Pearson STDs questions

Which of the following statements is true with regard to sexually transmitted infections (STIs) and older adults? A) Because pregnancy is no longer a concern, older adults may not use condoms, thereby increasing their risk of STIs. B) Normal age-related changes to the body put older adults at reduced risk of contracting STIs. C) STIs are rare among older adults because of decreased levels of sexual activity among the members of this population. D) Healthcare providers should avoid discussing STIs with older clients unless these clients initiate the conversation.

A) Because pregnancy is no longer a concern, older adults may not use condoms, thereby increasing their risk of STIs Rationale: Older adults are living longer, healthier lives and are engaging in sex more than in previous generations. Along with this increase in sexual activity comes an increase in STIs. Normal age-related changes to the body can put older adults at greater risk of infection. In addition, because pregnancy is no longer a concern, older adults may not use condoms or may use them inconsistently. Many older adults are hesitant to discuss sexual practices with their healthcare providers. Thus, providers play a key role in STI prevention by acknowledging that continuation of sexual activity is a normal part of aging, encouraging clients to talk about their sexual practice, dispelling myths about the risk of infection, and providing information that is relevant to older clients.

The nurse is caring for a client who was diagnosed with chlamydia. Which action by the nurse is appropriate for this client? A) Reporting the STI B) Instructing client to take antibiotics until symptoms resolved C) Visiting the home to follow up D) Tracking that the client filled a prescription

A) Reporting the STI Rationale: Sexually transmitted infections​ (STIs) like​ chlamydia, gonorrhea, and syphilis are all​ reportable, so the nurse may be involved with the reporting process. The nurse would not visit the​ client's home to follow up. Filling prescriptions are the responsibility of the client. Antibiotics would need to be taken for the prescribed amount of​ time, not just until symptoms resolve.

The nurse is teaching a client diagnosed with genital herpes simplex virus (HSV). How should the nurse describe the signs of an outbreak? SATA A) Itching B) Small, flat, flesh-colored warts C) Bleeding D) Ulcerations E) Burning

A, D, E - Itching - Ulcerations - Burning Rationale: Itching and burning in the affected area are common manifestations of an HSV outbreak. The lesions are small ulcerations.​ Small, flat,​ flesh-colored warts are a symptom of HPV.

A client with genital herpes asks the nurse how to manage pain when urinating and difficulty voiding. Which response by the nurse is correct? A) "Try to limit your fluid intake. That way, you won't have to void so often." B) "Pouring room-temperature water over your genitals may make it easier for you to start urinating." C) "Be sure to keep your genitals as dry as possible. Unnecessary exposure to water can worsen your infection and cause even greater pain upon urination." D) "Unfortunately, there's nothing you can do to eliminate your discomfort. It won't go away until your current herpes outbreak is over."

B) "Pouring room temperature water over your genitals may make it easier for you to start urinating." Rationale: Clients with genital herpes who complain of dysuria and difficulty voiding can be taught to pour water over the genitals to start urination and dilute the urine. Drinking additional fluids also helps dilute the urine and reduce the burning sensation when voiding. The nurse might additionally suggest the use of sitz baths (with tepid water) for 15-30 minutes several times a day. The warm water is soothing and decreases pain from ulcers and an irritated urethral meatus. It facilitates wound healing and facilitates urination.

The nurse is planning care for a client with gonorrhea who also has a history of prior sexually transmitted infections (STIs). What is the priority nursing action for this client? A) Instruction about the need to avoid all future sexual contact B) A plan for the client to contact sexual partners regarding the diagnosis C) Recommendation that the client increase fluids and rest D) Teaching regarding the importance of adequate nutrition

B) A plan for the client to contact sexual partners regarding the diagnosis rationale: The client has gonorrhea and a history of sexually transmitted infections. The nurse should therefore encourage the client to develop a plan for contacting sexual partners regarding the diagnosis. Increasing fluids, rest, and nutrition are important, but not as important as contacting sexual partners to protect their health and limit the spread of disease. In addition, the nurse should instruct the client to avoid sexual contact until recovered from the current illness, but not necessarily to avoid all future sexual contact.

A client diagnosed with a sexually transmitted infection reports having "no idea" how the illness was contracted. Which nursing diagnosis would be appropriate for the client at this time? A) Anxiety B) Deficient Knowledge C) Ineffective Coping D) Sexual Dysfunction

B) Deficient knowledge Rationale: The client's statement indicates deficient knowledge regarding the transmission of sexually transmitted infections. There is not enough information provided here to determine whether the diagnoses of sexual dysfunction, ineffective coping, and/or anxiety would also be appropriate for this client.

