Chapter 5: Sexually Transmitted Infections
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. "Many recognize they have the infection and seek treatment immediately." "Infections may be transmitted by individuals unaware that they have it." "The virus remains quiet until a stressful event occurs to reactivate it." "Your baby is protected from this infection by the placenta." "Transmission is through contact of infected mucous membranes."
"The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it." "Transmission is through contact of infected mucous membranes." Explanation: 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 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? "All individuals are susceptible if exposed to the infectious organism." "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." "Women are equally diagnosed over men as they will seek treatment first." "Certain infections can be transmitted to the newborn."
"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." Explanation: 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 nurse is caring for a client with vaginitis. What teaching(s) should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply. Take a bubble bath once a week. Avoid douching. Avoid using deodorant tampons. Wear only cotton panties and ventilated pantyhose. Clean the perineal area from back to front.
Avoid using deodorant tampons. Avoid douching. Wear only cotton panties and ventilated pantyhose. Explanation: The nurse should teach the client ways to help prevent vaginitis. Prevention activities include avoiding douching to prevent altering the vaginal environment; using condoms to avoid spreading the organism; urinating with knees spread wide apart; avoiding tights, nylon underpants, and tight clothes; wiping from front to back after using the toilet; washing only with hypoallergenic bar soap, avoiding liquid soaps or body washes; avoiding powders, bubble baths, and perfumed vaginal sprays; wearing clean cotton underpants; and washing and drying the vulvar area gently after baths or showers.
The nurse is caring for a client diagnosed with trichomoniasis. The health care provider has prescribed a single dose of metronidazole. Which information will the nurse provide this client? "Avoid alcohol consumption for at least 24 hours after you take this medication." "Once you are healed, you need to come back to get the human papillomavirus (HPV) vaccination." "We need to complete a pregnancy test first, to be sure you can take this medication." "You may crush or chew this tablet if you have difficulty swallowing medications."
Correct response: "Avoid alcohol consumption for at least 24 hours after you take this medication." Explanation: Metronidazole is an antibiotic used to treat bacterial infections of the vagina. The HPV vaccine is not required for clients diagnosed with trichomoniasis. The nurse would educate the client that having one sexually transmitted infection (STI) places the client at higher risk for future STIs; however, the client does not have to receive the vaccine. A pregnancy test is not necessary, because metronidazole is safe to take during pregnancy. Clients should not consume alcohol or foods or medicines that contain propylene glycol while taking metronidazole and for at least 1 day after to avoid unpleasant side effects (tachycardia, flushed, nausea, vomiting). The nurse would instruct the client to not crush, chew, or break the extended-release tablet.
The nurse is caring for a client diagnosed with candida vaginitis. The nurse knows additional teaching is needed when the client makes which statement? "Eating yogurt can may help limit 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." "I should wear cotton underwear to prevent future infections."
Correct response: "Douching is an effective way to cleanse the vaginal area after intercourse." Explanation: 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? "People with trichomoniasis will have burning when they urinate." "Genital ulcers are a sign of genital herpes simplex." "Gonorrhea can be prevented with a vaccine." "Chlamydia remains localized if not treated."
Correct response: "Genital ulcers are a sign of genital herpes simplex." Explanation: 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.
The clinic nurse is treating a client diagnosed with HIV. Which statement made by the client indicates the teaching was successful? "If I do not take my medications as prescribed, my red blood cell count will fall." "Right now I have HIV, but eventually it will develop into AIDS." "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."
Correct response: "If my CD4 T-cell count drops below 200 cells/mm3 (0.2 × 109/l), my HIV has progressed to AIDS." Explanation: 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.
After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement? "Condoms should be applied before any genital contact." "Condoms should be stored in a cool, dry place." "It's okay to use petroleum jelly with a latex condom." "Latex condoms are the best protection from STIs."
Correct response: "It's okay to use petroleum jelly with a latex condom." Explanation: If external lubricants are used, use only water-based lubricants with latex condoms. Oil-based or petroleum-based lubricants, such as body lotion, massage oil, or cooking oil, can weaken latex condoms. Latex condoms are the best protection from STIs. Condoms are applied before any genital contact because sperm is present in preejactulate fluid. Condoms also should be stored in a cool, dry place away from direct sunlight to prevent deterioration.
During a routine examination, a 14-year-old client states, "I do have unprotected sex." Which reply by the nurse is most appropriate? "Have you received the human papillomavirus (HPV) vaccine?" "You really need to be tested for sexually transmitted infections (STIs)." "Let me teach you how to properly apply a condom." "Do you understand the risks involved in having unprotected sex?"
