Chapter 46

Which assessment question is most likely to address the causation of a woman's new case of candidiasis?

"Have you been on antibiotics recently?"

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate the client by making which statement?

"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."

A client states to the nurse "How could I be sick! I feel fine!" The client has a sexually transmitted infection. What is the nurse's best response?

"Often, sexually transmitted infections are asymptomatic."

After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?

6 weeks to 8 months

Within how many days it is important to test anyone who has had sex with an individual who tests positive for gonorrhea?

60

Which client is at highest risk of developing trichomoniasis?

A client who is sexually active

Which information is essential for a nurse to include in the teaching plan for a client receiving metronidazole for trichomoniasis?

Abstinence is recommended until the therapy is completed.

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 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of medication is most likely to resolve her symptoms?

An azole antifungal agent

A nurse is caring for a client being treated for chlamydial infection. Which medication would the nurse anticipate being prescribed?

Azithromycin

The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of:

Blindness

Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has:

C. albicans

A female receives a Papanicolaou (Pap) test result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse would emphasize the need for continued follow-up to monitor for which potential complication?

Cervical dysplasia

Which sexually transmitted infection exists in two morphologically distinct forms, elementary and reticulate bodies?

Chlamydia

The nurse is reviewing the uses and side effects of azithromycin. For which infection is azithromycin the antibiotic of choice?

Chlamydial

A client develops Reiter's syndrome. Which symptoms will the nurse assess? Select all that apply.

Conjunctivitis Pain in the joints

Which event is associated with the primary stage of syphilis?

Correct response: Genital chancres

When is syphilis highly contagious?

During its primary stage

A female client presents at 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:

High-dose cefixime given in a single dose

Which statement(s) is true concerning syphilis? Select all that apply.

It is a reportable systemic sexually transmitted infection (STI). The disease is more prevalent in men. Primary spread of the disease is through direct contact with lesions.

An older adult 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?

Tertiary syphilis

What is the primary reason that the nurse urges clients to be seen by their health care provider when they have genital warts?

To be informed of the risk of premalignant and malignant changes

A client's presentation and recent sexual history are suggestive of gonorrhea. This suspected diagnosis can best be confirmed by:

culturing a sample of the client's penile discharge.

A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?

"I will take the acyclovir every 8 hours for the next week."

A client is diagnosed with granuloma inguinale. Which question should the nurse ask the client?

"Have you traveled outside of the country recently?"

A client asks how his condition, Condylomata acuminata, is caused. What is the nurse's best response?

"Human papillomavirus (HPV) is the cause of your condition."

Bacterial vaginosis is the most common vaginal infection seen by health care providers. What is the predominant symptom of bacterial vaginosis?

Grayish white discharge with a fishy odor

A female client is found to have genital warts during a routine pelvic examination. Which sexually transmitted infection will the nurse prepare to test for?

Human papillomavirus

A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in.

Secondary

A 20-year-old female comes to the clinic for an annual exam. She reports having unprotected sexual intercourse with several men over the last year. Blood tests reveal that she is positive for human papillomavirus. The nurse teaches the client about which complication that may occur because of the infection?

Cervical cancer

Which assessment finding correlates to advanced (tertiary) syphilis?

Dementia

While in its dormant state, what structure provides residence for herpes simplex virus to allow for replication?

Dorsal root ganglia

Which conditions may have been caused by herpes viruses? Select all that apply.

Genital ulcers Chicken pox Epstein-Barr syndrome

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

A female client is diagnosed with chlamydia during a routine pelvic examination. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?

My partner will need to take antibiotics at the same time I do."

An male client presents with urethral itching, burning, pain, and a creamy, yellow discharge following unprotected sex with a new partner 3 days ago. The nurse anticipates the client to be diagnosed with which sexually transmitted infection?

Neisseria gonorrhoeae

A client with herpes simplex virus (HSV) states, "I can stop taking my drugs because I'm cured. My lesions are gone." Knowing the pathophysiology behind the disappearance of HSV symptoms, the health care provider suspects the client is experiencing which phase of infection?

Periods of latency in the nervous system

Select the most reliable test to diagnose syphilis.

Serology

In a client suspected of having gonorrhea with active symptoms, what does the nurse tell the client about confirming the diagnosis?

Since you have discharge, we can perform a culture."

Which assessment finding helps the nurse confirm that the client has genital warts?

Soft, raised lesions on external genitalia

A client asks why his partners need to know that he was diagnosed with syphilis. What is the nurse's best response?

They will have to be treated prophylactically."

A client has been diagnosed with candidiasis. Which symptom was present to diagnose this condition?

Thick white secretions

A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women?

Trichomoniasis

A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice.

Azithromycin

A client presents to an 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?

Gonorrhea

Which statement about gonorrhea is correct?

Gonorrhea is a reportable sexually transmitted infection.

Select the treatment of choice for syphilis.

Long-acting penicillin in a single injection

For which STI should the nurse anticipate a prescription for antibiotics such as erythromycin or doxycycline since this infection will respond to antibiotic treatment?

Lymphogranuloma venereum (LGV)

After being diagnosed with bacterial vaginosis, the client is at risk for developing which potential complications? Select all that apply.

Pelvic inflammatory disease (PID) Preterm labor Postpartum endometritis Premature rupture of membranes

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that:

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

Select the correct statement regarding herpes simplex virus.

Only two strains of the virus are considered sexually transmittable.

Select the condition that contributes to the risk of infertility in males.

Trichomoniasis

Which instruction is essential for the nurse to include in the care plan for a client with herpes simplex virus-1 (HSV-1)?

"This disease is transmitted by oral secretions."

A male client is diagnosed with gonococcal urethritis. He tells the nurse he had recent sexual contact with a woman but states she did not appear to have any disease. What is the nurse's best response to the client?

"Women may not know they have gonorrhea because they may not have symptoms."

A client asks the nurse how he will know if he has syphilis after sexual contact. What is the nurse's best response?

"You will develop a sore on your penis or scrotum."

A nurse is attempting to culture a lesion to determine if a client has genital herpes. What is the nurse's best action?

Attempt to culture a lesion as soon as it develops.

A client presents to the outpatient 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:

Bacterial vaginosis

A sexually active female presents to the clinic with white copious vaginal discharge, itch, swelling, and dysuria. The nurse anticipates the client will be treated for the overgrowth of which organism?

Candida albicans

A couple presents to an infertility clinic. The health care provider will focus testing on which sexually transmitted infection (STI) that is very damaging to the reproductive system but rarely exhibits symptoms of infection?

Chlamydial infection

A 22-year-old female client states she has vaginal itching with pain and small vesicles that appear on the vagina when she is stressed. The health care provider suspects the client most likely is experiencing which condition?

Genital herpes

A male reports urethral pain and a creamy yellow, bloody discharge from the penis. The provider suspects the client has which sexually transmitted infection?

Gonorrhea

A nurse is assessing a male who is reporting nonspecific symptoms of prostate and periurethral gland pain. Which characteristic discharge makes the nurse suspect gonorrhea?

Purulent exudates

A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which sexually transmitted infection?

Syphilis