OB- Ch. 5

A client is returning with a third vaginal infection within a six-month period. During the health assessment, the nurse should ask about the client's use of which products? Select all that apply. 1- douches 2- deodorants 3- yogurt 4- herbs

1- douches 2- deodorants

Who is at risk for HPV?

Everyone is at risk; most sexually active men and women will get HPV at some point in their lives.

The most common viral infection in the U.S. is what? Estimated 80% of sexually active people contract it at some point in their lives.

Human Papillomavirus (HPV)

This stage of syphilis presents with no symptoms, can be infective the first 1-2 years of latency, some may go on to develop tertiary infections. This stage can last as long as 20 years.

Latent phase of syphilis

This stage of syphilis presents with tumors of the skin, bones, and liver; CNS symptoms, CV symptoms, and is usually not reversible. Can cause life-threatening heart disease and neurologic disease that slowly destroys the heart, eyes, brain, central nervous system, and skin.

Tertiary (late) syphilis

Clients who have had PID are prone to which complication? 1 -ectopic pregnancy 2- multiple gestation 3- ovarian cancer 4- inguinal lymphadenopathy

1 -ectopic pregnancy

During this phase of HIV, the HIV viral load drops rapidly because the host's immune system works well to fight this initial infection. The onset of this infection occurs 2-6 weeks after exposure. Symptoms include fever, pharyngitis, rash, and myalgia. Most people do not associate these flu-like symptoms with HIV. After initial exposure, there's a period of 3-12 months before the next phase.

Acute primary infection period

The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which count would indicate to the nurse that the client has AIDS? A. 1,000 cells/mm3 B. 700 cells/mm3 C. 450 cells/mm3 D. 200 cells/mm3

D. 200 cells/mm3 Rationale: When the CD4 T-cell count reaches 200 or less, the person has reached the stage of AIDS per the CDC. A CD4 T-cell count between 450 and 1,200 is considered normal. Reference: p. 196

An infection-induced inflammation of the female upper reproductive tract.

Pelvic Inflammatory Disease (PID)

This stage of syphilis is characterized by a lesion called a chancre, that is a painless purplish ulcer with a small raised margin with hard edges, at the site of bacterial entry- disappears within 1-6 weeks without intervention.

Primary syphilis

This STI is the second most commonly reported infection in the U.S.= It is highly contagious, potentially very severe, and reportable to health departments

Gonorrhea

Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? 1- erectile dysfunction 2- dysuria 3- painful ejaculation 4- hematuria

2- dysuria

A young sexually active woman asks the nurse what type of birth control would help prevent sexually transmitted infections as well as pregnancy. Which type would the nurse recommend? 1- oral contraceptives 2- withdrawal 3- condom 4- intrauterine device

3- condom

The cause of which STI is from an aerobic gram-negative intracellular diplococcus, that infects mucosal surfaces?

Gonorrhea

Where is the site of infection located in gonorrhea?

The columnar epithelium of the endocervix

Transmission of the herpes simplex virus occurs by which two ways?

1) Contact of mucous membranes 2) Breaks in the skin with visible or non-visible lesions

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? 1- genital warts 2- genital herpes 3- syphilis 4- chlamydia

1- 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.

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? 1- latency 2- secondary 3- primary 4- tertiary

1- latency

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? 1- metronidazole 2- acyclovir 3- clotrimazole 4- penicillin G

1- metronidazole

A woman is to receive penicillin G 3,000,000 units IM q6h as syphilis treatment. The medication is available as 1,500,000 units/mL. How many milliliters will be administered in 24 hours? Record your answer using a whole number.

2*4= 8

A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure? 1- "One or two treatments should get rid of the warts." 2- "I'm temporarily not contagious once the warts are destroyed." 3- "Once the warts are gone, then I know I'm cured." 4- "My partner doesn't need to be treated."

2- "I'm temporarily not contagious once the warts are destroyed." Genital warts when treated chemically will most likely be eradicated after three to six cycles of treatment. Eradication does not mean the condition is cured; the person is temporarily noncontagious once the warts are destroyed. All sexual contacts of the client need to be examined and treated.

