (condylomata acuminata), granuloma inguinale, and lymphoma venereum are not reportable by law.
A community health nurse is presenting to group of adolescents on how to reduce their risks of contracting sexually transmitted infections (STIs). The nurse feels confident learning has taken place when the participants identify which as the best preventive measure? engaging only in oral sex using combination oral contraceptives abstaining from sexual activity using latex condoms during sexual activity
using latex condoms during sexual activity -Safer-sex practices that include limiting the number of sexual partners and using latex condoms must be recommended to all sexually active individuals. Healthy People 2030 advocates for the increase in the proportion of sexually active persons aged 15 to 19 years who use condoms to provide barrier protection against disease. Abstinence is the safest way to protect them from an STI, but it has not been proven as a successful strategy for teens. Oral contraceptives will not protect them from an STI. They may still acquire an STI with oral sexual activity.
A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection? viral culture of vesicular fluid IgG/IgM antibody testing Papanicolaou smear treponemal testing
viral culture of vesicular fluid -Diagnosis of HSV is often based on clinical signs and symptoms and is confirmed by viral culture of fluid from the vesicles. The IgG/IgM antibody testing is frequently done for screening purposes. Papanicolaou (Pap) smears are an insensitive and nonspecific diagnostic test for HSV and should not be relied on for diagnosis. Treponemal testing is used to diagnose syphilis.
A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques are observed on the vaginal wall. The nurse suspects which condition? vulvovaginal candidiasis chlamydia bacterial vaginosis trichomoniasis
vulvovaginal candidiasis -Pruritus accompanied by a thick curd-like vaginal discharge and white plaques on the vaginal wall are characteristic of vulvovaginal candidiasis. Trichomoniasis is characterized by a heavy yellow or green or gray frothy or bubbly discharge. Bacterial vaginosis is characterized by a thin white homogeneous vaginal discharge. Chlamydia is usually manifested by a mucopurulent vaginal discharge.
