Chapter 5 PrepU
A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response? "The health care provider will prescribe antibiotics to cure this infection." "This can be cured with medications such as the recombinant human papillomavirus quadrivalent vaccine." "The lumps on your cervix can be cured by cryosurgery." "There is currently no medical treatment to cure HPV."
"There is currently no medical treatment to cure HPV." - It is a lifelong recurrent viral disease treated but not cured with medical treatment. Immunization regimes such as the recombinant human papillomavirus quadrivalent vaccine are for HPV prevention not cure. Cryosurgery will eliminate HPV warts but not cure it. Antibiotics will not be effective for a virus.
A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity? encouraging treatment for genital warts educating about HPV testing in women over age 30 teaching about the importance of regular Papanicolaou test administering HPV vaccine
administering HPV vaccine
A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia? 50% 70% 90% 30%
70%
A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? dry, hacking cough burning on urination painless chancre diffuse skin rash
burning on urination - Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the organisms enter the body, such as on the genitalia, anus, or lips.
The nurse cares for a client recently diagnosed with syphilis who has no known drug allergies. Which medication will the nurse expect the health care provider to prescribe? benzathine penicillin G miconazole doxycycline metronidazole
benzathine penicillin G
What is the medication of choice for early syphilis? ceftriaxone penicillin G benzathine doxycycline tetracycline
penicillin G benzathine
A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis? cottage cheese-like discharge warts in the vulva and labia vaginal odor smelling of fish intense itching of the vulva
vaginal odor smelling of fish - Bacterial vaginosis causes a "stale fish" vaginal odor. Cottage cheese-like discharge is seen in candidiasis and not in bacterial vaginosis, in which the discharge is thin and gray-white. Intense itching of the vulva is associated with candidiasis, not vaginosis. Warts in the vulva and labia are seen in human papillomavirus infection, not in vaginosis.
A school health nurse is presenting information on sexually transmitted infections (STIs) to a high school class. The nurse feels confident that learning has taken place when the students report: most adolescents will seek early treatment to cure the STI. female adolescents are more susceptible to STIs due to their anatomy. genital cancer is associated with the STI genital herpes. adolescent females make up more than three-quarters of HIV diagnosis.
female adolescents are more susceptible to STIs due to their anatomy.
What is the most common viral infection? trichomoniasis human papillomavirus (HPV) chlamydia gonorrhea
human papillomavirus (HPV)
Which medication is the most effective treatment for trichomoniasis? penicillin G benzathine doxycycline azithromycin metronidazole
metronidazole - The most effective treatment for trichomoniasis is metronidazole and tinidazole. Penicillin G benzathine is used for syphilis. Doxycycline and azithromycin are used in the treatment of chlamydia.
A nurse is preparing for a class discussion on sexually transmitted infections (STIs) to be given at a local high school. Which would the nurse include as a discussion priority? College students are more likely to engage in risky sexual behaviors leading to an STI. Adults aged 21 to 30 years are at greater risk of contracting an STI. Adolescents and young adults are the largest age group diagnosed with an STI. More single mothers are diagnosed with an STI causing sterility.
Adolescents and young adults are the largest age group diagnosed with an STI. - Individuals aged 15 to 24 years represent almost half of all cases of new STIs. Four in ten sexually active teen girls, not single mothers, have an STI that can cause infertility. In the United States, teens who are sexually active, not college-aged students, experience high rates of STIs.
A nurse is required to assess a client reporting unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess? dysfunctional uterine bleeding heavy yellow discharge erythema in the vulvovaginal area characteristic "stale fish" odor
characteristic "stale fish" odor
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common STI in the United States would the nurse expect to include? syphilis chlamydia gonorrhea genital herpes
chlamydia - Chlamydia is the most common and fastest-spreading bacterial STI in the United States, with 2.8 million new cases occurring each year. Gonorrhea is the second most frequently reported communicable disease in the U.S. The incidence of syphilis had been increasing for the past 6 years. One in five people older than age 12 is infected with the virus that causes genital herpes.
