MS Chapter 55 Sexually Transmitted Infections (PQR)

A patient who was diagnosed with gonorrhea did not return for treatment. When contacted, she reported that her symptoms had gone away so she thought she had recovered from the infection. The most appropriate response by the nurse would be which of the following? 1. "Without treatment, the bacteria remain in your body and you remain highly infectious." 2. "If your symptoms have cleared up, no reason exists to treat you now" 3. "If you have symptoms in the future, come to the clinic immediately" 4. "Fortunately, gonorrhea has no serious complications, but I must advise you to seek treatment anyway"

1. "Without treatment, the bacteria remain in your body and you remain highly infectious." Rationale: The nurse should respond, "Without treatment, the bacteria remain in your body and you remain highly infectious." It is essential for the patient to complete the prescribed course of antibiotics and return so that the physician can determine whether the treatment was effective. Telling the patient, "As long as your symptoms have cleared up, no reason exists to treat you now," is incorrect. Symptoms generally disappear after a few weeks, but if the infection is untreated, then the bacteria remain in the body and the person remains highly infectious. Also, responding to the patient, "If you have symptoms in the future, then come to the clinic immediately," does not emphasize that the patient has to be cleared of this course of the disease. The response, "Fortunately, gonorrhea has no serious complications, but I must advise you to seek treatment anyway," is also incorrect. If untreated, gonorrhea can cause sterility in both genders and infections that may lead to damage to heart tissue and joints. Men may develop epididymitis and prostatitis. Women may develop pelvic inflammatory disease (PID). People with gonorrhea are at increased risk for human immunodeficiency virus (HIV); people with HIV and gonorrhea are more likely to transmit HIV to another person.

What percentage of all cases of STIS involve people between the ages of 15 and 24? 1. 50% 2. 65% 3. 75% 4. 85%

1. 50% Rationale: In the US, an estimated 20 million new infections occur each year. Almost half of these are in persons between 15 to 24 years of age.

Which statements are related to Chlamydia trachomatis? Select all that apply. 1. An infection that is transmitted by contact with the mucous membranes in the mouth, eyes, urethra, vagina, or rectum 2. Characterized by genital irritation; a thin, gray discharge, and a fish odor 3. Characterized by a cauliflower-like mass 4. Treatment consists of antiviral drugs 5. Symptoms include penile discharge that is initially thin and then creamy, accompanied by painful urination 6. The most common STI in the US

1. An infection that is transmitted by contact with the mucous membranes in the mouth, eyes, urethra, vagina, or rectum 5. Symptoms include penile discharge that is initially thin and then creamy, accompanied by painful urination 6. The most common STI in the US Rationale: Chlamydia infection is thought to be the most common bacterial STI in the US. This infection is transmitted by contact with the mucous membranes in the mouth, eyes, urethra, vagina, or rectum. Symptoms are more noticeable in men and include penile discharge, painful or frequent urination. Women may experience vaginal discharge, painful urination, nausea, fever, painful intercourse, bleeding between menstrual periods, and lower abdominal pain.

The patient with untreated syphilis may develop which of the following? SATA 1. Blindness 2. Mental illness 3. Paralysis 4. Heart disease 5. Osteoporosis

1. Blindness 2. Mental illness 3. Paralysis 4. Heart disease Rationale: The patient with untreated syphilis may develop severe, potentially fatal complications, including neurosyphilis (meningitis, blindness, paralysis), and cardiovascular disease. Osteoporosis is not related to patients with untreated syphilis.

Which statements are related to syphilis? Select all that apply. 1. Characterized by a papule that becomes a painless red ulcer within a week 2. Patients are cured when the chancre disappears 3. The first sign of this infection is the chancre 4. During the secondary stage, pustules, fever, sore throat, and aching are symptoms that occur 5. Disease leaves the patient unable to resist opportunistic infections

1. Characterized by a papule that becomes a painless red ulcer within a week 3. The first sign of this infection is the chancre 4. During the secondary stage, pustules, fever, sore throat, and aching are symptoms that occur Rationale: A typical lesion, called a chancre, is the first sign of syphilis. During the primary stage, a reddish papule appears where the organism entered the body, usually on the genitals, anus, or mouth. Within 1 week, the papule becomes a painless red ulcer. When the chancre disappears, patients may assume that they are cured when in fact the infecting organism has moved into the blood. The secondary stage symptoms include rash on the extremities, chest or back, palms of the hands, and soles of the feet. Pustules that contain highly contagious material often develop. Fever, sore throat, and generalized aching are also seen in this stage.