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? 1- gonorrhea 2- chlamydia 3- syphilis 4- genital herpes

2- chlamydia

Which finding would alert the nurse to suspect that a client has a yeast infection? 1- changes in skin color 2- vulvar burning and itching 3- lymphadenopathy 4- acidic vaginal secretions

2- vulvar burning and itching

The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age? 1- 40 2- 32 3- 25 4- 28

3- 25

A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? 1- Taking the drug on an empty stomach 2- Using a sunscreen when outside 3- Avoiding alcohol consumption 4- Reporting signs of an oral yeast infection

3- Avoiding alcohol consumption

The nurse is reviewing medication orders for a pregnant patient diagnosed with a urinary tract infection. Which medication order should the nurse question for this patient? 1- Ampicillin 2- Amoxicillin 3- Tetracycline 4- Cephalosporin

3- Tetracycline

Which instruction should be given to a woman newly diagnosed with genital herpes? 1- Obtain a Papanicolaou test every 3 years. 2- Have your partner use a condom when lesions are present. 3- Use a water-soluble lubricant for relief of pruritus. 4- Limit stress and emotional upset as much as possible.

4- Limit stress and emotional upset as much as possible.

Therapeutic management for HSV involves the antiviral therapy of which of the following drugs? SATA A) Acyclovir B) Famciclovir C) Valacyclovir (Valtrex) D) Amoxicillin

A) Acyclovir B) Famciclovir C) Valacyclovir (Valtrex)

Therapeutic management of HIV/AIDS includes: SATA A) Antiretroviral therapy (ART) B) Long-acting injectable medication/oral meds to suppress viral load C) Antiviral medications

A) Antiretroviral therapy (ART) B) Long-acting injectable medication/oral meds to suppress viral load

Means of transmission for HSV include: SATA A) Kissing B) Oral sex C) Vaginal sex D) Vaginal birth E) Drinking/eating after another

A) Kissing B) Oral sex C) Vaginal sex D) Vaginal birth

During this phase of HIV, the immune system begins a constant battle to fight this viral invasion, but over time it falls behind. Diagnosis is finally confirmed when CD4 T-cell count is less than 200.

AIDS

Which instructions would the nurse include when teaching a woman with pediculosis pubis (crabs)? A. "Take the antibiotic until you feel better." B. "Wash your bed linens in bleach and cold water." C. "Your partner doesn't need treatment at this time." D. "Remove the nits with a fine-toothed comb."

D. "Remove the nits with a fine-toothed comb." Rationale: The nurse should instruct the client to remove the nits from the hair using a finetoothed comb. Permethrin cream and lindane shampoo are used as treatment, not antibiotics. Bedding and clothing should be washed in hot water to decontaminate it. Sexual partners should also be treated, as well as family members who live in close contact with the infected person. Reference: p. 195

What is the gold standard for HSV diagnosis? 1- culture 2- shave biopsy 3- excisional biopsy 4- punch biopsy

1- culture

After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment? 1- genital herpes 2- syphilis 3- gonorrhea 4- chlamydia

1- genital herpes

A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection? 1- viral culture of vesicular fluid 2- Papinicolaou smear 3- IgG/IgM antibody testing 4- treponemal testing

1- viral culture of vesicular fluid

A 19-year-old female client has been diagnosed with pelvic inflammatory disease (PID) caused by untreated gonorrhea. Which instructions should the nurse offer when caring for the client? Select all that apply. 1- Use an intrauterine device (IUD). 2- Avoid douching vaginal area. 3- Complete the antibiotic therapy. 4- Increase fluid intake. 5- Limit the number of sex partners.

2- Avoid douching vaginal area. 3- Complete the antibiotic therapy. 5- Limit the number of sex partners.

A client is being discharged from the gynecological unit after treatment for an acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include? 1- Provide the client with brochures on sexually transmitted disease prevention. 2- Arrange for follow-up visits to her health care provider. 3- Discuss the necessity of completing the antibiotic therapy. 4- Refer the client to the women's sexual health clinic.

3- Discuss the necessity of completing the antibiotic therapy.

The nurse is assessing a primigravida woman who reports vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. The nurse suspects the woman has contracted which disorder? 1- Chlamydia 2- Simple yeast infection 3- Trichomoniasis 4- Gonorrhea

3- Trichomoniasis

During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which diagnosis? 1- genital herpes 2- gonorrhea 3- condylomata acuminata 4- candidiasis

3- condylomata acuminata (genital warts)

A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition? 1- genital warts 2- genital herpes 3- gonorrhea 4- syphilis

3- gonorrhea

A nurse has performed disease prevention teaching with a female client who has genital herpes. Which client behavior indicates that the teaching has been successful? 1- The client keeps the affected area moist. 2- The client keeps her fingernails long. 3- The client wears tight-fitting jeans. 4- The client washes her hands before and after touching lesions.

