STD

a,b,c,e (Rationale The nurse assesses an adolescent client diagnosed with an STI for​ pain, impaired skin​ integrity, deficient​ knowledge, and disturbed body image. There is no need to assess the client for risk of altered parenting.)

The nurse is caring for an adolescent client who has been diagnosed with an STI. For which problem should the nurse assess this​ client? ​(Select all that​ apply.) a Deficient knowledge b Pain c Disturbed body image d Risk of altered parenting e Impaired skin integrity

c (Rationale Herpes is a viral STI.​ Chlamydia, gonorrhea, and syphilis are bacterial STIs.)

The nurse is educating a group of adolescent clients about STIs. The nurse has divided the infections into two​ groups: bacterial and viral. Which infection should the nurse discuss when teaching about viral​ STIs? a Syphilis b Gonorrhea c Herpes d Chlamydia

4 (many women do not seek treatment because they are unaware that they have gonorrhea. They may be symptom free or have only very mild symptoms until the disease progresses to PID. Dysuria and vaginal bleeding are not present in gonorrhea. Gonorrhea can lead to very serious complication. It can be cured with proper treatment)

When educating a female client with gonorrhea, the nurse should emphasize that for women, gonorrhea: 1. Is often marked by symptoms of dysuria or vaginal bleeding 2. does not lead to serious complications 3. can be treated but not cured 4. may not cause symptoms until serious complications occur

2 (managing stressful life events can decrease the incidence of outbreaks of HSV-2. Occlusive ointments should not be applied. Antiviral therapies will not cure herpes but can manage symptoms and decrease the incidence of outbreaks. Clients with HSV-2 should use condoms to prevent HSV transmission. Cells can be shed at other times, not only when vesicles are weeping)

A client diagnosed with genital HSV-2. The nurse should instruct the client that; 1. using occlusive ointments may decrease pain from the lesions 2. reducing stressful life events may decrease the incidence of herpetic outbreaks 3. there are no effective drug therapies to manage herpes symptoms 4. herpes is transmitted to partners only when lesions are weeping

c (Rationale: Vaginal fluid pH is slightly alkaline, as is semen. Spermatozoa cannot survive in an acidic environment. This disorder does not use glycogen, block the fallopian tubes, or increase the temperature inside the vagina.)

A client has been diagnosed with trichomoniasis vaginitis. The nurse explains during client teaching that this infection can affect fertility by: a utilizing the glycogen in vaginal secretions, leaving no nutrients for spermatozoa. b increasing the temperature inside the vagina, which decreases the motility of the spermatozoa. c decreasing the pH of the vaginal secretions, thereby destroying most spermatozoa. d creating a blockage of the fallopian tubes that prohibits spermatozoa from reaching the ovum.

3 (the client should be encouraged to report painful urination or urinary retention. lesions may appear 2-12 days after exposure. The client is capable of transmitting the virus even when asymptomatic, so a barrier contraceptive should be used. drinking extra fluids will not stop the lesions from forming)

A client tells the nurse that she has had sexual contact with someone whom she suspects has genital herpes. The nurse should instruct the client to: 1. anticipate lesions in 25-30 days 2. continue sexual activity unless lesions are present 3. report any difficulty urinating 4. drink extra fluids to prevent lesions from forming

3 (Zidovudine (AZT) interferes with the replication of HIV and thereby slows the progression of HIV infection to AIDS. There is no known cure for HIV. Today clients are not treated with monotherapy, but are usually on triple therapy due to much improved clinical response. Decreased viral loads with the drug combinations have improved the longevity and quality of life in clients with HIV/AIDS. AZT does not destroy the virus, enhance the bodies antibody production, or neutralize virus toxins)

A client with HIV infection is taking AZT the expected outcome of AZT is to : 1. destroy the virus 2. enhance the bodies antibody production 3. slow replication of the virus 4. neutralize toxins produced by the virus

d (Chlamydia is caused by​ bacteria, and not by​ protozoa, a​ fungus, or a virus)

A nurse in the health department is providing information about sexually transmitted infections​ (STIs) to Rachel​ Herrera, a​ 24-year-old with chlamydia. Ms. Herrera​ states, "I know I got this infection from my​ boyfriend, but what germs caused my​ infection?" Which response by the nurse is​ accurate? ​a "Your infection was caused by a​ virus." ​b "Your infection was caused by​ protozoa." ​c "Your infection was caused by a​ fungus." ​d "Your infection was caused by​ bacteria."

a,b,c,e (Rationale The client​'s sexual​ history, assessment, and examination must be​ documented, including symptoms​ (e.g., fever,​ chills, burning on​ urination, vaginal​ drainage) and their onset and duration. It is critical to document allergies for every​ client, especially because antibiotics may be ordered. An STI has not yet been​ confirmed, so a list of sexual contacts is not needed.)