Which of the following STIs can usually be cured with antimicrobials? SATA 1. Gonorrhea 2. Herpes simplex 3. Syphilis 4. Trichomonas 5. Chlamydia

1. Gonorrhea 3. Syphilis 4. Trichomonas 5. Chlamydia Rationale: Gonorrhea, syphilis, trichomoniasis, and chlamydia can usually be cured with antimicrobial drugs. There is no cure for herpes simplex virus infection, but the oral antiviral drugs acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) can help by partially controlling the signs and symptoms during initial and recurrent episodes.

Which is the cause of genital warts? 1. HPV 2. HSV 3. Chlamydia trachomatis 4. Neisseria gonorrhoeae

1. HPV Rationale: Although not always seen, the presence of genital warts is the most easily recognized sign of HPV infection

A school nurse is scheduled to talk to a group of college students about sexually transmitted infections. The nurse would caution the students to avoid which unsafe practices? (Select all that apply.) 1. Insertion of hand into vagina or rectum 2. Oral sex without a condom 3. Mutual masturbation 4. Open-mouthed kissing 5. Use of own sex devices or toys 6. Ingestion of urine or semen

1. Insertion of hand into vagina or rectum 2. Oral sex without a condom 6. Ingestion of urine or semen Rationale: Unsafe practices that could led to sexual transmission of infections include oral sex without a condom, ingestion of urine or semen, insertion of hand into vagina or rectum, vaginal or anal intercourse without a condom, oral-anal contact, and contact with blood. Mutual masturbation, open-mouthed kissing, and use of own sex devices or toys are considered safe practices. REF: p. 1097

In a health education class, the nurse is teaching the students about HSV infection. Which statements are true regarding HSV-1 and HSV-2? SATA 1. Type 2 is most often transmitted by genital contact 2. The modes of transmission of both types 1 and 2 are the same 3. Both types 1 and 2 can be treated with antiviral drugs 4. Type 1 only affects the genitals and type 2 only affects the mouth 5. Vaccines are available to prevent HSV-1 but not HSV-2

1. Type 2 is most often transmitted by genital contact 2. The modes of transmission of both types 1 and 2 are the same 3. Both types 1 and 2 can be treated with antiviral drugs Rationale: The modes of transmission of both types 1 and 2 herpes simplex virus (HSV) are the same, and both types can be treated with antiviral drugs. Type 1 (HSV-1) is transmitted through contact with open lesions, usually on the lips or inside the mouth. Type 2 (HSV-2) is most often transmitted by genital contact, and vaginal or anal intercourse and oral-genital contact are the primary transmission modes. But HSV-2 can be transferred by hand contact as well. There are no vaccines available and no cure for HSV infection exists. Oral antiviral drugs acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) help by partially controlling the signs and symptoms during initial and recurrent episodes.

Two screening tests for syphilis include the rapid plasma reagin (RPR) and the: 1. VDRL 2. RBC 3. WBC 4. BUN

1. VDRL Rationale: Tests for syphilis include screening and confirmation tests. Two screening tests are (1) the Venereal Disease Research Laboratory (VDRL) test and the rapid plasma (RPR) test. Both detect a protein that appears in the blood when a person has syphilis.

Female patients with gonorrhea are likely to have vaginal discharge, a burning sensation during urination, abnormal menstruation, and: 1. dyspnea 2. abdominal pain 3. hypotension 4. edema

2. abdominal pain Rationale: Women may experience (w/gonorrhea) vaginal discharge, bleeding during sexual intercourse, redness and swelling of the external genitalia, a burning sensation during urination, abdominal pain, or abnormal menstruation.

