Health and Ilness Exam 2 Part 2

Herpes 1 & 2 can cause

1 in 6 people aged 14-49 yr olds-likely much higher. MANY asymptomatic and undiagnosed. Transmitted through skin to skin contact with lesion, secretions (oral, vaginal, rectal) Diagnosed through exam, lesion culture. Initial outbreak often worst- malaise, body ache, headache, and then painful, itchy lesions.

Which are modes of heat loss in the newborn? Select all that apply. 1. Radiation 2. Urination 3. Convection 4. Conduction 5. Evaporation

1. Radiation 3. Convection 4. Conduction 5. Evaporation

The nurse is caring for a child after surgical removal of a brain tumor. The nurse should assess the child for which sign that would indicate that brainstem involvement occurred during the surgical procedure? 1. Inability to swallow 2. Elevated temperature 3. Altered hearing ability 4. Orthostatic hypotension

2. Elevated temperature

A client treated for an episode of hyperthermia is being discharged to home. The nurse determines that the client needs clarification of discharge instructions if the client states a need to perform which action? 1. Increase fluid intake. 2. Resume full activity level. 3. Stay in a cool environment when possible. 4. Monitor voiding for adequacy of urine output.

2. Resume full activity level.

The nurse has applied a hypothermia blanket to a client with a fever. A priority for the nurse is to inspect the skin frequently to detect which complication of hypothermia blanket use? 1. Frostbite 2. Skin breakdown 3. Venous insufficiency 4. Arterial insufficiency

2. Skin breakdown

A client with a neurological problem is experiencing hyperthermia. Which measure would be least appropriate for the nurse to use in trying to lower the client's body temperature? 1. Giving tepid sponge baths 2. Applying a hypothermia blanket 3. Placing ice packs in the axilla and groin areas 4. Administering acetaminophen (Tylenol) per protocol

3. Placing ice packs in the axilla and groin areas

The nurse is caring for a 6-year-old child with sensorineural hearing loss. Which would the nurse be least likely to identify as the cause of the child's hearing loss? A. Ototoxic medication use B. Acute otitis media C. Intrauterine exposure to rubella D. Excess noise exposure

B. Acute otitis media

The nursing instructor is talking with the junior nursing class about male reproductive issues. The instructor tells the students that the causes of erectile dysfunction include which of the following? Select all that apply. A) Alcoholism B) Spinal cord trauma C) Tadalafil D) Phosphodiesterase-5 inhibitors E) Diabetes

A) Alcoholism B) Spinal cord trauma D) Phosphodiesterase-5 inhibitors

When providing client education on hearing, the nurse should remind clients to utilize ear plugs when they are what? (Select all that apply.) A) At train stations B) Cleaning their homes C) Using lawnmowers D) Working with children E) At concerts

A) At train stations C) Using lawnmowers E) At concerts

Teaching for patients with a sexually transmitted disease (STD) would include (select all that apply) A) Treatment of sexual partner is important. B) Douching may help provide relief of itching. C) Cotton undergarments are preferred over synthetic materials. D) Sexual abstinence is indicated during the communicable phase of the disease. E) Condoms should be used during as well as after treatment during sexual activity.

A) Treatment of sexual partner is important. C) Cotton undergarments are preferred over synthetic materials. D) Sexual abstinence is indicated during the communicable phase of the disease. E) Condoms should be used during as well as after treatment during sexual activity.

The nurse has notes that the physician has a diagnosis of presbycusis on the client's chart. The nurse plans care knowing the condition is: A) sensorineural hearing loss that occurs with aging B) conductive hearing loss that occurs with aging C) Tinnitus that occurs with aging D) Nystagmus that occurs with aging

A) sensorineural hearing loss that occurs with aging

The nurse is providing discharge instructions to a client with glaucoma. Which activities does the nurse instruct the client to avoid? (Select all that apply.) A. Bending over to tie shoes B. Sitting with legs elevated C. Sleeping on more than two pillows D. Blowing the nose frequently E. Lifting objects weighing more than 10 pounds

A. Bending over to tie shoes D. Blowing the nose frequently E. Lifting objects weighing more than 10 pounds

The nurse is providing immediate postoperative care for a 3-month-old who had a cataract removed. Which intervention would be the priority? A. Ensuring the protective eye patch is securely in place B. Teaching the family how to use antibiotic eye drops C. Explaining to the parents about patching the eye as therapy D. Instructing parents about using protective sunglasses

A. Ensuring the protective eye patch is securely in place

Which interventions would be most appropriate to include in the plan of care for a client with visual deficits? Select all that apply. A.Describe the layout of the room. B.Introduce yourself when entering the room. C.Speak loudly when interacting with the client. D.Explain the unfamiliar sounds such as alarms E.Inform the client that the call light is "over there."

