Chapter 5: Sexually Transmitted Infections
The nurse is developing a teaching plan for a client diagnosed with genital herpes simplex (HSV). Which would the nurse include? Select all that apply. - The management of genital herpes includes antiviral therapy. - Little can be done to control the occurrences of infection. - The need to use good handwashing technique to prevent spread. - Educate the client to abstain from sexual activity until HSV lesions resolve. - The goal is for recurrences to be less frequent over time. - The management of genital herpes includes antibiotic therapy.
Answer: - The management of genital herpes includes antiviral therapy. - The need to use good handwashing technique to prevent spread. - Educate the client to abstain from sexual activity until HSV lesions resolve. - The goal is for recurrences to be less frequent over time.
A client is diagnosed with trichomoniasis infection. The nurse prepares to teach the client about which medication? A.) metronidazole B.) penicillin G C.) miconazole D.) fluconazole
Answer: A.) metronidazole
Which medication is the most effective treatment for trichomoniasis? A.) metronidazole B.) penicillin G benzathine C.) doxycycline D.) azithromycin
Answer: A.) metronidazole
The nurse is caring for a client diagnosed with candida vaginitis. The nurse knows additional teaching is needed when the client makes which statement? A.) "I should wear cotton underwear to prevent future infections." B.) "Douching is an effective way to cleanse the vaginal area after intercourse." C.) "Eating yogurt can may help limit future infections." D.) "Low blood sugar levels are a way to control vaginal infections."
Answer: B.) "Douching is an effective way to cleanse the vaginal area after intercourse."
A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? A.) Take the drug on an empty stomach. B.) Use a sunscreen when outside. C.) Avoid alcohol consumption. D.) Report signs of an oral yeast infection.
Answer: C.) Avoid alcohol consumption. Rationale: If alcohol is ingested when taking ceftriaxone, the client can experience a disulfiram-like reaction. Therefore the nurse would need to emphasize avoiding alcohol consumption. Taking the drug on an empty stomach may be appropriate but not the most important consideration. Using a sunscreen would be appropriate if the client was receiving doxycycline or tetracycline. Reporting the appearance of an oral yeast infection would be appropriate for a client receiving tetracycline.
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection? A.) syphilis B.) Candida albicans C.) gonorrhea D.) human immunodeficiency virus
Answer: C.) gonorrhea Rationale: Gonorrhea can be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. The newborn would develop congenital syphilis if exposed in utero. Exposure to Candida would cause thrush in the newborn. Exposure to HIV during gestation could lead to the birth of an HIV-positive newborn.
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? A.) erectile dysfunction B.) dysuria C.) painful ejaculation D.) hematuria
Answer: B.) dysuria
A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia? A.) 30% B.) 50% C.) 70% D.) 90%
Answer: C.) 70%
A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques are observed on the vaginal wall. The nurse suspects which condition? A.) trichomoniasis B.) bacterial vaginosis C.) vulvovaginal candidiasis D.) chlamydia
Answer: C.) vulvovaginal candidiasis
Which medications are appropriate to treat vaginal candidiasis? Select all that apply. - miconazole - fluconazole
Answer: - miconazole - fluconazole
The nurse is caring for a male client diagnosed with gonorrhea and chlamydia. Which health care provider order will the nurse question? A.) notification of all recent sexual partners B.) acyclovir 400 mg orally BID C.) avoidance of sexual activity until treatment is complete D.) rapid serum HIV test
Answer: B.) acyclovir 400 mg orally BID
Which finding would alert the nurse to suspect that a client has a yeast infection? A.) changes in skin color B.) vulvar burning and itching C.) lymphadenopathy D.) acidic vaginal secretions
Answer: B.) vulvar burning and itching
The nurse is teaching a client about sexually transmitted infections. The nurse determines the teaching was successful when the client makes which statement? A.) "Gonorrhea can be prevented with a vaccine." B.) "Chlamydia remains localized if not treated." C.) "People with trichomoniasis will have burning when they urinate." D.) "Genital ulcers are a sign of genital herpes simplex."
Answer: D.) "Genital ulcers are a sign of genital herpes simplex."
The nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection (STI). What would the nurse expect to assess if the adolescent has trichomoniasis? A.) green vaginal discharge B.) urinary incontinence C.) flu-like symptoms D.) lesions on the vulva
Answer: A.) green vaginal discharge
A client has presented reporting symptoms that suggest a gonorrheal infection. After laboratory testing confirms this diagnosis, the nurse anticipates that the client will also be treated for which infection? A.) chlamydia B.) HPV C.) syphilis D.) candidiasis
Answer: A.) chlamydia
Pelvic infection is most commonly caused by: A.) sexual transmission. B.) induced abortion (medical abortion). C.) hysteroscopy. D.) insertion of intrauterine device.
Answer: A.) sexual transmission.
A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response? A.) "The lumps on your cervix can be cured by cryosurgery." B.) "There is currently no medical treatment to cure HPV." C.) "This can be cured with medications such as the recombinant human papillomavirus quadrivalent vaccine." D.) "The health care provider will prescribe antibiotics to cure this infection."
Answer: B.) "There is currently no medical treatment to cure HPV."
A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection? A.) viral culture of vesicular fluid B.) Papanicolaou smear C.) IgG/IgM antibody testing D.) treponemal testing
Answer: A.) viral culture of vesicular fluid
A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease? A.) Ensure that the drinking water is disease-free. B.) Instruct people to get vaccinated for hepatitis B. C.) Educate about risks of injecting drugs. D.) Educate teenagers to delay onset of sexual activity.
Answer: B.) Instruct people to get vaccinated for hepatitis B.
A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe? A.) metronidazole B.) acyclovir C.) clotrimazole D.) penicillin G
Answer: A.) metronidazole
The nurse is caring for a female client diagnosed with vulvovaginal candidiasis. Which instruction will the nurse include in the teaching session with the client? A.) "Use superabsorbent tampons and change frequently." B.) "Notify your health care provider if you note thick, white vaginal discharge." C.) "It is best for you to wear cotton underwear." D.) "It is okay for you to take your oral fluconazole tablet with or without food."
Answer: C.) "It is best for you to wear cotton underwear."
A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem? A.) Explain the cause of the sexually transmitted infection (STI). B.) Provide the client with a telephone number for obtaining accurate information. C.) Affirm the client's good judgment in seeking treatment. D.) Schedule an appointment for follow-up care.
Answer: C.) Affirm the client's good judgment in seeking treatment.
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common bacterial STI in the United States would the nurse expect to include? A.) gonorrhea B.) chlamydia C.) syphilis D.) genital herpes
Answer: B.) chlamydia
A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response? A.) "It is not transmitted to your newborn as it is protected in the uterus." B.) "The risk of your newborn being infected with HIV infection is about 1%." C.) "It is only transmitted through the birth canal so a cesarean birth will be scheduled." D.) It is recommended to formula-feed your newborn as it is transmitted through your breast milk."
Answer: D.) It is recommended to formula-feed your newborn as it is transmitted through your breast milk." Rationale: An infected mother can transmit HIV infection to her newborn before or during birth and through breastfeeding. The risk of perinatal transmission of HIV from an infected mother to her newborn is about 25%. This risk falls to less than 1% if the mother receives antiretroviral therapy during pregnancy. HIV can be spread to the infant through breastfeeding. HIV-infected mothers should be counseled to avoid breastfeeding and use formula instead.
What is the most common viral infection? A.) human papillomavirus (HPV) B.) gonorrhea C.) chlamydia D.) trichomoniasis
Answer: A.) human papillomavirus (HPV)
A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply. - "The virus remains quiet until a stressful event occurs to reactivate it." - "Your baby is protected from this infection by the placenta." - "Many recognize they have the infection and seek treatment immediately." - "Infections may be transmitted by individuals unaware that they have it." - "Transmission is through contact of infected mucous membranes."
Answer: - "The virus remains quiet until a stressful event occurs to reactivate it." - "Infections may be transmitted by individuals unaware that they have it." - "Transmission is through contact of infected mucous membranes."
