Maternal Child Chap 5 Questions: STIs

Which medications are appropriate to treat chlamydia trachomatis? Select all that apply. A. valacyclovir B. cyclovir C. ofloxacin D. doxycycline E. azithromycin

ofloxacin, doxycycline, azithromycin Rationale: Chlamydia trachomatis is a bacterial infection and treatable with azithromycin, doxycycline, erythromycin, and ofloxacin antibiotics.

A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis? A. gonorrhea B. liver disease C. central nervous system disorder D. anemic disorder

A. gonorrhea Rationale: There is a common co-infection of chlamydia and gonorrhea when chlamydia is not treated with the necessary antibiotic medication combination. Anemia does not correlate with chlamydia, and there is no evidence that it precipitates liver disease. CNS disorders would be from syphilis.

After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement? A. "Latex condoms are the best protection from STIs." B. "Condoms should be applied before any genital contact." C. "It's okay to use petroleum jelly with a latex condom." D. "Condoms should be stored in a cool, dry place."

C. "It's okay to use petroleum jelly with a latex condom." Rationale: If external lubricants are used, use only water-based lubricants with latex condoms. Oil-based or petroleum-based lubricants, such as body lotion, massage oil, or cooking oil, can weaken latex condoms. Latex condoms are the best protection from STIs. Condoms are applied before any genital contact because sperm is present in preejactulate fluid. Condoms also should be stored in a cool, dry place away from direct sunlight to prevent deterioration.

A nurse educator is teaching a client about sexually transmitted infections. The client would learn that which medications are appropriate to treat chlamydia? Select all that apply. A. doxycycline B. acyclovir C. metronidazole D. azithromycin E. ceftriaxone

doxycycline, azithromycin, ceftriaxone Rationale: Antibiotics are usually used in treating this STI. The CDC treatment options for chlamydia include doxycycline or azithromycin. Because of the common co-infection of chlamydia and gonorrhea, a combination regimen of ceftriaxone with doxycycline or azithromycin is prescribed frequently.

Which medications are appropriate to treat vaginal candidiasis? Select all that apply. A. fluconazole B. gentamicin C. penicillin G benzathine D. miconazole E. azithromycin

fluconazole, miconazole Rationale: Therapeutic management for vaginal candidiasis includes miconazole, clotrimazole, terconazole, and fluconazole. The other choices are antibiotics and are not effective treatment for a fungal infection such as vaginal candidiasis.

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques on observed on the vaginal wall. The nurse suspects which condition? A. trichomoniasis B. vulvovaginal candidiasis C. bacterial vaginosis D. chlamydia

vulvovaginal candidiasis Rationale: Pruritus, a thick, curd-like vaginal discharge, and white plaques on the vaginal wall are characteristic of vulvovaginal candidiasis. Trichomoniasis is characterized by a heavy yellow or green or gray frothy or bubbly discharge. Bacterial vaginosis is characterized by a thin white homogeneous vaginal discharge. Chlamydia is usually manifested by a mucopurulent vagina discharge.

What is the most common early symptom of a sexually transmitted infection? A. amenorrhea B. dysuria C. menstrual cramping D. vaginal discharge

B. dysuria Rationale: Sexually transmitted infections common in adolescents present with dysuria as the common denominator for early symptoms in the majority of STIs. The other symptoms may present but not as an early indicator of a sexually transmitted infection.

At a sexual health workshop for older teenagers, the nurse discusses the human papillomavirus (HPV). Which statements made by the participants lead the nurse to believe teaching was successful? Select all that apply. A. "By getting the HPV vaccine, this infection can be prevented." B. "Women between the ages of 13 and 26 can receive the vaccination series." C. "The HPV vaccines will help prevent cervical cancer." D. "The HPV vaccine can be given to girls and boys as young as 9 years old." E. "There currently is no treatment, cure, or vaccine for HPV." "The vaccine that is available is not advised for our age group."

"By getting the HPV vaccine, this infection can be prevented." "Women between the ages of 13 and 26 can receive the vaccination series." "The HPV vaccines will help prevent cervical cancer." "The HPV vaccine can be given to girls and boys as young as 9 years old." Rationale: There is currently no medical treatment or cure for HPV, but there is now a preventative vaccine. Therapeutic management focuses on prevention through the use of the HPV vaccine and education. The FDA has approved three HPV vaccines to prevent cervical cancer. The CDC has recommended the vaccine for routine administration to 11- and 12-year-old girls and boys. The use of a HPV vaccine for girls and boys as young as 9 is recommended, and women between the ages of 13 and 26 can safely receive the vaccination series.

