ch. 5 3.0

What methods are used to confirm a diagnosis of syphilis? Select all that apply. 1 Performing a rapid plasma regain test 2 Obtaining a vaginal swab for gram staining 3 Assessing the patient for the presence of a chancre 4 Obtaining a cervical swab for nucleic acid amplification 5 Obtaining a swab of the lesions for a polymerase chain reaction

1 Performing a rapid plasma regain test 3 Assessing the patient for the presence of a chancre The appearance of a chancre is the first sign of primary syphilis. Rapid plasma regain testing is also used to detect syphilis. Gram staining and nucleic acid amplification are used to diagnose gonorrhea. Polymerase chain reaction testing is used to diagnose genital warts.

A client is returning with a third vaginal infection within a six-month period. During the health assessment, the nurse should ask about the client's use of which products? Select all that apply 1- douches 2- deodorants 3- yogurt 4- herbs

1- douches 2- deodorants

A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis? 1- cottage cheese-like discharge 2- intense itching of the vulva 3- warts in the vulva and labia 4- vaginal odor smelling of fish

4- vaginal odor smelling of fish

On vaginal examination of a 30 year old woman, the nurse documents the following findings: profuse, thin, grayish white vaginal discharge with a "fishy" odor; complaint of pruritis. On the basis of these findings, the nurse expects that this woman has: A. Bacterial vaginosis (BV) B. Candidiasis C. Trichomoniasis D. Gonorrhea

A. Bacterial vaginosis - Most women with BV complain of a characteristic "fishy odor". The discharge is usually profuse, thin, and has a white, gray, or milky color. Some women also have mild irritation or pruritus. The discharge associated with candidiasis is thick, white, and lumpy and resembles cottage cheese. Trichomoniasis may be asymptomatic, but women commonly have a characteristic yellowish to greenish, frothy, mucopurulent, copious, and malodorous discharge. Women with gonorrhea often are asymptomatic. They may have a purulent endocervical discharge, but discharge is usually minimal or absent.

a woman has a thick, white, lumpy, cottage-cheese like discharge, with patches on her labia and in her vagina. She complains of intense pruritis. The provider would order which preparation for treatment? A. Fluconazole B. Tetracycline C. Clindamycin D. Acyclovir

A. Fluconazole. Fluconazole, metronidazole, and clotrimazole are the drugs of choice to treat candidiasis. Tetracycline is used to treat syphilis Clindamycin is used to treat bacterial vaginosis Acyclovir is used to treat genital herpes.

The school nurse is leading a discussion with a group of adolescents on the various sexually transmitted infections (STIs). The nurse determines the session is successful when the students correctly choose which STIs as considered curable with proper treatment? Select all that apply. A. chlamydia B. gonorrhea C. trichomoniasis D. condylomata acuminata E. herpes type II virus

A. chlamydia B. gonorrhea C. trichomoniasis

What body areas might systemic (disseminated) gonorrhea involve? (Select all that apply.) a. Heart b. Eyes c. Meninges d. Skin e. Joints

ANS: a. Heart c. Meninges d.skin e. joints

In preparing a talk about STIs for high school students, the nurse should emphasize which of the following as high-risk groups? (Select all that apply.) a. Multiple or new sex partners b. Consistent barrier use c. Single women d. Women younger than 25 years old

a. Multiple or new sex partners c. Single women d. Women younger than 25 years old (Rationale: High-risk groups include single women, women younger than 25 years, African American women, women with a history of STIs, those with new or multiple sex partners, those with inconsistent use of barrier contraception, and women living in communities with high infection rates.)

