NURS 1200 Test 4 Study Guide from Sanderson - Infection (STIs, Communicable Disease, HIV)
Which intervention is the nurse's priority when caring for a child with HIV?
Protecting the child from infection
Which finding for a pregnant patient indicates a need for future intervention?
Rubella titer less than 1:8 (nonimmune)
Which orders would the nurse expect to receive from the primary health care provider for the client at 10 weeks' gestation who has been diagnosed with syphilis? (Select all that apply) A wait-and-see approach Recommendation for elective abortion Screening and testing of sexual partners None, bc the syphilis will most likely not affect the fetus in utero Intramuscular benzathine penicillin G, 2.4 million units, 1 dose
Screening and testing of sexual partners Intramuscular benzathine penicillin G, 2.4 million units, 1 dose
Which info would the nurse obtain in a health history for a sexually active 16 yr old to determine the client's risk for STIs? (Select all that apply) Sexual practices Barrier protection use Gender of sexual partners Number of sexual partners Use of illicit drugs before sex
Sexual practices Barrier protection use Gender of sexual partners Number of sexual partners Use of illicit drugs before sex
At which age would a child receive immunization for measles, mumps, and rubella (MMR)?
12 months
Which actions transmit HIV? (Select all that apply) Multiple mosquito bites Sharing syringe needles Breast-feeding a newborn Dry kissing an infected individual Anal intercourse Sharing drinking glasses
Sharing syringe needles Breast-feeding a newborn Anal intercourse
Which info regarding risks that may result from an untreated chlamydia infection would the nurse include when providing education for a female client? (Select all that apply) Sterility Ectopic pregnancy Blocked Fallopian tubes Pelvic inflammatory disease Increased likelihood of HIV infection
Sterility Ectopic pregnancy Blocked Fallopian tubes Pelvic inflammatory disease Increased likelihood of HIV infection
Which client has a higher risk for contracting HIV infection?
A client who shares equipment to snort or smoke drugs
Which consideration is most important when counseling the family of a child with HIV?
Susceptibility to infection
Which explanation would the nurse provide to the students in a sex education course regarding the etiology for an increase in gonorrhea prevalence? (Select all that apply) Symptoms of the disease are vague Screening blood tests are expensive The incubation period is relatively short Causative organisms have become resistant to treatment Diagnostic tests for the causative organism are not yet available.
Symptoms of the disease are vague The incubation period is relatively short Causative organisms have become resistant to treatment
Which preexisting condition necessitates a cesarean birth?
Active genital herpes
What is administered for neonatal herpes infection?
Acyclovir
Which population would the nurse include in a community education session on STIs? (Select all that apply) Adolescents Homosexual men Transgender clients Multiple sex partners IV drug users
Adolescents Homosexual men Transgender clients Multiple sex partners IV drug users
Which factor that influences the spread of STIs would the nurse include in a teaching session? (Select all that apply) Age Drug abuse Lack of education Multiple sex partners Absent or subtle symptoms Limited access to health care
Age Drug abuse Lack of education Multiple sex partners Absent or subtle symptoms Limited access to health care
The nurse is assessing a female client with suspected primary syphilis. Which sign of primary syphilis would the nurse expect the client to exhibit?
An indurated painless nodule on the vulva that is draining
A breast-feeding teenage mother is diagnosed with syphilis. Which would be the medication of choice for this client?
Benzathine penicillin
A client who is pos for HIV is admitted to a surgical unit after an orthopedic procedure. The nurse realizes that HIV is transmissible through which means? (Select all that apply) Feces Blood Semen Urine Sweat Tears
Blood Semen (and bodily fluids)
How is HIV transmitted?
Bodily fluids -Blood -Semen -Vaginal fluid -Breast milk Oral sex, contaminated needles, contact with maternal blood during the birthing process
In addition to being highly infectious, which additional fact would the nurse teach the client with gonorrhea?