A.Describe the layout of the room. B.Introduce yourself when entering the room. D.Explain the unfamiliar sounds such as alarms

Which describes perception? A.The ability to interpret impulses transmitted from the receptors that give meaning to the stimuli B.The process of receiving stimuli in the nerve endings C.A response to stimuli that declines over time D.Anything that stimulates a nerve receptor

A.The ability to interpret impulses transmitted from the receptors that give meaning to the stimuli

Which of the following statements best describes the relationship between biologic sex and gender identity? A.sex is chromosomally determined, while gender is a psychosocial construct B.biologic sex and gender identity are both modifiable by surgery and medical interventions C.biologic sex and gender identity are considered synonyms in nursing practice D.biologic sex is genetically determined but gender identity is chosen during adolescence

A.sex is chromosomally determined, while gender is a psychosocial construct

A 55-year-old male presents to the health care clinic with reports of decreased hearing over the past year. Which subjective data in the client's review of systems should the nurse recognize as risk factors for hearing loss? Select all that apply. A) Use of antihypertensive medication B) Chronic ear infections as a child C) History of measles at 3 years of age D) Wax blocking the ear canal E) Drinks six cups of coffee daily

B) Chronic ear infections as a child C) History of measles at 3 years of age D) Wax blocking the ear canal

The nurse is obtaining the history from the parents of an infant who is suspected of having infantile glaucoma. Which statement by the parents would help to confirm this suspicion? A. "Our child's eye looks about the same size as the other eye." B. "It seems like bright lights really bother our child." C. "Our child opens the eyes quite frequently when awake." D. "Our child's eye doesn't seem to tear much."

B. "It seems like bright lights really bother our child."

The nurse is educating the parents of a 7-year-old child who has hearing loss due to otitis media with effusion. Which statement by the parents indicates that further education is needed? A. "We need to make sure we are speaking clearly." B. "We need to raise the volume of our voices significantly so our child can hear us." C. "We need to face our child when we are speaking." D. "Using hand gestures as visual cues should help our child understand a little better."

B. "We need to raise the volume of our voices significantly so our child can hear us."

During patient teaching regarding self-administration of ophthalmic drops, which statement by the nurse is correct? A."Hold the eyedrops over the cornea, and squeeze out the drop." B."Apply pressure to the lacrimal duct area for 5 minutes after administration." C."Be sure to place the drop in the conjuctival sac of the lower lid." D."Squeeze your eyelid closed tightly after placing the drop into your eye."

C."Be sure to place the drop in the conjuctival sac of the lower lid."

A client who is receiving therapy with a hypothermia blanket starts to shiver. The nurse raises the blanket temperature and monitors the client. After 15 minutes the client's temperature has not increased and the client is still shivering. What should the nurse do next? A.Apply a smaller heating pad to the client's axillae and neck areas. B.Wait 10 more minutes and then check the client's temperature again. C.Remove the hypothermia blanket and notify the client's health care provider (HCP). D.Increase the blanket's temperature again and recheck the client's temperature in 15 minutes.

C.Remove the hypothermia blanket and notify the client's health care provider (HCP).

Syphillis testing and treatment

Can be transmitted from mom to baby during pregnancy and cause still birth 40% of untreated cases result in still birth Congenital syphilis can cause blindness, serious neuro problems, bone damage, deafness 50% asymptomatic Testing by VDRL and RPR (blood) Treat with antibiotics- Pen G IM Re-test at 6 & 12 months for up to 2 years

Bacterial infections are:

Chlamydia Gonorrhea Syphillis

The nurse is developing a plan of care for a client with new hearing aids. Which long-term goal is most appropriate for the client? A.The client will wear the hearing aids 90% of the time. B.The client will demonstrate successful insertion of the hearing aids. C.The client will verbalize an understanding of the need for hearing aids. D.The client will demonstrate how to properly care for the hearing aids within 2 weeks.

D.The client will demonstrate how to properly care for the hearing aids within 2 weeks.