Correct response: "Let me teach you how to properly apply a condom." Explanation: Health care providers have a unique opportunity to provide counseling and education to their clients. Nurses working with adolescents need to convey their willingness to discuss sexual habits, and any interactions with clients need to be direct and nonjudgmental. The nurse should use this opportunity to teach the client how to correctly apply a condom. Even if the client states previous understanding, the nurse would not assume the client has been properly educated on pregnancy and STI prevention. Asking if the client has received the HPV vaccine is a closed statement and does not provide the benefit of teaching preventative measures to the client. At this age, the client is prone to risk-taking behavior due to a lack of understanding risks and the permanence of some consequences. Asking a closed-ended question about risks is not beneficial to the nurse or client. The nurse would discuss the benefit of being tested for STIs, not dictate the client needs to be tested. This could cause the client to no longer trust the nurse.
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 results in ulcers in the genital area." "This STI is an infection that will result in the formation of genital warts." "This STI is an infection that will cause itching in the genital area."
Correct response: "This STI is characterized by an infection of your cervix." Explanation: 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 to suppress any symptoms of the infection." "The severity of future attacks will be much less after using this drug." "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."
Correct response: "This drug will help to suppress any symptoms of the infection." Explanation: 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 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? "It is important to put the condom on just before the penis is erect." "Ensure your condom is always available, so store condoms in your wallet." "Use only petroleum-based lubricants, such as body lotion or massage oil." "Withdraw the penis erect, holding the condom firmly against the penis."
Correct response: "Withdraw the penis erect, holding the condom firmly against the penis." Explanation: 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.
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? 40 25 32 28
Correct response: 25 Explanation: 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% 70% 90% 50%
Correct response: 70% Explanation: Asymptomatic infection is common among both men and women, affecting 50% and 70%, respectively.
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. Report signs of an oral yeast infection. Take the drug on an empty stomach. Use a sunscreen when outside.
Correct response: Avoid alcohol consumption. Explanation: 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 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? Arrange for follow-up visits to her health care provider. Refer the client to the women's sexual health clinic. Discuss the necessity of completing the antibiotic therapy. Provide the client with brochures on sexually transmitted infection prevention.
Correct response: Discuss the necessity of completing the antibiotic therapy. Explanation: 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 client comes to the clinic because she suspects she has syphilis. The nurse teaches the woman she will also need additional testing for: gonorrhea. chlamydia. trichomoniasis. HIV.
Correct response: HIV. Explanation: According to CDC guidelines, any clients seeking treatment for an STI should also be tested for HIV. Any clients with risky sexual behaviors, men who have sex with men, and all people 13 to 64 years old should also be tested. Trichomoniasis testing should be completed if the HIV-positive woman is pregnant and should be done annually if the woman is HIV positive.
A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby? Administer cephalosporins to mother during pregnancy. Perform cesarean birth to prevent infection. Administer an antiretroviral syrup to the newborn. Instill a prophylactic agent in the eyes of the newborn.
Correct response: Instill a prophylactic agent in the eyes of the newborn. Explanation: 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.
A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse prioritize to help prevent further spread of the infection in the community? Educate adolescents to delay the onset of sexual activity. Ensure that the drinking water is disease-free. Instruct people to get vaccinated. Educate about the risks of injecting drugs.
Correct response: Instruct people to get vaccinated. Explanation: The nurse should instruct all community members to get vaccinated for the prevention of hepatitis B. Ensuring that drinking water is disease-free and educating people about the risks involved with injecting drugs may help prevent hepatitis A, not hepatitis B. Delaying the start of sexual activity by adolescents may not protect them from hepatitis B in the long run.
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 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." It is recommended to formula-feed your newborn as it is transmitted through your breast milk." "The risk of your newborn being infected with HIV infection is about 1%."
Correct response: It is recommended to formula-feed your newborn as it is transmitted through your breast milk." Explanation: 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.
The nurse is preparing a presentation for a group of adolescents and young adults about sexually transmitted infections and the use of condoms. Which information will the nurse include? A condom does not need to be used for oral sex. Body lotion can be used as a lubricant. Leave space at the tip of the condom. Use both a male and female condom together.
Correct response: Leave space at the tip of the condom. Explanation: The condom should be positioned so there is space (approximately 0.5 in/1.25 cm) at the penis tip to collect the ejaculate without placing undue pressure on the condom. To be effective, a condom must be applied before any penile-vulvar contact as even preejaculation fluid may contain some sperm. To prevent transmission of sexually transmitted infections, condoms or dental dams are recommended for oral sex. It is not recommended to use both a male and female condom together. Only water-soluble lubricants should be used with condoms. Oil-based lubricants, such as body lotion, can weaken the condom making it more likely to tear or break during intercourse.
Which instruction should be given to a woman newly diagnosed with genital herpes? 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. Have your partner use a condom when lesions are present.