When developing a program for STI prevention, which action would need to be done first? increasing the availability of resources educating on how to promote sexual health getting individuals to change their behaviors interfering with the mode of transmission
educating on how to promote sexual health
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? "I should rub rather than scratch in response to itching." "I will wear loose cotton underwear." "I can pour hydrogen peroxide and water over my lesions." "I will apply a water-based lubricant to my lesions."
"I will wear loose cotton underwear." - Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. Lesions should not be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. The use of hydrogen peroxide and water on lesions is not recommended.
A client presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole. What is the paramount nursing intervention in discharge planning? Instruct the client not to drink alcohol with this treatment. Advise the client to take medication with a glass of milk. Counsel the client to refrain from sex for one week. Reassure the client further STI testing is not indicated.
Instruct the client not to drink alcohol with this treatment. - While counseling to abstain from sex for one week is appropriate, the most important intervention is counseling to avoid alcohol during metronidazole treatment. Alcohol consumption while taking metronidazole creates a severe gastrointestinal reaction of nausea, vomiting, and flushing. Metronidazole does not have to be taken with milk, and further STI testing is indeed recommended with the diagnosis of an STI.
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? painful ejaculation hematuria erectile dysfunction dysuria
dysuria - A male with the diagnosis of chlamydia will first experience dysuria as the primary symptom. The other symptoms listed do not correlate to men with the diagnosis of chlamydia.
A client diagnosed with human papillomavirus (HPV) asks the nurse if she will be at risk for developing cervical cancer. The nurse best responds by making which statement? "Cervical cancer is typically caused by the herpes simplex virus, not the human papillomavirus (HPV)." "You will likely contract cervical cancer so frequent screening testing will be very important." "If you get the human papillomavirus (HPV) vaccine you will no longer be at risk for developing cervical cancer." "Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer."
"Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer." - The human papillomavirus (HPV) is associated with causing both genital warts and cervical cancer. There is not enough information to definitively indicate that this client will or will not contract cancer. The herpes simplex virus is associated with shingles and genital herpes, not cervical cancer. The HPV vaccine prevents certain strains of HPV, but does not decrease the risk for cervical cancer if the person has already been exposed to the virus.
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? genital herpes syphilis chlamydia genital warts
Genital warts - Genital warts or condylomata acuminata is caused by the human papillomavirus (HPV), which places the adolescent at increased risk for cervical cancer. An increased risk for cervical cancer is not associated with genital herpes. An increased risk for cervical cancer is not associated with syphilis. An increased risk for cervical cancer is not associated with chlamydia.
A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge? chlamydia syphilis candidiasis gonorrhea
candidiasis - Although vaginal discharge can occur with any STI, genital/vulvovaginal candidiasis is one of the most common causes of vaginal discharge. It is also referred to as yeast, monilial, and a fungal infection. It is not considered an STI because candida is a normal constituent in the vagina and becomes pathogenic only when the vaginal environment becomes altered.
A parent at an educational session on sexually transmitted infections (STIs) asks the nurse if there are vaccines available to prevent STIs. How should the nurse respond? "Researchers have developed a vaccine to prevent human immunodeficiency virus." "At present there are no vaccines available to prevent STIs." "A vaccine has been approved to prevent the human papillomavirus." "There is a vaccine to prevent herpes simplex virus."
"A vaccine has been approved to prevent the human papillomavirus." - Vaccine-preventable STIs can be effectively prevented through preexposure vaccination. Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. The only vaccines currently available are for prevention of hepatitis A virus, hepatitis B virus, and HPV infection. Vaccination efforts focus largely on integrating the use of these available vaccines into STI prevention and treatment activities.
A community health nurse is conducting an educational session at a local community center on sexually transmitted infections (STIs). The nurse considers the session successful when participants identify which statement as correct? "At least antibiotics will cure a sexually transmitted infection." "STIs can't be transmitted through oral sexual intercourse." "Human papillomavirus is the cause of essentially all cases of cervical cancer." "Gonorrhea and syphilis are an infection seen only in men."
