Chapter 52 - Sexually Transmitted Infections

To prevent the infection and transmission of STIs, the nurse's teaching plan would include an explanation of a. the appropriate use of oral contraceptives. b. sexual positions that can be used to avoid infection. c. the necessity of annual Pap tests for patients with HPV. d. sexual practices that are considered high-risk behaviors.

: d sexual practices that are considered high-risk behaviors. Rationale: Many approaches to curtailing the spread of STIs have been advocated and have met with various degrees of success. Be prepared to discuss "safe" sex practices with all patients, not just those who are perceived to be at risk. These practices include abstinence, monogamy, avoidance of certain high-risk sexual practices, and use of condoms and other barriers to limit contact with potentially infectious body fluids or lesions. Sexual abstinence is a certain method of avoiding all STIs, but few people consider this a feasible alternative to sexual expression. Limiting sexual intimacies outside of a well-established monogamous relationship can reduce the risk of contracting an STI.

Which infection, reported in the health history of a woman who is having difficulty conceiving, will the nurse identify as a risk factor for infertility? a. N. gonorrhoeae b. Treponema pallidum c. Condyloma acuminatum d. Herpes simplex virus type 2

ANS: A Complications of gonorrhea include scarring of the fallopian tubes, which can lead to tubal pregnancies and infertility. Syphilis, genital warts, and genital herpes do not lead to problems with conceiving, although transmission to the fetus (syphilis) or newborn (genital warts or genital herpes) is a concern

Which patient will the nurse plan on teaching about the Gardasil vaccine? a. A 24-year-old female who has not been sexually active b. A 34-year-old woman who has multiple sexual partners c. A 19-year-old woman who is pregnant for the first time d. A 29-year-old woman who is in a monogamous relationship

ANS: A Gardasil is recommended for females ages 9 through 26, preferably those who have never been sexually active. It is not recommended for women during pregnancy or for older women

A 46-year-old man who has had blood drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which action should the nurse take next? a. Ask the patient about past treatment for syphilis. b. Explain the need for blood and spinal fluid cultures. c. Obtain a specimen for fluorescent treponemal antibody absorption (FAT-Abs) testing. d. Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

ANS: A Once antibody testing is positive for syphilis, the antibodies remain present for an indefinite period of time even after successful treatment, so the nurse should inquire about previous treatment before doing other assessments or testing. Culture, FAT-Abs testing, and assessment for symptoms may be appropriate, based on whether the patient has been previously treated for syphilis

A 29-year-old female patient is diagnosed with Chlamydia during a routine pelvic examination. The nurse knows that teaching regarding the management of the condition has been effective when the patient says which of the following? a. "My partner will need to take antibiotics at the same time I do." b. "Go ahead and give me the antibiotic injection, so I will be cured." c. "I will use condoms during sex until I finish taking all the antibiotics." d. "I do not plan on having children, so treating the infection is not important."

ANS: A Sex partners should be treated simultaneously to prevent reinfection. Chlamydia is treated with oral antibiotics. Abstinence from sexual intercourse is recommended for 7 days after treatment, and condoms should be recommended during all sexual contacts to prevent infection. Chronic pelvic pain, as well as infertility, can result from untreated Chlamydia

A 20-year-old woman who is being seen in the family medicine clinic for an annual physical exam reports being sexually active. The nurse will plan to teach the patient about a. testing for Chlamydia infection. b. immunization for herpes simplex. c. infertility associated with the human papillomavirus (HPV). d. the relationship between the herpes virus and cervical cancer.