4- The client washes her hands before and after touching lesions.

A pregnant woman is diagnosed with chlamydia and asks the nurse, "How will this infection affect my baby and pregnancy?" Which responses by the nurse are accurate? Select all that apply. A. "Your newborn can be infected during birth." B. "Your newborn may have eye infections from this infection." C. "Your membranes may rupture earlier than normal." D. "Your newborn is protected from this infection." E. "It will not have any effect on your pregnancy."

A. "Your newborn can be infected during birth." B. "Your newborn may have eye infections from this infection." C. "Your membranes may rupture earlier than normal." Rationale: STIs' effects on the fetus or newborn such as chlamydia include the newborn being infected during birth with eye infections (neonatal conjunctivitis), pneumonia, low birth weight, increased risk of premature rupture of the membranes (PROM), preterm birth, and stillbirth. Reference: p. 183

Term which applies to the most advanced stages of HIV infection=

AIDS- Acquired Immunodeficiency Syndrome

Chlamydia presents with which of the following symptoms? SATA A) Asymptomatic (most common) B) Dysuria (difficult/painful urination) C) Urinary frequency D) Dyspareunia (painful intercourse) E) Cervical discharge F) Endocervicitis G) Inflammations of rectum and lining of the eye H) Can infect throat I) Itching

ALL BUT I A) Asymptomatic (most common) B) Dysuria (difficult/painful urination) C) Urinary frequency D) Dyspareunia (painful intercourse) E) Cervical discharge F) Endocervicitis G) Inflammations of rectum and lining of the eye H) Can infect throat

A client is to receive 3 million units of penicillin G intramuscular to treat gonorrhea. The drug is available in 1,500,000 units/mL. How many milliliters should the nurse administer? Record your answer using a whole number.

Answer: 2 Rationale: Formula of D/H X V 3,000,00/1,500,000 X 1 mL = 2 mL; Reference: p. 188

During this phase of HIV, the infected person becomes asymptomatic, but the HIV virus begins to replicate. Even though there are no symptoms, the immune system runs down. A normal person has a CD4 T-cell count of 450-1,200 cells/uL. When the CD4 T-cell count reaches 200 the person has reached the stage of AIDS.

Asymptomatic infection

This STI is the most common cause of vaginal discharge=

Bacterial vaginosis

This disease results from an ascending polymicrobial infection of the upper female reproductive tract, frequently caused by untreated chlamydia or gonorrhea.

Pelvic Inflammatory Disease (PID)

This stage of syphilis appears 2-6 months after initial exposure and is manifested by flu-like symptoms, sore throat, and a maculopapular rash of the trunk, palms, and soles. Alopecia and adenopathy are both common during this stage. This stage lasts about 2 years long.

Secondary syphilis

A chronic, multistage, curable bacterial infection caused by the spirochete- Treponema pallidum that is typically transmitted sexually with an infected partner or congenitally from an infected mother to her fetus.

Syphilis

This STI can be passed in utero, and result in fetal/infant death. Congenital ___________ can lead to skin ulcers, rashes, fever, weakened or hoarse cry, swollen liver and spleen, jaundice and anemia, and various deformations.

Syphilis

This STI can cause premature rupture of membranes, preterm birth, and low birth weight.

Trichomoniasis

A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate a possible PID? Select all that apply. 1- lower abdominal tenderness 2- adnexal tenderness 3- cervical motion tenderness 4- constipation

1- lower abdominal tenderness 2- adnexal tenderness 3- cervical motion tenderness

Therapeutic management for gonorrhea includes using which of the following medications? SATA: A) Azithromycin B) Ceftriaxone C) Doxycycline D) Amoxicillin E) Penicillin

A) Azithromycin B) Ceftriaxone Must be cured with two antibiotics (dual therapy) to prevent drug resistance and is also effective against chlamydia

A woman has been diagnosed with trichomoniasis and asks the nurse when it would be safe to resume sexual activity. How should the nurse respond? A. "After treatment you must be symptom free to resume sexual activity." B. "You may resume sexual activity after you and your partner have been treated." C. "You and your partner must wait 10 days after you complete your treatment regimen." D. "When you have taken your medication and no longer have any discharge, then sexual activity is fine."

