OB -- STIs

B -- Informing the client about STIs and the risks involved with the HPV is important. The health care team has a duty to provide proper information to the client, including information related to STIs and the fact that although the HPV and HIV are both viruses that can be sexually transmitted, they are not the same virus. The onset of the HPV can be insidious. Often STIs go unnoticed. Abnormal bleeding is frequently the initial symptom. The client may have had the HPV before her current boyfriend. The nurse should make no deductions from this limited information.

A 25-year-old single woman comes to the gynecologist's office for a follow-up visit related to her abnormal Papanicolaou (Pap) smear. The test revealed that the client has the HPV. The woman asks, "What is that? Can you get rid of it?" Which is the best response for the nurse to provide? a. "It's just a little lump on your cervix. We can just freeze it off." b. "HPV stands for 'human papillomavirus.' It is a sexually transmitted infection that may lead to cervical cancer." c. "HPV is a type of early human immunodeficiency virus. You will die from this." d. "You probably caught this from your current boyfriend. He should get tested for this."

A -- The client is experiencing a candidiasis infection. Fluconazole, metronidazole, and clotrimazole are the drugs of choice to treat this condition. Tetracycline is used to treat syphilis. Clindamycin is used to treat bacterial vaginosis. Acyclovir is used to treat genital herpes.

A client exhibits a thick, white, lumpy, cottage cheese-like discharge, along with white patches on her labia and in her vagina. She complains of intense pruritus. Which medication should the nurse practitioner order to treat this condition? a. Fluconazole b. Tetracycline c. Clindamycin d. Acyclovir

B -- Amoxicillin or ceftriaxone can be part of the treatment plan for gonorrhea but the client should be treated empirically for chlamydia as well. Dual therapy with amoxicillin and ceftriaxone can be used for treatment of gonorrhea and empirical treatment of chlamydia. Benzathine penicillin is indicated for treatment of syphilis for the lactating client.

A client who is breastfeeding has been diagnosed with gonorrhea. Which treatment plan should the nurse expect to be implemented? a. Benzathine penicillin G 2.4 million units one injection b. Amoxicillin 500 mg three times a day for 7 days and ceftriaxone 250 mg IM injection c. Amoxicillin 500 mg three times a day for 1 week d. Ceftriaxone 250 mg IM injection

B -- HPV infection is the most prevalent viral STI seen in ambulatory health care settings.

A group of nurses are discussing virally sexually transmitted infections (STI) in the United States. Which STI would the nurses as affecting the most people? a. HSV-2 b. HPV c. HIV d. CMV

D -- For any infection, the entire prescription must always be taken.

A group of nurses are reviewing common bacterial sexually transmitted infections. Which statement should the nurses identify as not being accurate? a. Gonorrhea can be transmitted to the newborn by direct contact with gonococcal organisms in the cervix. b. Syphilis can be transmitted through kissing, biting, or oral-genital sex. c. Chlamydial infections and gonorrhea are more likely to occur in women younger than age 20. d. Medications for pelvic inflammatory disease (PID) can be discontinued once symptoms disappear.

B -- Genital warts are one of the most common sexually transmitted infections (STIs); however, it is also known as human papillomavirus (HPV), not genital herpes.

A nurse is reviewing clinical management of genital herpes. Which statement should the nurse identify as being inaccurate? a. Genital herpes is chronic and recurring and has no known cure. b. Genital herpes is also known as genital warts. c. Plain soap and water are all that is needed to clean hands that have come into contact with herpetic lesions. d. Stress, menstruation, trauma, and illnesses have been known to trigger recurrences.

B -- Contaminated milk and shellfish are common sources of infection for HAV. A vaccine exists for HBV but not for HCV. HBV is more contagious than HIV. The incidence of HCV is on the rise.

Five different viruses (A, B, C, D, and E) account for almost all cases of hepatitis infections. Which statement regarding the various forms of hepatitis is most accurate? a. Vaccine exists for hepatitis C virus (HCV) but not for HBV. b. HAV is acquired by eating contaminated food or drinking polluted water. c. HBV is less contagious than HIV. d. Incidence of HCV is decreasing.

A -- Most women with bacterial vaginosis complain of a characteristic "fishy" odor. The discharge is usually profuse, thin, and has a white, gray, or milky color. Some women may also experience mild irritation or pruritus. The discharge associated with candidiasis is thick, white, and lumpy and resembles cottage cheese. Trichomoniasis may be asymptomatic, but women commonly have a characteristic yellow-to-green, frothy, mucopurulent, copious, and malodorous discharge. Women with gonorrhea are often asymptomatic. Although they may have a purulent endocervical discharge, the discharge is usually minimal or absent.