A​ 24-year-old sexually active female client comes to the clinic with a complaint of burning on urination and a vaginal discharge. Documentation on the client​'s chart should include which​ information? ​(Select all that​ apply.) a History of unprotected sex b Allergies to any medications c Length of time since symptoms presented d Names and phone numbers of all sexual contacts e History of fever or chills

2 (because of the large dose the upper outer quadrant of the buttocks is recommended site. The deltoid and quadricepts lateralis of the thigh are not large enough for the recommended dose. In infants and small children, the midlateral aspect of the thigh may be preferred.)

Benzathine Penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The nurse should administer the injection in the : 1. deltoid 2. upper outer quadrant of the buttock 3. quadriceps lateralis of the thigh 4. midlateral aspect of the thigh

d (Gardasil and Cervarix may be used as vaccines to prevent HPV infection as well as cervical cancer. The vaccine is recommended for​ females, ages 11 to 26 and​ males, ages 11 to​ 21; therefore, this client is within the acceptable age range to receive the vaccine. There are no vaccines against syphilis and chlamydia.)

The nurse in the health department is speaking with Susie​ Munde, a​ 12-year-old girl, and her mother about sexually transmitted infections​ (STIs). The mother​ asks, "I heard there is a shot that can help against STIs. Is this​ true?" Which is the​ nurse's best​ response? ​a "Yes, there is a vaccine available to prevent​ syphilis." ​b "Yes, and you would use it along with medication to prevent​ chlamydia." ​c "Yes, but your daughter is too young for this​ vaccine." ​d "Yes, Gardasil and Cervarix may be used as vaccines to prevent human papillomavirus​ infections."

d (Rationale The adolescent will need to continue oral medication completely as prescribed. The client would not need to return for the second dose of oral antibiotics. Treatment will require more than one oral dose. No injection was​ prescribed, only oral antibiotic therapy.)

The nurse is caring for a female adolescent who has been diagnosed with gonorrhea. The client will be placed on oral antibiotic therapy. The nurse knows that the adolescent has understood the teaching when she makes which​ statement? ​a "I will need to take this one dose with​ food." ​b "I will need to have an injection of penicillin​ G." ​c "I will need to come back to the healthcare center in 12 hours for my second dose of oral​ antibiotics." ​d "I will need to take all my medication as​ prescribed."

c (Rationale Chlamydia is usually asymptomatic. When symptoms do​ occur, female clients may experience cervicitis and pelvic inflammatory​ disease, and male clients may experience urethritis.)

The nurse is caring for a female client with possible chlamydia. With which sign or symptom is this client most likely to​ present? a Urethritis b Cervicitis c No specific symptoms d Pelvic inflammatory disease

b (Rationale Seven days of doxycycline hyclate or erythromycin is an appropriate option for treatment of chlamydia. A single dose of intramuscular ceftriaxone or a single dose of oral cefixime is an appropriate option for treatment of gonorrhea. A single oral dose of metronidazole or tinidazole is an appropriate option for treatment of trichomoniasis.)

The nurse is caring for an adolescent client who has been diagnosed with chlamydia. Which treatment option is most appropriate for this​ client? a A single dose of oral cefixime b Doxycycline hyclate or erythromycin for 7 days c A single dose of intramuscular ceftriaxone d A single oral dose of metronidazole or tinidazole

d (Rationale: STIs can be contracted by any type of sexual​ contact, including oral and anal sex. STIs cannot be contracted from a toilet seat or by sharing a towel or a drinking glass with someone.)

The nurse is educating a group of adolescents on ways to decrease the risk of contracting an STI. Which information should the nurse include in the​ session? ​a "STIs can be contracted from shared​ towels." ​b "STIs can be contracted by sharing drinking​ glasses." ​c "STIs can be contracted from toilet​ seats." ​d "STIs can be contracted by oral​ sex."

2 (An important aspect of controlling the spread of STD's is obtaining a list of sex partners/contacts of an infected individual. These contacts in turn, should be encouraged to obtain immed. care. Many people with STDS are reluctant to reveal their sex contacts, which makes controlling STDs difficult. Increasing clients knowledge of the disease, reassuring clients that their records are confidential can motivate them to seek treatment, which does not help control the spread of the disease, but it is not as critical as information about the clients sexual contacts.)