Can produce sterility
Which medication would the nurse administer to prevent maternal transmission of infection to the newborn of a client with gonorrhea? (Select all that apply) Penicillin Acyclovir Ceftriaxone Doxycycline Levofloxacin
Ceftriaxone
Which would the nurse identify as increasing the risk of HIV transmission? (Select all that apply) Childbirth Monogamy Breast-feeding Needle sharing Shared plates and cups
Childbirth Breast-feeding Needle sharing
Which STI is most commonly reported?
Chlamydia
The nurse practitioner prescribes azithromycin for a sexually active woman with a history of mucopurulent discharge and bleeding associated with cervical dysplasia, dysuria, and dyspareunia. With which sexually transmitted infection are these clinical findings and medication therapy commonly associated?
Chlamydial infection
Which information will the nurse consider when planning care for a client with HIV who has been diagnosed with class 3 tuberculosis? (Select all that apply) Class 3 TB is a clinically active disease, which is contagious. TB is the leading cause of mortality in clients infected with HIV HIV-pos clients are more likely to have multidrug resistant TB Individuals with HIV usually have higher fevers with active TB infection Persons with active TB are usually treated on an outpatient basis
Class 3 TB is a clinically active disease, which is contagious. TB is the leading cause of mortality in clients infected with HIV Persons with active TB are usually treated on an outpatient basis
Which client would the nurse need to notify the health care provider about? A. Chlamydia - medication: Azithromycin B. Genital herpes - medication: Benzathine penicillin G C. Genital warts - medication: Imiquimod D. Gonorrhea - medication: Doxycycline
Client B Rationale: Genital herpes is an acute, recurring, incurable viral infection caused by herpes simplex virus. Antiviral drugs such as acyclovir and famciclovir are used for treatment - not antibiotics.
Which topics will the school nurse include in adolescent education on STIs? (Select all that apply) Condom use Sexual identity Types of contraception Number of sexual partners Alcohol and drug consumption
Condom use Types of contraception Number of sexual partners
The nurse suspects that a newborn's mother contracted rubella during the first trimester of pregnancy. Which newborn problems support the assumption? (Select all that apply) Fever Seizures Deafness Conjunctivitis Cardiac anomalies
Deafness Cardiac anomolies
When a client asks to be screened for HIV infection, which info will the nurse include in client teaching about the test?
Detects antibodies to HIV and may not detect acute infection
Which events indicate a need to suggest testing of a client for HIV? Diagnosed with TB in 1985 Traveled to Italy and Greece in the late 1990s Received blood transfusions in 1980 during total hip replacement surgery Engaged in sexual relations with someone of the same sex for several years Spent several nights in jail for a DUI
Diagnosed with TB in 1985 Received blood transfusions in 1980 during total hip replacement surgery Engaged in sexual relations with someone of the same sex for several years
The nurse understands which preparations use toxoids but not live viruses? (Select all that apply) Rotavirus vaccine Varicella virus vaccine Measles, mumps, and rubella virus vaccine Diphtheria, hepatitis B, pertussis (acellular), polio, and tetanus vaccine Diphtheria and tetanus toxoids and acellular pertussis vaccine
Diphtheria, hepatitis B, pertussis (acellular), polio, and tetanus vaccine Diphtheria and tetanus toxoids and acellular pertussis vaccine
What is used to treat chlamydia?
Doxycycline
Which dietary changes would the nurse suggest to the client with diarrhea associated with HIV? (Select all that apply) Eat more fatty food Eat much less roughage Drink two cups of coffee daily Eat more spicy and sweet food Drink plenty of fluids between meals
Eat much less roughage Drink plenty of fluids between meals Rationale: Clients w HIV often suffer from diarrhea. Roughage should be limited in the diet of a client who has diarrhea associated w HIV bc it isn't easily digestible. Drinking plenty of fluids helps compensate for fluid loss. Fatty foods are avoided bc they alter the process of digestion; coffee and spicy and sweet food are avoided bc it stimulates the GI tract and leads to diarrhea
When teaching a group of older adults about differences between the common cold and influenza, the nurse would educate the clients that it is most important to communicate with the health care provider about which symptom?
