Ch 5
A pregnant client at 24 weeks' gestation is diagnosed with bacterial vaginosis. Her doctor orders Flagyl to treat the problem. What would be appropriate education for the nurse to provide? 1. The client must be careful to observe for signs of preterm labor. 2. The client should advise her partner to seek therapy as soon as possible. 3. The main side effect of the medication is a large amount of vaginal discharge. 4. A repeat culture should be taken 2 weeks after completing the therapy.
Answer: 1 Explanation: 1. Clients with bacterial vaginosis are at risk for preterm labor.
The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority? 1. Encourage oral fluids 2. Administer cefotetan IV 3. Enforce bed rest 4. Remove IUC, if present
Answer: 2 Explanation: 2. Administration of medications to treat the disease is the first priority.
A client has been diagnosed with bacterial vaginosis. The nurse obtains a sexual history from the client, including contraceptive measures, number of sexual partners, and frequency of intercourse. What is the rationale for the questions? 1. Clients can infect their sexual partners. 2. The nurse is required by law to ask the questions. 3. Clients with bacterial vaginosis can become infected with HIV and other sexually transmitted diseases more easily. 4. The laboratory needs a full client history in order to know for which organisms and antibiotic sensitivities it should test.
Answer: 3 Explanation: 3. The change in normal flora increases the woman's susceptibility to other organisms, making the client more vulnerable to sexually transmitted diseases, including HIV.
Women with pyelonephritis during pregnancy are at significantly increased risk for which condition? 1. Foul-smelling discharge 2. Ectopic pregnancy 3. Preterm labor 4. A colicky large intestine
Answer: 3 Explanation: 3. Women with pyelonephritis during pregnancy are at significantly increased risk of preterm labor, preterm birth, development of adult respiratory distress syndrome, and septicemia.
The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (VVC), and knows the client understands when she makes which of the following statements? 1. "I need to apply the miconazole for 10 days." 2. "I need to douche daily." 3. "I need to add yogurt to my diet." 4. "I need to wear nylon panties."
Answer: 3 Explanation: 3. Yogurt helps reestablish normal vaginal flora.
A client in the emergency department is diagnosed with pelvic inflammatory disease. Before discharge, the nurse will provide the client with some health teaching about which topic? 1. Endometriosis 2. Menopause 3. Ovarian hyperplasia 4. IUD for contraception
Answer: 4 Explanation: 4. The woman who uses an IUD for contraception and has multiple sexual partners needs to understand clearly the risk she faces.
The nurse is teaching nursing students about the different kind of hepatitis. Which statement is the nurse likely to make? 1. Hepatitis A and B have vaccines to prevent them. 2. Hepatitis A, B, and C have vaccines to prevent them. 3. Hepatitis C, D, and E are all bloodborne. 4. Hepatitis A, C, and E are all fecal-oral contamination.
Answer: 1 Explanation: 1. Hepatitis A and B are the only two types of hepatitis that have vaccines.
A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be: 1. Oral acyclovir 2. Ceftriaxone IM 3. Azithromycin p.o. 4. Penicillin G IM
Answer: 1 Explanation: 1. Malaise, dysuria, and tingling or painful vesicles are indicative of a primary herpes simplex outbreak. Acyclovir treats herpes.
The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection? 1. 16-year-old sexually active girl, using no contraceptive 2. 22-year-old mother of two, developed dyspareunia 3. 35-year-old woman on oral contraceptives 4. 48-year-old woman with hot flashes and night sweats
Answer: 1 Explanation: 1. Teens have the highest incidence of sexually transmitted infections, especially chlamydia. A client not using contraceptives is not using condoms, which decrease the risk of contracting a STI.
The nurse is evaluating the outcomes of nursing care given a female client with a sexually transmitted infection (STI). Which of the following will the nurse verify about the client? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Had an identified infection 2. Could identify the mode of transmission 3. Would never cope with the infection 4. Could recognize the symptoms of an STI 5. Would not disclose the STI to her partner
Answer: 1, 2, 4 Explanation: 1. The infection must be identified and cured, if possible. If not, supportive therapy is provided. 2. The client and her partner should be able to describe the infection, its method of transmission, its implications, and the therapy. 4. The client must be able to recognize the symptoms of an STI.