Correct response: Limit stress and emotional upset as much as possible. Explanation: 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.
Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection? Pat or blot the skin dry. Take tub baths regularly. Have regular cancer screening examinations. Participate in early prenatal care.
Correct response: Participate in early prenatal care. Explanation: 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.
A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection? Antiviral drug therapy cures the infection completely. Recurrent HSV infection episodes are longer and more severe. Safety of antiviral therapy during pregnancy has not been established. Kissing during the primary episode does not transmit the virus.
Correct response: Safety of antiviral therapy during pregnancy has not been established. Explanation: The nurse should inform the client that there is no evidence to suggest that antiviral therapy is completely safe during pregnancy. HSV cannot be cured completely, even with timely antiviral drug therapy, and there may be recurrences. The viral shedding process continues for 2 weeks during the primary episode, and kissing during this period may transmit the disease. Recurrent HSV-infection episodes are shorter and milder.
The nurse is caring for a male client diagnosed with gonorrhea and chlamydia. Which health care provider order will the nurse question? notification of all recent sexual partners acyclovir 400 mg orally BID avoidance of sexual activity until treatment is complete rapid serum HIV test
Correct response: acyclovir 400 mg orally BID Explanation: 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 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? an antiviral agent an azole antifungal agent a penicillin antibiotic a quinolone antibiotic
Correct response: an azole antifungal agent Explanation: 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.
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 metronidazole benzathine penicillin G doxycycline
Correct response: benzathine penicillin G Explanation: 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 diffuse skin rash dry, hacking cough burning on urination
Correct response: burning on urination Explanation: 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? candidiasis syphilis chlamydia gonorrhea
Correct response: candidiasis Explanation: 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 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? syphilis chlamydia HPV candidiasis
Correct response: chlamydia Explanation: 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 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? gonorrhea candidiasis syphilis chlamydia
Correct response: chlamydia Explanation: 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 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 irregular menstrual cycles clients with fibrocystic breast disease clients who have not had babies
Correct response: clients who have genital warts Explanation: 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.
Clients who have had PID are prone to which complication? inguinal lymphadenopathy ectopic pregnancy ovarian cancer multiple gestation
Correct response: ectopic pregnancy Explanation: 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? getting individuals to change their behaviors educating on how to promote sexual health interfering with the mode of transmission increasing the availability of resources
Correct response: educating on how to promote sexual health Explanation: 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? using condoms urinating immediately after intercourse limiting sexual partners engaging in abstinence
Correct response: engaging in abstinence Explanation: 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 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.
Correct response: female adolescents are more susceptible to STIs due to their anatomy. Explanation: 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.
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? genital herpes gonorrhea syphilis chlamydia
Correct response: genital herpes Explanation: 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 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: genital pruritus and paresthesia. dysuria and lymphadenopathy. vaginal and urethral discharge. headache and fever.
Correct response: genital pruritus and paresthesia. Explanation: 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 23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect? syphilis chlamydia HSV gonorrhea
Correct response: gonorrhea Explanation: Typical symptoms in women infected with gonorrhea include abnormal vaginal discharge, dysuria, cervicitis, abnormal vaginal bleeding, Bartholin abscess, and PID.
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? green vaginal discharge lesions on the vulva urinary incontinence flu-like symptoms
Correct response: green vaginal discharge Explanation: 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.
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? herpes simplex syphilis trichomoniasis hepatitis A
Correct response: hepatitis A Explanation: 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? herpes virus Treponema pallidum human papillomavirus Haemophilus ducreyi bacillus
Correct response: human papillomavirus Explanation: 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.
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas copper-colored macules on the palms and soles that appeared after a brief fever one or more flat, wartlike papules in the genital area that are sensitive to touch a painless genital ulcer that appeared about 3 weeks after unprotected sex
Correct response: human papillomavirus (HPV) Explanation: HPV infection is the most common viral infection. Millions of Americans are infected with HPV, many unaware that they carry the virus.
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 six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? valacyclovir penicillin metronidazole azithromycin
Correct response: metronidazole Explanation: The character of the discharge, lack of recent sexual activity, and current antibiotic treatment point to infection with Trichomonas vaginalis, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, enable the protozoan to proliferate. Trichomoniasis responds well to treatment with metronidazole.
Which medication is the most effective treatment for trichomoniasis? metronidazole penicillin G benzathine azithromycin doxycycline
Correct response: metronidazole Explanation: 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.
A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe? clotrimazole penicillin G acyclovir metronidazole
Correct response: metronidazole Explanation: Trichomoniasis is a common vaginal infection with the therapeutic management of metronidazole or tinidazole for both partners. Trichomoniasis is a common, curable sexually transmitted infection (STI) caused by a parasitic protozoa called Trichomonas.