Elevated temperature
genital herpes symptoms
Fluid-filled vesicles in the genital area; painful, crusted sores on the genitals, anus, thighs, or buttocks. Can spread to the lips through oral contact.
Which sexually transmitted infection receives antiviral medications as the treatment choice?
Genital herpes
The nurse in the clinic is assessing a teenager with a tentative diagnosis of primary syphilis. Which is an early sign of this infection?
Genital lesion
Shortly after girth the nurse instills erythromycin ophthalmic ointment in the newborn's eyes. The father asks why an antibiotic is needed. The nurse explains it is routinely administered to prevent which type of infection?
Gonorrhea
Which disease would the nurse suspect in a 16-year-old client with a history of multiple sexual partners who is complaining of increased vaginal discharge, intermittent vaginal bleeding, excessive bleeding during menstruation, and pain in the lower abdomen?
Gonorrhea
Which diagnostic criterion should the nurse use to explain AIDS to a client with HIV?
Has a CD4+ T cell lymphocyte level of less than 200 cells/ mm^3 (60%)
Upon assessment of a client with HIV, the nurse discovers red to purple lesions on the client's neck, arms, and chest. Which virus presents skin lesions?
Herpesvirus 8 (HHV-8)
A rubella vaccination is prescribed for a client. Which statement made by the client is cause for concern?
I have been trying to conceive a baby for a few months because it could affect the fetus.
Which statement by an adolescent during an annual physical examination indicates the need for HIV testing?
I have shared needles when using drugs
The nurse is obtaining a health history form a client with HIV with a low viral load who has been asymptomatic for years. Which statement by the client indicates the need for additional education on the disease process?
I occasionally have oral sex without the use of protection.
Which nursing intervention indicates misinformation when providing care for clients with HIV?
I will ask the client to avoid involvement in community activities.
Which client statement confirms that the client who is being treated for an STI has understood the nurse's instructions regarding future sexual contacts?
I won't have unprotected sex again, and I'll tell my partners to be tested for STIs.
Which statement by the nursing student indicates understanding of the precautions need in the provision of care to a child who is HIV positive?
I'll put on gloves if I'm going to be in contact with bodily fluids.
A mother diagnosed w AIDS states she has been caring for her baby even though she has not been feeling well. Which important information would the nurse determine regarding the care provided by the mother?
If the mother is breast-feeding her baby
Which guidance would the nurse provide to a sexually active 16 yr old client when she inquires as to how she can protect herself from contracting HIV?
Insist that her partner use a condom when having sex.
Which education is appropriate to give a client at 16 weeks' gestation whose partner has just informed her that he has genital herpes?
Latex or polyurethane condoms must be used when the couple is having intercourse.
What is used for sexually acquired epididymitis?
Levofloxacin
Which clinic manifestations would the nurse expect to find in a client who has acute HIV infection? (Select all that apply) Malaise Confusion Constipation Swollen lymph glands Oropharyngeal candidiasis
Malaise Swollen lymph glands
A child is admitted with a fever, headache, cough, and has had a sore throat for the past week. Three days later, a rash appears at the hairline and spreads rapidly over the body. Which disease process would the nurse anticipate providing teaching for?
Measles
To ensure antibody-mediated immunity, which actions would the nurse instruct an older client to implement? (Select all that apply) Obtain a shingles vaccination Receive a tetanus booster injection Obtain the pneumococcal vaccination Receive annual testing for TB Receive an annual influenza vaccination Avoid obtaining the pertussis vaccination
Obtain a shingles vaccination Receive a tetanus booster injection Obtain the pneumococcal vaccination Receive an annual influenza vaccination
The nurse in the clinic is obtaining the health history of a 16 yr old boy with a complaint of a thick urethral discharge. Which is the most appropriate nursing action to help confirm a tentative diagnosis of gonorrhea?
Obtaining a urethral specimen for a culture
What is used to treat syphilis?