The nurse is interviewing the client newly diagnosed with syphilis. In order to prevent the spread of the disease, the nurse should focus the interview by: 1. motivating the client to undergo treatment 2. obtaining a list of the clients sexual contacts 3. increasing the clients knowledge of the disease 4. reassuring the client that medical records are confidential

d (Rationale The nurse should encourage the client to receive the hepatitis B vaccination. Although the nurse should encourage the client to tell her​ family, confidentiality should be maintained. The nurse should maintain a nonjudgmental attitude when providing education. The nurse should encourage the adolescent to notify sexual partners.)

The nurse is providing care in an outpatient clinic for an adolescent female who has been diagnosed with a sexually transmitted infection​ (STI). When providing​ care, it is important for the nurse to carry out which​ action? a Notifying the adolescent​'s family of the STI b Being judgmental when providing education c Telling the adolescent that she does not need to notify any sexual partners d Encouraging the client to receive the hepatitis B vaccination

c (Rationale Engaging in sex is a personal​ choice, and partners should never​ pressure, threaten, or abuse to obtain sexual favors. Safer sex does not include applying spermicides directly on female genitalia. Responsible sexual behavior involves more than just the physical act of sex itself. It also involves knowing how to identify the warning signs​ of, and how to protect​ against, dating violence and date rape. Showing a​ long-term commitment to a partner involves more than having sex.)

The nurse is teaching a group of adolescents about safer and more responsible sex practices. In addition to discussing​ abstinence, which information is the most appropriate for the nurse to include in the​ session? a "Having sex with someone you love shows the partner that you are committed to staying with him or her for the long term. " b "Safer sex includes applying spermicides on female genitalia to reduce transmission of infections before intercourse. " c "Engaging in sex is a personal choice that you should prepare for without ever feeling pressured by another. " d "Responsible sex involves knowing who your partner had sex with in the immediate past.

a (Rationale: Initially, gonorrhea infects the male urethra and the female cervix. The vulva, vagina, prostate, and external genitalia are not initially infected by gonorrhea)

The nurse is teaching a group of clients about sexually transmitted infections (STI). The nurse knows that teaching is successful when the clients identify that the infective organism responsible for gonorrhea initially targets which body part? a Male urethra and female cervix b Female vulva and vagina c Male prostate d Male and female external genitalia

a (Rationale The HPV vaccine decreases the risk of cervical cancer and should be encouraged for all adolescents. When one partner is diagnosed with an​ STI, both partners should be​ treated; however, this does not decrease the risk of cervical cancer. Avoiding all sexual contact decreases the risk of an STI. Completing all medication as prescribed is important when treating an STI but does not decrease the risk of cervical cancer.)

The nurse is teaching an adolescent client about decreasing the risk of cervical cancer. Which information is most important for the nurse to include in this​ session? a Encouraging administration of the human papillomavirus​ (HPV) vaccine b Avoiding all sexual contact c Completing all medication as prescribed d Completely treating both partners when one is diagnosed with an STI

1

The parents of a 12 year old girl ask why their daughter who is not sexually active should receive the HPV vaccine. The nurse should tell the parents that: 1. the vaccine is most effective against cervical cancer if given before becoming sexually active 2. Parents are never sure when their child might become sexually active 3. HPV is most common in teens and women in their late 20's 4. If your daughter is sexually assaulted, she may be exposed to HPV

1 (HSV infection is one of a group of infections when diagnosed in the presence of HIV infection are considered to be diagnostic for AIDS. Other aids defining illnesses include Karposis sarcoma, cytomeglovirus of the liver, spleen, or lymph nodes; and pneumocystis carinii peneumonia. HSV is not curable and does not cause severe electrolyte imbalances. HPV leads to cervical cancer.)