ANS: A Testing for Chlamydia is recommended for all sexually active females under age 25 by the Centers for Disease Control and Prevention. HPV infection does not cause infertility. There is no vaccine available for herpes simplex, and herpes simplex infection does not cause cervical cancer

A 19-year-old patient has genital warts around her external genitalia and perianal area. She tells the nurse that she has not sought treatment until now because "the warts are so disgusting." Which nursing diagnosis is most appropriate? a. Disturbed body image related to feelings about the genital warts b. Ineffective coping related to denial of increased risk for infection c. Risk for infection related to lack of knowledge about transmission d. Anxiety related to impact of condition on interpersonal relationships

ANS: A The patient's statement that her lesions are disgusting suggests that disturbed body image is the major concern. There is no evidence to indicate ineffective coping or lack of knowledge about mode of transmission. The patient may be experiencing anxiety, but there is nothing in the data indicating that the genital warts are impacting interpersonal relationships.

The nurse in the outpatient clinic notes that the following patients have not received the human papillomavirus (HPV) vaccine. Which patients should the nurse plan to teach about benefits of the vaccine (select all that apply)? a. 24-year-old man who has a history of genital warts b. 18-year-old man who has had one male sexual partner c. 28-year-old woman who has never been sexually active d. 20-year-old woman who has a newly diagnosed Chlamydia infection e. 30-year-old woman whose sexual partner has a history of genital warts

ANS: A, B, D The HPV vaccines are recommended for male and female patients between ages 9 through 26. Ideally, the vaccines are administered before patients are sexually active, but they offer benefit even to those who already have HPV infection

A 39-year-old patient with a history of IV drug use is seen at a community clinic. The patient reports difficulty walking, stating "I don't know where my feet are." Diagnostic screening reveals positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-Abs) tests. Based on the patient history, what will the nurse assess (select all that apply)? a. Heart sounds b. Genitalia for lesions c. Joints for swelling and inflammation d. Mental state for judgment and orientation e. Skin and mucous membranes for gummas

ANS: A, D, E The patient's clinical manifestations and laboratory tests are consistent with tertiary syphilis. Valvular insufficiency, gummas, and changes in mentation are other clinical manifestations of this stage

A 22-year-old patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin) and is given a prescription for doxycycline (Vibramycin) 100 mg bid for 7 days. The nurse explains to the patient that this combination of antibiotics is prescribed to a. prevent reinfection during treatment. b. treat any coexisting chlamydial infection. c. eradicate resistant strains of N. gonorrhoeae. d. prevent the development of resistant organisms.

ANS: B Because there is a high incidence of co-infection with gonorrhea and chlamydia, patients are usually treated for both. The other explanations about the purpose of the antibiotic combination are not accurate

A patient admitted with chest pain is also found to have positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-Abs) tests, rashes on the palms and the soles of the feet, and moist papules in the anal and vulvar area. Which action will the nurse include in the plan of care? a. Assess for arterial aneurysms. b. Wear gloves for patient contact. c. Place the patient in a private room. d. Apply antibiotic ointment to the perineum.

ANS: B Exudate from any lesions with syphilis is highly contagious. Systemic antibiotics, rather than local treatment of lesions, are used to treat syphilis. The patient does not require a private room because the disease is spread through contact with the lesions. This patient has clinical manifestations of secondary syphilis and does not need to be monitored for manifestations of tertiary syphilis

A 48-year-old male patient who has been diagnosed with gonococcal urethritis tells the nurse he had recent sexual contact with a woman but says she did not appear to have any disease. In responding to the patient, the nurse explains that a. women do not develop gonorrhea infections but can serve as carriers to spread the disease to males. b. women may not be aware they have gonorrhea because they often do not have symptoms of infection. c. women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations. d. when gonorrhea infections occur in women, the disease affects only the ovaries and not the genital organs.

ANS: B Many women with gonorrhea are asymptomatic or have minor symptoms that are overlooked. The disease may affect both the genitals and the other reproductive organs and cause complications such as pelvic inflammatory disease (PID). Women who can transmit the disease have active infections

A 32-year-old woman who is diagnosed with Chlamydia tells the nurse that she is very angry because her husband is her only sexual partner. Which response should the nurse make first? a. "You may need professional counseling to help resolve your anger." b. "It is understandable that you are angry with your husband right now." c. "Your feelings are justified and you should share them with your husband." d. "It is important that both you and your husband be treated for the infection."

