Chapter 5: Sexually Transmitted Infections

A female client, who has been newly diagnosed with herpes simplex virus (HSV) ask the nurse how long it will take for the "sores" to go away. How should the nurse respond?

"It will take about 2 weeks for the outbreak to fully heal."

A nurse is caring for a client with vaginitis. What teaching(s) should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply.

-Avoid douching. -Wear only cotton panties and ventilated pantyhose. - using deodorant tampons.

The public health nurse is teaching young adolescents in a sexual health class the proper use of a condom. Which statements made by the students indicate teaching was successful? Select all that apply.

-Only use latex condoms. -Place the condom on an erect penis. -Store the condoms in a cool, dry place.

Which medication is used to suppress viral load of the HSV-2 infection?

Acyclovir

A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community?

Discuss limiting the number of sex partners.

A client is diagnosed with trichomoniasis infection. The nurse prepares to teach the client about which medication?

Metronidazole

The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms?

Trichomoniasis

A client has presented reporting symptoms that suggest a gonorrheal infection. After laboratory testing confirms this diagnosis, the nurse anticipates that the client will also be treated for which infection?

chlamydia

When developing a program for STI prevention, which action would need to be done first?

educating on how to promote sexual health

A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment?

fluconazole

After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement?

"It's okay to use petroleum jelly with a latex condom."

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. What most likely contributed to her present condition?

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

A parent at an educational session on sexually transmitted infections (STIs) asks the nurse if there are vaccines available to prevent STIs. How should the nurse respond?

"A vaccine has been approved to prevent the human papillomavirus."

The nurse is caring for a client diagnosed with candida vaginitis. The nurse knows additional teaching is needed when the client makes which statement?

"Douching is an effective way to cleanse the vaginal area after intercourse."

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 statement by the client demonstrates 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."

The nurse is educating a client newly diagnosed with genital herpes. Which statement by the client indicates teaching has been successful?

"I can spread this infection if I have unprotected anal, vaginal, or oral sex."

The nurse is teaching a group of middle school students about sexually transmitted infections (STIs). Which statement by the students indicates a need for additional teaching about condom use?

"I will put the condom on just before orgasm."

A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure?

"I'm temporarily not contagious once the warts are destroyed."

A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response?

"There is currently no medical treatment to cure HPV."

A client with a history of herpes simplex virus type 2 (HSV-2) asks the nurse about future sexual activity. Which response by the nurse is most appropriate?

"To be responsible, you or your partner need to wear a condom during intercourse."

During a health education session, a teenage client asks the nurse when she should have her first "Pap test." How should the nurse reply?

"When you turn 21 years old."

The nurse knows which client is at the highest risk for contracting a sexually transmitted infection (STI)?

21-year-old client who tested positive for cocaine use and was treated for trichomoniasis twice in the past 3 years

A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia?

70%

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?

A painless genital ulcer that appeared about 3 weeks after unprotected sex

A nurse is preparing for a class discussion on sexually transmitted infections (STIs) to be given at a local high school. Which would the nurse include as a discussion priority?

Adolescents and young adults are the largest age group diagnosed with an STI.

A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem?

Affirm the client's good judgment in seeking treatment.

Which instruction should the nurse give to a client with genital herpes to help control the infection?

Avoid sexual contact until sores heal.

A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge?

Candidiasis

Which STI could be transmitted perinatally?

Herpes simplex

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?

Instill a prophylactic agent in the eyes of the newborn.

A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease?

Instruct people to get vaccinated for hepatitis B.

A client presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole. What is the paramount nursing intervention in discharge planning?

Instruct the client not to drink alcohol with this treatment.

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 is the woman's most likely treatment and prognosis?

Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.

Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection?

Participate in early prenatal care

A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?

Safety of antiviral therapy during pregnancy has not been established.

An HIV-positive client who is on antiretroviral therapy reports anorexia, nausea, and vomiting. Which suggestion should the nurse offer the client to cope with this condition?

Use high-protein supplements. to provide quick and easy protein and calories.

Which finding would alert the nurse to suspect that a client has a yeast infection?

Vulvar burning and itching

The nurse is caring for a male client diagnosed with gonorrhea and chlamydia. Which health care provider order will the nurse question?

acyclovir 400 mg orally BID

A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity?

administering HPV vaccine

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?

burning on urination

The nurse cares for multiple female clients. Which client is at the highest risk for developing cervical cancer?

client who smokes 2 packs of cigarettes a day and birthed a newborn at 39 weeks' gestation when 15 years of age

A client is diagnosed with bacterial vaginosis and is prescribed medication therapy. The nurse would anticipate which drugs as being prescribed? Select all that apply.

clindamycin metronidazole

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 for developing which diagnosis?

condylomata acuminata

Clients who have had PID are prone to which complication?

ectopic pregnancy

A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports:

genital pruritus and paresthesia.

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

gonorrhea

The community health nurse is teaching sexually transmitted infections to a high school health class. The nurse determines that the teaching was successful when the group identifies what potential cause for intellectual disability in the newborn?

herpes type 2 (genital herpes)

Which stage of syphilis occurs when the infected person has no signs or symptoms of syphilis?

latency

Which medications are appropriate to treat vaginal candidiasis? Select all that apply.

miconazole fluconazole

What is the medication of choice for early syphilis?

penicillin G benzathine

Pelvic infection is most commonly caused by:

sexual transmission

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis?

sore throat and flu-like symptoms

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

syphilis

Which factor in a client's history indicates she is at risk for candidiasis?

use of corticosteroids

A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection?

viral culture of vesicular fluid

A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding?

yeast infections

A woman who has had repeated candidal infections asks the nurse about ways to help prevent them. Which response(s) by the nurse would be appropriate? Select all that apply.

"Shower instead of taking baths." "Use white, unscented toilet paper." "Avoid wearing exercise pants with spandex."

A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply.

"The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it." "Transmission is through contact of infected mucous membranes."

A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student?

"Withdraw the penis erect, holding the condom firmly against the penis."

A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe?

Ceftriaxone

The clinic nurse is treating a client diagnosed with HIV. Which statement made by the client indicates an understanding of the diagnosis?

"If my T-cell count drops below 200 cells/mm3 (0.2 × 109/l), my HIV has progressed to AIDS."

A client is being discharged from the gynecological unit after treatment for acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include?

Discuss the necessity of completing the antibiotic therapy.

A client diagnosed with genital herpes asks the nurse about future sexual experiences. Which response by the nurse is appropriate?

"If you plan to have future sexual relationships, you need to let your partner know of your history prior to intercourse."

The nurse is caring for a female client diagnosed with vulvovaginal candidiasis. Which instruction will the nurse include in the teaching session with the client?

"It is best for you to wear cotton underwear."

A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching?

"This drug will help to suppress any symptoms of the infection."

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 six 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?

An azole antifungal agent