PrepU ch 51 & 66 study questions
A 28-year-old sexually active client presented to a clinic because they were concerned about a round, painless sore on the shaft of their penis that had appeared 2 days prior to the visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. What information should the nurse communicate to the patient? a) "An antibiotic injection is the best treatment since the lesion has just occurred." b) "Abstain from sexual activity for 2 weeks, after which the lesion will resolve." c) "Without treatment, the lesion will increase in size and become painful." d) "No treatment is necessary unless you notice a rash on your chest."
a) "An antibiotic injection is the best treatment since the lesion has just occurred."
Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? a) "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day." b) "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." c) "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." d) "I hope this medicine works before this disease gets into my urine and destroys my kidneys."
a) "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."
The public health nurse has been talking to a group of community members about sexually transmitted infections. Which statement by one of the participants demonstrates an understanding of methods during sexual intercourse to decrease the risk of a sexually transmitted infection? a) "I will make sure and wash my genital area before and after having sexual intercourse." b) "Sexually transmitted infections cannot be passed without having sexual intercourse." c) "Using condoms will always prevent a sexually transmitted infection." d) "If I find out that I have a sexually transmitted infection, I should limit sexual contact to the individual I believe gave me the infection."
a) "I will make sure and wash my genital area before and after having sexual intercourse."
A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? a) "I will wear loose cotton underwear." b) "I can pour moisturizer over my lesions." c) "I will apply a water-based lubricant to my lesions." d) "I should rub rather than scratch in response to itching."
a) "I will wear loose cotton underwear."
The nurse is counseling a client who has been diagnosed with two sexually transmitted infections. The client is shocked and states not knowing how this has happened. Which of the following statements is most appropriate by the nurse? a) "Your partner could have been asymptomatic at that time." b) "Sexually transmitted infections have obvious signs of their presence." c) "Your partner should have told you of a previous infection." d) "You should have asked your partner if they have any infections."
a) "Your partner could have been asymptomatic at that time."
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? a) Burning on urination b) Painless chancre c) Dry, hacking cough d) Diffuse skin rash
a) Burning on urination
The nurse is assessing a client in the emergency department who grimaces and reports swelling of the testicles, burning on urination and a green discharge from the penis. The nurse suspects the client will be diagnosed with which infection? a) Gonorrhea b) Trichomoniasis c) Herpes genitalis d) Primary syphilis
a) Gonorrhea
The nurse is completing a community education via a pamphlet on sexually transmitted diseases. Which key point is most important for the nurse to emphasize? a) Many people are asymptomatic and show no symptoms contributing to the spread of the disease. b) Some sexually transmitted diseases can be transmitted to newborns through the birth canal. c) Some sexually transmitted diseases can cause infertility caused by scarring of reproductive organs. d) Common age-groups for clients with sexually transmitted diseases are in their late teens and 20s.
a) Many people are asymptomatic and show no symptoms contributing to the spread of the disease.
The nurse is working in the labor and delivery suite when a client with active herpes simplex virus type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care will the nurse prepare for? a) Prepare for a cesarean section. b) Administer an intravenous antibiotic to the client while in labor. c) Complete a full assessment of the newborn on delivery. d) Place an antibacterial ointment on the client's lesions.
a) Prepare for a cesarean section.
Which STD seems to accelerate in HIV-positive clients? a) Syphilis b) Trichomoniasis c) Herpes d) Gonorrhea
a) Syphilis
When developing a teaching plan for a client with syphilis, which of the following would be most important to include? a) With proper treatment, the disease can eventually be cured. b) Sexual contact can be resumed after treatment. c) Oral therapy needs to continue after the initial injection. d) Condoms have little effect in preventing the transmission of the disease.
a) With proper treatment, the disease can eventually be cured.
The nurse educator is teaching a group of young adult clients about sexually transmitted infections. The nurse explains that which infection is most likely to be "silent" with no overt symptoms? a) chlamydia b) pelvic inflammatory disease c) syhpillis d) herpes genitalis (HSV-2)
a) chlamydia
A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: a) the importance of informing his partners of the disease. b) the option of disregarding safer-sex practices now that he's already infected. c) why the disease is transmittable only when visible lesions are present. d) the need for the use of petroleum products.
a) the importance of informing his partners of the disease.