The primary reason that a herpes simplex virus infection is a serious concern to a client with HIV infection is that it: 1. in an AIDS defining illness 2. is curable only after 1 year of antiviral therapy 3. leads to cervical cancer 4. causes severe electrolyte imbalances

1 (Chlamydia infection is associated with preterm labor and birth and with neonatal infection, and thus should be treated in pregnancy. Azithromycin is safe in pregnancy and is effective in curing chlamydia infection. Focus: Prioritization)

What would be accurate and priority information to give Ms. N about the positive chlamydia test result? 1. By taking the medication now and having her partner treated, she can help avoid complications in the pregnancy. 2. The medication for chlamydia infection is not safe in pregnancy, and she should use condoms until she can be treated postpartum. 3. Chlamydia infection cannot really be cured and may recur despite treatment. 4. Chlamydia infection does no harm to the baby during the pregnancy or at delivery, but treatment is recommended to avoid pelvic inflammatory disease in the woman.

d (Rationale Many women do not seek treatment because they are unaware that they have gonorrhea. They may be​ symptom-free or have very mild symptoms until the disease progresses to pelvic inflammatory disease. If​ untreated, gonorrhea can lead to pelvic inflammatory disease. If the woman is pregnant and the infant is infected at​ delivery, it can cause blindness in the newborn. Gonorrhea can be cured with proper treatment. Dysuria or vaginal bleeding is not present with gonorrhea)

When educating a female client with​ gonorrhea, the nurse should emphasize which information is true about women with​ gonorrhea? a It can be treated but not cured. b It does not lead to serious complications. c It is often marked by symptoms of dysuria or vaginal bleeding. d It may not cause symptoms until serious complications occur.

4 (Education to prevent behaviors that cause HIV transmission is the primary method of controlling HIV infection. Behaviors that place people at risk for HIV infection include unprotected sex, sharing needles for IV drug use. Educating clients about using condoms during sex is a priority in controlling HIV transmission)

When teaching the client about HIV, the nurse should take into account the most effective method known to control the spread of HIV infection is: 1. premarital serological screening 2. prophylactic treatment of exposed people 3. lab screening of pregnant women 4. ongoing sex education about preventative behaviors

b (Examining one​'s own readiness to engage in intimate behavior with​ another, considering one​'s own thoughts and feelings associated with sexual​ behavior, and verbalizing how to identify the warning signs of dating violence and date rape all demonstrate that the client is exhibiting responsible sexual behavior. Engaging in sex with an untreated partner exhibits irresponsible sexual behavior.)

Which behavior exhibits irresponsible sexual​ behavior? a Examining one​'s own readiness to engage in intimate behavior with another b Engaging in sex with an untreated partner c Verbalizing how to identify the warning signs of dating violence and date rape d Considering one​'s own thoughts and feelings associated with sexual behavior

c (Rationale: Menstrual blood can affect the results of a gonorrhea culture. Douching within 24 hours may affect results. Persistent discharge and recent diagnosis of herpes are not barriers to specimen collection.)

Which factor, if reported to the nurse by a client prior to collection of a gonorrhea culture, would result in postponing the specimen collection? a Persistent vaginal discharge b Recent diagnosis and treatment for vaginal herpes c Currently menstruating d Douching 3 days ago

a,c (Rationale Only certain types of birth control allow for safer sex and reduce risk for sexually transmitted infections​ (STIs). Male and female condoms offer barrier protection. Petroleum jelly does not provide additional barrier protection. Partners should never​ pressure, threaten, or abuse to obtain sexual favors.)

Which information regarding safer and more responsible behavior should the nurse provide when counseling adolescent clients who have chosen to be sexually​ active? ​(Select all that​ apply.) a "You can choose to say ​'No​' to​ sex, even if your​ long-term partner says that your relationship has matured beyond the mutual masturbation stage. b "Insist that your opposite sex partner use birth control to reduce the risk of HIV. c "Women should carry and use female condoms. d "If your partner insists on having sex even though you don​'t want​ to, you should comply to show you really love him. " e "Latex condoms lubricated with petroleum jelly provide for comfort and additional barrier protection.

b (Teaching importance of abstinence from sexual activity while being​ treated, demonstrating proper placement of​ condoms, and supporting the client with the decision to contact partners who may be infected are all appropriate nursing interventions in helping teach clients about STIs. The nurse would encourage the client to complete the entire course of antibiotic treatment and not to stop taking them when symptoms resolve.)

Which nursing intervention would be inappropriate for the nurse to teach a client about sexually transmitted infections​ (STIs)? a Supporting the decision to contact partners who may be infected b Encouraging the use of antibiotics until symptoms resolve c Abstaining from sexual activity while being treated d Demonstrating proper placement of condoms

a (During the primary stage of​ syphilis, the client will experience​ chancre-like painless ulcerations that last for up to 5 weeks. The second stage occurs up to 10 weeks after initial infection. The client will experience​ fever, malaise,​ lymphadenopathy, patchy​ alopecia, and a diffuse rash. During the latent​ stage, the client is asymptomatic for years to a lifetime. The tertiary stage can occur 2 years after onset of symptoms and includes changes in the cardiovascular​ system, bone,​ skin, or viscera.)