Which medications are appropriate to treat vaginal candidiasis? Select all that apply. a. miconazole b. fluconazole c. azithromycin d. gentamicin e. penicillin G benzathine

a. miconazole b. fluconazole

Which information in a patient's medical history is associated with a risk for pelvic inflammatory disease (PID)? Select all that apply. 1 Smoking 2 Age >30 years 3 History of chlamydia 4 Multiple sexual partners 5 Intrauterine device (IUD) in place since last year

1 Smoking 3 History of chlamydia 4 Multiple sexual partners Having had a previous sexually transmitted infection like chlamydia, multiple sexual partners, and smoking put a patient at greater risk for PID. Being younger than 26 years and a recently placed IUD (within the previous 3 weeks not in place for a year) are additional risk factors for PID.

A woman comes to the clinic reporting vaginal discharge. The nurse suspects trichomoniasis based on which symptoms? Select all that apply. 1- urinary frequency 2- yellow/green discharge 3- joint pain 4- blister-like lesions 5- muscle aches

1- urinary frequency 2- yellow/green discharge

What manifestations does the nurse expect to find on assessment in a patient with gonorrhea? Select all that apply. 1. Dysuria 2. Rectal bleeding 3. Dry, chapped lips 4. Blisters in the throat 5. Green vaginal discharge

1. Dysuria 2. Rectal bleeding 4. Blisters in the throat 5. Green vaginal discharge The patient with gonorrhea can have blisters in the throat, green vaginal discharge, dysuria, and rectal bleeding. The patient also has reddened throat, ulcerated lips, and tender gingivae. Though the infection can be asymptomatic, men can notice dysuria if symptoms are present. Dry, chapped lips are not a common symptom of gonorrhea.

When developing a teaching plan for an 18 year old client who asks about treatments for sexually transmitted infections, the nurse should explain that: A. Acyclovir (Zovirax) can be used to cure herpes genitalis B. Chlamydia trachomatis infections are usually treated with penicillin C. Ceftriaxone sodium (Rocephin) may be used to treat Neisseria gonorrhoeae infections. D. Metronidazole (Flagyl) is used to treat condylomata acuminata.

C. Ceftriaxone sodium (Rocephin) may be used to treat N. gonorrhoeae infections and is commonly combined with doxycycline hyclate (Vibramycin). Both the client and her partner should be treated if gonorrhea is present.

Examination of a primigravid client having increased vaginal secretions since becoming pregnant reveals clear, highly acidic vaginal secretions. The client denies any itching or burning. The nurse interprets these findings as a response related to which of the following? A. A decrease in vaginal glycogen stores. B. Development of a sexually transmitted infection. C. Prevention of expulsion of the cervical mucus plug D. Control of the growth of pathologic bacteria

D. An increase in clear, highly acidic vaginal secretions is a normal finding during pregnancy that aids in controlling the growth of pathologic bacteria. Vaginal secretions increase because of the influence of estrogen secretion and increased vaginal and cervical vascularity. The highly acidic nature of the vaginal secretions is caused by the action of Lactobacillus acidophilus, which increases lactic acid content of the secretions. The increased acidity helps to make the vagina resistant to bacterial growth.

A nurse expects to find which manifestations in the male patient who has both Chlamydia and gonorrhea? a. Painful urination and purulent urethral discharge b. A single, firm painless open sore on the shaft of the penis c. Red superficial vesicles on the shaft of the penis d. A single or a cluster of wartlike growth in the anal-rectal area e. watery white penile discharge and dyspareunia

a. Painful urination and purulent urethral discharge

A 24-year-old female client presents with various complaints. She admits to having unprotected sexual intercourse. Which of the following findings would indicate a possible PID? (Select all that apply.) a. Cervical motion tenderness b. Constipation c. Adnexal tenderness d. Lower abdominal tenderness

a. Cervical motion tenderness c. Adnexal tenderness d. Lower abdominal tenderness (Rationale: Minimal criteria of PID as established by the CDC include lower abdominal tenderness, adnexal tenderness, and cervical motion tenderness.)