A young woman is being treated at the university clinic for genital HSV-2 infection. The teaching plan for her should include with of the following statements? SATA 1. You should have yearly PAP tests b/c you are at increased risk for cervical cancer 2. You should not become pregnant b/c the herpes infection causes fetal deformities 3. Once you have finished taking your medicine, you will be cured of the herpes infection 4. Your partner must use a condom for intercourse even when lesions are not present 5. Medications may reduce the frequency and severity of your symptoms

1. You should have yearly PAP tests b/c you are at increased risk for cervical cancer 4. Your partner must use a condom for intercourse even when lesions are not present 5. Medications may reduce the frequency and severity of your symptoms Rationale: The teaching plan for a woman with genital herpes simplex virus type 2 (HSV-2) infection should include encouraging the women to have yearly Papanicolaou tests because she is at increased risk for cervical cancer and telling the patient that her partner must use a condom for intercourse even when lesions are not present. The woman also needs to be advised that medications can reduce the frequency and severity of her symptoms. She can become pregnant, but a physician should supervise her closely. Various guidelines are used to determine whether the patient should have a vaginal delivery or cesarean section. The goal is to decrease the risk of transmission to the baby. New diagnostic procedures allow the physician to detect active disease more accurately than in the past. No cure for HSV infection exists, but the oral antiviral drugs acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) help by partially controlling the signs and symptoms during initial and recurrent episodes. She needs to know to start the drug when preliminary (prodromal) symptoms of recurrence are experienced or within 1 day of the outbreak of lesions. Some patients with especially disabling recurrences can take one of these drugs continuously to reduce the frequency of outbreaks.

The treatment for gonorrhea is a single dose of IM ceftriaxone sodium (Rocephin) and: (SATA) 1. azithromycin 2. doxycycline 3. penicillin 4. tetracycline

1. azithromycin 2. doxycycline Rationale: Treatment usually consists of a single dose of IM ceftriaxone sodium (Rocephin) and either azithromycin or doxycycline.

Specimens collected during a pelvic exam are handled as: 1. infective material 2. clean specimen 3. sterile specimen 4. chemically unstable material

1. infective material Rationale: Specimens may be collected for laboratory study. The specimen is handled as infective material, prepared according to agency procedures, labeled, and sent to the laboratory.

Patients with gonococcal, chlamydial, HSV, trichomonal, or yeast infections often have: 1. vaginal or penile discharge 2. increased temperature or tachycardia 3. generalized infection and rash 4. mouth sores and pharyngitis

1. vaginal or penile discharge Rationale: Patients with gonococcal, chlamydia, herpes simples, trichomonas, or yeast infections often have discharge from the vagina or penis

A patient who was admitted to the hospital after an injury is diagnosed with syphilis in the primary stage. During the nursing assessment, the nurse is likely to find: 1. A rash on the extremities, chest or back, palms of the hands, and soles of the feet 2. A reddish papule or painless red ulcer on the genitals, anus, or mouth 3. Tender lymph nodes in the area of the skin lesion 4. Fever, sore throat, and generalized aching

2. A reddish papule or painless red ulcer on the genitals, anus, or mouth Rationale: The primary stage of syphilis involves a typical lesion, called a chancre, that is the first sign of syphilis. The chancre is a reddish papule-like lesion that appears where the organism entered the body, usually on the genitals, anus, or mouth. Signs and symptoms change throughout the course of the disease. If untreated, syphilis progresses through four stages: (1) primary, (2) secondary, (3) latent, and (4) late. The secondary stage involves a rash on the extremities, chest or back, palms of the hands, and soles of the feet. Pustules that contain highly contagious material often develop. The patient is contagious during the first and second stages. Lymph nodes in the area of the skin lesion can be enlarged but they are not tender. Fever, sore throat, and generalized aching are also seen in the secondary stage.

Which STI can be manifested by infant inclusion conjunctivitis? 1. Hepatitis 2. Chlamydia 3. Syphilis 4. HPV

2. Chlamydia Rationale: Newborns of women infected with chlamydia may have eye infections (infant inclusion conjunctivitis) or infant pneumonia. Therefore, erythromycin ophthalmic ointment may be ordered for the newborn because it is effective against chlamydial infection as well as gonorrhea. Syphilis, HPV, and hepatitis are not manifested as newborn eye infections.REF: p. 1083

Nurses in the newborn nursery anticipate that erythromycin ophthalmic ointment will be ordered for the newborn of a mother who has: (SATA) 1. Genital warts 2. Chlamydia 3. Gonorrhea 4. Hepatitis B 5. Syphilis

2. Chlamydia 3. Gonorrhea Rationale: Newborns of women with gonorrhea or chlamydial infection may acquire eye infections during birth. Erythromycin ophthalmic ointment is ordered for the newborn of a mother who has chlamydia or gonorrhea. Chlamydial infection is thought to be the most common bacterial sexually transmitted infection (STI) in the United States, and symptoms are similar to those of gonorrhea.