The clinical manifestations of primary syphilis can be diagnostic. Select all the symptoms consistent with this diagnosis. a) a painless lesion forms at the site of infection b) It occurs 2 to 3 weeks after initial inoculation with the organism c) a rash spreads to the extremities by week 4 d) the lesion resolves in 2 months.
a, b, d
A client has been diagnosed with genital herpes. Knowing that education is an essential part of nursing care of the client with a genital herpes infection, the nurse plans to include which method(s) to minimize HIV transmission? Select all that apply. a) Avoiding IV drug use b) Avoiding physical contact with others in crowded places c) Avoiding unprotected sexual intercourse d) Avoiding HPV vaccinations e) Avoiding multiple sexual partners
a, c, e
The nurse educator is teaching a group of nursing students about the physiologic manifestations of tertiary syphilis. The students respond correctly by stating which major organ systems are identified as the most affected by tertiary syphilis? a) Integumentary and genitourinary b) Cardiovascular and neurological c) Respiratory and endocrine d) Musculoskeletal and gastrointestinal
b) Cardiovascular and neurological
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? a) Gonorrhea b) Genital herpes c) Chlamydia d) Syphilis
b) Genital herpes
A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department? a) Human papillomavirus (HPV) b) Gonorrhea c) bacterial vaginitis d) Genital herpes
b) Gonorrhea
Which of the following sexually transmitted infections (STIs) could be transmitted perinatally? a) Gonorrhea b) Herpes simplex c) Chlamydia d) Trichomoniasis
b) Herpes simplex
The nurse is seeing a client in the community health clinic who reports finding "sores" in the mouth. On assessment, the nurse notes the lesions appear flat, flesh colored and papillary. What should the nurse do next? a) Provide the client with information about having a colposcopy b) Obtain a health history that includes inquiring about sexual health practices c) Suggest serology testing for herpes simplex virus (HSV) d) Inform the client that the lesion in the mouth is consistent with a human papillomavirus (HPV) infection
b) Obtain a health history that includes inquiring about sexual health practices
To confirm a diagnosis of syphilis, the nurse would identify the gram-negative bacteria, Treponema palladium, on the laboratory report. The nurse knows that this bacteria is classified among: a) Proteobacteria b) Spirochetes c) Green-sulphur bacteria d) Cyanobacteria
b) Spirochetes
The nurse is providing care to a client who has been diagnosed with gonorrhea. The nurse also prepares the client for treatment of which of the following? a) Human immunodeficiency virus b) Syphilis c) Chlamydia d) Herpes simplex
b) Syphilis
Which of the following is the medication of choice for early syphilis? a) Tetracycline b) Doxycycline c) Penicillin G benzathine d) Rocephin
c) Penicillin G benzathine
The nurse is caring for a group of clients at a public health clinic. Which sexually transmitted disease would the nurse focus the client education on curative goals? a) HPV b) chlamydia c) genital herpes d) HIV
b) chlamydia
The nurse recognizes the client is in which stage of syphilis when the client has no signs or symptoms of syphilis? a) tertiary b) latency c) primary d) sedondary
b) latency
Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? a) tertiary b) latency c) primary d) secondary
b) latency
Which of the following are risk factors for the development of a sexually transmitted disease (STD)? Select all that apply. a) Over 30 years of age b) Prostitution c) Starting sex at a late age d) Multiple partners e) Unprotected sex
b, d, e
The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? a) "It is very hard to see signs of infection in the heat of passion." b) "I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation." c) "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." d) "It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now."
c) "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected."
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? a) Copper-colored macules on the palms and soles that appeared after a brief fever b) Patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas c) A painless genital ulcer that appeared about 3 weeks after unprotected sex d) One or more flat, wart-like papules in the genital area that are sensitive to touch
c) A painless genital ulcer that appeared about 3 weeks after unprotected sex
A client with suspected primary syphilis is to undergo diagnostic testing. Which of the following would the nurse expect to be done to confirm this diagnosis? a) Rapid plasma reagin circle card test (RPR-CT) b) Venereal Disease Research Laboratory (VDRL) test c) Direct identification in a specimen from the chancre lesion d) Fluorescent treponemal antibody absorption tests (FTA-ABS)
c) Direct identification in a specimen from the chancre lesion
A client is diagnosed with herpes simplex. Which statement about herpes simplex infection is true? a) A client with genital herpes lesions may have sexual contact but must use a condom. b) Herpetic keratoconjunctivitis usually is bilateral and causes systemic symptoms. c) During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature birth. d) Genital herpes simplex lesions are painless, fluid-filled vesicles that ulcerate and heal in 3 to 7 days.
c) During early pregnancy, herpes simplex infection may cause spontaneous abortion or premature birth.