A. "After treatment you must be symptom free to resume sexual activity." Rationale: Trichomoniasis is the most prevalent nonviral sexually transmitted infection. It is treated with metronidazole, usually a single 2-gram dose. For treatment to be effective all sexual partners of the client need to be treated. Sexual activity can resume after the partners have been treated and both the woman and partner are symptom free. There is no timeline for this to occur and treatment will not be effective if both the woman and her partner are not treated. The infection will reoccur. Reference: p. 181

A client with trichomoniasis is to receive metronidazole. What should the nurse instruct the client to avoid while taking this drug? A. alcohol B. nicotine C. chocolate D. caffeine

A. alcohol Rationale: The client should be instructed to avoid consuming alcohol when taking metronidazole because severe nausea and vomiting could occur. There is no need to avoid nicotine, chocolate, or caffeine when taking metronidazole. Reference: p. 181

This STI can be infected during delivery. Can cause eye infections (neonatal conjunctivitis), pneumonia, low-birth weight, preterm birth, or still birth.

Chlamydia

If the HIV-infected infant goes untreated, progression to AIDS and eventual ____________ will occur.

Fatality

The nurse is teaching a group of middle school students about sexually transmitted infections (STIs). Which statement by the students indicates a need for additional teaching about condom use? 1- "Put the condom on just before orgasm." 2- "Latex condoms provide the best protection against STIs." 3- "Putting the condom on just before insertion defeats the purpose." 4- "Don't store condoms in your wallet."

1- "Put the condom on just before orgasm."

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? 1- Fluconazole 2- Tetracycline 3- Clindamycin 4- Acyclovir

1- Fluconazole

A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis? 1- Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. 2- Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. 3- Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection. 4- Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.

2- Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.

A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata? 1- herpes virus 2- human papillomavirus 3- Treponema pallidum 4- Haemophilus ducreyi bacillus

2- human papillomavirus

Therapeutic management of a patient with PID include: SATA A) Empiric broad-spectrum antibiotics- doxycycline, cetotaxime, azithromycin, metronidazole B) Oral fluids C) Bed rest D) IV fluids E) Pain management

A) Empiric broad-spectrum antibiotics- doxycycline, cetotaxime, azithromycin, metronidazole B) Oral fluids C) Bed rest E) Pain management

Risk factors for BV include: SATA A) Multiple sexual partners B) Douching C) Lack of vaginal lactobacilli D) Having HIV

A) Multiple sexual partners B) Douching C) Lack of vaginal lactobacilli

Which finding would the nurse expect in a client with bacterial vaginosis? A. vaginal pH of 3 B. fish-like odor of discharge C. yellowish-green discharge D. cervical bleeding on contact

B. fish-like odor of discharge Rationale: Manifestations of bacterial vaginosis include a thin, white, homogenous vaginal discharge with a characteristic stale fishy odor, vaginal pH greater than 4.5, and clue cells on wet-mount examination. A yellowish-green discharge with cervical bleeding on contact would be characteristic of trichomoniasis. Reference: p. 182

With this STI, 50-70% of women are asymptomatic, but it may also present with a vaginal discharge which is accompanied with a fishy foul odor (sometimes)

Bacterial vaginosis

This is the most common bacterial STI in the U.S.; the majority are asymptomatic.

Chlamydia

This STI can be infected during delivery. Ophthalmia neonatorum can lead to blindness and or sepsis in babies (including arthritis and meningitis). Rhinitis, vaginitis, and preterm birth may occur.

Gonorrhea

Which medications are appropriate to treat chlamydia trachomatis? Select all that apply. 1- azithromycin 2- ofloxacin 3- valacyclovir 4- doxycycline 5- acyclovir

1- azithromycin 2- ofloxacin 4- doxycycline

Which medication is the most effective treatment for trichomoniasis? 1- metronidazole 2- penicillin G benzathine 3- doxycycline 4- azithromycin

1- metronidazole

A woman is diagnosed with a vaginal infection. After teaching the client about measures to reduce her risk, the nurse determines that the client needs additional teaching when she states which factor as increasing her risk? 1- antibiotic therapy 2- menstruation 3- douching 4- use of feminine hygiene sprays

2- menstruation

A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply. 1- 29 years of age 2- multiple sex partners 3- intrauterine contraceptive device inserted 3 weeks ago 4- vaginal douching approximately once a week 5- residence in a suburban area

