Ch 46 Sexual Transmitted Infections

Which clients are at highest risk of developing candidiasis? Select all that apply

-A client who completed a 10-day course of antibiotic therapy for a urinary tract infection -A client who is pregnant -A client newly diagnosed with diabetes mellitus type 2

A 46-year-old male client comes to the clinic after receiving a positive Venereal Disease Research Laboratory (VDRL) test following a blood test for life insurance screening. Which action should the nurse take next?

Ask the client about past treatment for syphilis

A client is diagnosed with chronic vulvovaginal candidiasis. Which assessment finding would be present to confirm this diagnosis

Four episodes of vulvovaginal candidiasis (confirmed symptoms) so far this year

A nurse suspects a client has trichomoniasis based on which assessed vaginal discharge

Frothy green

A female client presents at an STD clinic. She is in the first trimester of pregnancy and has tested positive for gonorrhea. Because strains of N. gonorrhoeae have become resistant to penicillin, the current treatment recommendation includes:

High-dose cefixime given in a single dose

A client is diagnosed with trichomoniasis. Which findings likely helped to confirm this diagnosis?

Sexual activity

Select the most common symptom a female diagnosed with chlamydial infection will develop

Mucopurulent cervical discharge

The nurse determines that teaching was effective when a client who has been treated for Chlamydia states the importance of

No follow-up is needed.

The nurse should assess a client with a hx of untreated chlamydia for which potential disease process?

Reiter syndrome

Candidiasis is a leading cause of vaginal infections. Which antifungal agent is only available with a prescription (not available OTC) to treat candidiasis?

Terconazole

A client is receiving metronidazole for treatment of trichomoniasis. Which assessment finding presents the most cause for concern?

The client states he drinks three beers a day

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her HCP has confirmed as attribute to HPV infection. Which information should the health care provider give the client?

There is a chance that these will clear up on their own without any tx.

A nurse practitioner is examining a female client who presents with symptoms of pain during intercourse. The nurse notes the presence of small hemorrhagic areas on the cervix. Based on this observation, which sexually transmitted infection does the nurse suspect?

Trichomoniasis

A client who has recovered from an initial genital herpes outbreak is seeking advice about controlling the condition. The client asks the nurse, "Can I take antiviral medication now while I don't have sores to prevent another outbreak?" What is the nurse's best response?

"The use of antiviral medication between outbreaks is not recommended unless there is evidence that the virus is active.

The nurse is counseling a client who just received the recommended treatment for uncomplicated gonorrhea. The client asks if a test will need to be done to determine if the treatment was successful. What is the nurse's best response?

"This single dose of the two medications does not require any follow-up, but if symptoms persist contact your health care provider."

A 20 year old male has presented to a health clinic with multiple genital lesions that are filled with viscous, creamy exudate and has subsequently been diagnosis 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"

A client with painful genital herpes lesions relates pain as being a 7 out of 10. Which interventions should the nurse conduct? Select all that apply

-Apply cool compresses. -Call the health care provider for oral analgesics. -Apply topical anesthetic cream

What are the central nervous symptoms associate with tertiary stage syphilis?

-Ataxia -Dementia -Blindness

Which factors are associated with development of a sexually transmitted infection (STI)? Select all that apply

-Bacteria -Chlamydia -Virus -Parasite

A male diagnosed with gonorrhea will likely complain of which clinical manifestations? Select all that apply

-Creamy, yellow discharge -Pain in the urethra with urination

While working in an STI clinic, the nurse should be aware that which diagnostic tools are available for diagnosing chlamydial infections?

-Direct fluorescent antibody testing - Gram stain where polymorphonuclear leukocytes are identified - Enzyme-linked immunosorbent assay (ELISA) -Nucleic acid amplification tests (NAATs)

Which assessment finding does the nurse expect in the client with trichomoniasis? Select all that apply

-Identifying the parasite through microscopic study - Erythema of the vaginal area

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

-Importance of being tested for chlamydia infection -The development of vaccines to protect against specific human papillomavirus (HPV) strains -The importance of annual PAP smears for early detection of cervical cancer

A client with a history of candidiasis is concerned about why the signs and symptoms always occur after she is prescribed an antibiotic. Which statements by the client indicate that further teaching is indicated? Select all that apply