A client who has developed a painless penile ulcer is diagnosed with syphilis. What treatment would the provider prescribe? a) IV penicillin G; multiple dosing b) oral penicillin G; single dose c) IV penicillin G; single dose d) IV tetracycline; single dose
c) IV penicillin G; single dose
Nursing students are reviewing information about sexually transmitted infections (STIs). They demonstrate a need for additional review when they identify which of the following as an example? a) Chlamydia b) Human papilloma virus c) Shigella d) Syphilis
c) Shigella
A nurse has performed disease prevention teaching with a client who has genital herpes. Which client behavior indicates that the teaching has been successful? a) The client wears tight-fitting jeans. b) The client keeps their fingernails long. c) The client washes their hands before and after touching lesions. d) The client keeps the affected area moist.
c) The client washes their hands before and after touching lesions.
The nurse is presenting a community lecture about STIs, and emphasizes that some STIs are easily cured with early and adequate treatment. Which is not among these easily treated diseases? a) chlamydia b) syphilis c) genital herpes d) gonorrhea
c) genital herpes
The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority? a) anxiety b) knowledge deficit c) impaired skin integrity d) powerlessness
c) impaired skin integrity
A nurse practitioner is treating a client with early latent syphilis of less than 1 year's duration. The nurse told the c lient about the need to receive penicillin G benzathine injections according to the following protocol: a) Seven injections, at one per day. b) eight injections, at 7-day intervals. c) one injection d) three injections at 7-day intervals
c) one injection
The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client? a) "Coinfection with the herpes simplex virus is common with chlamydia." b) "If you become reinfected, symptoms will immediately be present." c) "It is very important to maintain good handwashing, even while you are being treated." d) "Abstain from any sexual activity for 1 week after the antibiotic is complete."
d) "Abstain from any sexual activity for 1 week after the antibiotic is complete."
You are a school nurse teaching a health class about the chain of infection in the transmission of sexually transmitted diseases (STDs). A student asks you which part of the chain of infection can be missing when transmission occurs. What would be your best answer? a) "Not everyone is susceptible to STDs, but they still get them." b) "STDs can be gotten from bed linens and toilet seats, so you don't really need a reservoir." c) "You can be missing any part of the chain of infection except the infectious agent." d) "All parts of the chain of infection have to be present for the disease to be passed to another human."
d) "All parts of the chain of infection have to be present for the disease to be passed to another human."
The nurse is seeing a client in a community health clinic who reports having dyspareunia and pelvic tenderness after their menstrual period. The client also reports experiencing pain with bowel movements. What question should the nurse include when obtaining the client's health history? a) "Do you use any types of douching agents after your menstrual period?" b) "Do you get cold sores around your mouth or genital areas?" c) "Have you noticed a fish-like odor during your menstrual period?" d) "Have you ever been assessed for gonorrhea and chlamydia in the past?
d) "Have you ever been assessed for gonorrhea and chlamydia in the past?
The nurse is talking to a client who has come to the doctor's office to ensure that the client's sexually transmitted infection (STI) has been successfully treated. Which statement by the client requires further instruction? a) "I realize that using a condom with a spermicide will eliminate most chances of getting any type of a sexually transmitted infection." b) "I will plan to use a dental dam from now on whenever I engage in oral sex." c) "I'm glad that the health care practitioner checked me for STIs when I came for my regular checkup because I didn't have any symptoms." d) "It's great that I don't have to worry about having this infection again because I'm now immune to it."
d) "It's great that I don't have to worry about having this infection again because I'm now immune to it."
An adolescent informs the school nurse that they are afraid of contracting an STI but their partner does not want to use condoms. What is the best response by the nurse? a) "If they won't use a condom, then they don't care about you." b) "I can understand your concern and you should bring them here so that I can talk with them about STIs." c) "You are too young to be having sex at all." d) "The use of condoms is one of the best ways to reduce the risk of acquiring an STI."
d) "The use of condoms is one of the best ways to reduce the risk of acquiring an STI."