ANS: B This response expresses the nurse's acceptance of the patient's feelings and encourages further discussion and problem solving. The patient may need professional counseling, but more assessment of the patient is needed before making this judgment. The nurse should also assess further before suggesting that the patient share her feelings with the husband because problems such as abuse might be present in the relationship. Although it is important that both partners be treated, the patient's current anger suggests that this is not the appropriate time to bring this up

Which topics will the nurse include when preparing to teach a patient with recurrent genital herpes simplex (select all that apply)? a. Infected areas should be kept moist to speed healing. b. Sitz baths may be used to relieve discomfort caused by the lesions. c. Genital herpes can be cured by consistent use of antiviral medications. d. Recurrent genital herpes episodes usually are shorter than the first episode. e. The virus can infect sexual partners even when you do not have symptoms of infection.

ANS: B, D, E Patients are taught that shedding of the virus and infection of sexual partners can occur even in asymptomatic periods, that recurrent episodes resolve more quickly, and that sitz baths can be used to relieve pain caused by the lesions. Antiviral medications decrease the number of outbreaks, but do not cure herpes simplex infections. Infected areas may be kept dry if this decreases pain and itching

When a 31-year-old male patient returns to the clinic for follow-up after treatment for gonococcal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection, which question is most appropriate for the nurse to ask the patient? a. "Did you take the prescribed antibiotic for a week?" b. "Did you drink at least 2 quarts of fluids every day?" c. "Were your sexual partners treated with antibiotics?" d. "Do you wash your hands after using the bathroom?"

ANS: C A common reason for recurrence of symptoms is reinfection because infected partners have not been simultaneously treated. Because gonorrhea is treated with one dose of antibiotic, antibiotic therapy for a week is not needed. An adequate fluid intake is important, but a low fluid intake is not a likely cause for failed treatment. Poor hygiene may cause complications such as ocular trachoma but will not cause a failure of treatment

A woman is diagnosed with primary syphilis during her eighth week of pregnancy. The nurse will plan to teach the patient about the a. likelihood of a stillbirth. b. plans for cesarean section c. intramuscular injection of penicillin. d. antibiotic eye drops for the newborn.

ANS: C A single injection of penicillin is recommended to treat primary syphilis. This will treat the mother and prevent transmission of the disease to the fetus. Instillation of erythromycin into the eyes of the newborn is used to prevent gonorrheal eye infections. C-section is used to prevent the transmission of herpes to the newborn. Although stillbirth can occur if the fetus is infected with syphilis, treatment before the tenth week of gestation will eliminate in utero transmission to the fetus.

Which statement by a 24-year-old patient indicates that the nurse's teaching about management of primary genital herpes has been effective? a. "I will use acyclovir ointment on the area to relieve the pain." b. "I will use condoms for intercourse until the medication is all gone." c. "I will take the acyclovir (Zovirax) every 8 hours for the next week." d. "I will need to take all of the medication to be sure the infection is cured."

ANS: C The treatment regimen for primary genital herpes infections includes acyclovir 400 mg 3 times daily for 7 to 10 days. The patient is taught to abstain from intercourse until the lesions are gone. (Condoms should be used even when the patient is asymptomatic.) Acyclovir ointment is not effective in treating lesions or reducing pain. Herpes infection is chronic and recurrent

After the nurse has taught a patient with a newly diagnosed sexually transmitted infection about expedited partner therapy, which patient statement indicates that the teaching has been effective? a. "I will tell my partner that it is important to be examined at the clinic." b. "I will have my partner take the antibiotics if any STI symptoms occur." c. "I will make sure that my partner takes all of the prescribed medication." d. "I will have my partner use a condom until I have finished the antibiotics."