The nurse is caring for a client in the clinic whom she suspects has vaginosis. Which test best determines whether this sexually active woman has the disorder? 1. The observation of mycelia upon direct microscopy in a 10% potassium hydroxide preparation 2. The addition of a 10% potassium hydroxide solution to the vaginal secretions 3. A vaginal pH of less than 4.5 4. A Gram stain positive for the fungus
Answer: 2 Explanation: 2. Adding a 10% potassium hydroxide solution to the vaginal secretion of a client with bacterial vaginosis, called a "whiff" test, produces a fishy smell.
In providing community education about hepatitis, the nurse includes information on the chronic forms of hepatitis. A form of hepatitis that becomes chronic is which of the following? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Hepatitis A 2. Hepatitis B 3. Hepatitis C 4. Hepatitis D 5. Hepatitis E
Answer: 2, 3, 4 Explanation: 2. Unlike hepatitis A infection, hepatitis B infection is chronic. 3. Unlike hepatitis A infection, hepatitis C infection is chronic. 4. Unlike hepatitis A infection, hepatitis D infection is chronic.
The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement? 1. "She could become pregnant." 2. "She could have severe vaginal itching." 3. "He could get an infection in the tube that carries the urine out." 4. "It could cause us to develop a rash."
Answer: 3 Explanation: 3. Chlamydia is a major cause of nongonococcal urethritis (NGU) in men.
The clinic nurse teaches the pregnant client being treated for trichomoniasis about the risks to her pregnancy due to this infection. Which statement would indicate successful teaching? 1. "I am at risk of having a preterm birth because of this infection." 2. "I might need to have my membranes ruptured because of this infection." 3. "I am at risk of having a baby with a high birth weight." 4. "I may have intercourse with my husband while bring treated for this infection."
Answer: 1 Explanation: 1. There is a risk of preterm birth and rupture of membranes.
The nurse is providing health education to a group of young people. When teaching about the prevention of sexually transmitted infections (STIs), the nurse will teach which concepts? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Decision-making skills in refusing intercourse 2. How to reduce high-risk behaviors 3. That Pap smears might be needed more often 4. The safety of oral sex 5. Use of petroleum-based lubricants with condoms
Answer: 1, 2, 3 Explanation: 1. Effective prevention and control of STIs is based on planning ahead, review of decision-making skills, and developing strategies to refuse sex. 2. Effective prevention and control of STIs is based on the reduction of high-risk behaviors. Use of recreational drugs and alcohol can increase sexual risk taking. 3. The presence of a genital infection can lead to an abnormal Pap smear. Women with certain infections should have more frequent Pap tests.
The nurse working in a women's clinic recognizes that which clients are most at risk for developing vulvovaginal candidiasis? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Clients using antibiotics 2. Immunocompetent clients 3. Pregnant clients 4. Multiparous clients 5. Diabetic clients
Answer: 1, 3, 5 Explanation: 1. A predisposing factor to yeast infections includes the use of antibiotics. 3. Predisposing factors to yeast infections include pregnancy. 5. Predisposing factors to yeast infections include glycosuria and diabetes mellitus.
A client comes to the clinic complaining of a thick, white, tenacious discharge and vulvular soreness. Which medication treatment will the nurse teach the client about? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. Silver sulfadiazine 2. Metronidazole 3. Clindamycin cream 4. Ceftriaxone sodium 5. Doxycycline
Answer: 2, 3 Explanation: 2. Metronidazole is the preferred treatment for vulvovaginal candidiasis. 3. Although less effective than metronidazole, clindamycin cream can be used to treat vulvovaginal candidiasis.
The client has been diagnosed with hepatitis B. Which statement indicates to the nurse that the client needs more education? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "This infection could be sexually transmitted." 2. "I might get jaundiced from this illness." 3. "An immunization exists to prevent getting hepatitis B." 4. "I might have gotten this infection from food." 5. "The incubation period is 15-50 days."
Answer: 4, 5 Explanation: 4. Hepatitis B is found in blood and body fluids, and therefore can be sexually transmitted. Hepatitis A and E are foodborne, and transmitted by fecal-oral contamination. 5. The incubation period for hepatitis B is 45-160 days.
