CH 46 NCLEX Qs

A nurse is caring for a client in whom genital herpes is being ruled out. Which information helps to confirm the diagnosis? Select all that apply. a) Pain on urination b) Positive urine culture c) Painful lesions d) Pustules e) Itching

a) Pain on urination c) Painful lesions d) Pustules e) Itching Symptoms of primary genital herpes infection include pain on urination, pustules, painful lesions, and itching. Tingling and pain in the genital area are also possible with urinary retention. Positive urine cultures do not help to diagnose this condition.

The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of: a) Blindness b) Genital infection c) Urethritis d) Pruritus

a) Blindness Neonates are routinely treated with various antibacterial agents applied to the conjunctiva within 1 hour of birth to protect against undiagnosed gonorrhea and other diseases. Neonates born to infected mothers can acquire the infection during passage through the birth canal and are in danger of developing gonorrheal conjunctivitis, with resultant blindness, unless treated promptly.

The public health nurse is presenting a program on the prevalence of STIs. Which information should be included in the presentation? Select all that apply. a) Drugs can mange infections but do not control the spread. b) STIs may be asymptomatic. c) STIs are only bacterial. d) Partners of infected persons are easy to find and treat. e) Condoms do not prevent the spread of STIs.

a) Drugs can mange infections but do not control the spread. b) STIs may be asymptomatic. Many factors contribute to the increased prevalence and the continued spread of STIs. STIs are frequently asymptomatic; partners of infected persons are often difficult to notify and treat, Condoms could prevent the spread of many STIs, but they often are not used or are used improperly. In addition, there currently are no cures for viral STIs; although there are drugs available that may help to manage the infections, they do not entirely control the spread. Also, drug-resistant microorganisms are rapidly emerging, making treatment of many STIs more difficult.

Select the treatment of choice for syphilis. a) Long-acting penicillin in a single injection b) UV radiation to the genital area c) Oral amoxicillin for 10 days d) Topical clotrimazole cream

a) Long-acting penicillin in a single injection The treatment of choice for syphilis is penicillin. Because of the spirochetes' long generation time, effective tissue levels of penicillin must be maintained for several weeks. Long-acting injectable forms of penicillin are used.

A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a redbrown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in. a) Secondary b) Primary c) Tertiary d) Latent

a) 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.

Which clients would the nurse determine are at increased risk of infection with gonorrhea? Select all that apply. a) The client who does not use condoms b) The client with multiple sexual partners c) The client who has constant urinary tract pain d) The client who is younger than 25 years of age e) The client who married late in life

a) The client who does not use condoms b) The client with multiple sexual partners d) The client who is younger than 25 years of age Clients who are identified as being at increased risk of infection include those who are 25 and under, have multiple sexual partners, and do not use condoms. Clients who marry late in life or have constant urinary tract pain are not documented to be at increased risk.

Within how many days it is important to test anyone who has had sex with an individual who tests positive for gonorrhea? a) 180 b) 60 c) 90 d) 365

b) 60 All sex partners within 60 days prior to discovery of the infection should be contacted, tested, and treated.

Which collection sites should be used for sampling to accurately diagnose gonorrhea? (Select all that apply.) a) Uterine lining b) Anal canal c) Urethra d) Nasal passages e) Oropharynx

b) Anal canal c) Urethra e) Oropharynx A specimen should be collected from the appropriate site (i.e., endocervix, urethra, anal canal, or oropharynx), inoculated onto a suitable medium, and transported under appropriate conditions. The nasal passages and the uterine are not sites that would be used for the collection of Neisseria gonorrhoeae.

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply. a) Deafness b) Dementia c) Seizures d) Ataxia e) Blindness

b) Dementia d) Ataxia e) Blindness Central nervous system lesions can produce dementia, blindness, or injury to the spinal cord, with ataxia and sensory loss. Neither deafness nor seizures are associated with this stage of progression.

A teenage female client who is being seen in the family medicine clinic for an annual physical exam reports being sexually active. Which should the nurse plan to teach the client? Select all that apply a) Information on immunization for herpes simplex b) The importance of annual PAP smears for early detection of cervical cancer c) Importance of being tested for chlamydia infection d) The development of vaccines to protect against specific human papillomavirus (HPV) strains e) Problems with infertility associated with human papillomavirus (HPV)

b) The importance of annual PAP smears for early detection of cervical cancer c) Importance of being tested for chlamydia infection d) The development of vaccines to protect against specific human papillomavirus (HPV) strains The rates of many STIs are highest among adolescents. According to CDC estimates, chlamydial infections reported from each of the 50 states and the District of Columbia equaled approximately 1.3 million new cases in 2010, predominantly among people younger than 25 years of age. The CDC estimates about twice the reported rate of people actually are infected with chlamydia. Testing for chlamydia is recommended for all sexually active females under age 25 by the Centers for Disease Control and Prevention. Human papillomavirus (HPV) can increase risk of cervical cancer, and PAP smears should be performed annually for early detection. There is no vaccine available for herpes simplex, and herpes simplex infection does not cause cervical cancer.