The nurse is obtaining a history on an adolescent client. Which reported behavior should be concerning? A) Verbalizing how to identify the warning signs of dating violence and date rape B) Engaging in sex with a diaphragm with a non-monogamous partner C) Practicing abstinence for the first 6 months of a monogamous relationship D) Asking a partner in a monogamous relationship to be tested for STDs

B) Engaging in sex with a diaphragm with a non-monogamous partner Rationale: While a diaphragm prevents​ pregnancy, it does not prevent transmission of infection. This method of birth control should not be used alone in​ non-monogamous relationships. This statement would be concerning. A person can be infected with HIV and able to infect others for 6 months before seroconversion. Practicing abstinence for the first 6 months of a monogamous​ relationship, then being retested would be ideal. Asking a partner in a monogamous relationship to be tested for STDs is not a concerning behavior. Verbalizing how to identify the warning signs of dating violence and date rape would demonstrate that the client is exhibiting responsible sexual behavior.

Which intervention should the nurse discuss with a client newly diagnosed with herpes regarding viral shedding? A) Following a low-protein diet B) Not sharing bath towels C) Taking antivirals D) Abstaining from sex

B) Not sharing bath towels Rationale: Health teaching for clients with genital herpes involves helping them manage their condition with the least possible disruption in lifestyle and relationships. The use of hygiene​ practices, including not sharing towels or other personal​ items, and the use of latex​ condoms, will protect others from viral shedding. Abstaining from sex will help keep the virus from​ spreading, but there is still risk involved with viral shedding. A​ low-protein diet is not related to viral shedding. Taking antivirals helps decrease the length of the outbreak but is not related to viral shedding.

The nurse is caring for a client diagnosed with syphilis. The client has a rash covering both palms of the hands. The nurse explains that the client is in which stage of syphilis? A) Latent B) Secondary stage C) Tertiary stage D) Primary stage

B) Secondary stage rationale: Manifestations of secondary syphilis after the initial chancre include a​ rash, especially on the palms of the hands or soles of the​ feet; mucous patches in the oral​ cavity; sore​ throat; generalized​ lymphadenopathy; condyloma lata​ (flat, broad-based​ papules) on the​ labia, anus, or corner of the​ mouth; flulike​ symptoms; and alopecia. The primary stage of syphilis is characterized by the appearance of a chancre and by regional enlargement of lymph​ nodes; little or no pain accompanies these warning signs. During the latent period a client has no​ symptoms, however, during the early part of this​ stage, sexual transmission is possible. Roughly​ 15% of untreated individuals progress to​ late-stage or tertiary syphilis.

The nurse is caring for a client who has been diagnosed with herpes. Following the diagnosis, which intervention should the nurse include in the plan of care? A) Teach client to refrain from sexual activity until the disease is cured B) Teach client how to keep herpes blisters clean and dry C) Perform a physical exam D) Instruct the client to take antibiotics until symptoms resolve

B) Teach the client how to keep herpes blisters clean and dry Rationale: Teaching the client how to keep the lesions clean and dry reduces the possibility of secondary infection and speeds the healing process.. There is no cure for herpes. Treatment focuses on relieving symptoms and preventing spread of the infection. Herpes is a virus and is treated with antiviral​ medications, not antibiotics.

The nurse is conducting a history and physical assessment of a sexually active teenager. Which findings should the nurse identify as consistent with genital herpes? SATA A) Low BP B) Headache C) Fever D) Dysuria E) Vaginal discharge

B, C, D, E Rationale: Manifestations of genital herpes include flulike symptoms (e.g., headache, fever), dysuria, and vaginal discharge. Low blood pressure is not a manifestation of genital herpes.

The nurse is caring for an adolescent client who has been diagnosed with an STI. which problem should the nurse assess in this client? SATA A) Risk of altered parenting B) Deficient knowledge C) Impaired skin integrity D) Disturbed body image E) Pain

B, C, D, E Rationale: The nurse should assess the client for​ pain, deficient​ knowledge, disturbed body​ image, and impaired skin integrity. There is no need to assess the client for risk of altered parenting.

