Chapter 28: Infections

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms? 1 an azole antifungal agent 2 penicillin antibiotic 3 a quinolone antibiotic 4 an antiviral agent

1

A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect which finding once the microorganism disseminates throughout the body? 1 painful joints 2 sore throat 3 intermenstrual bleeding 4 painful urination

1

A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment? 1 Fluconazole 2 Tetracycline 3 Clindamycin 4 Acyclovir

1

A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response? 1 "This STI is characterized by an infection of your cervix." 2 "This STI is an infection that will cause itching in the genital area." 3 "This STI is an infection that results in ulcers in the genital area." 4 "This STI is an infection that will result in the formation of genital warts."

1

The nurse is caring for clients who have STIs. Which client is most at risk for becoming infertile due to the infection? 1 a woman diagnosed with trichomoniasis 2 a woman diagnosed with chlamydia 3 a woman diagnosed with syphilis 4 a woman diagnosed with herpes simplex virus

2

A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe? 1 penicillin 2 tetracycline 3 levofloxacin 4 ceftriaxone

4

A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports: 1 headache and fever. 2 vaginal and urethral discharge. 3 dysuria and lymphadenopathy. 4 genital pruritus and paresthesia.

4

A pregnant client is complaining of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? 1 ceftriaxone IM 2 oral erythromycin 3 benzathine penicillin G IM 4 oral metronidazole

4

A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings? 1 the possibility of a chlamydia infection 2 an acute stage of the gonorrheal infection 3 a reaction to the gonorrheal medications 4 a positive pregnancy test

1

The nurse is assessing a primigravida woman who reports vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. The nurse suspects the woman has contracted which disorder? 1 Chlamydia 2 Simple yeast infection 3 Trichomoniasis 4 Gonorrhea

3

A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent? 1 acyclovir 2 ceftriaxone 3 podophyllum resin 4 doxycycline

4

A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure? 1 "One or two treatments should get rid of the warts." 2 "I'm temporarily not contagious once the warts are destroyed." 3 "Once the warts are gone, then I know I'm cured." 4 "My partner doesn't need to be treated."

2

What is the most common early symptom of a sexually transmitted infection? 1 menstrual cramping 2 dysuria 3 vaginal discharge 4 amenorrhea

2

A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply. 1 29 years of age 2 multiple sex partners 3 intrauterine contraceptive device inserted 3 weeks ago 4 vaginal douching approximately once a week 5 residence in a suburban area

2, 3, 4,

After teaching a client diagnosed with candidiasis about preventative measures, the nurse determines that the teaching was effective when the client states she will take which action? 1 Avoid exposure to sun. 2 Use sunscreen regularly. 3 Avoid tight pants. 4 Exercise to prevent fatigue.

3

A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge? 1 candidiasis 2 syphilis 3 gonorrhea 4 chlamydia

1

What is the gold standard for HSV diagnosis? 1 culture 2 shave biopsy 3 excisional biopsy 4 punch biopsy

1

Which instruction should be given to a woman newly diagnosed with genital herpes? 1 Obtain a Papanicolaou test every 3 years. 2 Have your partner use a condom when lesions are present. 3 Use a water-soluble lubricant for relief of pruritus. 4 Limit stress and emotional upset as much as possible.

4

Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? 1 "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." 2 "I hope this medicine works before this disease gets into my urine and destroys my kidneys." 3 "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." 4 "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."

4

A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis? 1 Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. 2 Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. 3 Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection. 4 Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.

2

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which statement by the client demonstrates understanding of his health problem? 1 "Either me or a partner could end up with an eye infection from chlamydia that could make us blind." 2 "Even though I couldn't end up sterile, a woman that I give it to certainly could." 3 "Each of the 3 stages of the disease seems to be worse than the previous one." 4 "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

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