Which stage of syphilis is characterized by​ chancre-like, painless ulcerations on the genital​ area? a Primary stage b Secondary stage c Latent stage d Tertiary stage

a,c,d (Syphilis is a sexually transmitted disease. The microorganism is transmitted when the open lesions are present. The incubation period is the time the microorganism takes to become established in the body. The microorganism invades the body through blood and lymph. A lesion will develop.​ However, these lesions are often overlooked. In this particular​ case, the incubation period is 10 to 90 days. Syphilis spreads through blood and lymph. The lymph nodes become enlarged as the disease progresses. Both men and women can be infected with syphilis.)

Which statements regarding syphilis are​ true? ​(Select all that​ apply.) a It has an incubation period of 10 to 90 days. b It is only contracted through anal sex. c It is contracted by unprotected sex. d It spreads through the body by way of blood and lymph. e Only women are at risk for syphilis.

d (Rationale Condoms should be used for every sexual encounter. Application of petroleum jelly to a condom does not provide an additional barrier. The retesting time frame for HIV is 6 months. The relative comfort of different types of condoms is an individual preference.)

Which teaching about reducing the risk of sexually transmitted infections​ (STIs) should the nurse provide to sexually active adolescent male​ clients? a "Natural or​ animal-skinned condoms feel more comfortable than latex versions. b "An initial HIV test result needs to be followed up with a retest exactly 1 month after the initial test. c "Application of petroleum jelly to the condom provides an additional barrier. d "Condoms should be used for every sexual encounter.

a,c,e (Rationale: Goal achievement is indicated by the​ client's ability to describe preventive​ behaviors, health​ practices, and treatment modalities. The client acknowledging to not have unprotected sex and planning to notify sexual partners are necessary measures to prevent the spread of the infection. Herpes is a virus and cannot be​ cured, but an antiviral medication will help shorten and prevent outbreaks. Triggers for exacerbation include​ stress, menses, or trauma.)

After a nurse has completed discharge​ teaching, which statements made by a client treated for genital herpes would indicate that discharge instructions were​ understood? ​(Select all that​ apply.) ​a "I'll try to keep my stress level​ down." b ​"I don't need to use a​ condom." ​c "I understand this antiviral medication will help shorten and prevent​ outbreaks." d ​"I'm glad the medication prescribed will cause this infection to be​ cured." e "I will notify my sex partners so they can get​ treatment."

b (Rationale: Closed-ended, yes-or-no questions are a barrier to communication with the client. Using a nonjudgmental attitude enhances communication. When talking about sexual and sensitive matters, the client may be more comfortable if dressed. Use of culturally sensitive approaches enhances communication. )

In interviewing a client concerning sexually transmitted infections (STI), the nurse should recognize that which is a barrier to client disclosure? a Collecting information while the client is dressed b Use of yes-or-no questions c Use of a culturally sensitive approach d Nurse's use of nonjudgmental attitude

c (Rationale Individuals between the ages of 15 and 24 account for half of the 20 million new cases of STIs each year. The adolescent​ male, age​ 17, is at the greatest risk for contracting an STI.)

The community nurse is teaching a group of clients about STIs. Which client is at the greatest risk for contracting an​ STI? a A married male​ client, age 50 b A divorced female​ client, age 32 c An adolescent male​ client, age 17 d An older adult female​ client, age 65

a,b,c,e (Small, flat,​ flesh-colored warts are a symptom of HPV.​ Itching, bleeding, and burning in the affected area are common manifestations of HPV in female clients. Ulcerations do not occur with genital warts.)

Which clinical manifestations are expected for a client diagnosed with human papillomavirus​ (HPV)? ​(Select all that​ apply.) a Burning b Bleeding c Itching d Ulcerations ​e Small, flat,​ flesh-colored warts

c (Syphilis affects the central nervous system in the tertiary or final stage. This occurs after many years of untreated infection. Improperly treated syphilis will invade the central nervous system. This can take many years to​ occur, but it will occur over a period of time. The ulcer occurs early in the disease during the first stage. The central nervous system is affected during the last stage of syphilis. Central nervous system damage occurs during the tertiary or last stage. This stage begins many years​ later, long after the secondary stage has ended.)

Which teaching statement by the nurse correctly demonstrates knowledge of when syphilis affects the nervous​ system? ​a "Syphilis rarely affects the central nervous​ system." ​b "Syphilis affects the central nervous system during the secondary stage when there is a​ rash." ​c "Syphilis affects the central nervous system during the final​ stage." ​d "Syphilis affects the central nervous system during the incubation​ period."