The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention? 1. Age 30, treated for PID 2. Age 25, monogamous 3. Age 20, pregnant 4. Age 27, uses a diaphragm
Answer: 1 Explanation: 1. Exposure to sexually transmitted infections increases the risk of abnormal cell changes and cervical cancer.
The nurse is evaluating the outcomes of nursing care for a woman with a urinary tract infection. Which of the following does the nurse include in the evaluation? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. The client implements self-care measures for prevention. 2. The client completed the prescribed antibiotics. 3. The client knows self-care measures for worsening symptoms. 4. The client states that UTIs are controlled, not cured. 5. The client knows that cranberry juice can help prevent UTIs.
Answer: 1, 2 Explanation: 1. In the evaluation, the nurse should determine whether the client implements self-care measures to help prevent recurrent UTI as part of her personal routine. 2. Evaluation includes whether the client completed her prescribed course of antibiotic therapy.
The nurse is teaching a group of young women how to prevent urinary tract infections. What will the nurse include in the teaching? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. The importance of good hygiene 2. How to recognize the signs and symptoms 3. How to take prescribed antibiotics 4. Fluids are restricted to 1000 ml 5. To urinate only when the urge is strong
Answer: 1, 2, 3 Explanation: 1. The nurse should make sure that women are aware of good hygiene practices, and should provide information on other ways to avoid UTI. 2. Women need to know the signs and symptoms of UTIs to secure prompt treatment. 3. If an infection is present, the woman needs information on how to take antibiotics, and needs to know to complete all of them.
The nurse is discharging a client after hospitalization for pelvic inflammatory disease (PID). Which statements indicate that teaching was effective? Note: Credit will be given only if all correct and no incorrect choices are selected. Select all that apply. 1. "I might have infertility because of this infection." 2. "It is important for me to finish my antibiotics." 3. "Tubal pregnancy could occur after PID." 4. "My PID was caused by a yeast infection." 5. "I am going to have an IUD placed for contraception."
Answer: 1, 2, 3 Explanation: 1. Women sometimes become infertile because of scarring in the fallopian tubes as a result of the inflammation of PID. 2. Antibiotic therapy should always be completed when a client is diagnosed with any infection. 3. The tubal scarring that occurs from tubal inflammation during PID can prevent a fertilized ovum from passing through the tube into the uterus, causing an ectopic or tubal pregnancy.
The nurse is preparing an education session for women on the prevention of urinary tract infections (UTIs). Which statement should be included? 1. Lower urinary tract infections rarely occur in women. 2. The most common causative organism of cystitis is E. coli. 3. Wiping from back to front after a BM will help prevent a UTI. 4. Back pain often develops with a lower urinary tract infection.
Answer: 2 Explanation: 2. E. coli is present in 75% to 90% of women with UTIs.
The nurse is admitting a client who is 12 weeks pregnant and an IV drug user. She has had a number of sexual partners, complains of malaise, and has yellow in the eyes, nausea, and vomiting. Having obtained this history, the nurse suspects that the client has which condition? 1. Hepatitis E 2. Hepatitis C 3. Gonorrhea 4. Hepatitis A
Answer: 2 Explanation: 2. Hepatitis C is bloodborne, and found in drug users and those who have multiple sexual partners.
The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes? 1. "I should douche daily to prevent infection." 2. "I could have another breakout during my period." 3. "I am more likely to develop cancer of the cervix." 4. "I should use sodium bicarbonate on the lesions to relieve discomfort."
Answer: 2 Explanation: 2. Menstruation seems to trigger recurrences of herpes.
The nurse's response to a client with a history of pelvic inflammatory disease who is trying to get pregnant is based on the knowledge that which condition can contribute to an infertility problem? 1. Hepatitis 2. Postinfection tubal damage 3. Pelvic abscess 4. Tubal infection
Answer: 2 Explanation: 2. Postinfection tubal damage is the most likely cause, as the infection causes tubal damage, which can lead to infertility.
