Ch. 41 Pathophysiology

A female college student is distressed at the recent appearance of genital warts, an assessment finding that her care provider has confirmed as attributable to human papillomavirus (HPV) infection. Which of the following information should the care provider give the client? A) "There is a chance that these will clear up on their own without any treatment." B) "It's important to start treatment soon, so I will prescribe you pills today." C) "Unfortunately, this is going to greatly increase your chance of developing pelvic inflammatory disease." D) "I'd like to give you an HPV vaccination if that's okay with you."

A) "There is a chance that these will clear up on their own without any treatment."

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that: A) A large percentage (70%) of those infected experience no symptoms of the disease. B) The lesions (LSILs) occur on the cervix and can only be detected by a Pap test. C) Lesions take a long time to incubate and the small papules are usually located inside the vagina. D) The organism spreads upward to the prostate gland in males and fallopian tubes in females.

A) A large percentage (70%) of those infected experience no symptoms of the disease.

A couple presents to an infertility clinic. The health care provider will focus testing on which of the following sexually transmitted infections (STIs) that is very damaging to the reproductive system but rarely exhibits symptoms of infection? A) Chlamydial infection B) Herpes simplex virus infection C) Gonorrhea D) Syphilis

A) Chlamydial infection

A male diagnosed with gonorrhea will likely complain of which of the following clinical manifestations? Select all that apply. A) Creamy, yellow discharge B) Pain in the urethra with urination C) Difficulty starting a stream of urine D) "Fish"-smelling discharge from the penis E) Diffuse pelvic pain

A) Creamy, yellow discharge B) Pain in the urethra with urination

A client presents to a STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI? A) Gonorrhea B) Chlamydial infection C) Human papillomavirus infection D) Genital herpes simplex virus infection

A) Gonorrhea

A female client presents 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: A) High-dose cefixime given in a single dose B) Ten-day supply of Flagyl C) Doxycycline over the course of 1 week D) No treatment until after the baby is born

A) High-dose cefixime given in a single dose

A 22-year-old client has presented to her primary care provider for her scheduled Pap smear. Abnormal results of this diagnostic test may imply infection with: A) Human papillomavirus (HPV) B) Chlamydia trachomatis C) Candida albicans D) Trichomonas vaginalis

A) Human papillomavirus (HPV)

Men whose sexual partners have been diagnosed with Trichomonas vaginalis will likely exhibit: A) No symptoms of infection B) Copious amounts of frothy discharge from the penis C) Numerous pustules on the penal shaft D) Redness and pain at the urethral meatus

A) No symptoms of infection

A woman who has developed vulvovaginal candidiasis will likely go to her health care provider complaining of: Select all that apply. A) Redness B) Edema C) Frothy, foul-smelling discharge D) Painful urination E) Pustules on labia

A) Redness B) Edema D) Painful urination

An elderly female has slowly developed dementia and loss of vision. She is being evaluated for nursing home placement. Routine admission blood work reveals that the client tested positive for which STI associated with her current symptoms? A) Tertiary syphilis B) Chlamydial C) Gonorrhea D) Human papillomavirus infection

A) Tertiary syphilis

Which of the following assessment questions is most likely to address the causation of a woman's new case of candidiasis? A) "Have you recently begun a new sexual relationship?" B) "Have you been on antibiotics recently?" C) "Have you noticed any new growths on your vagina in recent months?" D) "Do you use condoms during sexual activity?"

B) "Have you been on antibiotics recently?"

A female receives a PAP smear result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse will emphasize the need for continued follow-up since HPV is directly associated with: A) Uterine cancer B) Cervical dysplasia C) Genital herpes lesions D) Urinary tract infections

B) Cervical dysplasia

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation? A) Uterine cancer B) Fallopian tube damage C) Amenorrhea D) Vaginal adhesions

B) Fallopian tube damage

When educating a teenager diagnosed with genital herpes (herpes simplex virus type 2, HSV-2), the health care provider needs to inform her of the importance of careful follow-up since she may be at greater risk for future development of: A) Cervical cancer B) HIV transmission C) Localized necrosis D) Urinary tract infection

B) HIV transmission

The physiological reasoning behind giving acyclovir, an antiviral medication, to a client diagnosed with genital herpes would include the fact that these drugs: A) Attack the cell wall and totally destroy the virus, thus curing the client B) Interfere with viral DNA replication, which can decrease the frequency of recurrences C) Will prevent the organism from developing a resistance to the treatment protocols D) Can be obtained without a prescription and usually applied topically

B) Interfere with viral DNA replication, which can decrease the frequency of recurrences

A client with herpes simplex virus (HSV) presents to the clinic stating, "I can stop taking my drugs because I'm cured. My lesions are gone." The health care provider bases his or her response knowing the pathophysiology behind the disappearance of HSV symptoms infection relates to: A) Replication of the squamous epithelium B) Periods of latency in the nervous system C) Inhibition of cell-mediated immunity D) Production of exotoxins

B) Periods of latency in the nervous system

A client presents to the GYN clinic complaining of large amounts of frothy yellow-green discharge that smells very foul. Immediately, the health care provider is thinking this client most likely has: A) Candidiasis B) Trichomoniasis C) Bacterial vaginosis D) Chlamydial infection

B) Trichomoniasis

The most prevalent vaginal infection to be spread through sexual contact is: A) Candidiasis B) Trichomoniasis C) Vulvovaginitis D) Bacterial vaginosis

B) Trichomoniasis

A client presents to the out-client clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of: A) Trichomonas vaginalis B) Chlamydial C) Bacterial vaginosis D) Syphilis

C) Bacterial vaginosis

Which of the following phenomena is thought to underlie the decreased reported incidence of some sexually transmitted infections (STIs)? A) Increased knowledge of the correct use of condoms B) Increased public funding for health promotion activities C) Decreased reporting of cases of certain STIs D) Decreased numbers of sexual partners among young adults

C) Decreased reporting of cases of certain STIs

Which of the following signs and symptoms is most clearly suggestive of primary genital herpes in a male client? A) Presence of purulent, whitish discharge from the penis B) Emergence of hard, painless nodules on the shaft of the penis C) Itching, pain, and the emergence of pustules on the penis D) Production of cloudy, foul-smelling urine

C) Itching, pain, and the emergence of pustules on the penis

A sexually transmitted infection that is caused by a microorganism with two morphologically distinct forms is: A) Chancroid B) Candidiasis C) Trichomonas vaginalis D) Chlamydia

D) Chlamydia

While in its dormant state, herpes simplex virus resides and replicates in the: A) Local lymph nodes B) Subcutaneous tissue C) Mucous membrane D) Dorsal root ganglia

D) Dorsal root ganglia

Which of the following events is associated with the primary stage of syphilis? A) Development of gummas B) Development of central nervous system lesions C) Palmar rash D) Genital chancres

D) Genital chancres

Of the following STIs, for which STI should the nurse anticipate a prescription for antibiotics such as tetracycline or doxycycline since this infection will respond to antibiotic treatment? A) Human papillomavirus (HPV) infection B) Herpes simplex virus type 2 (HSV-2) infection C) Candidiasis D) Lymphogranuloma venereum (LGV)

D) Lymphogranuloma venereum (LGV)