The nurse is teaching a client about caring for herpes lesions. Which statement made by the client expresses understanding? A) "I should wear jeans, not shorts, to keep the lesions covered." B) "I should wash the lesions with antibacterial soap." C) "I should dry the lesions with a hair dryer on a cool setting." D) I should wear nylon underwear."

C) "I should dry the lesions with a hair dryer on a cool setting." Rationale: Teach the client how to keep herpes blisters clean and dry. The area should be washed daily with mild soap and water. Lesions should be dried using a hair dryer turned to a cool setting. The client should wear loose cotton clothing that will not trap moisture and avoid wearing panty hose and tight jeans. Keeping the lesions clean and dry reduces the possibility of secondary infection and speeds the healing process.

The nurse is caring for a pregnant client who has syphilis. Which is a priority intervention? A) Screening and treating the client's partner B) Scheduling treatment after birth of the baby C) Treating the client with an antibiotic D) Treating the client with an antifungal

C) Treating the client with an antibiotic Rationale: Syphilis is a bacterial infection and can be safely treated and cured during pregnancy with an antibiotic. An antifungal does not treat bacterial infections. The​ client's partner should be screened and​ treated, but treating the client is a priority. There is no need to wait until the baby is born to treat the​ client; the client can safely take antibiotics during pregnancy.

The nurse is assessing a client who presents with an open sore on his penis. Which question by the nurse best elicits additional data related to this finding? A) "Do you think you have a disease? " B) "Have you had sexual intercourse recently?" C) "Are you promiscuous?" D) "When did you initially notice this open area?"

D) "When did you initially notice this open area?" Rationale: It is important that the nurse record the onset of the open area. The remaining questions are all closed and will not elicit much information, although determining the date of the last episode of sexual intercourse might be indicated later if a disease is diagnosed. Asking the client about promiscuity is judgmental.

Which of the following actions on the part of the nurse is most appropriate when treating an 8-year-old client who is exhibiting the symptoms of a sexually transmitted infection (STI)? A) Immediately perform a detailed examination and collect relevant specimens B) Assume that the child acquired the infection during the perinatal period C) Initiate presumptive treatment of the STI as soon as possible D) Anticipate the need to follow mandatory reporting guidelines

D) Anticipate the need to follow mandatory reporting guidelines Rationale: In some cases, STIs in young children may be the result of perinatally acquired infections that can persist for 2 to 3 years; however, the general rule is to consider infection evidence of abuse. STI testing should be conducted prior to initiating treatment of children exhibiting STI symptoms in order obtain a reliable diagnosis. It is essential to examine and collect specimens from children in a manner that minimizes trauma to them; thus, examination and collection should be conducted by a clinician with specific experience in the area of child sexual abuse. Because STIs in children are often a result of sexual abuse, and also because public health authorities require the reporting of certain STIs, the nurse should anticipate the need to follow mandatory reporting guidelines.

A client presents for evaluation of a possible STI. Which assessment finding should the nurse consider a potential indication of an STI? A) Vaginal dryness B) Thick, cottage cheese-like vaginal discharge C) Absence of expected menses D) Burning and frequency of urination

D) Burning and frequency of urination rationale; Common symptoms of an STI include burning and increased frequency of urination. Vaginal dryness and absence of expected menses are not symptoms of STI.​ Thick, cottage​ cheese-like vaginal discharge is indicative of a yeast​ infection, not an STI.

The nurse is caring for a client who has been diagnosed with reactive arthritis. the nurse notes symptoms of an STI. Which STI should the nurse suspect? A) Gonorrhea B) Syphilis C) Herpes D) Chlamydia

D) Chlamydia Rationale: Reactive arthritis​ (formally Reiter​ syndrome) is a complication of​ chlamydia, which is most likely to occur in men. It does not occur secondary to​ gonorrhea, herpes simplex​ virus, or syphilis.

A client presents with a sore tip of the penis. The client reveals having sex with two partners. Upon examination the nurse notices swelling in the client's groin, along with chancre. How should the nurse interpret this swelling in the groin? A) Retention B) Necrosis C) Allergic reaction D) Lymphadenopathy

D) Lymphadenopathy Rationale: Lymphadenopathy is a swelling or abnormal number of lymph nodes in a specific area of the body. Lymphadenopathy is inflammatory and usually caused by an infection. Necrosis is death of tissue. Retention is holding pockets of fluid. An allergic reaction produces​ hives, rash,​ fever, difficulty​ breathing, and itching.