A patient is diagnosed with Chlamydia. What should the nurse recognize as the priority for optimizing the patient's health? 1. Teaching the patient the correct application of a condom 2. Diagnostic testing for other STIs 3. Obtaining a complete list of recent sexual partners 4. Role-playing with the patient how to discuss sexual history

2. Diagnostic testing for other STIs Rationale: Patients are often infected with more than one STI concurrently. Therefore, the priority is to identify any coinfections the patient may have and to treat them appropriately and promptly. Obtaining a complete list of recent sexual partners is an appropriate intervention to optimize the sexual health of the patient's partners and prevent reinfection, but it will not remedy the current infection the patient is experiencing. Condom application and discussion of sexual histories are an important skill for patients who are sexually active to prevent future infection. REF: p. 1083

Which emergency drugs for possible hypersensitivity reactions need to be kept on hand when administering drug therapy to patients with: (SATA) 1. Acyclovir (Zovirax) 2. Diphenhydramine hydrochloride (Benadryl) 3. Didanosine (Videx) 4. Pentamidine isethionate (Pentam) 5. Epinephrine 6. Corticosteroids

2. Diphenhydramine hydrochloride (Benadryl) 5. Epinephrine 6. Corticosteroids Rationale: When injections are given to an outpatient, ask the patient to remain for 30 minutes afterward in case an allergic reaction occurs. Emergency drugs, including epinephrine, corticosteroids, and diphenhydramine hydrochloride (Benadryl), must be readily available.

The nurse will be administering Penicillin G to a patient who has a recent diagnosis of syphilis. What should the nurse remember about this treatment? (Select all that apply.) 1. The medication should be given with milk. 2. Have the patient watch for headache, fever, muscle aches 3. The drug may cause photosensitivity. 4. The nurse should report anal itching. 5. A single dose is usually sufficient

2. Have the patient watch for headache, fever, muscle aches 5. A single dose is usually sufficient Rationale: The treatment of choice for syphilis is parenteral penicillin G. For an infection of less than 1 year's duration, a single dose is usually sufficient. Anal itching and photosensitivity are side effects of doxycycline. Penicillin G does not need to be given with milk. About 60% of patients treated with penicillin experience the Jarisch-Herxheimer reaction and have headache, fever, and muscle aches that persist for 12 to 24 hours after treatment. REF: p. 1089

Information for effective use of condoms should include which of the following statements? SATA 1. Condoms provide 100% protection against disease transmission 2. Latex condoms are preferred over natural membrane condoms 3. Use only oil-based lubricants to prevent breakage of the condom 4. Leave a space of about 1 inch at the tip for semen 5. Remove the used condom carefully to prevent spillage of contents

2. Latex condoms are preferred over natural membrane condoms 4. Leave a space of about 1 inch at the tip for semen 5. Remove the used condom carefully to prevent spillage of contents Rationale: Effective use of condoms should include information that latex condoms are preferred over natural-membrane condoms because some pathogens can pass through natural-membrane condoms. Also, to put a condom on, hold it by the tip and unroll it onto the penis and leave a space of about 1 inch at the tip for semen. Make sure to withdraw the penis carefully after ejaculation to keep the condom from slipping off and spilling the contents and to avoid unprotected contact. Condoms do not provide 100% protection against disease transmission. Use only water-based lubricants because oil-based and other lubricants can cause the condom to break. Spermicidal drugs may be used. Protect condoms from heat and sunlight to keep them from deteriorating, and do not use condoms that are brittle, discolored, or in damaged packages.

A female patient is taking erythromycin for the treatment of chlamydial infection. The nurse educates the patient to report which of these side effects? 1. Candidiasis 2. Ringing in the ears 3. Photosensitivity 4. Vaginitis

2. Ringing in the ears Rationale: The patient taking erythromycin should be educated about reporting tinnitus or jaundice. Vaginitis, photosensitivity, and candidiasis are side effects of other medications. REF: p. 1085

What is the treatment of choice for a patient who has trichomoniasis? 1. Penicillin 2. Tinidazole (Tindamax) 3. Acyclovir 4. Tetracycline

2. Tinidazole (Tindamax) Rationale: Tinidazole (Tindamax) is the DOC for treating trichomoniasis, with metronidazole (Flagyl) as a less expensive option.