Which of the following is the primary reason that the nurse urges patients to be seen by their healthcare provider when they have genital warts? a) To receive intravenous antibiotics b) To be informed of the risk of premalignant and malignant changes c) To be informed of the chance of transmitting to others d) To have an magnetic resonance imaging to screen for other conditions

b) To be informed of the risk of premalignant and malignant changes The association with premalignant and malignant changes has increased concern regarding the diagnosis and treatment of this viral infection. Intravenous antibiotics are not used to treat viruses. The patient does not have to see the healthcare provider to be told that they have a risk of transmitting this condition to others. There are several pharmacologic treatments for symptomatic removal of visible genital warts, and cryotherapy is one of them.

Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has: a) C. trachomatis b) T. vaginalis c) C. albicans d) N. gonorrhoeae

c) C. albicans Candida albicans has a definitive morphology under the microscope of budding yeast filaments (hyphae) and a low pH.

When is syphilis highly contagious? a) When gummas lesions are observable b) Years 3 to 5 of its latent stage c) During its primary stage d) After the characteristic rash disappears

c) During its primary stage The infection is highly contagious during its primary stage, but because the symptoms are mild, it frequently goes unnoticed. The other options are not necessarily indicators of a highly contagious period.

The nurse should assess this client for which potential disease process related to untreated chlamydial infections? a) Early-onset dementia b) Cervical cancer c) Reiter syndrome d) HIV encephalopathy

c) Reiter syndrome Reiter syndrome, a reactive arthritis that includes the triad of urethritis, conjunctivitis, and painless mucocutaneous lesions, is a complication of an untreated chlamydial infection. The remaining options are not related to chlamydial infection.

A patient is diagnosed with granuloma inguinale. Which of the following questions should the nurse ask the patient? a) "Have you had all of your vaccinations?" b) "Have you ever had genital herpes?" c) "Have you been near anyone who has had the flu?" d) "Have you traveled outside of the country recently?"

d) "Have you traveled outside of the country recently?" Granuloma inguinal is caused by a Gram-negative bacillus Klebsiella granulomatis, which is a tiny encapsulated intracellular parasite. This disease is almost nonexistent in the United States but is found most frequently in tropical areas such as India, Brazil, the West Indies, and parts of China, Australia, and Africa.

A client presents with signs and symptoms of candidiasis and is concerned about why this occurs after taking antibiotics. The most appropriate information for the nurse to provide would be: a) The inappropriate use of antibiotics will cause overgrowth of Candida. b) The bacterium is found in the vagina and can overgrow due to poor vaginal hygiene. c) Antibiotics cause an increase in vaginal glycogen, which promotes candidiasis. d) Antibiotics suppress the normal protective vaginal flora allowing overgrowth of C. albicans.

d) Antibiotics suppress the normal protective vaginal flora allowing overgrowth of C. albicans. Antibiotics suppress the normal protective vaginal flora which will allow C. albicans to overgrow. Other factors that contribute to vaginal candidiasis include oral contraceptives, diabetes, and HIV.

A client has been diagnosed with a chlamydial infection. Select the pharmacological treatment of choice. a) Acyclovir b) Ceclor c) Bactrim d) Azithromycin

d) Azithromycin The CDC recommends the use of azithromycin or doxycycline in the treatment of chlamydial infection; penicillin is ineffective. Azithromycin or amoxicillin is the preferred choice in pregnancy.

Which conditions is associated with domelike lesions on both the inner thighs and vaginal area that produce a curd-like exudate? a) Chancroid b) Genital herpes c) Genital warts d) Molluscum contagiosum

d) Molluscum contagiosum The lesions described with the curd-like exudate fits the description of molluscum contagiosum lesions. None of the remaining options present with a curd-like exudate.

For a woman, what is the most serious long term outcome of an infection resulting from exposure to the N. gonorrhea bacteria? a) Dysuria b) Bartholin gland abscesses c) Post intercourse bleeding d) Sterility

d) Sterility There may be infections of the uterus and development of acute or chronic infection of the fallopian tubes (i.e., salpingitis), with ultimate scarring and sterility. The other options are less serious in nature.

A nurse is interviewing a patient about issues with infertility. Which condition contributes to the risk of infertility in both men and women? a) Herpes simplex b) Chancroid c) Genital warts d) Trichomoniasis

d) Trichomoniasis Trichomoniasis increases the risk of infertility in women because the trichomonads serve as vectors for the spread of pathogens into the fallopian tubes. In men it contributes to decreased mobility and viability of sperm. The others do not have the same risks for infertility.