Which manifestations are characteristic of the late or tertiary stage of syphilis (select all that apply)? a. Heart failure b. Tabes dorsalis c. Saccular aneurysms d. Mental deterioration e. Generalized cutaneous rash f. Destructive skin, bone, and soft tissue lesions

a. Heart failure b. Tabes dorsalis c. Saccular aneurysms d. Mental deterioration f. Destructive skin, bone, and soft tissue lesions In the tertiary (or late) stage of syphilis there can be gummas (chronic destructive lesions), cardiovascular problems (heart failure, aneurysms, valve insufficiency), and neurosyphilis manifestations (mental deterioration, tabes dorsalis, and speech disturbances). Generalized cutaneous rash occurs in the secondary stage of syphilis, a few weeks after the chancre appears.

The client is single, admits to not using condoms during sexual intercourse, and has had multiple partners over the past year. Which of the following symptoms would alert the nurse to a possible gonorrheal infection? (Select all that apply.) a. Mild sore throat b. Dysuria c. Abnormal uterine bleeding d. Abnormal vaginal discharge

a. Mild sore throat b. Dysuria c. Abnormal uterine bleeding d. Abnormal vaginal discharge (Rationale: All of the above complaints are possible symptoms of gonorrheal infection.)

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. 1- "The virus remains quiet until a stressful event occurs to reactivate it." 2- "Your baby is protected from this infection by the placenta." 3- "Many recognize they have the infection and seek treatment immediately." 4- "Infections may be transmitted by individuals unaware that they have it." 5- "Transmission is through contact of infected mucous membranes."

1- "The virus remains quiet until a stressful event occurs to reactivate it." 4- "Infections may be transmitted by individuals unaware that they have it." 5- "Transmission is through contact of infected mucous membranes."

At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include? 1- This infection is the most common infectious cause of infertility. 2- This infection is lifelong as it cannot be treated with medication. 3- Antiviral drug regimes will cure this infection. 4- The new recombinant human papillomavirus vaccine will prevent the infection.

1- This infection is the most common infectious cause of infertility.

A woman with a history of genital lesions caused by herpes simplex virus (HSV) has been admitted to the labor unit at 39 weeks' gestation. She said she was given medicine prophylactically a few weeks ago to prevent lesions at the time of birth. Which medication is safe to give to a pregnant women with HSV? 1- acyclovir 2- benzathine penicillin 3- chloroquine 4- mefloquine

1- acyclovir

A pregnant client is diagnosed with chlamydia and is to receive antimicrobial therapy. Which drug would the nurse least likely expect to be prescribed? 1- azithromycin 2- erythromycin 3- ofloxacin 4- levofloxacin

1- azithromycin

Which medications are appropriate to treat chlamydia trachomatis? Select all that apply. 1- azithromycin 2- ofloxacin 3- valacyclovir 4- doxycycline 5- acyclovir

1- azithromycin 2- ofloxacin 4- doxycycline

What is the gold standard for HSV diagnosis? 1- culture 2- shave biopsy 3- excisional biopsy 4- punch biopsy

1- culture

A nurse is assessing a client who has a history of pelvic inflammatory disease (PID). The nurse would be alert for which complication? Select all that apply. 1- ectopic pregnancy 2- pelvic abscess 3- fibrosis 4- inguinal lymphadenopathy

1- ectopic pregnancy 2- pelvic abscess 3- fibrosis

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? 1- latency 2- secondary 3- primary 4- tertiary

1- latency

A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate a possible PID? Select all that apply. 1- lower abdominal tenderness 2- adnexal tenderness 3- cervical motion tenderness 4- constipation

1- lower abdominal tenderness 2- adnexal tenderness 3- cervical motion tenderness

A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider most likely prescribe? 1- metronidazole 2- acyclovir 3- clotrimazole 4- penicillin G

1- metronidazole

A nurse is assessing a client diagnosed with pelvic inflammatory disease (PID). Which finding would the nurse most likely assess? Select all that apply. 1- oral temperature of 102°F (39°C) 2- painful urination 3- right upper quadrant pain 4- tenderness with cervical motion 5- negative pregnancy history 6- clear vaginal discharge