ANS: C With expedited partner therapy, the patient is given a prescription or medications for the partner. The partner does not need to be evaluated by the health care provider, but is presumed to be infected and should be treated concurrently with the patient. Use of a condom will not treat the presumed STI in the partner

A 32-year-old man who has a profuse, purulent urethral discharge with painful urination is seen at the clinic. Which information will be most important for the nurse to obtain? a. Contraceptive use b. Sexual orientation c. Immunization history d. Recent sexual contacts

ANS: D Information about sexual contacts is needed to help establish whether the patient has been exposed to a sexually transmitted infection (STI) and because sexual contacts also will need treatment. The other information also may be gathered but is not as important in determining the plan of care for the patient's current symptoms

A 55-year-old woman in the sexually transmitted infection (STI) clinic tells the nurse that she is concerned she may have been exposed to gonorrhea by her partner. To determine whether the patient has gonorrhea, the nurse will plan to a. interview the patient about symptoms of gonorrhea. b. take a sample of cervical discharge for Gram staining. c. draw a blood specimen or rapid plasma reagin (RPR) testing. d. obtain secretions for a nucleic acid amplification test (NAAT).

ANS: D NAAT has a high sensitivity (similar to a culture) for gonorrhea. Because women have few symptoms of gonorrhea, asking the patient about symptoms may not be helpful in making a diagnosis. Smears and Gram staining are not useful because the female genitourinary tract has many normal flora that resemble N. gonorrhoeae. RPR testing is used to detect syphilis

A primary HSV infection differs from recurrent HSV episodes in that (select all that apply) a. only primary infections are sexually transmitted. b. symptoms are less severe during recurrent episodes. c. transmission of the virus to a fetus is less likely during primary infection. d. systemic manifestations such as fever and myalgia are more common in primary infection. e. lesions from recurrent HSV are more likely to transmit the virus than lesions from primary HSV.

B symptoms are less severe during recurrent episodes. D systemic manifestations such as fever and myalgia are more common in primary infection. Rationale: Primary herpes simplex virus (HSV) infections (i.e., genital herpes) tend to be associated with local inflammation and pain, and they are accompanied by systemic manifestations of fever, headache, malaise, myalgia, and regional lymphadenopathy. The symptoms of recurrent genital herpes episodes are less severe, and the lesions usually heal within 8 to 12 days

The individual with the lowest risk for sexually transmitted pelvic inflammatory disease is a woman who uses a. oral contraceptives. b. barrier methods of contraception. c. an intrauterine device for contraception. d. Norplant implant or injectable Depo-Provera for contraception.

B. barrier methods of contraception. Rationale: The condom is considered to be the best form of protection against sexually transmitted infections (STIs).

The nurse is obtaining a subjective data assessment from a woman reported as a sexual contact of a man with chlamydial infection. The nurse understands that symptoms of chlamydial infection in women a. are frequently absent. b. are similar to those of genital herpes. c. include a macular palmar rash in the later stages. d. may involve chancres inside the vagina that are not visible.

a are frequently absent Rationale: Chlamydial infections are known as a silent disease because symptoms are absent or minor in most infected women and in many men.

In assessing patients for STIs, the nurse needs to know that many STIs can be asymptomatic. Which STIs can be asymptomatic (select all that apply)? a. Syphilis b. Gonorrhea c. Genital warts d. Genital herpes e. Chlamydial infection

a, b, c, d, e Rationale: Syphilis (especially in the later stages), gonorrhea, genital warts, genital herpes, and chlamydial infection can all be asymptomatic. Because of the high prevalence of asymptomatic STIs, screening of populations at high risk is needed to identify those who are infected.

A young male patient is seeking treatment for recurrence of genital tingling, burning, and itching. The nurse will expect a prescription for which class of medications? a. Antivirals b. Antibiotics c. Vaccination d. Contraceptives

a. Antivirals This patient is experiencing a reoccurrence of genital herpes (HSV2). Although not a cure, he will be treated with antiviral medications to decrease the duration of viral shedding and the healing time of genital lesions and reduce outbreaks. Antibiotics and contraceptives are not used to treat acute HSV2. There are no vaccinations for HSV.