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

"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." Rationale: 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.

When teaching a woman diagnosed with genital herpes lesions, the nurse would include which measure? A. washing hands with soap and water after touching lesions B. applying ice packs to the area for comfort C. refraining from using condoms during sexual intercourse D. drying lesions with a hair dryer set on high

A. washing hands with soap and water after touching lesions Rationale: Hand washing with soap and water after touching lesions is essential to avoid autoinoculation. Extremes of temperature, such as ice or hot packs, to the genital area should be avoided. Drying the lesions is appropriate, but the hair dryer should be set on a low setting. Condoms should be used with all new or noninfected partners.

A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity? A. encouraging treatment for genital warts B. educating about HPV testing in women over age 30 C. teaching about the importance of regular Papanicolaou test D. administering HPV vaccine

D. administering HPV vaccine Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be a primary prevention activity. If the woman does not receive primary prevention with the vaccine, then secondary prevention would focus on education about the importance of receiving regular Papanicolaou tests and, for women over age 30, including an HPV test to determine whether the woman has a latent high-risk virus that could lead to precancerous cervical changes.

A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement? A. "Women are diagnosed with two thirds of the new cases of STIs annually." B. "Certain infections can be transmitted to the newborn." C. "All individuals are susceptible if exposed to the infectious organism." D. "Women are equally diagnosed over men as they will seek treatment first." E. "After only a single exposure, women are twice as likely as men to acquire STIs."

"Women are diagnosed with two thirds of the new cases of STIs annually." "Certain infections can be transmitted to the newborn." "After only a single exposure, women are twice as likely as men to acquire STIs." Rationale: STIs are biologically sexist, presenting greater risk and causing more complications among women than among men. Women are diagnosed with two thirds of the new cases of STIs annually in the United States. After only a single exposure, women are twice as likely as men to acquire infections from pathogens. Certain infections can be transmitted in utero to the fetus or during childbirth to the newborn.

A female client, who has been newly diagnosed with herpes simplex virus (HSV), ask the nurse how long it will take for the "sores" to go away. How should the nurse respond? A. "It will take about 2 weeks for the outbreak to fully heal." B. "The pain should go away in a few days once the 'sores' crust over." C. "The first outbreak takes about 3 weeks to heal with medication." D. "Once you start the medication it will take about 1 week."

A. "It will take about 2 weeks for the outbreak to fully heal." Rationale: During an initial occurrence vesicles appear on the labia or perineum. These vesicles open, begin to weep, then crust over, dry and then disappear without scar formation. This is the process of viral shedding and takes about 2 weeks to complete. Recurrent episodes of an outbreak take a shorter time for this to occur. Medication used to treat the outbreak is required for a 10-day period. The amount of pain does not determine how long the outbreak will need to heal.

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

A. "The virus remains quiet until a stressful event occurs to reactivate it." B. "Infections may be transmitted by individuals unaware that they have it." D. "Transmission is through contact of infected mucous membranes." Rationale: 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.

A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response? A. "This STI is characterized by an infection of your cervix." B. "This STI is an infection that results in ulcers in the genital area." C. "This STI is an infection that will cause itching in the genital area." D. "This STI is an infection that will result in the formation of genital warts."

A. "This STI is characterized by an infection of your cervix." Rationale: STIs like chlamydia result in a cervicitis that implies the presence of inflammation or infection of the cervix. It produces quantities of purulent discharge. Cervicitis is usually caused by gonorrhea or chlamydia. Chlamydia will not produce ulcers or warts and is not a STI that has itching associated with it.

When developing a program for STI prevention, which action would need to be done first? A. educating on how to promote sexual health B. getting individuals to change their behaviors C. interfering with the mode of transmission D. increasing the availability of resources

A. educating on how to promote sexual health Rationale: The key to successful treatment and prevention of STIs is education to promote sexual health. Behavior changes, increasing the availability of resources, and interfering with modes of transmission are important, but all of these require education.

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection? A. gonorrhea B. Candida albicans C. syphilis D. human immunodeficiency virus

A. gonorrhea Rationale: Gonorrhea can be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. The newborn would develop congenital syphilis if exposed in utero. Exposure to Candida would cause thrush in the newborn. Exposure to HIV during gestation could lead to the birth of an HIV-positive newborn.