1- oral temperature of 102°F (39°C) 2- painful urination 4- tenderness with cervical motion 5- negative pregnancy history

What is the medication of choice for early syphilis? 1- penicillin G benzathine 2- doxycycline 3- tetracycline 4- ceftriaxone

1- penicillin G benzathine

A patient with general paresis has a medical history that shows a positive Venereal Disease Research Laboratory test 10 years ago without follow-up treatment and a likely diagnosis of tertiary syphilis. In addition to the paresis, what other manifestations are found in this stage of the disease? Select all that apply. 1 Sore throat 2 Hearing loss 3 Low-grade fever 4 Aortic aneurysm 5 Lesions on the oral mucosa 6 Hard, smooth, weeping lesion 7 Rash on palmar or plantar surfaces

2 Hearing loss 4 Aortic aneurysm 5 Lesions on the oral mucosa Tertiary syphilis manifestations include hearing loss, aortic aneurysm, and oral mucosal lesions. Secondary syphilis manifestations include a rash on the palms and soles, low-grade fever, and sore throat. Primary syphilis manifestations include a hard, smooth weeping lesion known as a chancre.

A 19-year-old female client has been diagnosed with pelvic inflammatory disease (PID) caused by untreated gonorrhea. Which instructions should the nurse offer when caring for the client? Select all that apply. 1- Use an intrauterine device (IUD). 2- Avoid douching vaginal area. 3- Complete the antibiotic therapy. 4- Increase fluid intake. 5- Limit the number of sex partners.

2- Avoid douching vaginal area. 3- Complete the antibiotic therapy. 5- Limit the number of sex partners.

Which finding would the nurse expect in a client with bacterial vaginosis? 1- vaginal pH of 3 2- fish-like odor of discharge 3- yellowish-green discharge 4- cervical bleeding on contact

2- fish-like odor of discharge

When preparing a teaching plan for a female adolescent with a sexually transmitted infection (STI), the nurse plans to address the fact that the adolescent is at increased risk for cervical cancer. Which STI would the adolescent most likely have? 1- genital warts 2- genital herpes 3- syphilis 4- chlamydia

2- genital herpes

A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply. 1- 29 years of age 2- multiple sex partners 3- intrauterine contraceptive device inserted 3 weeks ago 4- vaginal douching approximately once a week 5- residence in a suburban area

2- multiple sex partners 3- intrauterine contraceptive device inserted 3 weeks ago 4- vaginal douching approximately once a week

A primigravid client at 38 weeks' gestation is admitted to the labor suite in active labor. The client's physical assessment reveals a chlamydial infection. The nurse explains that if the infection is left untreated, the neonate may develop which of the following? A. conjunctivitis B. heart disease C. harlequin sign D. brain damage

A. conjunctivitis Conjunctivitis is a common complication of neonates who are born to mothers with untreated chlamydial infection. Neonatal pneumonia is another condition associated with chlamydial infection of the mother.

After a preparation for parenting class session, a pregnant client tells the nurse that she has had some yellow-gray frothy vaginal discharge and local itching. The nurse's best action is to advise the client to do which of the following? A. Use an over the counter cream for yeast infections B. Schedule an appointment at the clinic for an examination C. Administer a vinegar douche under low pressure D. Prepare for preterm labor and delivery.

B. Schedule an appointment at the clinic for an examination Increased vaginal discharge is normal during pregnancy, but yellow-gray frothy discharge with local itching is associated with infection (Trichomonas vaginalis). The client's symptoms must be further assessed by a health professional because the client needs treatment for this condition. T. vaginalis infection is commonly treated with metronidazole (Flagyl). However, this drug is not used in the first trimester. In the first trimester, the typical treatment is topical clotrimazole. Although a yeast infection is assoiciated with vainal itching, the vaginal discharge is cheese-like.