A client is diagnosed with bacterial vaginosis and is prescribed medication therapy. The nurse would anticipate which drugs as being prescribed? Select all that apply. - clindamycin - metronidazole - penicillin G - doxycycline - azithromycin
Answer: - clindamycin - metronidazole Rationale; Clindamycin or metronidazole is used to treat bacterial vaginosis. Penicillin G may be used to treat syphilis. Doxycycline or azithromycin is used to treat chlamydia.
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. - 29 years of age - multiple sex partners - intrauterine contraceptive device inserted 3 weeks ago - vaginal douching approximately once a week - residence in a suburban area
Answer: - multiple sex partners - intrauterine contraceptive device inserted 3 weeks ago - vaginal douching approximately once a week
A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? A.) "Human papillomavirus is the cause of essentially all cases of cervical cancer." B.) "At least antibiotics will cure a sexually transmitted infection." C.) "Gonorrhea and syphilis are infections seen only in men." D.) "STIs can't be transmitted through oral sexual intercourse."
Answer: A.) "Human papillomavirus is the cause of essentially all cases of cervical cancer." Rationale: Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer, which is the fourth most common cancer in women in the United States. Up to 95% of cervical squamous cell carcinomas and nearly all preinvasive cervical neoplasms are caused by the HPV. Antibiotics will only cure those STIs caused by bacterial infections. A viral STI infection is a lifetime infection. Gonorrhea and syphilis affect both men and women. Sexually transmitted infections are infections of the reproductive tract caused by microorganisms transmitted through oral sexual intercourse.
The nurse is teaching a group of middle school students about sexually transmitted infections (STIs). Which statement by the students indicates a need for additional teaching about condom use? A.) "I will put the condom on just before orgasm." B.) "Latex condoms provide the best protection against STIs." C.) "I will put the condom on just before insertion." D.) "I will not store condoms in my wallet."
Answer: A.) "I will put the condom on just before orgasm."
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 infections. What is the nurse's best response? A.) "This STI is characterized by an infection of your cervix." B.) "This STI is an infection that will cause itching in the genital area." C.) "This STI is an infection that results in ulcers in the genital area." D.) "This STI is an infection that will result in the formation of genital warts."
Answer: A.) "This STI is characterized by an infection of your cervix." Rationale: STIs like chlamydia result in cervicitis, which implies the presence of inflammation or infection of the cervix. It produces quantities of purulent discharge. Cervicitis is usually caused by gonorrhea or chlamydia. Chlamydia will not produce ulcers or warts and is not an STI that has itching associated with it.
Which instruction should the nurse give to a client with genital herpes to help control the infection? A.) Avoid sexual contact until sores heal. B.) Apply antibacterial medication. C.) Avoid people with upper respiratory infections. D.) Apply imiquimod cream.
Answer: A.) Avoid sexual contact until sores heal.
A client presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole. What is the paramount nursing intervention in discharge planning? A.) Instruct the client not to drink alcohol with this treatment. B.) Counsel the client to refrain from sex for one week. C.) Advise the client to take medication with a glass of milk. D.) Reassure the client further STI testing is not indicated.
Answer: A.) Instruct the client not to drink alcohol with this treatment. Rationale; While counseling to abstain from sex for one week is appropriate, the most important intervention is counseling to avoid alcohol during metronidazole treatment. Alcohol consumption while taking metronidazole creates a severe gastrointestinal reaction of nausea, vomiting, and flushing. Metronidazole does not have to be taken with milk. Further STI testing is indeed recommended with the diagnosis of an STI.
An HIV-positive client who is on antiretroviral therapy reports anorexia, nausea, and vomiting. Which suggestion should the nurse offer the client to cope with this condition? A.) Use high-protein supplements. B.) Eat dry crackers after meals. C.) Limit number of meals to three a day. D.) Constantly drink fluids while eating.
Answer: A.) Use high-protein supplements.
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? A.) a painless genital ulcer that appeared about 3 weeks after unprotected sex B.) copper-colored macules on the palms and soles that appeared after a brief fever C.) patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas D.) one or more flat, wartlike papules in the genital area that are sensitive to touch
Answer: A.) a painless genital ulcer that appeared about 3 weeks after unprotected sex Rationale; A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts.
