LEWIS CH. 52: STI

19. The nurse in the outpatient clinic notes that the following patients have not received the human papillomavirus (HPV) vaccine. Which patients should the nurse plan to teach about benefits of the vaccine (select all that apply)? a. 24-year-old man who has a history of genital warts b. 18-year-old man who has had one male sexual partner c. 28-year-old woman who has never been sexually active d. 20-year-old woman who has a newly diagnosed Chlamydia infection e. 30-year-old woman whose sexual partner has a history of genital warts

a. 24-year-old man who has a history of genital warts b. 18-year-old man who has had one male sexual partner d. 20-year-old woman who has a newly diagnosed Chlamydia infection

15. Which patient will the nurse plan on teaching about the Gardasil vaccine? a. A 24-year-old female who has not been sexually active b. A 34-year-old woman who has multiple sexual partners c. A 19-year-old woman who is pregnant for the first time d. A 29-year-old woman who is in a monogamous relationship

a. A 24-year-old female who has not been sexually active

4. A 46-year-old man who has had blood drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which action should the nurse take next? a. Ask the patient about past treatment for syphilis. b. Explain the need for blood and spinal fluid cultures. c. Obtain a specimen for fluorescent treponemal antibody absorption (FAT-Abs) testing. d. Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

a. Ask the patient about past treatment for syphilis.

10. A 19-year-old patient has genital warts around her external genitalia and perianal area. She tells the nurse that she has not sought treatment until now because the warts are so disgusting. Which nursing diagnosis is most appropriate? a. Disturbed body image related to feelings about the genital warts b. Ineffective coping related to denial of increased risk for infection c. Risk for infection related to lack of knowledge about transmission d. Anxiety related to impact of condition on interpersonal relationships

a. Disturbed body image related to feelings about the genital warts

17. A 39-year-old patient with a history of IV drug use is seen at a community clinic. The patient reports difficulty walking, stating I dont know where my feet are. Diagnostic screening reveals positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-Abs) tests. Based on the patient history, what will the nurse assess (select all that apply)? a. Heart sounds b. Genitalia for lesions c. Joints for swelling and inflammation d. Mental state for judgment and orientation e. Skin and mucous membranes for gummas

a. Heart sounds d. Mental state for judgment and orientation e. Skin and mucous membranes for gummas

12. A 29-year-old female patient is diagnosed with Chlamydia during a routine pelvic examination. The nurse knows that teaching regarding the management of the condition has been effective when the patient says which of the following? a. My partner will need to take antibiotics at the same time I do. b. Go ahead and give me the antibiotic injection, so I will be cured. c. I will use condoms during sex until I finish taking all the antibiotics. d. I do not plan on having children, so treating the infection is not important.

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

8. Which infection, reported in the health history of a woman who is having difficulty conceiving, will the nurse identify as a risk factor for infertility? a. N. gonorrhoeae b. Treponema pallidum c. Condyloma acuminatum d. Herpes simplex virus type 2

a. N. gonorrhoeae

2. A 20-year-old woman who is being seen in the family medicine clinic for an annual physical exam reports being sexually active. The nurse will plan to teach the patient about a. testing for Chlamydia infection. b. immunization for herpes simplex. c. infertility associated with the human papillomavirus (HPV). d. the relationship between the herpes virus and cervical cancer.

a. testing for Chlamydia infection.

14. A 32-year-old woman who is diagnosed with Chlamydia tells the nurse that she is very angry because her husband is her only sexual partner. Which response should the nurse make first? a. You may need professional counseling to help resolve your anger. b. It is understandable that you are angry with your husband right now. c. Your feelings are justified and you should share them with your husband. d. It is important that both you and your husband be treated for the infection.

b. It is understandable that you are angry with your husband right now.