A nurse is teaching a community health class of women and explains that a sexually transmitted infection (STI) is associated with an increased risk of infertility in women. Which of the following STIs would the nurse identify? a) Herpes simplex b) Syphilis c) Chlamydia d) Gonorrhea

c) Chlamydia

Trichomoniasis

Flagellated protozoan parasite Transmitted by exposure to sexual fluids. Dysuria, pelvic pain, change in discharge- often green or "rust" Incubation period: 1 week - 1 month or longer Most common sites: Men - urethra; Women - cervix May be asymptomatic for years Testing by culture. Can be seen with microscopy. Treat with antibiotics- Metronidazole 500mg PO BID. Patient teaching includes: Increased risk for preterm birth or low birth weight infants

A student nurse is doing clinical hours at an OB/GYN clinic. The student is helping to develop a plan of care for a patient with gonorrhea has presented at the clinic. The student knows that the care plan for this patient should be include what in the treatment of gonorrhea? a) Concurrent treatment for chlamydia b) Avoidance of the use of tampons c) Vaginal smears every 6 months d) Radiation therapy to destroy cancerous cells

a) Concurrent treatment for chlamydia

Herpes 1 & 2

HSV-1: Oral lesions HSV-2: Perineal lesions Both strains enter mucous membranes and spread throughout body Incubation period: 2 days - 2 weeks (primary)- can be asymptomatic for months or years Valacyclovir and acyclovir used for supportive treatment

Viral infections are

Herpes Genital warts

Syphillis

Primary: Chancre Secondary: malaise, headache, enlarged liver Tertiary- may be latent for years and then affect heart and CNS (cardiac complications, psychosis) Transmitted through direct contact with a chancre (syphilitic lesion) during vaginal, anal, or oral sex Can occur internally (vagina, rectum mouth/tongue) or externally (genitals, anus, lips) Incubation period: 10 - 90 days

Human PapillomaVirus (HPV)

Virus High and low risk strains High risk causes cancers- cervical, vulvar, penile, anal, throat. Often years to develop. No symptoms. Low risk causes genital warts- can be removed. 70-90% of infections often cleared by immune systemrapidly, before detection. HPV vaccination can prevent more than 90% of cancers caused by HPV. Ages 9-45. Contraindicated in pregnancy. Women 21-65 should be screened every 3 years

Gonorrhea treament and testing

Testing by vaginal/male urethral culture, urine test, throatculture. Screen for HIV and other infections Treat with dual antibiotics- Ceftriaxone 500mg IM and tx for chlamydia if not ruled out with Doxycycline 100mg PO BID x 7 days (or pregnancy alternative) Expedited Partner Therapy (EPT) Re-test in 7-14 days for test of cure (if needed) or after 3-12 mos. months for re-screen.

Gonorrhea

Transimitted through exposure to sexual fluids (vaginal, anal, oral) Incubation period: few days-1week Most common sites: Men - urethra; Women - cervix May be asymptomatic or symptomatic Symptomatic: yellow discharge, pelvic pain, dysuria.

Chlamydia

Transmitted through exposure to sexual fluids (vaginal, anal or oral) Incubation period: 1-3 weeks Most common sites: Men - urethra; Women - cervix May be asymptomatic or symptomatic Symptomatic: yellow discharge, pelvic pain, dysuria. At risk for PID, infertility, ectopic pregnancy, increased susceptibility to HIV. Screen positive patients for gonorrhea, HIV and syphilis

Chlamydia diagnostic test and treatment

Urine test or cervical/vaginal/male urethralculture Treatment *Doxycycline 100mg PO BID x 7days* or Azithromycin 1 gram PO x 1(pregnancy or compliance issues) Screen all sexually active female patients<25 Re-test in >4 weeks for test of cure inpregnant patients

A patient comes to the clinic after being informed by a sexual partner of possible recent exposure to syphilis. The nurse will examine the patient for what characteristic finding of syphilis in the primary clinical stage? a. Chancre b. Alopecia c. Condylomata lata d. Regional adenopathy

a. Chancre

Common age-related changes in the auditory system include (select all that apply) a. drier cerumen. b. tinnitus in both ears. c. auditory nerve degeneration. d. atrophy of the tympanic membrane. e. greater ability to hear high-pitched sounds.

a. drier cerumen. b. tinnitus in both ears. c. auditory nerve degeneration. d. atrophy of the tympanic membrane.

Care of the patient experiencing an acute attack of Ménière's disease includes (select all that apply) a. giving antiemetics as needed. b. implementing fall precautions. c. keeping the room dark and quiet. d. placing the patient on NPO status. e. ambulating in the hall independently.

a. giving antiemetics as needed. b. implementing fall precautions. c. keeping the room dark and quiet.

