Pathophysiology Exam 2: STIs, Urological & Genitourinary Disorders
A nurse is teaching a client who is in the third trimester of pregnancy and has herpes genitalis. Which of the following instructions should the nurse include? (a) "Clean the lesions twice a day with hydrogen peroxide." (b) "Apply a hot compress to the affected areas." (c) "Talk with your doctor about a prescription for acyclovir to treat your symptoms." (d) "Expect to receive penicillin prior to delivery."
(c) "Talk with your doctor about a prescription for acyclovir to treat your symptoms." (a) The nurse should instruct the client to clean the lesions twice per day with saline solution. (b) The nurse should instruct the client to take a warm sitz bath with baking soda in the water. (d) Herpes simplex is a virus; penicillin treats bacterial infections, not viral infections.
A nurse is caring for a client who has HIV. Which of the following types of isolation should the nurse implement to prevent the transmission of HIV? (a) Protective isolation (b) Droplet precautions (c) Standard precautions (d) Airborne precautions
(c) Standard precautions
A nurse is teaching a client who has genital herpes about self-management. Which of the following instructions should the nurse include in the teaching? (a) Use an alcohol-based soap to clean lesions (b) Wear a condom during sexual activity when lesions are present (c) Take a sitz bath once per day (d) Apply a warm compress to the lesions
(d) Apply a warm compress to the lesions
A nurse is providing discharge instructions to a male client who is being treated for genital warts. Which of the following statements indicates that the client understands how to prevent the transmission of this sexually transmitted infection (STI)? (a) "I will bring my sexual partner for treatment." (b) "Now that I've had my first dose of medicine, I can resume sexual activity. (c) "Once I have been treated, I don't have to use condoms anymore." (d) "Once treatment is complete and I am free of symptoms, I don't have to return to the clinic.
(a) "I will bring my sexual partner for treatment."
A nurse is teaching a client who has human immunodeficiency virus (HIV) about the early manifestations of acquired immune deficiency syndrome (AIDS). Which of the following statements should the nurse include in the teaching? (a) "You can expect a persistent fever and swollen glands." (b) "You can expect an elevated white blood cell count." (c) "You can expect increased blood pressure and edema." (d) "You can expect weight gain."
(a) "You can expect a persistent fever and swollen glands." Clients who have AIDS can have persistent fever, swollen glands, diarrhea, weight loss, and fatigue. These manifestations indicate the onset of AIDS.
A nurse is teaching a client who has active genital herpes simplex virus, type 2. Which of the following statements should the nurse include in the teaching? (a) "You will have a cesarean birth prior to the onset of labor." (b) "Your baby will receive erythromycin eye ointment after birth to treat the infection." (c) "You should take oral metronidazole for 7 days prior to 37 weeks gestation." (d) "You should schedule a cesarean birth after your water breaks."
(a) "You will have a cesarean birth prior to the onset of labor." Whenever possible, a cesarean birth should be scheduled prior to the onset of labor or rupture of membranes to reduce the risk of neonatal transmission of herpes. (b) Erythromycin provides prophylaxis against ophthalmia neonatrum. It is given to prevent gonorrhea and chlamydia infections in newborns. (c) The client who has active herpes should receive a prescription for acyclovir. Metronidazole should be prescribed for bacterial vaginosis. (d) A cesarean birth should be planned prior to the rupture of membranes. If rupture of membranes occurs, an emergency cesarean birth should be done as soon as possible, but every attempt should be made to prevent this situation.
A nurse is planning an educational program for a group of young adults about reducing the risk of cervical cancer. Which of the following interventions should the nurse include? (a) Get the human papillomavirus (HPV) immunization (b) Avoid the use of tampons on a routine basis (c) Avoid drinking alcohol (d) Get a Papanicolaou test every year starting at age 30
(a) Get the human papillomavirus (HPV) immunization
A nurse is providing discharge teaching to a client who has HIV. Which of the instructions about infection prevention should the nurse include? (Select all that apply) (a) Avoid large gatherings of people (b) Clean toothbrush by running through the dishwasher (c) Change pet litter boxes with disposable gloves (d) Consume fresh fruit and raw vegetables (e) Avoid digging in the garden
(a), (b), (e) The nurse should instruct the client to avoid large crowds or gatherings of people, especially if individuals have been ill or exposed to illness; this can place clients who have HIV at risk for infection. The client should clean the toothbrush by running it through the dishwasher. If the client does not have a dishwasher, rinsing the toothbrush with bleach followed by hot water is also effective at destroying bacteria on the toothbrush. The client should avoid digging in the garden because exposure to the dirt, which contains bacteria and organisms, places the client at risk for infection. The client should avoid changing pet litter boxes altogether, and fresh fruit and raw vegetables contain bacteria. The client should consume only fruits and vegetables that have been cooked thoroughly.
A nurse is teaching a client who has human immunodeficiency virus (HIV) about how the virus is transmitted. Which of the following statements should the nurse include in the teaching? (a) "HIV can be transmitted as soon as a person develops manifestations." (b) "HIV can be transmitted to anyone who has had contact with infected blood." (c) "HIV is transmitted through the respiratory route via droplets." (d) "HIV is transmitted only during the active phase of the virus."
(b) "HIV can be transmitted to anyone who has had contact with infected blood." The concentration of the virus is highest in blood but also has been isolated in other body fluids, including sputum, saliva, cerebrospinal fluid, urine, and semen. Clients who have HIV are cautioned to practice safe sex, avoid donating blood, and abstain from sharing needles with others.