The nurse is assessing a client with syphilis. Which stage of syphilis is characterized by a chancre, painless ulcerations on the genital area? A) Latent stage B) Secondary stage C) Tertiary stage D) Primary stage

D) Primary stage Rationale: During the primary stage of​ syphilis, the client will experience​ chancre-like, painless ulcerations that last for up to 5 weeks. The second stage occurs up to 10 weeks after initial infection. The client will experience​ fever, malaise,​ lymphadenopathy, patchy​ alopecia, and a diffuse rash. During the latent​ stage, the client is asymptomatic for years to a lifetime. The tertiary stage can occur 2 years after the onset of symptoms and includes changes in the cardiovascular​ system, bone,​ skin, and viscera.

The nurse has completed discharge teaching for a client treated for genital herpes. Which statement by the client indicates teaching was effective? SATA A) "I will notify my sex partners so they can get treatment." B) "I'll try to keep my stress level down." C) "I understand this antiviral medication will help shorten and prevent outbreaks." D) "I'm glad the medication prescribed will cure this infection." E) "I don't need to use a condom."

A, B, C Rationale: The client acknowledging the need to keep stress levels​ down, planning to notify sexual​ partners, and understanding about the antiviral​ medication, which will help shorten and prevent​ outbreaks, indicates correct understanding. The​ client's ability to describe preventive​ behaviors, health​ practices, and treatment modalities indicates goal achievement. The conceptions that unprotected sex is safe and that the medication will cure herpes are​ incorrect; herpes is a virus and cannot be cured. Next Question

The nurse recives notification from the lab that. a client tests positive for syphilis. Which nursing action should the nurse implement? SATA A) Recommend that a pregnancy test be obtained B) Ensure that this case is reported to the public health system C) Verify the client's drug allergies D) Inform the client that syphilis is not contagious if there are no symptoms of infection E) Initiate client teaching regarding STIs and their consequences

A, B, C, E Rationale: In the event of a positive syphilis​ test, the nurse would report the case to the public health​ system, initiate client teaching regarding​ STIs, verify the​ client's drug allergies in preparation for the prescribed treatment​ regime, and—if the client is female—arrange for a pregnancy test. Syphilis is​ contagious, and it is critical to treat the infection to avoid​ complications, even when there are no symptoms present.

The nurse is teaching at a community health clinic about the risk factors for syphilis. Which statement should the nurse include? SATA A) It has an incubation period of 10-90 days B) Only women are at risk for syphilis C) It spreads through the body by way of blood and lymph nodes D) It is only contracted through anal sex E) It is contracted by unprotected sex

A, C, E Rationale: Syphilis is a sexually transmitted​ infection, wherein the microorganisms invade the body and spread through blood and lymph nodes. The incubation period is 10 to 90 days. Both men and women can be infected with​ syphilis; however, it is not only anal sex through which this infection can be contracted.

The nurse is providing education to sexual partners about the importance of treatment for a chlamydia infection. Which client statements indicate this teaching was effective? Select all that apply. A) "Chlamydia can cause inflammation of the tube that carries urine from the bladder to outside the body." B) "Severe vaginal itching can be a consequence of chlamydia." C) "Rashes commonly occur with this disease." D) "Chlamydia can spread to the uterus and fallopian tubes and result in infertility." E) "Chlamydia can result in pregnancy complications."

A, D, E Rationale: In men, chlamydia is a major cause of nongonococcal urethritis. In women, chlamydia cervicitis can ascend and become pelvic inflammatory disease, or infection of the uterus, fallopian tubes, and sometimes ovaries. Pregnant women with an untreated chlamydia infection are at greater risk of developing complications such as miscarriage, premature birth, or stillbirth. Chlamydia does not cause vaginal itching or a rash.

The nurse is planning care to address pain in a client with genital herpes. Which intervention would most be appropriate for this plan of care? A) Do not submerge lesions in water. B) Clean lesions two or three times a day with warm water and soap. C) Dry lesions with a hair dryer turned to the hot setting. D) Wear tight cotton clothing.

B) Clean lesions two or three times a day with warm water and soap Rationale: Measures to reduce the discomfort of herpes lesions include cleansing the lesions two or three times a day with warm water and mild soap. Lesions should be dried using a hair dryer turned to the cool setting, and it is important to wear loose cotton clothing that will not trap moisture. Tepid sitz baths are also useful in decreasing pain from ulcers and an irritated urethral meatus.