On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish-white vaginal discharge with a "fishy" odor and complaints of pruritus. Based upon these findings, which condition would the nurse suspect? a. Bacterial vaginosis b. Candidiasis c. Trichomoniasis d. Gonorrhea

D

Primary prevention of Pelvic inflammatory disease or PID, includes which of the following? a. Get routine testing for chlamydia b. Get early treatment of PID and take all antibotics c. Never kiss despite both partners tests negative for STD d. Avoid getting STDs, such as chlamydia and gonorrhea

D -- The usual treatment for Chlamydia bacterial infection is doxycycline or azithromycin. Concurrent treatment of all sexual partners is needed to prevent recurrence. No known cure is available for HSV; therefore, the treatment focuses on pain relief and preventing secondary infections. Because no cure is known for AIDS, prevention and early detection are the primary focus of care management. HPV causes condylomata acuminata (venereal warts); no available treatment eradicates the virus.

The nurse providing care in a women's health care setting must be knowledgeable about STIs. Which STIs can be successfully treated? a. HSV b. AIDS c. Venereal warts d. Chlamydia

A, C, D, E

The nurse should be familiar with the use of the five Ps as a tool for evaluating risk behaviors for STIs and the HIV. Which components would the nurse include in her use of the five Ps as an assessment tool? (Select all that apply.) a. Number of partners b. Level of physical activity c. Prevention of pregnancy d. Protection from STIs e. Past history

D

Which STD can be prevented by a vaccine and reduce a person's risk for certain types of cancer? a. Herpes simplex virus b. Gonorrhea c. Hepatitis B d. Human papilloma virus

C -- Genital herpes is a chronic and recurring disease for which no known cure is available; therefore, it does not respond to antibiotics. Chlamydia is a bacterial infection that is treated with doxycycline or azithromycin. Gonorrhea is a bacterial infection that is treated with any of several antibiotics. Syphilis is a bacterial infection that is treated with penicillin.

Which STI does not respond well to antibiotic therapy? a. Chlamydia b. Gonorrhea c. Genital herpes d. Syphilis

C -- HBV is the most life-threatening viral condition to the fetus and neonate. HAV is not the most threatening to the fetus nor is HSV the most threatening to the neonate. Although serious, CMV is not the most life-threatening viral condition to the fetus.

Which condition is the most life-threatening virus to the fetus and neonate? a. Hepatitis A virus (HAV) b. Herpes simplex virus (HSV) c. Hepatitis B virus (HBV) d. Cytomegalovirus (CMV)

B -- Doxycycline is effective for treating chlamydia; however, it should be avoided if a woman is pregnant. Podofilox is a recommended treatment for nonpregnant women diagnosed with human papillomavirus infection. Acyclovir is recommended for genital herpes simplex virus infection. Penicillin is the preferred medication for syphilis.

Which medication should the nurse identify as recommended by the CDC for the treatment of chlamydia? a. penicillin b. doxycycline c. podofilox d. acyclovir

C

Which of the following STDs poses the least danger for the fetus of a mother who has the infection? a. syphilis b. herpes simplex virus c. trichomonas vaginalis d. gonorrhea

B -- The woman with acute PID should be on bed rest in a semi-Fowler position. Broad-spectrum antibiotics are used; antiviral therapy is ineffective. Antibiotics must be taken as prescribed, even if symptoms subside. Few pelvic examinations should be conducted during the acute phase of the disease.

Which treatment regime would be most appropriate for a client who has been recently diagnosed with acute pelvic inflammatory disease (PID)? a. Oral antiviral therapy b. Bed rest in a semi-Fowler position c. Antibiotic regimen continued until symptoms subside d. Frequent pelvic examination to monitor the healing progress

A -- The initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of the HSV infection commonly have only local symptoms that usually are less severe than those of the initial infection. With HPV infection, lesions are a chronic problem. The HIV is a retrovirus. Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered the body. Severe depression of the cellular immune system associated with the HIV infection characterizes AIDS, which has no cure. In most adults, the onset of CMV infection is uncertain and asymptomatic. However, the disease may become a chronic, persistent infection.

Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? a. Herpes simplex virus 2 (HSV-2) b. HPV c. HIV d. CMV