-It is important to complete the full course of antibiotics to prevent the outbreak of candidiasis from occurring. -Antibiotics cause an increase in vaginal glycogen stores, which promotes candidiasis. -The candidiasis outbreaks are not likely associated with the antibiotic therapy but rather the chronic nature of the infection

Primary genital herpes is a sexually transmitted infection (STI) caused by either the herpes simplex virus type 1 or type 2. What are the initial symptoms of primary genital herpes infections? Select all that apply

-Itching - Genital pain -Small pustules

A client was diagnosed with herpes simplex virus (HSV) several months ago and has adapted his lifestyle to limit the frequency and severity of recurrences. Which actions help facilitate this goal? Select all that apply.

-Limiting stress -Getting adequate sleep

The public health nurse is tracking the incidence and prevalence of common sexually transmitted infections (STIs) in a population. What factors that influence the statistics related to STIs should the nurse consider when examining the data? Select all that apply

-Mandatory reporting of cases is only required for three STIs. -Many STIs are asymptomatic. -Some common STIs are incurable

When counseling a client who is 3 months' pregnant and who recently went on a vacation to South America where she received several mosquito bites, the biggest complication the provider should prepare her for is delivering a child with which type(s) of defect? Select all that apply

-Microcephaly -Eye concerns -Hearing problems

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

After being diagnosed with bacterial vaginosis, the client is at risk for developing which potential complications? Select all that apply.

-Pelvic inflammatory disease (PID) -Preterm labor -Postpartum endometritis -Premature rupture of membranes

The nurse is caring for a client with active chancroid lesions. What should the nurse include in the client's plan of care? Select all that apply.

-Protect the client from contact with lesion exudate. -Assess for lymphadenopathy. -Use contact precaution isolation. -Administer analgesics

A woman who has developed vulvovaginal candidiasis will likely report which clinical manifestations to her health care provider? Select all that apply

-Redness -Edema -Painful urination

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

-STIs may be asymptomatic. -Drugs can manage infections but do not control the spread

A client presents with copious, frothy, malodorous green/yellow vaginal discharge. A diagnosis of Trichomoniasis is made. The client tells the nurse that she has not been sexually active and is concerned. Select the possible modes of transmission. Select all that apply

-Sexual contact -Fomites -Swimming pools -Hot tubs

A older female client has developed some central nervous system symptoms not usually common in her family history. After months of no improvement, the provider ordered blood panels that returned as positive for syphilis. Having been married for decades, the provider suspects tertiary syphilis based on which finding(s)? Select all that apply.

-Slowly progressing dementia -Gradual loss of sight -Lack of voluntary coordination resulting in gait abnormality

When screening for a STD, microscopic evaluation of a discharge culture reveals hyphae and a pH level of 4.2. Which conditions are not likely to present based on the findings?

-T. vaginalis -N. gonorrhoeae -C. trachomatis

Which clients would the nurse determine 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

For a client to be diagnosed with bacterial vaginosis, which assessment findings would the nurse report? Select all that apply

-Thin white discharge from the vaginal area - "Fishy" odor

Which symptoms would a nurse assess in a male client with gonorrhea? Select all that apply

-Urethral pain -Creamy, yellow discharge - Bloody discharge

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

-being born prematurely. -congenital defects.

The health nurse is dealing with a case of untreated chlamydial infection. The nurse suspects the client has developed Reiter syndrome. Which clinical manifestation would support this diagnosis?

-pain when urinating -asymmetric complaints of stiffness and pain in knees and sacroiliac joints. Diffuse pinkness of the conjuctiva along with watery and itchy eyes

A public health nurse is planning a vaccination schedule for a local high school. What age group and time frame should the nurse plan for when scheduling the recombinant human papillomavirus vaccine?

14-year-old students with a second vaccination in 6 months

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit:

no symptoms of infection.

A woman and her male partner both have contracted gonorrhea. The nurse should monitor both clients for signs and symptoms of what complication?

Bacteremic heart valves

Trichomoniasis, being a STI, can cause a number of complications. It is a risk factor for which complication in both the male and female population?

HIV transmission

When educating a teenager dx with genital herpes, the HCP needs to inform the teen of the importance of careful follow-up to prevent future development of which complication

HIV transmission

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 fact most accurately underlies the educator's response?

The disease is rare outside the tropics