"Human papillomavirus is the cause of essentially all cases of cervical cancer." - Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer, which is the fourth most common cancer in women in the United States. Up to 95% of cervical squamous cell carcinomas and nearly all preinvasive cervical neoplasms are caused by the HPV. Antibiotics will only cure those STIs caused from a bacterial infections. A viral STI infection is a lifetime infection. Gonorrhea and syphilis affects both men and women. Sexually transmitted infections (STIs) are infections of the reproductive tract caused by microorganisms transmitted through oral sexual intercourse.
A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment? Tetracycline Fluconazole Acyclovir Clindamycin
Fluconazole -Treatment of candidiasis includes miconazole cream or suppository, clotrimazole tablet or cream, terconazole cream or intravaginal suppository, or fluconazole oral tablet. Most of these medications are used intravaginally in the form of a cream, tablet, or suppositories for 3 to 7 days. If fluconazole is prescribed, a 150-mg oral tablet is taken as a single dose. The other medications would not be appropriate.
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? copper-colored macules on the palms and soles that appeared after a brief fever patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas a painless genital ulcer that appeared about 3 weeks after unprotected sex one or more flat, wartlike papules in the genital area that are sensitive to touch
a painless genital ulcer that appeared about 3 weeks after unprotected sex - A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts.
A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease? Educate teenagers to delay onset of sexual activity. Educate about risks of injecting drugs. Ensure that the drinking water is disease free. Instruct people to get vaccinated for hepatitis B.
Instruct people to get vaccinated for hepatitis B. - The nurse should instruct all community members to get vaccinated for prevention of hepatitis B. Ensuring that drinking water is disease free and educating people about the risks involved with injecting drugs may help prevent hepatitis A, not hepatitis B. Delaying the start of sexual activity by teenagers may not protect them from hepatitis B in the long run.
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. "The virus remains quiet until a stressful event occurs to reactivate it." "Your baby is protected from this infection by the placenta." "Infections may be transmitted by individuals unaware that they have it." "Many recognize they have the infection and seek treatment immediately." "Transmission is through contact of infected mucous membranes."
"The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it." "Transmission is through contact of infected mucous membranes." - Genital herpes simplex is transmitted by contact of mucous membranes or breaks in the skin with visible or nonvisible lesions. Most genital herpes infections are transmitted by individuals unaware that they have an infection. Kissing, sexual contact (including oral sex), and vaginal birth are means of transmission. The virus remains latent until stimuli such as fever, stress, ultraviolet radiation, or immunosuppression occurs and reactivates it.
The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis? trauma to the bladder irritation of vaginal walls being postmenopausal spontaneous abortion
irritation of vaginal walls - Factors that trigger growth of trichomoniasis include irritation of vaginal walls, pregnancy, sexual activity, trauma to the vaginal walls, systemic illness, menstruation, and emotional upsets.
A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which nursing intervention may help foster the client's self-esteem? Explain the cause of the sexually transmitted infection (STI). Provide the client with a telephone number for obtaining accurate information. Affirm the client's good judgment in seeking treatment. Schedule an appointment for follow-up care.
Affirm the client's good judgment in seeking treatment. - The nurse should affirm the client's good judgment in seeking treatment. Acknowledging positive action helps increase the client's self-esteem. Explaining the cause of the STI and how to avoid potential consequences or complications dispels inaccurate beliefs and misconceptions and helps the client to acquire realistic information. It does not help the client's self-esteem to be positive. Providing the client with a telephone number for obtaining objective and authoritative information helps the client to ask more questions about an STI and its treatment. Medical follow-up promotes compliance with therapeutic regimen and does not help the client's self-esteem to be positive.
A nurse is caring for a client with vaginitis. What teaching(s) should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply. Avoid douching. Clean the perineal area from back to front. Avoid using deodorant tampons. Take a bubble bath once a week. Wear only cotton panties and ventilated pantyhose.
Avoid douching. Avoid using deodorant tampons. Wear only cotton panties and ventilated pantyhose.
Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?
trichomoniasis - The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery, and frothy or purulent. The discharge associated with candidiasis is thick, white, and resembles cottage cheese in appearance while that associated with infection due to G. vaginalis is thin and grayish white, with a marked fishy odor. With gonorrhea, vaginal discharge is purulent when present but, in many women, gonorrhea produces no symptoms.