A nurse is caring for a client who has trichomoniasis and a prescription for metronidazole. Which of the following instructions should the nurse provide to the client about the treatment plan? (a) "Your partner needs to be cultured and be treated with metronidazole only if his cultures are positive." (b) "You and your partner need to take the medication and use a condom during intercourse until cultures are negative." (c) "If both you and your partner are treated simultaneously, you may continue to engage in sexual intercourse." (d) "Only you will need to take the metronidazole, but you should not have intercourse until your culture is negative."
(b) "You and your partner need to take the medication and use a condom during intercourse until cultures are negative." Trichomonas vaginalis is the organism that causes the sexually transmitted infection trichomoniasis. Both men and women can be infected with trichomoniasis. Clinical findings include yellowish to greenish, frothy, mucopurulent, copious discharge with an unpleasant odor, as well as itching, burning, or redness of the vulva and vagina. Trichomoniasis can be treated easily with metronidazole. However, for the treatment to work, it is important to make sure both sexual partners receive treatment to prevent reinfection. Instruct the client to use condoms during sexual intercourse while being treated.
A nurse is planning for a client in labor who is positive for HIV. Which of the following actions should the nurse take after the baby is born? (a) Encourage the mother to breastfeed (b) Administer the hepatitis B vaccine prior to discharge (c) Implement contact and droplet precautions when providing care for the infant (d) Collect a cord blood specimen to test for the presence of HIV
(b) Administer the hepatitis B vaccine prior to discharge Infants who are exposed to HIV should receive all routine vaccinations. Infants who are infected with HIV can receive all inactivated vaccinations.
A nurse is teaching a client about urinary tract infections (UTIs). Which of the following manifestations should the nurse include? (a) Weight gain (b) Back pain (c) Vaginal discharge (d) Muscle cramps
(b) Back pain Back pain and flank pain are manifestations of a UTI. Other manifestations include frequency, urgency, and cloudy, foul-smelling urine. (a) Weight gain is not a manifestation of a UTI because a UTI does not cause fluid retention. Weight gain can be a manifestation of acute kidney injury and fluid overload. (c) Vaginal discharge is a manifestation of a vaginal infection, not a UTI. (d) Muscle cramps can be a manifestation of uremia, not a UTI.
A nurse is caring for a male client who reports a thick urethral discharge. Which of the following actions should the nurse take? (a) Contact the client's sexual partners (b) Obtain a urethral specimen for culture (c) Prepare to administer penicillin to the client (d) Obtain blood for a rapid plasma reagin test
(b) Obtain a urethral specimen for culture The nurse should obtain a urethral specimen for culture to identify the presence of Neisseria gonorrhoeae. Prompt, effect antibiotic treatment and prevention of complications depend on culture results. The nurse should prepare to administer IM ceftriaxone. The client is exhibiting manifestations of gonorrhea, which has become resistant to penicillin as well as tetracycline and ciprofloxacin.
A nurse is providing teaching to a client who has a history of urinary tract infections (UTIs). Which of the following client statements indicates the need for additional teaching? (a) "I will empty my bladder every 4 hours." (b) "I will drink 2 L of fluids per day." (c) "I will use a vaginal douche daily." (d) "I will wear cotton underwear."
(c) "I will use a vaginal douche daily." The client should avoid vaginal douches, bubble baths, and any substances that can increase the risk of UTIs. The client should use mild soap and water to wash the perineal area.
A nurse is caring for a client who has human immunodeficiency virus (HIV). The client asks the nurse, "Should I tell my partner that I am HIV positive?" Which of the following statements should the nurse provide? (a) "That is your decision alone." (b) "I would if I were you." (c) "It sounds like you are unsure what to say to your partner." (d) "Your provider is required by law to notify your partner."
(c) "It sounds like you are unsure what to say to your partner." This response uses the therapeutic communication tools of clarifying and restatement. It identifies that the client is unsure whether or how to approach the issue of being HIV positive with his partner, a common concern of clients due to fear of rejection. This response shows that the nurse is open to further communication with the client and encourages his expression of feelings.
A community health nurse is caring for a client who was exposed to HIV 2 days ago. The client asks the nurse what she should do. Which of the following responses should the nurse provide? (a) "I will administer an HIV vaccine today, and it will need to be repeated in 3 months." (b) "I will administer an HIV test today, and you will need to return in 48 hours to have me read the results." (c) "You will need to have an HIV test every other week for 6 months." (d) "You will need to take prophylactic medications for 4 weeks."
(d) "You will need to take prophylactic medications for 4 weeks." The client will need to take prophylactic medications for 4 weeks to prevent the virus from replicating within the body.
A nurse in an urgent-care center is caring for a 15-year-old client whose symptoms suggest a sexually transmitted infection (STI). The client's parent is unavailable, but the client's grandmother accompanied the client to the clinic. Which of the following actions should the nurse take? (a) Explain that the treatment can wait until the parent is available. (b) Inform the grandmother that she may give consent for the treatment. (c) Invoke the principle of implied consent and prepare the client for treatment. (d) Ask the adolescent to the consent form.
(d) Ask the adolescent to sign the consent form. Unemancipated minors (i.e. those who do not live on their own, are not married, and are not in the military) can legally give informed consent for diagnostic procedures and treatment in some situations. These situations include treatment for STIs and substance use disorders.
A nurse is reviewing the laboratory findings for 4 clients. Which of the following infections should be reported to the public health department? (a) Bacterial vaginosis (b) Trichomoniasis (c) Candidiasis (d) Gonorrhea
(d) Gonorrhea Gonorrhea is often asymptomatic. The client might have purulent endocervical discharge. Gonorrhea is one of the infectious conditions on the Nationally Notifiable Infections list and should be reported by the nurse to the community health department, which will report the infection to the CDC.