The patient who has a conductive hearing loss a. hears better in a noisy environment. b. hears sound but does not understand speech. c. often speaks loudly because his or her own voice seems low. d. has clearer sound with a hearing aid if the loss is less than 30 dB.

a. hears better in a noisy environment.

Bacterial infections are treated with

antibiotics

Viral infections are treated with

antivirals

A male patient comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention? a) Painful red papules on the shaft of the penis b) Foul-smelling discharge from the penis c) Rashes on the palms of the hands and soles of the feet d) Cauliflower-like warts on the penis

b) Foul-smelling discharge from the penis

While summarizing teaching about genital herpes, which patient statement indicates a need for further instruction? a. "No cure is available for my genital herpes." b. "I will utilize my medication when I begin to have symptoms." c. "Genital herpes may be caused by herpes simplex virus type 1 or 2" d. "I am not able to infect a sexual partner unless I have active lesions."

b. "I will utilize my medication when I begin to have symptoms."

The patient is being treated for a recurrent episode of Chlamydia. What should the nurse include in patient teaching? a. If you are treated, your sexual partner will not need to be treated. b. Abstain from sexual intercourse for 7 days after finishing the treatment. c. You will probably get gonorrhea if you have another recurrence of Chlamydia. d. Because you have been treated before, you do not need to take all the medication this time.

b. Abstain from sexual intercourse for 7 days after finishing the treatment.

When planning care for a patient with disturbed sensory perception related to increased intraocular pressure caused by primary open-angle glaucoma, what nursing action would be a priority? a. Giving anticipatory guidance about the loss of central vision that will occur b. Encouraging compliance with drug therapy for the glaucoma to prevent vision loss c. Recognizing that eye damage caused by glaucoma can be reversed in the early stages d. Managing the pain patients with glaucoma have that persists until the optic nerve atrophies

b. Encouraging compliance with drug therapy for the glaucoma to prevent vision loss

A patient is diagnosed with severe myopia. Which type of correction is the patient planning to have if they state, "I can't wait to be able to see after they implant a contact lens over my lens"? a. Photorefractive keratectomy (PRK) b. Phakic intraocular lenses (phakic IOLs) c. Refractive intraocular lens (refractive IOL) d. Laser-assisted in situ keratomileusis (LASIK)

b. Phakic intraocular lenses (phakic IOLs)

Which strategies would best aid the nurse communicate with a patient who has a hearing loss (select all that apply)? a. Overenunciate speech. b. Speak normally and slowly. c. Exaggerate facial expressions. d. Raise the voice to a higher pitch. e. Write out names or difficult words.

b. Speak normally and slowly. e. Write out names or difficult words.

What assessment technique should the nurse use to assess an adult patient's tympanic membrane? a. Have the patient tilt the head toward the nurse. b. Stabilize the otoscope with your fingers on the patient's cheek. c. Pull the auricle down and back to straighten the auditory canal. d. Use a speculum slightly larger than the size of the patient's ear canal.

b. Stabilize the otoscope with your fingers on the patient's cheek.

Teach the patient who is newly fitted with bilateral hearing aids to (select all that apply) a. replace the batteries monthly. b. clean the ear molds weekly or as needed. c. clean ears with cotton-tipped applicators daily. d. disconnect or remove the batteries when not in use. e. initially restrict usage to quiet listening in the home.

b. clean the ear molds weekly or as needed. d. disconnect or remove the batteries when not in use. e. initially restrict usage to quiet listening in the home.

A man 50 years of age has a long history of diabetes, which is poorly controlled. What does diabetes greatly increase the man's risk of experiencing? a. sexually transmitted infections b. erectile dysfunction c. retarded ejaculation d. premature ejaculation

b. erectile dysfunction

The nurse teaches a patient scheduled for an electronystagmography that the test involves a. measuring ear drum movement in response to pressure. b. recording eye movements associated with ear irrigation. c. placing an electrode on the eardrum and assessing for dizziness. d. wearing headphones and determining which sounds can be heard.

b. recording eye movements associated with ear irrigation.

A patient comes to the outpatient clinic for treatment of uncomplicated gonorrhea. Which patient statement requires immediate clarification by the nurse? a. "I should avoid alcohol use for at least 2 weeks." b. "I will have my sexual partner come in for treatment." c. "After I start the antibiotic, it is safe to have sex again." d. "After treatment, I do not need to return to the clinic for retesting."

c. "After I start the antibiotic, it is safe to have sex again."