A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity? A.) administering HPV vaccine B.) teaching about the importance of regular Papanicolaou test C.) educating about HPV testing in women over age 30 D.) encouraging treatment for genital warts
Answer: A.) administering HPV vaccine
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? A.) an azole antifungal agent B.) a penicillin antibiotic C.) a quinolone antibiotic D.) an antiviral agent
Answer: A.) an azole antifungal agent
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? A.) fluconazole B.) tetracycline C.) clindamycin D.) acyclovir
Answer: A.) fluconazole
The nurse in the sexual health clinic is obtaining a health history of a client who suffers form heroin use disorder. The client reports chronic flulike symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect? A.) hepatitis A B.) herpes simplex C.) trichomoniasis D.) syphilis
Answer: A.) hepatitis A Rationale: Hepatitis A produces flulike symptoms with malaise, skin rashes, fatigue, anorexia, nausea, pruritus, fever, and upper right quadrant pain. Symptoms of hepatitis B are similar to those of hepatitis A, but with less fever and skin rash involvement. Syphilis, herpes simplex, and trichomoniasis do not present with these types of symptoms.
What is the medication of choice for early syphilis? A.) penicillin G benzathine B.) doxycycline C.) tetracycline D.) ceftriaxone
Answer: A.) penicillin G benzathine Rationale: A single dose of penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Clients who are allergic to penicillin are usually treated with doxycycline or tetracycline. Ceftriaxone is not the medication of choice for syphilis.
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? A.) the possibility of a chlamydia infection B.) an acute stage of the gonorrheal infection C.) a reaction to the gonorrheal medications D.) a positive pregnancy test
Answer: A.) the possibility of a chlamydia infection Rationale: Any woman suspected of having gonorrhea should be tested for chlamydia also because coinfection (45%) is extremely common. The nursing management of chlamydia and gonorrhea includes treatment of both. The prevalence of chlamydia and gonorrhea is increasing dramatically.
The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms? A.) trichomoniasis B.) herpes simplex 2 C.) human papillomavirus D.) syphilis
Answer: A.) trichomoniasis
A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding? A.) yeast infections B.) loss of appetite C.) hypertension D.) acidity and heartburn
Answer: A.) yeast infections
A client diagnosed with human papillomavirus (HPV) asks the nurse if she will be at risk for developing cervical cancer. The nurse best responds by making which statement? A.) "Cervical cancer is typically caused by the herpes simplex virus, not the human papillomavirus (HPV)." B.) "Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer." C.) "If you get the human papillomavirus (HPV) vaccine you will no longer be at risk for developing cervical cancer." D.) "You will likely contract cervical cancer so frequent screening testing will be very important."
Answer: B.) "Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer."
The nurse is teaching college students about human papillomavirus (HPV). Which statement made by a college student indicates additional teaching is needed? A.) "The HPV vaccine is recommended for males and females, even for those who are not sexually active yet." B.) "People exposed to HPV will show symptoms within 1 to 3 weeks of being exposed." C.) "Most people who contract HPV will not have any long-term effects from the virus." D.) "There currently is not a test that can detect if someone has been exposed to HPV."
Answer: B.) "People exposed to HPV will show symptoms within 1 to 3 weeks of being exposed." Rationale; The nurse will provide clarification for stating symptoms will develop within 1 to 3 weeks of exposure. Many people exposed to HPV never develop symptoms or they may develop symptoms years later. HPV most often self-resolves without the person ever knowing they were exposed. The HPV vaccine is recommended for males and females who are 11 to 12 years of age (can be as young as 9 years of age). It is best to receive the vaccine before becoming sexually active to ensure protection is in place prior to exposure. There is not a test to show someone has been exposed. If the person does not develop symptoms, such as cervical cancer or genital warts, exposure often is unknown.
The nurse is caring for a client recently diagnosed with genital herpes. The client asks about appropriate ways to prevent future outbreaks. What is the nurse's best response? A.) "It is important that you always have protected intercourse to prevent spreading the virus." B.) "Regular exercise, getting an adequate amount of sleep, and eating healthy meals are appropriate." C.) "Taking acetaminophen, ibuprofen, or aspirin to relieve pain may be of benefit for you." D.) "Wash sores gently with soap and water and then pat them dry."