A patient comes to the clinic after being informed by a sexual partner of possible recent exposure to syphilis. The nurse will examine the patient for what characteristic finding of syphilis in the primary clinical stage? a. Chancre b. Alopecia d. Condylomata lata c. Regional adenopathy

a. Chancre Chancres appear in the primary stage of the bacterial invasion of Treponema pallidum, the causative organism of syphilis. The other findings do not appear until the secondary stage of syphilis, occurring a few weeks after the chancres appear.

What should teaching for patients with a sexually transmitted infection (STI) include (select all that apply.)? a. Treatment of sexual partners b. Douching may help to provide relief of itching. Importance of retesting after treatment to confirm cure c. Cotton undergarments are preferred over synthetic materials. d. Sexual abstinence is indicated during the communicable phase of the disease. e. Condoms should be used during as well as after treatment during sexual activity.

a. Treatment of sexual partners

What should teaching for patients with a sexually transmitted infection (STI) include (select all that apply.)? a. Treatment of sexual partners b. Douching may help to provide relief of itching. Importance of retesting after treatment to confirm cure c. Cotton undergarments are preferred over synthetic materials. d. Sexual abstinence is indicated during the communicable phase of the disease. e. Condoms should be used during as well as after treatment during sexual activity.

a. Treatment of sexual partners c. Cotton undergarments are preferred over synthetic materials. d. Sexual abstinence is indicated during the communicable phase of the disease. e. Condoms should be used during as well as after treatment during sexual activity.

A 22-yr-old man is being treated at a college health care clinic for gonorrhea. What should the nurse include in patient teaching? a. "While being treated for the infection, you will not be able to pass this infection on to your sexual partner." b. "While you're taking the antibiotics, you will need to abstain from participating in sexual activity and drinking alcohol." c. "It's important to complete your full course of antibiotics in order to ensure that you become resistant to reinfection." d. "The symptoms of gonorrhea will resolve on their own, but it is important for you to abstain from sexual activity while this is occurring."

b. "While you're taking the antibiotics, you will need to abstain from participating in sexual activity and drinking alcohol." Treatment for gonorrhea necessitates abstinence from sexual activity (to prevent infection of partners) and alcohol (to avoid urethral irritation). The disease is not self-limiting, nor does successful treatment confer future resistance.

A 52-yr-old man with a primary infection of genital herpes was prescribed acyclovir (Zovirax) orally for 10 days. The patient returns to the clinic for a follow-up visit. Which finding indicates that treatment is effective? a. Negative bacterial culture b. Absence of genital lesions c. Reduction of genital warts d. No drainage from chancre sore

b. Absence of genital lesions Primary genital herpes is a viral disorder caused by the herpes simplex virus. Genital herpes results in painful, vesicular lesions. The lesions rupture, form crusts, and heal in 17 to 21 days. Genital warts are caused by the human papillomavirus. Genital herpes is caused by a viral infection (not bacterial). Syphilis is caused by a bacterial organism and results in a chancre, which is a painless, indurated lesion.

The patient is being treated for a recurrent episode of Chlamydia. What should the nurse include in patient teaching? a. If you are treated, your sexual partner will not need to be treated. b. Abstain from sexual intercourse for 7 days after finishing the treatment. c. You will probably get gonorrhea if you have another recurrence of Chlamydia. d. Because you have been treated before, you do not need to take a full course of medication this time.

b. Abstain from sexual intercourse for 7 days after finishing the treatment. Abstinence and then condom use are the best prevention of STIs. Spermicidal jellies or creams do not reduce the risk of contracting STIs. Most STIs are curable, but complications are serious and costly if they are not cured. Douches may spread the infection, undermine local immune responses, and do not prevent STIs. Cleansing of the penis will provide comfort after an STI has been diagnosed but will not prevent STIs.