A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect which finding once the microorganism disseminates throughout the body? intermenstrual bleeding painful joints sore throat painful urination
Correct response: painful joints Explanation: The client with an anal gonorrheal infection experiences symptoms of gonorrhea where the microorganism has invaded the rectum. After the microorganism disseminates throughout the body, the client may manifest a skin rash, fever, and painful joints. Other symptoms such as infections of the urinary tract or vagina, sore throat, intermenstrual bleeding due to cervicitis, and painful urination are associated with the organism's invasion of those structures, depending on the nature of the sexual contact.
What is the medication of choice for early syphilis? penicillin G benzathine tetracycline ceftriaxone doxycycline
Correct response: penicillin G benzathine Explanation: A single dose of penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Clients who are allergic to penicillin are usually treated with doxycycline or tetracycline. Ceftriaxone is not the medication of choice for syphilis.
A nurse is assessing a male client recently diagnosed with genital herpes. Which finding would most likely correlate with this diagnosis? reports of itching, tingling and pain in genital area a chancre on the penis wart-like flesh-colored lesions on the scrotal area painful urination with a penile discharge present
Correct response: reports of itching, tingling and pain in genital area Explanation: Initial symptoms for a male with genital herpes would include itching, tingling, and pain in genital area followed by small pustules and blister-like genital lesions. Gonorrhea presents with a penile discharge (pus). Wart-like lesions that are soft, moist, or flesh-colored and appear on the scrotum with HPV. Syphilis in both male and female presents with a chancre.
Pelvic infection is most commonly caused by: sexual transmission. insertion of intrauterine device. induced abortion (medical abortion). hysteroscopy.
Correct response: sexual transmission. Explanation: Pelvic infection is most commonly caused by sexual transmission but can also occur with invasive procedures such as endometrial biopsy, induced abortion (medical abortion), hysteroscopy, or insertion of an intrauterine device.
A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis? pain-free crusty genital lesions yellow vaginal discharge sore throat and flu-like symptoms painful dysuria
Correct response: sore throat and flu-like symptoms Explanation: With a secondary infection of syphilis, there would be no evidence of vaginal lesions present. Present would be a maculopapular rash (hands and feet); a sore throat; lymphadenopathy; and flu-like symptoms. Dysuria is not seen in the secondary infection. A yellow vaginal discharge is for gonorrhea.
Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? gonorrhea Gardnerella vaginalis vaginitis candidiasis trichomoniasis
Correct response: trichomoniasis Explanation: 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. The discharge 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 assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms? human papillomavirus herpes simplex 2 trichomoniasis syphilis
Correct response: trichomoniasis Explanation: Trichomoniasis symptoms are vulvar itching and a malodorous foamy yellow vaginal discharge.
A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis? cottage cheese-like discharge warts in the vulva and labia vaginal odor smelling of fish intense itching of the vulva
Correct response: vaginal odor smelling of fish Explanation: Bacterial vaginosis causes a "stale fish" vaginal odor. Cottage cheese-like discharge is seen in candidiasis and not in bacterial vaginosis, in which the discharge is thin and gray-white. Intense itching of the vulva is associated with candidiasis, not vaginosis. Warts in the vulva and labia are seen in human papillomavirus infection, not in vaginosis.
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 treponemal testing Papanicolaou smear
Correct response: viral culture of vesicular fluid Explanation: 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? trichomoniasis chlamydia bacterial vaginosis vulvovaginal candidiasis
Correct response: vulvovaginal candidiasis Explanation: 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.
A nurse is preparing a teaching plan for a female client diagnosed with genital ulcers. Which instructions would the nurse include in this teaching plan? Select all that apply. "Use a condom when having sexual intercourse with any noninfected partner." "Avoid having sex when any ulcers are present." "Apply ice packs to the area for 20 minutes every few hours." "Try using cool sitz baths to help relieve the discomfort." "Air dry any lesions with a hair dryer on the low setting."
Use a condom when having sexual intercourse with any noninfected partner." "Avoid having sex when any ulcers are present." "Air dry any lesions with a hair dryer on the low setting." Explanation: Teaching a client with genital ulcers includes avoiding extremes of temperature such as ice packs or hot packs, using a condom with all new or uninfected sexual partners, avoiding sex during the prodromal period and when lesions are present, using lukewarm sitz baths for discomfort, and air-drying lesions with a hair dryer on the low setting.
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. 29 years of age vaginal douching approximately once a week multiple sex partners residence in a suburban area intrauterine contraceptive device inserted 3 weeks ago
multiple sex partners intrauterine contraceptive device inserted 3 weeks ago vaginal douching approximately once a week Explanation: 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.