2 (Women with HPV are much more likely to develop cervical cancer than women who have never had the disease. Cervical cancer is considered a STD. Regular exams, including papanicolaou tests are recommended to detect and treat cervical cancer at an early stage. Girls and women as well as boys and men around ages 9-26, depending on the vaccine, should receive the vaccine to prevent HPV. HPV does not cause sterility, uterine fibroid tumors, or irregular menses.)

Women who have HPV are at risk for development of : 1. sterility 2. cervical cancer 3. uterine fibroid tumors 4. irregular menses

b (Rationale The most important aspect in controlling the spread of an STI is obtaining a list of the client​'s sexual contacts. Reassuring the client that records are​ confidential, motivating the client to undergo​ treatment, and increasing the client​'s knowledge can help control the spread of the infection but are not as critical as information about the client​'s sexual contacts)

he nurse is interviewing a client newly diagnosed with syphilis. Which nursing action is most important to control the spread of the​ infection? a Motivating the client to undergo treatment. b Obtaining a list of the client​'s sexual contacts. c Reassuring the client that records are confidential. d Increasing the client​'s knowledge of the infection

3 (metronidazole can cause a disulfiram-like reaction if it is taken with alcohol. Tachycardia, N/V, and other serious interaction can occur. Flagyl will make the urine a darker color. Oral contraceptives should never be discontinued with trichomoniasis. The parner also requires treatment to prevent retransmission of the infection)

A female client is treated for trichomoniasis with metronidazole. The nurse instructs the client that: 1. the medication should not alter the color of the urine 2. she should discontinue oral contraceptive use during the treatment 3. she should avoid alcohol during treatment 4. her partner does not need treatment

d (Rationale: Women with HPV genital infection are advised to have an annual pelvic exam and PAP smear, since there is increased risk of cervical cancer. While a breast exam and mammogram are recommended, they are not screenings for cervical cancer. Stool testing for occult blood and CBC will not detect cervical cancer. )

A female client with genital warts caused by human papillomavirus (HPV) asks the nurse what future tests will be needed to monitor this disease. The nurse recommends a yearly: a complete blood count (CBC) to detect infection. b stool for occult blood. c breast exam and mammogram. d pelvic exam and PAP smear.

4 (Dysuria and mucopurulent urethral discharge characterize gonorrhea in men. Gonococcal symptoms are so painful and bothersome for men that they usually seek treatment with the onset of symptoms. Impotenence, scrotal swelling, and urine retention are not associated with gonorrhea.)

A female client with gonorrhea informs the nurse she has had sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men, the symptoms of gonorrhea include: 1. impotence 2. scrotal swelling 3. urine retention 4. dysuria

4 (HIV infection is transmitted through blood and body fluids particularly vaginal and seminal secretions. A blood transfusion is one way the disease is contracted. Other modes of transmission are sexual intercourse with an infected person and sharing IV needles with an infected person. Women now have the highest rate of newly diagnosed HIV infection. Many of these women contracted HIV from unprotected sex with male partners. HIV cannot be transmitted from hugging, inhaling cocaine, or sharing utensils)

A nurse is planning care for a 25 year old diagnosed with HIV. The client asks the nurse "How could this have happened?" The nurse responds to the question based on the the most frequent mode of transmission is: 1. hugging an HIV positive sexual partner without using barrier precautions 2. inhaling cocaine 3. sharing food utensils with an HIV positive person without proper cleaning of the utensils 4. having sexual intercourse with an HIV person without using a condom

1,2,3,4,6 (The client is suspected of having a STI. Therefore the clients sex history, assessment, and exam must be documented, including any symptoms (such as fever and chills, and enlarged glands) and their onset and duration. Allergies are critical to document for every client but are especially noteworthy in this case because of impending antibiotic orders. IF a STD is confirmed, sex contacts need treatment. To protect privacy, the names and phone numbers should never be placed in the medical record. The public health dept. will assist in obtaining the info and treating known sex contacts)

A sexually active male client has burning on urination, and a milky discharge from the urethral meatus. What documentation should be included on the clients medical record? Select all that apply 1. history of unprotected sex (sex without a condom) 2. length of time symptoms presented 3. history of fever and chills 4. presence of any enlarged lymph nodes on exam 5. names and phone numbers of all sexual contacts 6. allergies to any medications