Which intervention by the nurse can help decrease the burning upon urination for a female client with gonorrhea? A) Providing a Sitz bath B) Increasing fluids C) Taking diuretics D) Running ice water over the perineal area

B) Increasing fluids Rationale: Drinking additional fluids helps dilute the urine and reduce the burning sensation. For dysuria and urinary​ retention, pouring water over the genitals to start urination and dilute the urine may be suggested. Sitz baths​ (with tepid​ water) for​ 15-30 minutes, several times a​ day, is soothing and decreases pain from ulcers and an irritated urethral meatus. Taking diuretics would not be an appropriate treatment for gonorrhea.

A college student is being treated for chlamydia. What should the nurse teach this student to decrease the risk of transmitting another sexually transmitted infection? A) Unprotected sex is acceptable if you know the partner well. B) Latex condoms should be used for all sexual activity. C) Birth control pills will help decrease the risk of pregnancy and STDs. D) Condoms should be used with petroleum jelly.

B) Latex condoms should be used for all sexual activity Rationale: Latex condoms should be used for all sexual activity to decrease the risk of contracting and/or spreading a sexually transmitted infection. Although birth control pills can decrease the risk of pregnancy, they do not protect against the transmission of sexually transmitted infections. Petroleum jelly can damage a condom, defeating its purpose for safe sex. Unprotected sex should only be considered when both partners have been tested for STIs and the relationship is mutually monogamous.

A client reports burning urination and a vaginal discharge. Which information should the nurse include in the client's documentation? SATA A) Names and phone numbers of all sexual contacts B) Allergies to any medications C) History of fever or chills D) Length of time since symptoms presented E) History of unprotected sex

B, C, D, E Rationale: The​ client's sexual​ history, assessment, and examination must be​ documented, including symptoms like​ fever, chills, burning on​ urination, vaginal​ drainage, and their onset and duration. It is critical to document allergies for every​ client, especially because antibiotics may be ordered. An STI has not yet been​ confirmed, so a list of sexual contacts is not needed.

A public health nurse is educating a group of adults about the incidence and prevalence of sexually transmitted infections (STIs). Which statement should be included? A) "Males have higher rates of gonorrhea and chlamydia, whereas women have higher rates of syphilis." B) "Men are disproportionately affected by STIs as compared to women and infants." C) "Women often experience few early manifestations of infection, which causes them to delay diagnosis and treatment." D) "The incidence of STIs is highest among young Caucasian females."

C) "Women often experience few early manifestations of infection, which causes them to delay diagnosis and treatment." Rationale: Women often experience few early manifestations of sexually transmitted infection, which can lead to delays in diagnosis and treatment. Women have higher rates of gonorrhea, whereas men have higher rates of chlamydia and syphilis. Women and infants are disproportionately affected by STIs as compared to men.

The nurse is preparing to administer an IM injection of one antibiotic and an oral dose of another antibiotic for a client with gonorrhea. The client wants to know why both are needed. Which rationale for dual treatment should the nurse include in the explanation? A) Specific portal of entry B) Strength of the bacteria C) Antimicrobial resistance D) Client's immunity

C) Antimicrobial resistance Rationale: The goals of treatment for the client with gonorrhea include eradication of the organism and any coexisting​ disease, and prevention of reinfection or transmission. Due to concerns about antimicrobial resistance in N. gonorrhoeae​, the Centers for Disease Control and Prevention​ (CDC) recommends dual treatment that includes a single injection of an antibiotic and a single oral dose of another antibiotic. These medications should be administered at the same​ time, if possible.

A client is experiencing dysuria, urinary frequency, and vaginal discharge. For which STI should the nurse prepare the client for testing? SATA A) Syphilis B) HIV C) Chlamydia D) HPV E) Gonorrhea

C, E - Chlamydia - Gonorrhea Rationale: Chlamydia and gonorrhea are both bacterial infections that invade the same target organs, including the cervix and male urethra, and create the manifestations of dysuria, urinary frequency, and discharge. The other sexually transmitted infections listed here target other organs and/or create other manifestations.

The nurse explains the importance of testing for STIs to a newly pregnant client. During which tie period should the nurse explain that this test will take place? A) Immediately after finding out she is pregnant B) Second prenatal visit C) Only if the client has symptoms D) First prenatal visit

D) First prenatal visit Rationale: Very few early manifestations of an infection are​ experienced, so clients may not know whether they are infected or not. All pregnant women should therefore be tested for​ STIs, including​ HIV, as part of routine medical care during their first prenatal visit.