Learning Quiz | Sexually Transmitted Infections

A client is told that her herpes virus has been latent. What does the nurse say to explain this to the client?

"Latent means the virus remains dormant and can reactivate." Viruses that follow the neurons can lay dormant in the dorsal root ganglia and reactivate at a later time. It is not known what reactivates the virus.

A male client is diagnosed with gonococcal urethritis. He tells the nurse he had recent sexual contact with a woman but states she did not appear to have any disease. What is the nurse's best response to the client?

"Women may not know they have gonorrhea because they may not have symptoms." People with gonorrhea may be asymptomatic and may unwittingly spread the disease to their sexual partners. 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 client asks "How could I have chlamydia? I feel fine!" What is the nurse's best response?

"Women with this condition are often asymptomatic." Women with chlamydia often are asymptomatic. It does not make the condition any less serious, and the condition should be treated.

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

Candida albicans Candida albicans is the most commonly identified organism in vaginal yeast infections. Women with vulvovaginal candidiasis commonly complain of vulvovaginal pruritus accompanied by irritation, erythema, swelling, dysuria, and dyspareunia. The characteristic discharge, when present, is usually thick, white, and odorless.

Which statement is true concerning genital herpes?

Clients can have recurrent infections. Clients can have recurrent infections. The first episode is usually the most painful. Clients can test positive without symptoms. Herpes lesions often itch.

Which statements are true concerning genital herpes?

Clients can have recurrent infections. The first episode is usually the most painful. Clients can test positive without symptoms. Herpes lesions often itch.

A male reports urethral pain and a creamy yellow, bloody discharge from the penis. The provider suspects the client has which sexually transmitted infection?

Gonorrhea In men, the initial symptoms of gonorrhea include urethral pain and a creamy, yellow, sometimes bloody discharge. Candidiasis, trichomoniasis, and bacterial vaginosis are vaginal infections that can be sexually transmitted, and the male partner usually is asymptomatic. Chancroid causes genital ulcers; the lesions begin as macules, progress to pustules, and then rupture.

A client who has been diagnosed with gonorrhea asks the nurse if anyone has to know about it. The best response by the nurse is:

Gonorrhea is a reportable sexually transmitted infection. All sex partners within 60 days prior to discovery of the infection should be contacted, tested, and treated. There are no exceptions to the requirement.

A 22-year-old client has presented to the primary health care provider for an annual Papanicolaou (Pap) test. Which infection will give abnormal results of this diagnostic test?

Human papillomavirus (HPV) Although a Pap test does not test directly for HPV, dysplasia of cervical cells is strongly associated with HPV infection. The only test for HPV is for high-risk HPV DNA. An abnormal Pap test is not indicative of chlamydial infection, trichomoniasis, or candidiasis.

A male client presents to the clinic with profuse, purulent urethral discharge with painful urination. Which information will be most important for the nurse to obtain?

Recent sexual contacts The Centers for Disease Control and Prevention (CDC) requires reporting of chlamydia, syphilis, and gonorrhea and, therefore, tracks these three STIs most specifically. There are many factors that contribute to the increased prevalence and the continued spread of STIs. One key factor is that STIs are frequently asymptomatic, which promotes the spread of infection by people who are unaware they are carrying the infection. Obtaining a list of recent partners can help to identify and treat potential carriers.

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

Secondary Manifestations of secondary syphilis include symptoms of a rash (especially on the palms and soles), fever, sore throat, stomatitis, nausea, loss of appetite, and inflamed eyes, which may come and go for a year but usually last for 3 to 6 months. Secondary manifestations may include alopecia and genital lesions called condylomata lata.

Select the most reliable test to diagnose syphilis.

Serology Although PCR tests have been developed for syphilis, serology tests remain the mainstay for diagnosis. Two general types of serology tests are available: nonspecific (nontreponemal) tests and the specific treponemal tests. The other tests are not reliable.

While teaching a class on health promotion to a group of high school students a student asks, "How is herpes simplex virus type 2 (HSV-2) transmitted?" Which response by the nurse is most accurate?

Sexual encounters Genital herpes is known as HSV-2 and is spread by sexual encounters. Molluscum contagiosum is transmitted from skin-to-skin contact, fomites, and autoinoculaton. Kissing is usually not a method of transmission for sexually transmitted infections.

A female client is infected with human papillomavirus (HPV) following unprotected sexual intercourse. The nurse prepares to teach the client about the risk of developing which cancer?

cervical The association with premalignant and malignant cervical changes has increased the concern regarding the diagnosis and treatment of HPV. Lack of regular cervical cancer screening (Pap test) is the primary risk factor for development of invasive cervical cancer.

A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which of his statements is most accurate?

"Even when I'm not having a recurrence, I could still pass the virus on to you." HSV transmission can occur both during and between recurrences. HSV-2 is associated more with genital herpes than cold sores, and cold sores do not provide antibody protection. Prior contact with the virus does not confer immunity.

Which client is at highest risk of developing trichomoniasis?

A client who is sexually active A reported risk factor for trichomoniasis is sexual activity, as the parasite can be transmitted to sexual partners.

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

Syphilis The timing of the second stage of syphilis varies even more than that of the first, lasting from 1 week to 6 months. The symptoms of a rash (especially on the palms, mucous membranes, meninges, lymph nodes, stomach, soles, and liver), fever, sore throat, stomatitis, nausea, loss of appetite, and inflamed eyes may come and go for a year but usually last for 3 to 6 months. Secondary manifestations may include some loss of hair and condylomata lata. These lesions are elevated, red-brown lesions that may ulcerate and produce a foul discharge. They are 2 to 3 cm in diameter, contain many spirochetes, and are highly infectious.

A 20-year-old female comes to the clinic for an annual exam. She reports having unprotected sexual intercourse with several men over the last year. Blood tests reveal that she is positive for human papillomavirus. The nurse teaches the client about which complication that may occur because of the infection?

cervical cancer Human papillomaviruses (HPVs), members of the papovavirus family, cause cutaneous and genital warts, and several genotypes are associated with cervical cancer. The first vaccine (HPV 9-valent, recombinant) to prevent cervical cancer, precancerous genital lesions, genital warts, and anal and oropharyngeal cancers due to HPV types 6, 11, 16, and 18 was developed in 2006.

A client's presentation and recent sexual history are suggestive of gonorrhea. This suspected diagnosis can best be confirmed by:

culturing a sample of the client's penile discharge. Diagnosis of gonorrhea is based on the history of sexual exposure and symptoms. It is confirmed by identification of the organism on Gram stain or culture. A Gram stain usually is an effective means of diagnosis in symptomatic men (i.e., those with discharge). In women and asymptomatic men, a culture usually is preferred because the Gram stain often is unreliable. Culture has been the gold standard, particularly when the Gram stain is negative.