The client demonstrates that the nurse's teaching regarding ways to prevent a recurrence of her urinary tract infection was effective when she makes which statement? 1. "I should wipe from back to front after urination." 2. "I should urinate when I feel the urge." 3. "I should try to restrict my intake of fruits." 4. "I should use a diaphragm."
Answer: 2 Explanation: 2. Retention overdistends the bladder, and can lead to infection.
After a sex education class at a high school, the nurse overhears a student discussing safe sex practices. Which statement indicates that teaching was successful? 1. "I don't have to worry about getting infected if I have oral sex." 2. "Teen women are the group at highest risk for sexually transmitted infections." 3. "The best thing to do if I have sex a lot is to use spermicide each and every time." 4. "Boys get the HIV virus more easily than girls do."
Answer: 2 Explanation: 2. Teens with multiple sex partners are more susceptible to sexually transmitted diseases.
The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone IM and doxycycline orally? 1. A pregnant client with gonorrhea and a yeast infection 2. A nonpregnant client with gonorrhea and chlamydia 3. A pregnant client with syphilis 4. A nonpregnant client with chlamydia and trichomoniasis
Answer: 2 Explanation: 2. The combined treatment of ceftriaxone IM and doxycycline orally provides dual treatment for gonorrhea and chlamydia, which frequently occur together.
Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (PID)? 1. CBC (complete blood count) with differential 2. Venereal Disease Research Laboratory (VDRL) 3. Throat culture for Streptococcus A 4. RPR (Rapid Plasma Reagin)
Answer: 3 Explanation: 3. Streptococcus of the throat is not associated with PID.
A client asks the nurse about treatment for human papilloma viral warts. The nurse's response should be based on what knowledge? 1. An antiviral injection cures approximately 50% of all cases. 2. Aggressive treatment is required to cure warts. 3. Warts often spread when an attempt is made to remove them surgically. 4. No single treatment is best for all types of warts or for all clients.
Answer: 4 Explanation: 4. All atypical, pigmented, and persistent warts should be biopsied and treatment instituted promptly.
) A nurse is teaching a middle school health class on the different types of viral hepatitis. Which statement made by a student indicates the need for further teaching? 1. "Both hepatitis A and E are not chronic infections." 2. "Hepatitis A is characterized by symptoms of jaundice, anorexia, nausea, vomiting, malaise, and fever." 3. "Hepatitis B, C, and D have symptoms similar to those of hepatitis A, and can also include arthralgias, arthritis and skin eruptions or rash." 4. "Both hepatitis B and C have an incubation period of 45-160 days."
Answer: 4 Explanation: 4. Hepatitis B has an incubation period of 45-160 days, but hepatitis C has an incubation period of 14-180 days.
The nurse is educating a group of female adolescents regarding sexually transmitted infections. The nurse knows that learning was achieved when an individual states that the most common symptom is which of the following? 1. Menstrual cramps 2. Heavy menstrual periods 3. Flu-like symptoms 4. Usually there are no signs or symptoms
Answer: 4 Explanation: 4. It is common for women to experience no signs or symptoms when they have contracted a sexually transmitted disease.
A nonpregnant client is diagnosed with bacterial vaginosis (BV). What does the nurse expect to administer? 1. Penicillin G 2 million units IM one time 2. Zithromax 1 mg p.o. b.i.d. for 2 weeks 3. Doxycycline 100 mg p.o. b.i.d. for a week 4. Metronidazole 500 mg p.o. b.i.d. for a week
Answer: 4 Explanation: 4. The nonpregnant woman who is diagnosed with bacterial vaginosis (BV) is treated with metronidazole 500 mg orally twice a day for 7 days.
A 12-year-old girl and her mother are at the doctor's office for a routine check-up for the daughter. The mother tells the nurse that she would like the daughter to have the Gardasil vaccine that is effective against the human papilloma virus. The nurse does some teaching, and knows it has been successful when the mother makes which statement? 1. "The human papilloma virus is spread through casual contact in schools." 2. "Gardasil will protect against all types of the human papilloma virus." 3. "The human papilloma virus affects a million people in the United States." 4. "Gardasil will be given to my daughter in three doses."
Answer: 4 Explanation: 4. This is true. The vaccine is given in three doses.