Penicillin
Which is included in the care of a newborn infant whose mother has untreated syphilis since the second trimester of pregnancy?
Testing for congenital syphilis
Which medication used to treat syphilis is contraindicated in pregnancy?
Tetracycline Rationale: Can be administered to clients who are allergic to penicillin G; can cause birth defects or staining/discoloration to the fetus' developing teeth. Amoxicillin is safe to treat syphilis in pregnancy. Clotrimazole is used to treat candidiasis and Metronidazole is used to treat bacterial vaginosis.
An adolescent reports irritation in the vagina and yellowish green, malodorous discharge. Which infection is the adolescent likely to have?
Trichomoniasis
Which medication reduces the risk of HIV infection in unaffected individuals?
Truvada Rationale: first medication approved to reduce the risk for HIV infection
To reduce the incidence of HIV transmission, which basic strategies would the nurse teach a health class? (Select all that apply) Using condoms Using separate toilets Practicing sexual abstinence Preventing direct casual contacts Sterilizing the household utensils
Using condoms Practicing sexual abstinence
An older adult has undergone chemo. Which agent could be administered to decrease the risk of a potentially contagious common viral infection?
Zoster vaccine
Famciclovir
an antiviral medication that helps in reducing the symptoms of infection.
Methdilazine medication
anithistamine; treats the skin and provides relief from itching
Syphilis, gonorrhea, and chlamydia are all infections caused by _____.
bacteria
According to HIV disease classification, a client is in the second stage of HIV disease if the CD4+ T cell count is
between 200 and 499 cells/mm^3
Candidiasis
causes vaginal itching, painful urination, and thick, white, lumpy, and cottage cheese-like discharge
Bacterial vaginosis
characteristic "fishy" odor along with white, gray, or milky and thin discharge
Pertussis
commonly seen in young children; characterized by a whooping cough
oral thrush symptoms
creamy white or yellow raised lesions in mouth; lesions can bleed; and can spread in immunocompromised or to mothers of infected babies
The nurse is counseling an HIV pos woman on precautions to be followed. How often should the patient go for routine gynecological care including pelvic examination?
every 6 months
Dysuria, heavy greenish-yellow purulent discharge, and swollen Bartholin glands are signs of
gonorrhea
According to HIV disease classification, a client is in the first stage of HIV disease if the CD4+ T cell count is
greater than 500 cells/ mm^3
Painful blisters on the genitalia, fever, malaise, dysuria, and dyspareunia are signs of
herpes simplex 2 virus infection
According to HIV disease classification, a client with HIV is in the third stage of the disease if the CD4+ T cell count is
less than 200 cells/mm^3
Kaposi sarcoma symptoms
malignant vascular, red to purple lesions on the skin
Cromolyn medication
manages allergic rhinitis and asthma
Rubella
mild viral disease characterized by fever, sore throat, and swelling in the lymph nodes behind the ear and back of the neck; a rash may appear and spread to the torso and arms
A client with AIDS reports painless, white, raised lesions on the lateral aspect of the tongue. Which disease would the nurse suspect?
oral hairy leukoplakia
A client visits a pcp and reports chills, severe abdominal pain, and increased vaginal discharge. Which infection would the nurse suspect?
pelvic inflammatory disease
Gabapentin
prescribed to clients suffering from neuralgia caused by shingles
Chancre
red, round, superficial ulcer with a yellowish serous discharge that is a sign of primary syphilis
Symmetrical rash accompanied by malaise, fever, anorexia, and headache is indicative of
secondary syphilis
Gonorrhea
severe pain along with diarrhea and greenish yellow discharge
The nurse is teaching parents of toddlers why children receiving specific medications should not receive varicella vaccines. Which medications would the nurse include in the discussion?
steroids Rationale: Steroids have an immunosuppressive effect.
Abacavir medication
treats HIV infection and is a reverse transcriptase inhibitor
Mumps
viral disease commonly seen in children between the ages of 5 and 15. Symptoms include: swelling of the parotid gland accompanied by local pain and tenderness.