A patient with gonorrhea is being treated with Rocephin. Which side effects would the nurse expect to see? Select all that apply. 1. discoloration of teeth 2. allergic reaction in patients allergic to cephalosporins or penicillin 3. nephrotoxicity 4. superinfections 5. tachycardia

2. allergic reaction in patients allergic to cephalosporins or penicillin 3. nephrotoxicity 4. superinfections Rationale: Side effects of Rocephin include---nausea, vomiting, headache, dizziness, and (rarely bleeding). Allergic reactions. Patients allergic to penicillin may have cross-sensitivity to cephalosporins. Nephrotoxicity with high doses or renal disease. Superinfections: diarrhea, candidiasis. IV route: pain, thrombophlebitis. IM route: pain, induration at injection site.

Females with HSV infections are advised to have annual Papanicolaou smears because they are at increased risk of: 1. pyelonephritis 2. cervical cancer 3. kidney failure 4. AIDS+

2. cervical cancer Rationale: Women with HPV, HSV, and condylomata are advise to have annual Papanicolaou tests because they are at increased risk of cervical cancer

Gonorrhea is transmitted most often by: 1. infected mothers to newborn infants 2. direct sexual contact 3. skin lacerations of medical personnel 4. toilet seats and doorknobs

2. direct sexual contact Rationale: Gonorrhea is transmitted most often by direct sexual contact.

If untreated, sterility, prostatitis in males, and pelvic inflammatory disease in females may result from: 1. syphilis 2. gonorrhea 3. HSV infection 4. genital warts

2. gonorrhea Rationale: If untreated, gonorrhea can cause sterility in both sexes and infections that may lead to damage to heart tissue and joints. Men may develop epididymitis and prostatitis. Women may develop PID and ectopic pregnancy.

Gonorrhea can be found in the pharynx, urethra, uterus, and: 1. kidney 2. rectum 3. heart 4. lungs

2. rectum Rationale: The bacterium that causes gonorrhea is Neisseria gonorrhoeae. This organism lives in warm, moist areas of the body such as the cervix and urethra. Areas affected by local gonorrhea infections may include the pharynx, rectum, urethra, prostate, epididymis, uterus, and fallopian tubes.

Untreated STIS can lead to serious complications such as PID and: 1. edema 2. sterility 3. shock 4. kidney failure

2. sterility Rationale: Untreated STI can lead to serious complications such as PID and sterility.

After completing treatment for primary or secondary syphilis, the patient is advised not to engage in sexual activity for: 1. 5 days 2. 2 weeks 3. 1 month 4. 6 months

3. 1 month Rationale: Advise the patient not to engage in sexual activity until 1 month after completing treatment for primary or secondary syphilis

The teaching plan for a patient with genital warts should include which of the following statements? 1. This condition cannot be transmitted to a sexual partner 2. Genital warts are caused by personal hygiene 3. A topical medication can remove the warts but is not curative 4. Once the warts are removed, they are unlikely to come back

3. A topical medication can remove the warts but is not curative Rationale: The teaching plan for a patient with genital warts should include information that a topical medication can remove the warts but is not curative. Genital warts can be transmitted to a sexual partner and are not caused by poor personal hygiene. There is no cure for these warts but removal of visible warts provides symptomatic relief. Some treatments such as the application of podofilox, imiquimod, or kunecatechins can be managed by the patient. Other treatments must be administered by the physician (i.e., cryotherapy, which uses liquid nitrogen or solid carbon dioxide [CO2] to freeze the warts; topical trichloroacetic acid, bichloroacetic acid, or podophyllin resin; surgical removal; injection of interferon into the lesions).

Which is the drug of choice for treating HSV? 1. Penicillin G 2. Tetracycline hydrochloride (Achromycin) 3. Acyclovir (Zovirax) 4. Metronidazole (Flagyl)

3. Acyclovir (Zovirax) Rationale: No cure for HSV infection exists but the oral antiviral drug acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) help by partially controlling the signs and symptoms during initial and recurrent episodes.