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

B. This infection is the most common infectious cause of infertility. Rationale: The young have the most to lose from acquiring STIs, since they may not reach their full reproductive potential. In women, chlamydia is linked with cervicitis, salpingitis, ectopic pregnancy, pelvic inflammatory disease, and infertility. It is likely the most common infectious cause of infertility in women. Recombinant human papillomavirus vaccine is for the HPV STI. Antibiotics will cure this STI only.

The nurse is preparing to administer medication therapy to a woman diagnosed with syphilis. The nurse would expect to administer: A. metronidazole. B. azithromycin C. miconazole. D. doxycycline.

B. azithromycin Rationale: Single-dose therapy is preferred for ease of use of azithromycin (Zithromax, Z-Pak) 1 g orally once; ceftriaxone (Rocephin) 250 mg IM once; ciprofloxacin (Cipro) 500 mg orally twice a day for 3 days; or erythromycin base 500 mg orally three times a day for 7 days. Penicillin G benzathine 2.4 million units IM weekly for 3 weeks can also be used for treatment, but client adherence can be challenging. Miconazole is used to treat candidiasis. Metronidazole is used to treat trichomoniasis. Doxycycline is used to treat chlamydia.

The community health nurse is teaching sexually transmitted infections to a high school health class. The nurse determines that the teaching was successful when the group identifies what potential cause for intellectual disability in the newborn? A. trichomoniasis B. herpes type II (genital herpes) C. human papillomavirus D. chlamydia

B. herpes type II (genital herpes) Rationale: Herpes type II (genital herpes) contamination at birth may cause intellectual disability, premature birth, low birth weight, blindness, or death. Human papillomavirus or venereal warts may result in the development of warts in the throat (laryngeal papillomatosis) of the newborn; these are uncommon but life-threatening. Chlamydia can cause eye infections (neonatal conjunctivitis), pneumonia, low birth weight, increased risk of premature rupture of the membranes (PROM), preterm birth, and stillbirth. Trichomoniasis causes low birth-weight, increased risk of PROM, and preterm birth.

A pregnant client has been prescribed a quinolone medication to treat gonorrhea. What is most important for the nurse to do before administering the medication? A. Instruct the client to retest after treatment B. Ask the client about allergies C. Notify the health care provider D. Teach the client about the medication

C. Notify the health care provider Rationale: Although quinolone drugs are very effective in the treatment of gonorrhea, their effect on the fetus has not been totally proven. It has been believed quinolones cause fetal malformations, especially if taken in the first trimester. Therefore, it is advised quinolones not be taken in pregnancy. When the nurse receives this prescription the health care provider must be notified. There may be a reason for the medication unknown to the nurse or there could simply be a mistake in realizing the client is pregnant. The health care worker should prescribe knowing all the facts and weigh risks versus benefits. Allergies, teaching and retesting instructions should all be done, but alerting the health care provider would be the first action.

Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? A. painful ejaculation B. erectile dysfunction C. dysuria D. hematuria

C. dysuria Rationale: 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.

The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms? A. human papillomavirus B. herpes simplex II C. trichomoniasis D. syphilis

C. trichomoniasis Rationale: Trichomoniasis symptoms are vulvar itching and a malodorous foamy yellow vaginal discharge.

A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely? A. vaginal bleeding B. foul-smelling discharge C. chancres at the vaginal site D. vesicles on the labia

D. chancres at the vaginal site Rationale: Syphilis is divided into four stages: primary, secondary, latency, and tertiary. Primary syphilis is characterized by a chancre at the site of bacterial entry. Foul-smelling discharge would not be noted. Vesicles on the labia are not associated with syphilis. Bleeding from the vagina could be normal menses and does not correlate with syphilis.

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? A. penicillin G B. acyclovir C. clotrimazole D. metronidazole

D. metronidazole Rationale: Trichomoniasis is a common vaginal infection with the therapeutic management of metronidazole or tinidazole for both partners. Trichomoniasis is a common, curable sexually transmitted infection (STI) caused by a parasitic protozoa called Trichomonas.

A nurse is conducting a program about genital herpes infection at a community clinic. The nurse determines that additional discussion is needed when the group identifies which activity as a means of transmission? A. sexual contact B. giving vaginal birth C. kissing D. sharing contaminated needles

D. sharing contaminated needles Rationale: Herpes simplex virus is transmitted primarily by direct contact with an infected individual who is shedding the virus and may include kissing, sexual contact, and vaginal birth. Sharing contaminated needles is a means of transmitting HIV.