1 ( a frothy purulet vaginal discharge in a sexually active female client is typically caused by a STI such as trichomonas. Other disease such as chlamydia may be present. Both the client and the boyfriend need treatment after the disease is determined. Normal variations in female discharge should be clear to white, not frothy or purulent. The client should be instructed to wear cotton underwear and avoid pantyhose, wet gym clothes, and tight fitting garments, such as jeans, so that air can circulate)

An 18 year old female client who is sexually active with her boyfriend has a purulent vaginal discharge that is sometimes frothy. The nurse interprets this as suggesting; 1. sexually transmitted infection 2. normal variation in vaginal discharge 3. need for vaginal douching 4. side effect of birth control method

1 (statistics reveal that the incidence of STDs is rising more rapidly in teenagers than among any other age group. Many reasons have been given for this trent, including a change in societal norms and increasingly sexual activity among teens. During this developmental stage, teens may engage in high risk behaviors because they are living in the present and feel it will not happen to them)

Which group has experienced the greatest rise in the incidence of STDs over the past two decades? 1. teenagers 2. divorced people 3. young married couples 4. older adults

1 (asking the client to describe her nervousness gives her the opportunity to express her concerns. It also allows the nurse to understand her better and gives the nurse a base to respond to the clients stated fears, questions or needs for further info. Responses that make assumptions about the source of concern or offer reinforcement are not supportive and block successful communication)

An 18 year old is to have a pelvic exam. Which response by the nurse would be best when the client says that she is nervous about the upcoming pelvic exam? 1. Can you tell me more about how you are feeling? 2. You are not alone. Most women feel uncomfortable about this exam 3. Do not worry about Dr. Smith. He is a specialist in female problems 4. We will do everything we can to avoid embarassing you

4 (The client is likely exhibiting symptoms of herpes genitalis, which include painful blisters or vesicles that appear 2-20 days after the transmission of the disease. The client was most likely exposed from her new partner. The client should be referred to an HCP for treatment. Having her partner wear a condom, increasing fluids, or using a lubricant jelly will not treat the infection. While having her partner wear a condom will not cure the infection, having future partners wear condoms will help prevent the transmission)

Assessment of a 36 year old woman who has malaise and dysuria reveals a temp of 100F and painful blisters on the outside of her vagina. The client tells the nurse she had intercourse with a new partner 5 days ago. What should the nurse do? 1. advise the client to ask her partner to use a condom 2. encourage the client to increase fluids to 3000 mL/day 3. Tell the client to use a lubricant jelly on the blisters 4. Refer the client to the healthcare provider

a (Rationale: All partners have been exposed and should be made aware, tested, and treated as indicated. A cesarean is needed only if herpes lesions are present or there are prodromal symptoms at delivery. Genetic evaluation and more frequent monitoring of hemoglobin and hematocrit are not indicated. )

The nurse explains to a 24-year-old pregnant client with a sexually transmitted disease (STD) that follow-up care includes: a contacting and treating all sexual partners. b delivery by cesarean section. c amniocentesis for evaluation of genetic damage. d close monitoring of hemoglobin and hematocrit.

d (he client acknowledging that she will not have unprotected sex and will notify her sexual partners is a preventive measure and indicates understanding. The other options are not protective measures and indicate the need for additional teaching.)

The nurse has completed discharge teaching to Angel​ Reese, a​ 33-year-old treated for a sexually transmitted infection​ (STI). Which statement by Ms. Reese indicates that the discharge instructions were​ understood? ​a "I don't need to have my sexual partner wear a condom because​ I'm not allergic to penicillin and​ I'll come for a shot at the first sign of​ infection." ​b "I will be careful not to have intercourse with someone who has an​ STI." ​c "If you're going to get​ it, you're going to get​ it." ​d "I will notify my sex partners and not have unprotected sex from now​ on."

b (Asking the client to describe her nervousness gives her the opportunity to express concerns and allows the nurse to understand the client better. The other three responses make​ assumptions, are not supportive of the​ client's feelings, and block therapeutic communication.)

Jenny​ Jones, a​ 20-year-old college​ student, is being seen at the university health center. The nurse gathers a health history and suspects Ms. Jones may have a sexually transmitted infection​ (STI). Which response by the nurse is best when the client says that she is nervous about the upcoming pelvic​ examination? ​a "We'll do everything we can to avoid embarrassing​ you." ​b "Can you tell me more about how you are​ feeling?" ​c "You are not alone. Most women feel uncomfortable about this​ examination." ​d "Do not worry about the doctor.​ He's a specialist in female​ problems."

b (The nurse educates women of reproductive age about STIs and risks and complications associated with untreated infections. Congenital syphilis is transferred to the fetus via placental​ circulation; therefore, mother and neonate need treatment.)