Which condition of generally requires the identification and treatment of sexual partners? a) Bartholinitis b) Endometriosis c) Candidiasis d) Chlamydia trachomatis infection
d) Chlamydia trachomatis infection
A nurse is caring for a client diagnosed with a chlamydia infection. The nurse teaches the client about disease transmission and advises the client to inform sexual partners of the infection. The client refuses, stating, "This is my business and I'm not telling anyone. Beside, chlamydia doesn't cause any harm like the other STIs." How should the nurse proceed? Select all that apply. a) Continue to pressure the client for the sexual partner's contact information. b) Inform the client's sexual contacts of their possible exposure to chlamydia. c) Do nothing because the client's sexual habits place him at risk for contracting other sexually transmitted infections. d) Educate the client about why it's important to inform sexual contacts so they can receive treatment. e) Inform the health department that this client contracted a chlamydia infection.
d) Educate the client about why it's important to inform sexual contacts so they can receive treatment.
A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? a) Painful red papules on the shaft of the penis b) Rashes on the palms of the hands and soles of the feet c) Cauliflower-like warts on the penis d) Foul-smelling discharge from the penis
d) Foul-smelling discharge from the penis
Which type of sexually transmitted disease is the nurse most accurate to highlight in the client's history as it remains dormant in the body and can reoccur at any time? a) Syphilis b) Chlamydia c) Gonorrhea d) Herpes infection
d) Herpes infection
The nurse is providing education regarding sexually transmitted diseases. Which statement regarding herpes virus 2 (herpes genitalis) is accurate? a) Transmission of the virus only occurs when a carrier is symptomatic b) Transmission of the virus requires sexual contact. c) The virus is very difficult to kill. d) In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.
d) In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.
Which instruction should be given to a woman newly diagnosed with genital herpes? a) Use a water-soluble lubricant for relief of pruritus. b) Have your partner use a condom when lesions are present. c) Obtain a Papanicolaou (Pap) test every 3 years. d) Limit stress and emotional upset as much as possible.
d) Limit stress and emotional upset as much as possible.
The nurse has been teaching a client with genital herpes how to care for the lesions. Which of the following statements by the client indicates that additional instruction is needed? a) "I'll wear occlusive underwear to prevent transmission of the virus." b) "I'll use a sitz bath to decrease the inflammation of the sores." c) "I can wash the lesions gently with soap and pat them dry with a towel." d) "It's important that I drink plenty of fluids."
a) "I'll wear occlusive underwear to prevent transmission of the virus."
A nurse is caring for a male client with gonorrhea who's receiving ceftriaxone (Rocephin) and doxycycline (Vibramycin). The client asks the nurse why he's receiving two antibiotics. How should the nurse respond? a) "Many people infected with gonorrhea are infected with chlamydia as well." b) "This combination of medications will eradicate the infection faster than a single antibiotic." c) "The combination of these two antibiotics reduces the risk of reinfection." d) "Because there are many resistant strains of gonorrhea, more than one antibiotic may be required for successful treatment."
a) "Many people infected with gonorrhea are infected with chlamydia as well."
Which intervention should a nurse perform after administering an injection of penicillin to a client with an infection? a) Make the client wait at least 30 minutes before leaving the health care facility. b) Encourage the client to breathe deeply. c) Advise the client to massage the injected muscle for 10 minutes. d) Instruct the client to lie flat for 6 hours once home.
a) Make the client wait at least 30 minutes before leaving the health care facility.
The nurse is caring for a female client who has been diagnosed with Neisseria gonorrhoeae. The nurse is aware that if this client had not received treatment, what other serious issues could have resulted from this disease? Select all that apply. a) Infection and scarring of the Fallopian tubes b) Infection of the epididymis c) Increased risk of HIV infection d) Urethral stricture e) Eye infection in an infant born to a woman with this disease
a, c, e
The nurse is providing education to a client who has a positive nontreponemal test (NTT). The client states, "If I've already had a positive test and I know I have syphilis, why do I need to have another test?" How should the nurse respond? a) "An additional test needs to be done to determine which antibiotics you will need." b) "A second test can help confirm the diagnosis, because the NTT can give a false-positive result." c) "This test will help determine of the infection has moved to the third stage." d) "Another test can identify additional sexually transmitted infections you may have acquired."
b) "A second test can help confirm the diagnosis, because the NTT can give a false-positive result."