The nurse is preparing to administer timolol eyedrops for treatment of glaucoma. What statement made by the patient would cause the nurse to hold the medication and report to the health care provider? a. "I have sinusitis." b. "I have migraine headaches a lot." c. "I have chronic obstructive pulmonary disease." d. "I have a history of chronic urinary tract infections."

c. "I have chronic obstructive pulmonary disease."

A patient newly diagnosed with glaucoma asks the nurse what has made the pressure in the eyes so high. Which is the nurse's most accurate response? a. Back pressure from cardiac congestion causes corneal edema. b. Cerebral venous dilation prevents normal interstitial fluid resorption. c. Increased production of aqueous humor or blocked drainage increases pressure. d. Congenital anomalies of the lacrimal gland or duct obstruct the passage of tears.

c. Increased production of aqueous humor or blocked drainage increases pressure.

Which finding related to primary open-angle glaucoma would the nurse expect to find when reviewing a patient's history and physical examination report? a. Absence of pain or pressure b. Blurred vision in the morning c. Seeing colored halos around lights d. Eye pain accompanied with nausea and vomiting

c. Seeing colored halos around lights

The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is? a. spermicides b. a cervical cap c. condoms d. a diaphragm

c. condoms

What is associated with the resolution phase of the male sexual response cycle? a. intense physical pleasure b. the ability to begin the excitement phase again c. feelings of relaxation and fulfillment d. increased blood flow to the penis

c. feelings of relaxation and fulfillment

In a patient with vertigo, the parts of the ear most likely involved are the (select all that apply) a. cochlea. b. ossicles. c. vestibule. d. semicircular canals. e. tympanic membrane.

c. vestibule. d. semicircular canals.

A 16-year-old patient comes to the free clinic and is diagnosed with primary syphilis. The patient states that she contracted this disease by holding hands with someone who has syphilis. What is the most appropriate nursing diagnosis for this patient? a) Alteration in comfort related to impaired skin integrity b) Fear related to complications c) Noncompliance with treatment regimen related to age d) Knowledge deficit related to modes of transmission

d) Knowledge deficit related to modes of transmission

A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: a) why the disease is transmittable only when visible lesions are present. b) the need for the use of petroleum products. c) the option of disregarding safer-sex practices now that he's already infected. d) the importance of informing his partners of the disease.

d) the importance of informing his partners of the disease.

The nurse teaches a patient prescribed dipivefrin eyedrops to manage chronic open-angle glaucoma. Which statement, if made by the patient to the nurse, indicates that further teaching is needed? a. "The eyedrops could cause a fast heart rate and high blood pressure." b. "I will need to take the eyedrops twice a day for at least 2 to 3 months." c. "I may have eye discomfort and redness from the use of these eyedrops." d. "I will apply gentle pressure on the inside corner of my eye after each eyedrop."

d. "I will apply gentle pressure on the inside corner of my eye after each eyedrop."

The nurse obtains a history from a 34-year-old man diagnosed with chlamydia. Which patient statement indicates additional teaching is required? a. "This infection can be cured by taking antibiotics." b. "It is important to use condoms for all sexual activity." c. "I will avoid sexual contact for 1 week after taking the antibiotics." d. "My sexual partner does not have symptoms and will not need treatment."

d. "My sexual partner does not have symptoms and will not need treatment."

Which event discovered during pregnancy would alert the nurse that a cesarean section delivery is indicated? a. Contact with a person with syphilis 2 weeks ago b. Treatment for gonococcal pharyngitis before conception c. Treatment for C. trachomatis at her 20th week of gestation d. Active herpes simplex virus type 2 vesicles on her cervix at the time of delivery

d. Active herpes simplex virus type 2 vesicles on her cervix at the time of delivery

A normal finding the nurse would expect when assessing hearing would be a. absent cone of light. b. bluish purple tympanic membrane. c. fluid level at hairline in the tympanum. d. midline tone heard equally in both ears.

d. midline tone heard equally in both ears.

A female client informs the nurse that her husband is concerned about her sexual response. The client reports that during stimulation her husband has noticed her clitoris disappears, and he wonders if she is enjoying the experience despite her positive responses to his stimulation. The nurse explains that building excitement and the reaction of the clitoris are normal characteristics of which stage of the sexual response cycle? a. resolution phase b. orgasm c. excitement phase d. plateau phase

d. plateau phase