The nurse counsels a group of pregnant women about potential complications to unborn children that result from untreated sexually transmitted infections. What information will the nurse include in the​ presentation? a "Newborns born to mothers with Human Papillomavirus​ (HPV) are at risk for wart formation later in life. " b "Congenital syphilis is transferred to the fetus through the placental circulation. c "There is a​ 75% chance of fetal anomalies if the mother has genital herpes during pregnancy. d "The fetus is protected from any complication related to an untreated sexually transmitted infection if it is born by Cesarean section.

a,c,d,e (Rationale: Important client teaching for the male client learning to use a condom includes application of a new condom prior to each sex act as condoms should never be reused. Withdrawal of the penis while still erect and holding the base of the condom will prevent leakage of semen. The condom is made thin to allow for maximum sensation so it is easily torn or broken and must be handled carefully. The condom must be applied to allow air at the tip to provide space for the ejaculate to be collected. Oil-based lubricants should not be used as they can damage the condom and increase risk of condom failure. Water based lubricants may be used if needed. )

The nurse is teaching a male client about the use of condoms to reduce the risk of sexually transmitted disease (STD). The nurse includes which topics for discussion? (Select all that apply.) a Use a new condom with each sex act. b Use oil-based lubricants such as petroleum jelly. c Allow space at the tip of the condom. d Withdraw while the penis is erect. e Handle the condom carefully to ensure no damage.

3 (The chancre of syphilis is characteristically a painless, moist ulcer. The serous discharge is very infectious. Because the chancre is usually painless and disappears, the client may not be aware of it or may not seek care. The chancre does not appear as pimples or warts and does not itch, thus making diagnosis difficult)

The typical chancre of syphilis appears as: 1. a grouping of small tender pimples 2. an elevated wart 3. a painless moist ulcer 4. an itching, crusted area

c (In a female​ client, human papillomavirus​ (HPV) presents as​ painless, wartlike growths on the external and internal genitalia. Pediculosis pubis is nits on and around the pubic hair that cause itching. Syphilitic lesion is a​ nontender, solitary papule that changes to a draining wound.)

What abnormal finding of the female genitalia is represented by​ painless, wartlike growths on the​ vulva, inner​ vagina, and​ cervix? ​a Fluid-filled blisters b Syphilitic lesion c Human papillomavirus d Pediculosis pubis

1 (The client with herpes should be taught to abstain from sexual intercourse while lesions are present. Condoms should be used at all times as the virus can be shed without lesions present. Multiple partners would promote the spread of genital herpes. There is no vaccine available to prevent genital herpes. Although periodic exams should be advised, a urologist does not necessarily need to be seen when lesions occur)

What is the most important information for the nurse to teach a client newly diagnosed with genital herpes? 1. use condoms at all times during sexual intercourse 2. A urologist should be seen only when lesions occur 3. Oral sex is permissible without a barrier 4. Determine if your partner has received a vaccine against herpes

a,e (Rationale: Because it frequently involves tissue trauma that facilitates invasion of pathogens, anal intercourse is considered a high-risk sexual behavior, as is having intercourse with a partner who is infected with an STD. Use of oral contraceptives, monogamous relationships, and age of 23 years are not risks for STD. )

A client is admitted to the clinic with a nursing diagnosis of Acute Pain in her pelvis region. When taking a sexual history for a female client, the nurse recognizes that which factor puts the client at risk for sexually transmitted disease (STD)? (Select all that apply.) a Report of anal intercourse b Use of oral contraceptives c Current monogamous relationship d 23-year-old client e Partner has an STD

3 (While some areas may specify a minimum ate for treatment (usually 12-14 years old) generally adolescents have the right to seek treatment for STI's without parental consent. These medical records are not shared without the clients permission. However teens must be made aware that certain infections including gonorrhea must be reported by law to public health agencies. Patner notification will take place but methods vary.)

A 17 year old senoir calls the clinic because she thinks she might have gonorrhea. She wants to be seen but wants assurances that no one will know. Which is the most appropriate response by the nurse? 1. Because you are underage we will need your parents consent to treat you 2. we can treat you without your parents consent, but they have the right to review your medical record 3. we can see you without your parents consent but have to report any positive result to the public health department 4. we can see you and will not share your results with anyone.