The nurse is seeing a client who was recently diagnosed with primary syphilis after reporting a painless penis lesion to his health care provider. The client states, "I don't want anyone to find out that I have this disease." How should the nurse respond? a) "It is important that you inform your sexual partners you have this infection. I can sit with you while you make the necessary phone calls." b) "You're test results are reported to a public health department. You will need to share the information about your sexual contacts, and they will notify and screen those people." c) "It is part of my role to contact anyone you have had sexual contact with. Please provide the contact information to me." d) "Your health is personal and confidential. No one outside this room needs to know about your infection."
b) "You're test results are reported to a public health department. You will need to share the information about your sexual contacts, and they will notify and screen those people."
The nurse is assessing a client who states having had "unusual aches" in the muscles and joints. On physical examination, the nurse notes the client has rough, reddish-brown spots on the palms and the soles of the feet. The client reports being infected with a "cold sore" from her partner 1 month ago. What should the nurse anticipate will be the next step in this client's care? a) Administration of pain medication b) A prescription for a nontreponemal test (NTT) c) Obtaining a culture from the rash covered areas d) A prescription for a topical antibiotic
b) A prescription for a nontreponemal test (NTT)
The nurse is providing education about treatment for syphilis to a client who has a confirmed infection. The client states, "Penicillin causes me to have raised, red bumps all over my body. Will I have to take it again?" How should the nurse respond? a) "There are many alternatives to taking antibiotics to treat syphilis." b) "Ceftriaxone is an antibiotic that is also effective in the treatment of this infection." c) "You can be treated with an alternative antibiotic called doxycycline." d) "Topical application of an immune response modifier can be used instead."
c) "You can be treated with an alternative antibiotic called doxycycline."
The nurse educator is planning a health promotion class with a focus on sexually transmitted infections. What points regarding risk factors for chlamydia and gonorrhea should the nurse educator include? Select all that apply. a) "Once treatment has been completed, reinfection with either of these infections is not possible." b) "Women between 28 to 35 years of age are in a unique high risk category for both these infections." c) "Young adults and teenagers are a high risk age group for both these infections." d) "If you have been notified that you have these infections, you are obligated to inform any past sexual partners." e) "Your chances of contracting these infections are higher the more sexual partners you have."
c) "Young adults and teenagers are a high risk age group for both these infections." e) "Your chances of contracting these infections are higher the more sexual partners you have."
Which of the following medications are used to suppress viral load of the HSV-2 infection? a) Metronidazole (Flagyl) b) Clindamycin (Cleocin) c) Acyclovir (Zovirax) d) Penicillin
c) Acyclovir (Zovirax)
The nurse educator, who is teaching a class on sexually transmitted infections, recognizes that teaching has been effective when students indicate which statement is true about the difference between colonization and infection? a) "Colonization and infection are interchangeable terms used to describe a bacterial invasion." b) "Both colonization and infection require treatment with different antibiotics." c) "Colonization results in symptoms such as redness and swelling, infection results in fever." d) "Colonization becomes infection when the host and organism interact."
d) "Colonization becomes infection when the host and organism interact."
A nurse is developing a plan of care for a client experiencing their first outbreak of genital herpes. Which issue would the nurse most likely identify as the priority? a) Hyperthermia related to body's response to an infectious process b) Ineffective coping related to the increased stress associated with the infection c) Deficient knowledge related to the disease and its transmission d) Acute pain related to the development of the genital lesions
d) Acute pain related to the development of the genital lesions
Which term describes the time interval after primary infection when a microorganism lives within the host without producing clinical evidence? a) Susceptibility b) Virulence c) Incubation period d) Latency
d) latency
A patient comes to the clinic with complaints of a painless sore on their lip 2 weeks after they had oral sex with their partner. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in? a) secondary b) latency c) tertiary d) primary
d) primary
A nurse is caring for a male client with gonorrhea. The client asks how he can reduce his risk of contracting another sexually transmitted disease (STD). The nurse should instruct the client to: a) expect to limit the number of sexual partners to less than five over his lifetime. b) ask all potential sexual partners if they have an STD. c) consider intercourse safe if his partner has no visible discharge, lesions, or rashes. d) wear a condom every time he has intercourse.
d) wear a condom every time he has intercourse.