2- multiple sex partners 3- intrauterine contraceptive device inserted 3 weeks ago 4- vaginal douching approximately once a week

A female client comes to the clinic for an evaluation. Assessment reveals flu-like symptoms and a maculopapular rash on her trunk, and the palms of her hands and the soles of her feet. The client also reports hair loss and fatigue. She states, "I had a small ulcer near my vagina about 6 weeks ago that went away." Based on these findings, the nurse suspects that the client has syphilis at which stage? 1- primary 2- secondary 3- early latent 4- late latent

2- secondary

How does gonorrhea present? SATA: A) Dysuria B) Urinary frequency C) May be asymptomatic D) Dyspareunia (painful intercourse) E) Vaginal discharge- greenish/yellowish F) Endocervicitis G) Arthritis H) PID I) Rectal infection J) Yeast infections

A) Dysuria B) Urinary frequency C) May be asymptomatic D) Dyspareunia (painful intercourse) E) Vaginal discharge- greenish/yellowish F) Endocervicitis G) Arthritis H) PID I) Rectal infection

________________ trachomatis, an intracellular parasite that can't produce its own energy and depends on the host for survival, is the bacterium that causes what STI?

Chlamydia

Genital warts or condylomata are caused by what STI?

HPV

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. 1- "The virus remains quiet until a stressful event occurs to reactivate it." 2- "Your baby is protected from this infection by the placenta." 3- "Many recognize they have the infection and seek treatment immediately." 4- "Infections may be transmitted by individuals unaware that they have it." 5- "Transmission is through contact of infected mucous membranes."

1- "The virus remains quiet until a stressful event occurs to reactivate it." 4- "Infections may be transmitted by individuals unaware that they have it." 5- "Transmission is through contact of infected mucous membranes."

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? 1- "This STI is characterized by an infection of your cervix." 2- "This STI is an infection that will cause itching in the genital area." 3- "This STI is an infection that results in ulcers in the genital area." 4- "This STI is an infection that will result in the formation of genital warts."

1- "This STI is characterized by an infection of your cervix."

A nurse is caring for a client undergoing treatment for bacterial vaginosis. Which instruction should the nurse give the client to prevent recurrence of bacterial vaginosis? 1- Practice monogamy. 2- Use oral contraceptives. 3- Avoid smoking. 4- Undergo colposcopy tests frequently.

1- Practice monogamy.

At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include? 1- This infection is the most common infectious cause of infertility. 2- This infection is lifelong as it cannot be treated with medication. 3- Antiviral drug regimes will cure this infection. 4- The new recombinant human papillomavirus vaccine will prevent the infection.

1- This infection is the most common infectious cause of infertility.

An HIV-positive client who is on antiretroviral therapy reports anorexia, nausea, and vomiting. Which suggestion should the nurse offer the client to cope with this condition? 1- Use high-protein supplements. 2- Eat dry crackers after meals. 3- Limit number of meals to three a day. 4- Constantly drink fluids while eating.

1- Use high-protein supplements.

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? 1- a painless genital ulcer that appeared about 3 weeks after unprotected sex 2- copper-colored macules on the palms and soles that appeared after a brief fever 3- patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas 4- one or more flat, wartlike papules in the genital area that are sensitive to touch

1- a painless genital ulcer that appeared about 3 weeks after unprotected sex

A woman with a history of genital lesions caused by herpes simplex virus (HSV) has been admitted to the labor unit at 39 weeks' gestation. She said she was given medicine prophylaxically a few weeks ago to prevent lesions at the time of birth. Which medication is safe to give to a pregnant women with HSV? 1- acyclovir 2- benzathine penicillin 3- chloroquine 4- mefloquine

1- acyclovir

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 six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms? 1- an -azole antifungal agent 2- a penicillin antibiotic 3- a quinolone antibiotic 4- an antiviral agent

1- an azole antifungal agent

A pregnant client is diagnosed with chlamydia and is to receive antimicrobial therapy. Which drug would the nurse least likely expect to be prescribed? 1- azithromycin 2- erythromycin 3- ofloxacin 4- levofloxacin

1- azithromycin

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? 1- burning on urination 2- dry, hacking cough 3- diffuse skin rash 4- painless chancre

1- burning on urination

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? 1- candidiasis 2- syphilis 3- gonorrhea 4- chlamydia