What do Papanicolaou smears detect? 1. Syphilis 2. Gonorrhea 3. Cancer of the cervix 4. HSV infection

3. Cancer of the cervix Rationale: An infected woman should be taught to have a Pap test done annually to detect cervical cancer early.

Which STI has symptoms similar to those of gonorrhea? 1. Syphilis 2. Herpes Simplex 3. Chlamydia 4. HIV

3. Chlamydia Rationale: Chlamydia is transmitted by contact with the mucous membrane in the mouth, eyes, urethra, vagina, or rectum. The symptoms are like those of gonorrhea (asymptomatic; penile discharge; burning sensation while urinating; painful intercourse; abnormal menstruations)

Which infections are classified as curable sexually transmitted infections? 1. Chlamydia, giardiasis, cytomegalovirus, and hepatitis B 2. Campylobacteriosis, gonorrhea, cytomegalovirus, and hepatitis B 3. Chlamydia, gonorrhea, syphilis, and trichomonas 4. Chlamydia, gonorrhea, cryptosporidiosis, and hepatitis B

3. Chlamydia, gonorrhea, syphilis, and trichomonas Rationale: According to the World Health Organization, syphilis, chlamydia, gonorrhea, and trichomonas are all classified as curable sexually transmitted infections when treated. Giardiasis and cryptosporidiosis are waterborne infections, and campylobacteriosis is a foodborne infection. REF: p. 1083

Which STI can be transmitted through the placenta, causing an infant to be born with the disease? 1. HSV infection 2. Gonorrhea 3. Syphilis 4. Chlamydia

3. Syphilis Rationale: Syphilis is caused by a spirochete (coiled bacteria) called Treponema pallidum. The organism is generally transmitted by sexual contact but can also be spread through breaks in the skin. It can also be passed through the placenta, thus causing an infant to be born with the disease.

A patient with bacterial vaginosis is being treated with metronidazole (Flagyl). A few days after beginning the treatment, the patient begins to experience vomiting and has a blood pressure of 90/60 mm Hg and a pulse of 110 beats/min. What would the nurse suspect? 1. The patient is experiencing an anaphylactic reaction from the medication. 2. The patient is experiencing an adverse reaction from the medication. 3. The patient has consumed alcohol and is experiencing a disulfiram-like reaction. 4. The patient is experiencing normal side effects of the medication.

3. The patient has consumed alcohol and is experiencing a disulfiram-like reaction. Rationale: When a patient consumes alcohol while taking metronidazole, the combination can trigger a disulfiram-like reaction with vomiting, tachycardia, and hypotension. The patient is experiencing these signs and symptoms. Although the patient is experiencing an adverse reaction, the option does not detail why the patient is experiencing the reaction. Vomiting, tachycardia, and hypotension are not normal side effects of this medication. Vomiting, tachycardia, and hypotension are not signs and symptoms of an anaphylactic reaction from this medication. REF: p. 1085

Which of the following is the purpose of reporting STIs? 1. To prosecute the individuals who are transmitting the disease to others 2. To emphasize to infected persons the importance of practicing safe sex 3. To reduce transmission of the infection by treating all infected persons 4. To teach the public about measures to prevent STIs

3. To reduce transmission of the infection by treating all infected persons Rationale: The purpose of reporting sexually transmitted infections (STIs) is to reduce transmission of the infection by treating all infected persons. STIs include a number of conditions that can be transmitted from one person to another during intimate contact. The term sexually transmitted disease (STD) is commonly used to describe these same conditions as well. The difference in the two terms is that a disease, by definition, has recognizable signs and symptoms, whereas infections may or may not manifest specific signs and symptoms. Individuals are not prosecuted for transmitting the disease to others. Reporting STIs is not related to emphasizing to infected persons the importance of practicing safe sex. That intervention is done by health care providers. Reporting does not reduce transmission of the infection by treating all infected persons nor teach the general public about measures to prevent STIs.

If males have a whitish- or greenish-colored discharge from the penis and complain of a burning sensation during urination, this is suggestive of: 1. HSV infection 2. chlamydia 3. gonorrhea 4. syphilis

3. gonorrhea Rationale: Men who do have symptoms (of gonorrhea) often have whitish or greenish discharge from the penis and often complain of a burning sensation during urination. Testicular pain and swelling may also be present.