The nurse administers a Gardasil vaccine to an 18-yr-old female patient. After the injection, which patient instruction is priority? a. Avoid sexual activity for 24 to 48 hours. b. Remain lying down for at least 15 minutes. c. Return to the clinic in 6 months for a second dose. d. Use two methods of birth control to avoid pregnancy.

b. Remain lying down for at least 15 minutes. To prevent syncope (fainting) during and after the administration of Gardasil, the patient should remain sitting or lying down for 15 minutes. The vaccine is not recommended during pregnancy. Gardasil vaccine is given in three IM doses over a 6-month period. There are no sexual activity restrictions after administration of Gardasil.

Provide emotional support to a patient with an STI by a. offering information on how safer sexual practices can prevent STIs. b. showing concern when listening to the patient who expresses negative feelings. c. reassuring the patient that the disease is highly curable with appropriate treatment. d. helping the patient who received an STI from his or her sexual partner in forgiving the partner.

b. showing concern when listening to the patient who expresses negative feelings. Rationale: The diagnosis of an STI may be met with a variety of emotions, such as shame, guilt, anger, and even a desire for vengeance. Provide counseling, and try to help the patient verbalize feelings. Support and a willingness to listen to the patient's concerns are needed.

A 19-yr-old man comes to the outpatient clinic for treatment of uncomplicated gonorrhea. Which patient statement requires immediate clarification by the nurse? a."I should avoid alcohol intake for at least 2 weeks." b."I will have my sexual partner come in for treatment." c. "After I start the antibiotic, it is safe to have sex again." d."After the treatment, I do not need to return to the clinic for retesting."

c. "After I start the antibiotic, it is safe to have sex again." Patients should avoid sexual intercourse for 7 days after completing treatment with antibiotics. All sexual contact of patients with gonorrhea must be evaluated and treated to prevent reinfection. Patients should abstain from sexual intercourse and alcohol during treatment. Sexual intercourse allows the infection to spread and can delay healing. Alcohol is irritating to the healing urethral walls. Patients with uncomplicated gonorrhea who are treated do not need to return to the clinic to confirm the disease has been cured.

In working with teenagers, what should the nurse include when teaching about prevention of STIs? a. Spermicidal jellies reduce the risk of getting STIs. b. STIs are easily cured so prevention is not important. c. Abstinence and then condoms are the best prevention. d. Douches for women and cleaning the penis will prevent STIs.

c. Abstinence and then condoms are the best prevention. Teaching for patients with an STI should include the treatment of all sexual partners, retesting after treatment to confirm cure, cotton undergarments are more comfortable, sexual abstinence is needed during the communicable phase of the infection to prevent spread, and condoms should be used for sexual activity during and after treatment to prevent spread and reinfection. Douching may spread the infection or alter the local immune responses and is therefore contraindicated in patients with STIs.

A 24-yr-old patient is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. She is sexually active and has multiple partners. What should the nurse explain as the rationale for Chlamydia screening? a. Chlamydia is frequently comorbid with HIV. b. Chlamydial infections may progress to sepsis. c. Untreated chlamydial infections can lead to infertility. d. Chlamydial infections are treatable only in the early stages of infection.

c. Untreated chlamydial infections can lead to infertility.

A 24-yr-old patient is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. She is sexually active and has multiple partners. What should the nurse explain as the rationale for Chlamydia screening? a. Chlamydia is frequently comorbid with HIV. b. Chlamydial infections may progress to sepsis. c. Untreated chlamydial infections can lead to infertility. d. Chlamydial infections are treatable only in the early stages of infection.

c. Untreated chlamydial infections can lead to infertility. Because of the potential for infertility, routine screening for Chlamydia is recommended for women sexually active younger than age 25 years and annually for those older than 25 years with one or more risk factors for the infection. Chlamydia is not a primary risk for sepsis and is not noted to be strongly correlated with HIV infection. The disease is treatable at all stages of infection.

