Ch 46

Which of the following factors are known to contribute to vaginal yeast infections? Select all that apply.

- Poorly controlled diabetes - Recent antibiotic therapy - Use of oral contraceptives - High hormone levels during pregnancy

Within how many days is it important to test anyone who has had sex with an individual who test positive for gonorrhea?

60 days

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. Which of the following phenomena most likely contributed to her present condition?

A sharp reduction in the number of lactobacilli in the client's vaginal flora.

A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications?

"Do you have pain when you urinate or have difficulty starting the stream?"

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which of the following statements by the client demonstrates the best understanding of his health problem?

"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."-- Seventy-five percent of woman with chlamydial infections are asymptomatic.

A campus-based peer counseling group is conducting an information blitz on sexually transmitted diseases. Which of the following statements about genital warts requires correction?

"Genital warts can take up to a month after exposure to first become visible."-- Genital warts can take between 6 weeks to 8 months to incubate after exposure.

A patient is diagnosed with granuloma inguinale. Which of the following question should the nurse ask the patient?

"Have you traveled outside of the country recently?"

A nurse is interviewing a patient about issues with infertility. Which condition contributes to the risk of infertility in both men and women?

Trichomoniasis

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply

• Dementia • Blindness • Ataxia

The health nurse is dealing with a case of untreated chlamydial infection. The nurse suspects the patient has developed Reiter syndrome. Which of the following clinical manifestations would support this diagnosis? Select all that apply.

- Diffuse pinkness of the conjunctiva along with watery and itchy eyes - Asymmetric complaints of stiffness and pain in knees and sacroiliac joints - Pain when urinating

While working in a sexually transmitted disease (STD) clinic, the nurse should be aware that which of the following diagnostic tools are available for diagnosing chlamydial infections? Select all that apply.

- Gram stain where polymorphonuclear leukocytes are identified - Direct fluorescent antibody testing - Western blot testing - Nucleic acid amplification tests (NAATs)

A pregnant teenager has arrived at a free clinic seeking care. She has had no prenatal care and is currently 27 weeks' gestation. Upon testing for a sexually transmitted disease (STD), it is found that she has active T. pallidum (syphilis). Given the fact that she has active syphilis at this stage in her pregnancy, it is very likely her fetus is at risk for: Select all that apply.

- being born prematurely. - congenital defects.

Unbeknownst to him, a 30-year-old male has contracted Treponema pallidum during a sexual encounter the night before. Place the following manifestations of the microorganism in the chronological order that they would occur in the absence of treatment. Use all the options.

1) Development of painless chancres on the man's scrotum. 2) Appearance of a rash on the man's palms and feet 3) Latency 4) formation of aneurysms --The primary stage of syphilis includes chancre formation, while the secondary stage often involves a rash on the palms and feet. Latency occurs between the second and third stages, the latter often including cardiovascular effect such as aneurysm formation.

A client presents with signs and symptoms of Candidiasis and is concerned about why this occurs after taking antibiotics. The most appropriate information for the nurse to provide would be

Antibiotics suppress the normal protective vaginal flora allowing overgrowth of C. albicans.

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 6 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?

Clotrimazole, an antifungal agent

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 of developing which of the following diagnoses?

Condylomata acuminata (genital warts)

The public health nurse is presenting a program on the prevalence of STI's. Which information should be included in a presentation? Select all that apply

Drugs can manage infections but did not control the spread, STI's may be asymptomatic

When is syphilis highly contagious?

During its primary stage

A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last 2 days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's first priority?

Gonorrhea-- The rapid onset and bloody penile discharge that the client cites are characteristics of gonorrhea.

After hearing horror stories about the signs, symptoms, and course of lymphogranuloma venereum (LGV), a high school student has asked a visiting sexual health educator about the odds of acquiring the disease among sexually active Americans. Which of the following facts will most accurately underlie the educator's response?

Men who have sex with men are at particular risk of LGV.

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 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole-- The character of the discharge, lack of recent sexual activity, and current antibiotic treatment point to infection with Trichomonas vaginalis, which can exist asymptomatically and flare up only if conditions such as an imbalance in normal vaginal flora resulting from antibiotic treatment enable the protozoan to proliferate.

Which conditions associated with domelike lesions on both the inner thighs and vaginal area that produce a curd-like exudate?

Molluscum contagiosum

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 are the woman's most likely treatment and prognosis?

Oral antiprotozoals to the patient and sexual partners to help prevent complications.

Which collection sites should be used for sampling to accurately diagnose gonorrhea? Select all that apply

Oropharynx, urethra, anal canal

The nurse should assess this client for which potential disease process related to untreated chlamydial infections?

Reiter syndrome- A reactive arthritis that includes the triad of urethritis, conjunctivitis, and painless mucocutaneous lesions, is a complication of an untreated chlamydia infection

A teenage female client who is being seen in the family medicine clinic for an annual physical exam reports being sexually active. Which should the nurse plan to teach the client? Select all that apply

The development of vaccines to protect against specific human papilloma virus strains, the importance of annual Pap smear's for early detection of cervical cancer, importance of being tested for chlamydia

Which of the following is the primary reason that the nurse urges patients to be seen by their healthcare provider when they have genital warts?

To be informed of the risk of premalignant and malignant changes

A patient with a yeast infection asks the nurse how they diagnose this infection. The nurse will base her response knowing this is primarily diagnosed by

looking at the spores on a wet-mount slide using 20% potassium hydroxide.

A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which of his statements is most accurate?

"Even when I'm not having a recurrence, I could still pass the virus on to you."

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate to include which of the following accurate statements?

"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."

The nurse provided prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of

Blindness

Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has

C. Albicans

A 23-year-old diagnosed with syphilis presents with Palmar rash, sore throat, fever, and a red brown lesion on the genital area. The symptoms have been present for three weeks. Select the stage of syphilis this client is currently in

Secondary stage. The stage may come and go for a year but usually last 3 to 6 months

Which clients with the nurse determines are at increased risk of infection with gonorrhea? Select all that apply

The client who is younger than 25 years of age -the client with multiple sexual partners - the client who does not use condoms

A nurse is caring for a client in whom genital herpes is being ruled out. Which information helps to confirm the diagnosis? Select all that apply

Pain on urination, pustules, painful lesions, itching

In a busy STD clinic on a large university campus, a group of students have developed tetracycline- and penicillin-resistant strains of N. gonorrhoeae. Given these results, the nurse can expect that which of the following medications will be prescribed?

Single injection of Rocephin (ceftriaxone)

For a woman, what is the most serious long-term outcome of an infection resulting from exposure to gonorrhea?

Sterility

A 20-year-old male has presented to a health clinic with multiple genital lesions that are filled with a viscous, creamy exudate and has subsequently been diagnosed with molluscum contagiosum. What is his care provider most likely to tell him about the plan for treating the diagnosis?

"This kind of infection often subsides on its own and doesn't grow more serious over time."