18. Which topics will the nurse include when preparing to teach a patient with recurrent genital herpes simplex (select all that apply)? a. Infected areas should be kept moist to speed healing. b. Sitz baths may be used to relieve discomfort caused by the lesions. c. Genital herpes can be cured by consistent use of antiviral medications. d. Recurrent genital herpes episodes usually are shorter than the first episode. e. The virus can infect sexual partners even when you do not have symptoms of infection.

b. Sitz baths may be used to relieve discomfort caused by the lesions. d. Recurrent genital herpes episodes usually are shorter than the first episode. e. The virus can infect sexual partners even when you do not have symptoms of infection.

6. A patient admitted with chest pain is also found to have positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-Abs) tests, rashes on the palms and the soles of the feet, and moist papules in the anal and vulvar area. Which action will the nurse include in the plan of care? a. Assess for arterial aneurysms. b. Wear gloves for patient contact. c. Place the patient in a private room. d. Apply antibiotic ointment to the perineum.

b. Wear gloves for patient contact.

3. A 22-year-old patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin) and is given a prescription for doxycycline (Vibramycin) 100 mg bid for 7 days. The nurse explains to the patient that this combination of antibiotics is prescribed to a. prevent reinfection during treatment. b. treat any coexisting chlamydial infection. c. eradicate resistant strains of N. gonorrhoeae. d. prevent the development of resistant organisms.

b. treat any coexisting chlamydial infection.

5. A 48-year-old male patient who has been diagnosed with gonococcal urethritis tells the nurse he had recent sexual contact with a woman but says she did not appear to have any disease. In responding to the patient, the nurse explains that a. women do not develop gonorrhea infections but can serve as carriers to spread the disease to males. b. women may not be aware they have gonorrhea because they often do not have symptoms of infection. c. women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations. d. when gonorrhea infections occur in women, the disease affects only the ovaries, not the genital organs.

b. women may not be aware they have gonorrhea because they often do not have symptoms of infection.

16. After the nurse has taught a patient with a newly diagnosed sexually transmitted infection about expedited partner therapy, which patient statement indicates that the teaching has been effective? a. I will tell my partner that it is important to be examined at the clinic. b. I will have my partner take the antibiotics if any STI symptoms occur. c. I will make sure that my partner takes all of the prescribed medication. d. I will have my partner use a condom until I have finished the antibiotics.

c. I will make sure that my partner takes all of the prescribed medication.

7. Which statement by a 24-year-old patient indicates that the nurses teaching about management of primary genital herpes has been effective? a. I will use acyclovir ointment on the area to relieve the pain. b. I will use condoms for intercourse until the medication is all gone. c. I will take the acyclovir (Zovirax) every 8 hours for the next week. d. I will need to take all of the medication to be sure the infection is cured.

c. I will take the acyclovir (Zovirax) every 8 hours for the next week.

11. When a 31-year-old male patient returns to the clinic for follow-up after treatment for gonococcal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection, which question is most appropriate for the nurse to ask the patient? a. Did you take the prescribed antibiotic for a week? b. Did you drink at least 2 quarts of fluids every day? c. Were your sexual partners treated with antibiotics? d. Do you wash your hands after using the bathroom?

c. Were your sexual partners treated with antibiotics?

9. A woman is diagnosed with primary syphilis during her eighth week of pregnancy. The nurse will plan to teach the patient about the a. likelihood of a stillbirth. b. plans for cesarean section c. intramuscular injection of penicillin. d. antibiotic eye drops for the newborn.

c. intramuscular injection of penicillin.

1. A 32-year-old man who has a profuse, purulent urethral discharge with painful urination is seen at the clinic. Which information will be most important for the nurse to obtain? a. Contraceptive use b. Sexual orientation c. Immunization history d. Recent sexual contacts

d. Recent sexual contacts

13. A 55-year-old woman in the sexually transmitted infection (STI) clinic tells the nurse that she is concerned she may have been exposed to gonorrhea by her partner. To determine whether the patient has gonorrhea, the nurse will plan to a. interview the patient about symptoms of gonorrhea. b. take a sample of cervical discharge for Gram staining. c. draw a blood specimen or rapid plasma reagin (RPR) testing. d. obtain secretions for a nucleic acid amplification test (NAAT).

d. obtain secretions for a nucleic acid amplification test (NAAT).