A nurse is conducting a home visit with a mother and her 1 week old infant, who is at risk for acquired neonatal congenital syphilis. Which finding specific to this disease does the nurse look for while assessing the infant? A. Diarrhea B. Hypothermia C. Vigorous feeding D. A copper-colored rash

D. A copper-colored rash Signs of congenital neonatal syphilis- including poor feeding, slight hyperthermia, and "snuffles" (copious clear serosanguinous mucous drainage from the nose)- may be nonspecific at first. By the end of the first week, however, a copper-colored maculopapular dermal rash is characteristically observed on the palms and soles, in the diaper area, and around the mouth and anus.

A primigravid client at 8 weeks' gestation tells the nurse that since having had sexual relations with a new partner 2 weeks ago, she has noticed flu-like symptoms, enlarged lymph nodes, and clusters of vesicles on her vagina. The nurse refers the client to a primary health care provider because the nurse suspects which of the following sexually transmitted infections? A. Gonorrhea B. Chlamydia trachomatis infection C. Syphilis D. Herpes genitalis

D. Herpes genitalis The client is reporting symptoms typically associated with herpes genitalis. Some women have no symptoms of gonorrhea. Others may experience vaginal itching and a thick, purulent vaginal discharge. C. trachomatis infection in women is commonly asymptomatic, but symptoms may include a yellowish discharge and painful urination. The first symptom of syphilis is a painless chancre.

The nurse is developing a teaching plan for a client diagnosed with genital herpes simplex (HSV). Which would the nurse include? Select all that apply. a. The management of genital herpes includes antiviral therapy. b. Little can be done to control the occurrences of infection. c. The need to use good hand washing technique to prevent spread. d. Educate the client to abstain from sexual activity until HSV lesions resolve. e. The goal is for recurrences to be less frequent over time. f. The management of genital herpes includes antibiotic therapy.

a. The management of genital herpes includes antiviral therapy. c. The need to use good hand washing technique to prevent spread. d. Educate the client to abstain from sexual activity until HSV lesions resolve. e. The goal is for recurrences to be less frequent over time.

Which patients meet the criteria for Chlamydia screening? (Select all that apply.) a. A 40-year-old woman who is sexually active and uses barrier protection consistently b. A 15-year-old female woman who is sexually active with one partner c. A 22-year-old woman who is sexually active and uses barrier protection inconsistently d. A 23-year-old woman who has had four sexual partners in the last 3 months e. A 34 year-old woman who uses barrier protection inconsistently with multiple sexual partners f. A 36-year-old pregnant woman making the first prenatal visit

b. A 15-year-old female woman who is sexually active with one partner c. A 22-year-old woman who is sexually active and uses barrier protection inconsistently d. A 23-year-old woman who has had four sexual partners in the last 3 months e. A 34 year-old woman who uses barrier protection inconsistently with multiple sexual partners f. A 36-year-old pregnant woman making the first prenatal visit

What are characteristics of a herpes simplex virus infection? (select all that apply) a. Treatment with acyclovir can cure genital herpes .b. Herpes simplex virus type 2 (HSV-2) is capable of causing only genital lesions. c. Recurrent symptomatic genital herpes may be precipitated by sexual activity and stress. d. To prevent transmission of genital herpes, condoms should be used when lesions are present. e. The primary symptom of genital herpes is painful vesicular lesions that rupture and ulcerate.

c. Recurrent symptomatic genital herpes may be precipitated by sexual activity and stress. e. The primary symptom of genital herpes is painful vesicular lesions that rupture and ulcerate. Sexual activity and stress may precipitate the recurrence of genital herpes symptoms of painful vesicular lesions that rupture and ulcerate. Acyclovir only decreases recurrences of genital herpes. Herpes simplex virus type 2(HSV-2) may cause oral or genital lesions. Prevention of the spread of genital herpes is best done with avoidance of sexual activity when lesions are present.