The history and physical of a 29-yr-old female patient are indicative of human papillomavirus (HPV) infection. What treatment option should be discussed with the patient? a. Gardasil b. Antibiotic therapy c. Wart removal options d. Treatment with antiviral drugs

c. Wart removal options Although discussion should focus on the various options for physically removing the symptomatic warts, the removal may or may not decrease infectivity. The HPV vaccine (Gardasil) is ineffective in cases of existing HPV, and neither antiviral nor antibiotic drugs are effective treatments.

While summarizing teaching regarding genital herpes, which patient statement indicates a need for further instruction? a. "No cure is available for my genital herpes." b. "I will utilize my medication when I begin to have symptoms." c. "Genital herpes may be caused by herpes simplex virus type 1 or 2" d. "I am not able to infect a sexual partner unless I have active lesions."

d. "I am not able to infect a sexual partner unless I have active lesions." The majority of herpes simplex virus (HSV) transmission occurs during asymptomatic periods. When active lesions are present, the patient is most likely to infect others. There is no cure for HSV, but antiviral medication is prescribed for current infections or suppression of recurrent infections. Early treatment reduces the duration of ulcers and risk of transmission. HSV-1 has been commonly associated with cold sores or fever blisters. HSV-2 has been more associated with genital disease. However, HSV-1 and HSV-2 can cause oral or genital lesions.

The nurse obtains a history from a 34-yr-old woman diagnosed with a chlamydial infection. Which patient statement indicates additional teaching is required? a. "This infection can be cured by taking antibiotics." b."It is important to use condoms for all sexual activity." c. "I will avoid sexual contact for 1 week after taking the antibiotics." d. "My sexual partner does not have symptoms and will not need treatment."

d. "My sexual partner does not have symptoms and will not need treatment." All sexual partners require treatment. Most men and women with chlamydial infections are either asymptomatic or have minor symptoms. Chlamydial infections are caused by Chlamydia trachomatis, a gram-negative bacterium. Antibiotics will cure this disease. Patients should avoid sexual intercourse for 7 days after completing treatment with antibiotics. Condoms should be used for all sexual contacts.

Which event discovered during pregnancy would alert the nurse that a cesarean section delivery is indicated? a. Contact with an individual with syphilis 2 weeks ago b. Treatment for gonococcal pharyngitis before conception c. Treatment for Chlamydia trachomatis at her 20th week of gestation d. Active herpes simplex virus type 2 vesicles on her cervix at the time of delivery

d. Active herpes simplex virus type 2 vesicles on her cervix at the time of delivery The woman with active herpes simplex virus type 2 at the time of delivery has the greatest risk for the fetus, and the baby will be delivered by cesarean section to prevent infection. Syphilis has an average incubation period of 21 days, so even if the contact was sexual, the syphilis should not infect the baby at birth. The woman treated for gonococcal pharyngitis should have been cured with treatment, but the baby's eyes will be treated at birth to prevent gonorrheal eye infection regardless. Treatment of the pregnant woman with Chlamydia trachomatis prevents transfer of the infection to the fetus.

A 30-yr-old woman reports the recent appearance of itchy lesions on her vulva, some of which have recently burst. Which STI should the nurse suspect first? a. HIV b. Gonorrhea c. Chlamydia d. Genital herpes

d. Genital herpes A primary episode of genital herpes is often marked by multiple small, vesicular lesions on the genitals. This symptomatology is not commonly associated with HIV, gonorrhea, or Chlamydia.

Explain to the patient with gonorrhea that treatment will include both ceftriaxone and azithromycin because a. azithromycin helps prevent recurrent infections. b. some patients do not respond to oral drugs alone. c. coverage with more than one antibiotic will prevent reinfection. d. the increasing rates of drug resistance requires the use of at least two drugs.

d. the increasing rates of drug resistance requires the use of at least two drugs. Rationale: The treatment of gonorrhea is a single intramuscular (IM) dose of ceftriaxone (Rocephin) in combination with azithromycin (Zithromax). Due to increasing rates of drug-resistant gonorrhea, dual therapy is needed to address potential drug resistance.