Answer: B.) "Regular exercise, getting an adequate amount of sleep, and eating healthy meals are appropriate."
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? A.) Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. B.) Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. C.) Antifungal medications are effective against the anovulation and risk for HIV that accompany the infection. D.) Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.
Answer: B.) Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.
A nurse is conducting a class for high school students on preventing sexually transmitted infections (STIs). Which information would the nurse emphasize as the sole method for not contracting STIs? A.) limiting sexual partners B.) engaging in abstinence C.) using condoms D.) urinating immediately after intercourse
Answer: B.) engaging in abstinence
A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata? A.) herpes virus B.) human papillomavirus C.) Treponema pallidum D.) Haemophilus ducreyi bacillus
Answer: B.) human papillomavirus
A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community? A.) Promote the use of oral contraceptive pills (OCPs). B.) Emphasize the importance of good body hygiene. C.) Discuss limiting the number of sex partners. D.) Emphasize not sharing personal items with others.
Answer: C.) Discuss limiting the number of sex partners.
A client is being discharged from the gynecological unit after treatment for acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include? A.) Provide the client with brochures on sexually transmitted infection prevention. B.) Arrange for follow-up visits to her health care provider. C.) Discuss the necessity of completing the antibiotic therapy. D.) Refer the client to the women's sexual health clinic.
Answer: C.) Discuss the necessity of completing the antibiotic therapy.
Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection? A.) Pat or blot the skin dry. B.) Have regular cancer screening examinations. C.) Participate in early prenatal care. D.) Take tub baths regularly.
Answer: C.) Participate in early prenatal care. Rationale: The nurse should recommend that a pregnant client with a sexually transmitted infection who is at risk for infection transmission receive early prenatal care because some STIs can be transmitted during birth. Patting or blotting the skin dry is helpful in reducing friction and the itch-scratch-itch cycle. The nurse should recommend clients infected with carcinogenic viruses to have regular cancer screening examinations to facilitate early diagnosis and optimistic prognosis. Taking tub baths regularly would have no effect on infection transmission.
A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. What most likely contributed to her present condition? A.) unprotected sex with a new partner who is a carrier of the relevant bacteria B.) autoinoculation from a cold sore, wart, or oral fungal infection C.) a sharp reduction in the number of lactobacilli in the client's vaginal flora D.) proliferation of sexually-transmitted protozoa
Answer: C.) a sharp reduction in the number of lactobacilli in the client's vaginal flora
During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk for developing which diagnosis? A.) genital herpes B.) gonorrhea C.) condylomata acuminata D.) candidiasis
Answer: C.) condylomata acuminata
Which factor in a client's history indicates she is at risk for candidiasis? A.) nulliparity B.) menopause C.) use of corticosteroids D.) use of spermicidal jelly
Answer: C.) use of corticosteroids Rationale: Small numbers of the fungus Candida albicans are commonly in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. Pregnancy, not nulliparity, increases the risk of candidiasis. Candidiasis is rare before menarche and after menopause. The use of hormonal contraceptives, not spermicidal jelly, increases the risk of candidiasis.
The nurse is caring for a client diagnosed with trichomoniasis. The health care provider has prescribed a single dose of metronidazole. Which information will the nurse provide this client? A.) "You may crush or chew this tablet if you have difficulty swallowing medications." B.) "Once you are healed, you need to come back to get the human papillomavirus (HPV) vaccination." C.) "We need to complete a pregnancy test first, to be sure you can take this medication." D.) "Avoid alcohol consumption for at least 24 hours after you take this medication."
Answer: D.) "Avoid alcohol consumption for at least 24 hours after you take this medication." Rationale: Metronidazole is an antibiotic used to treat bacterial infections of the vagina. The HPV vaccine is not required for clients diagnosed with trichomoniasis. The nurse would educate the client that having one sexually transmitted infection (STI) places the client at higher risk for future STIs; however, the client does not have to receive the vaccine. A pregnancy test is not necessary, because metronidazole is safe to take during pregnancy. Clients should not consume alcohol or foods or medicines that contain propylene glycol while taking metronidazole and for at least 1 day after to avoid unpleasant side effects (tachycardia, flushed, nausea, vomiting). The nurse would instruct the client to not crush, chew, or break the extended-release tablet.