Paralysis, mental illness, blindness, and heart disease may occur as complications of: 1. HSV infection 2. cervicitis 3. syphilis 4. gonorrhea

3. syphilis Rationale: The patient with untreated syphilis may develop severe, potentially fatal complications, including neurosyphilis (meningitis, blindness, paralysis) and cardiovascular disease

A male patient is newly diagnosed with HIV and is informed that he needs to wear condoms. Which statement by the patient would suggest that further education is required? 1. "I will use latex condoms during sexual intercourse." 2. "I will use only water-based lubricants with the condoms." 3. "I will always discard the condoms after they have been used. 4. "I am not going to be able to use spermicidal agents."

4. "I am not going to be able to use spermicidal agents." Rationale: Spermicidal agents may be used with the condoms. Latex condoms are preferred during sexual intercourse. Only water-based lubricants should be used because others can cause the condom to break. For sanitary disposal, condoms should always be discarded after use. REF: p. 1098

Serologic tests for STIS are designed to detect infectious diseases by measuring: 1. WBCs 2. RBCs 3. Clotting factors 4. Antigens or antibodies

4. Antigens or antibodies Rationale: Serologic tests may be ordered to detect infections with hep A, B, C, D, and E; syphilis; HIV; herpes simples; and cytomegalovirus. These tests are designed to detect infections by measuring antigens or antibodies in the blood.

A patient comes to the outpatient clinic and is diagnosed with gonorrhea. What initial treatment would the nurse anticipate will be initiated? 1. Doxycycline (Vibramycin) and tetracycline (Panmycin) 2. Penicillin 3. Ciprofloxacin (Cipro) and levofloxacin (Levaquin) 4. Ceftriaxone (Rocephin) and azithromycin

4. Ceftriaxone (Rocephin) and azithromycin Rationale: Gonorrhea is initially treated with ceftriaxone and either azithromycin or doxycycline. Ciprofloxacin, levofloxacin, and tetracycline are not used for the treatment of gonorrhea. Penicillin is not used as much because of resistant organisms. REF: p. 1087

How is HSV transmitted? Select all that apply. 1. Air droplets 2. Mouth-to-nose contact 3. Fecal contamination 4. Hand contact 5. Sexual contact

4. Hand contact 5. Sexual contact Rationale: The virus that causes cold sores (herpes febrilis or herpes simplex virus-1 (HSV-1)) is transmitted through contact with open lesions, usually on the lips or inside the mouth. HSV-2 is generally transmitted through sexual contact. Vaginal or anal intercourse and oral-genital contact are the primary transmission modes but HSV-2 can be transferred by hand contact as well.

The nursing supervisor becomes concerned after overhearing a nurse state, "People who get sexually transmitted infections (STIs) deserve whatever happens to them. They shouldn't have been engaging in promiscuous behavior." Which statement best describes the reason the nursing supervisor is concerned? 1. The supervisor is concerned patients with STIs may offend the LPN. 2. Caring for patients with STIs lowers the morale of the clinic staff. 3. Nursing staff may refuse to care for patients with STIs. 4. Patients may be reluctant to seek care when they fear being judged.

4. Patients may be reluctant to seek care when they fear being judged. Rationale: Judgmental attitudes can function as a barrier to accessing health care services for those with STIs, which can lead to continued spread of the infection. Health care providers need to put aside their personal beliefs to provide excellent nursing care to patients despite the fact that patients may engage in lifestyles that nursing staff may disagree with. REF: p. 1082

With an STI, common reasons that patients give for seeking medical care include pain, fever, lesions, or genital: 1. itching 2. edema 3. bleeding 4. discharge

4. discharge Rationale: The history begins with an exploration of the patient's reason for medical care. With an STI, common reasons include pain, fever, lesions, and genital discharge.

Some STIS are painless, but patients may have pain associated with oral lesions, rectal lesions, or: 1. vaginal bleeding 2. genital edema 3. nerve irritation 4. pelvic infection

4. pelvic infection Rationale: Some STIS are painless, but patients may have pain associated with pelvic infection, oral lesions, or rectal lesions.

The treatment of choice for syphilis is: 1. doxycycline calcium (Vibramycin) 2. erythromycin 3. tetracycline 4. penicillin

4. penicillin Rationale: The treatment choice for syphilis is parenteral penicillin G unless contraindicated