The nurse is teaching a woman diagnosed with genital herpes. The nurse will provide additional teaching if the client makes which statement? A.) "Once my lesions go away, they could come back at any time." B.) "I will wear loose-fitting underwear and pants while I am healing." C.) "I can take acetaminophen, ibuprofen, or aspirin to help with my pain." D.) "I should apply warm compresses to my lesions to relieve pain and itching."
Answer: D.) "I should apply warm compresses to my lesions to relieve pain and itching." Rationale: The nurse would provide clarification if the client indicates to apply warm compresses. Cool compresses should be used to avoid increasing irritation of the lesions. The lesions can return at any time after healing takes place. Outbreaks are often brought about by fatigue, genital irritation or injury, menstruation, and stress. It is appropriate for the client to take acetaminophen, ibuprofen, or aspirin to help with the pain. Loose-fitting, cotton garments are recommended to promote airflow to the area.
The nurse is providing education on the prevention of sexually transmitted infections (STIs) to clients. The nurse understands which client is at the highest risk of contracting an STI? A.) A 17-year-old client who is in a monogamous relationship with a 25-year-old partner and engages in unprotected sex. B.) A 20-year-old client who reports having protected sexual intercourse with three others, male and female, over the past five years. C.) A 25-year-old client who refused to receive the human papillomavirus vaccine and whose parents both have HIV. D.) A 30-year-old client who consumes alcohol multiple times per week, uses cocaine, and has a history of prostitution.
Answer: D.) A 30-year-old client who consumes alcohol multiple times per week, uses cocaine, and has a history of prostitution. Rationale: The nurse will look for the client with the most risk factors for contracting an STI. The 30-year-old client is at the highest risk due to the use of alcohol and drugs and a history of forced sexual activity (3 risk factors). Other risk factors include age of 24 years or less, multiple partners, unprotected intercourse, and a history of STIs. Although the 17-year-old client is young and having unprotected intercourse, the client is in a monogamous relationship, indicating only 2 risk factors. The 20-year-old client is young and has protected intercourse with multiple partners (2 risk factors). The 25-year-old has no risk factors.
A female client is prescribed metronidazole for the treatment of trichomoniasis. Which instruction should the nurse give the client undergoing treatment? A.) Avoid extremes of temperature to the genital area. B.) Use condoms during sex. C.) Increase fluid intake. D.) Avoid alcohol.
Answer: D.) Avoid alcohol. Rationale: The nurse should counsel the client taking metronidazole to avoid alcohol during the treatment because mixing the two causes severe nausea and vomiting. Avoiding extremes of temperature to the genital area is a requirement for clients with genital ulcers, not trichomoniasis. The nurse should instruct the client to avoid sex, regardless of using condoms, until she and her sex partners are cured (when therapy has been completed and both partners are symptom-free). It is not required to increase fluid intake during treatment.
Which instruction should be given to a woman newly diagnosed with genital herpes? A.) Obtain a Papanicolaou test every 3 years. B.) Have your partner use a condom when lesions are present. C.) Use a water-soluble lubricant for relief of pruritus. D.) Limit stress and emotional upset as much as possible.
Answer: D.) Limit stress and emotional upset as much as possible. Rationale: Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it is not known whether the virus can be transmitted at this time. During an outbreak, creams and lubricants should be avoided because they may prolong healing. Because a relationship has been found between genital herpes and cervical cancer, a Papanicolaou test is recommended every year.
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? A.) azithromycin B.) valacyclovir C.) penicillin D.) metronidazole
Answer: D.) metronidazole
Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? A.) candidiasis B.) Gardnerella vaginalis vaginitis C.) gonorrhea D.) trichomoniasis
Answer: D.) trichomoniasis
A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis? A.) cottage cheese-like discharge B.) intense itching of the vulva C.) warts in the vulva and labia D.) vaginal odor smelling of fish
Answer: D.) vaginal odor smelling of fish