1- candidiasis

A nurse is assessing a client who has a history of pelvic inflammatory disease (PID). The nurse would be alert for which complication? Select all that apply. 1- ectopic pregnancy 2- pelvic abscess 3- fibrosis 4- inguinal lymphadenopathy

1- ectopic pregnancy 2- pelvic abscess 3- fibrosis

Working at the local health clinic, the nurse recognizes that STIs can often result in PID. When a client with a history of repeat STIs presents to the clinic reporting severe abdominal cramping and bleeding, the immediate concern is to ensure the client does not have: 1- ectopic pregnancy. 2- genital herpes simplex. 3- endometriosis. 4- secondary urinary tract infection.

1- ectopic pregnancy.

Which medications are appropriate to treat vaginal candidiasis? Select all that apply. 1- miconazole 2- fluconazole 3- azithromycin 4- gentamicin 5- penicillin G benzathine

1- miconazole 2- fluconazole

A nurse is assessing a client diagnosed with pelvic inflammatory disease (PID). Which finding would the nurse most likely assess? Select all that apply. 1- oral temperature of 102°F (39°C) 2- painful urination 3- right upper quadrant pain 4- tenderness with cervical motion 5- negative pregnancy history 6- clear vaginal discharge

1- oral temperature of 102°F (39°C) 2- painful urination 4- tenderness with cervical motion 5- negative pregnancy history

What is the medication of choice for early syphilis? 1- penicillin G benzathine 2- doxycycline 3- tetracycline 4- ceftriaxone

1- penicillin G benzathine

Pelvic infection is most commonly caused by: 1- sexual transmission. 2- surgical abortion. 3- hysteroscopy. 4- insertion of intrauterine device.

1- sexual transmission.

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis? 1- sore throat and flu-like symptoms 2- pain-free crusty genital lesions 3- yellow vaginal discharge 4- painful dysurea

1- sore throat and flu-like symptoms

A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings? 1- the possibility of a chlamydia infection 2- an acute stage of the gonorrheal infection 3- a reaction to the gonorrheal medications 4- a positive pregnancy test

1- the possibility of a chlamydia infection

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? 1- trichomoniasis 2- herpes simplex II 3- human papillomavirus 4- syphilis

1- trichomoniasis

A woman comes to the clinic reporting vaginal discharge. The nurse suspects trichomoniasis based on which symptoms? Select all that apply. 1- urinary frequency 2- yellow/green discharge 3- joint pain 4- blister-like lesions 5- muscle aches

1- urinary frequency 2- yellow/green discharge

A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community? 1- Promote use of oral contraceptives. 2- Emphasize the importance of good body hygiene. 3- Discuss limiting the number of sex partners. 4- Emphasize not sharing personal items with others.

3- Discuss limiting the number of sex partners.

After teaching a group of young adult women on preventing pelvic inflammatory disease, the nurse determines that the teaching was successful when the group identifies which method as effective? 1- using hormonal contraception 2- using a vaginal douche weekly 3- having infected sexual partners receive treatment 4- obtaining routine treatment if at risk and asymptomatic

3- having infected sexual partners receive treatment

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? 1- trichomoniasis 2- bacterial vaginosis 3- vulvovaginal candidiasis 4- chlamydia

3- vulvovaginal candidiasis

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which statement by the client demonstrates understanding of his health problem? 1- "Either me or a partner could end up with an eye infection from chlamydia that could make us blind." 2- "Even though I couldn't end up sterile, a woman that I give it to certainly could." 3- "Each of the 3 stages of the disease seems to be worse than the previous one." 4- "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

4- "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

A young couple are disappointed that they are not yet pregnant and are seeking assistance at the health clinic. After assessing their medical history, the nurse discovers the female has a history of several episodes of PID. The nurse predicts this may be a source of the infertility related to which factor? 1- It causes anovulation due to interference with secretion of pituitary hormones. 2- It causes changes in cervical mucus that make it less receptive to penetration by sperm. 3- It causes sperm-agglutinating antibodies to be produced in the vagina. 4- It interferes with the transport of ova due to tubal scarring.

4- It interferes with the transport of ova due to tubal scarring.

When describing sexually transmitted infections and testing, the nurse explains that a client is typically tested for chlamydia, gonorrhea, and syphilis at the same time for which reason? 1- The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client. 2- The infecting bacterium in all cases is the same, and therefore clients have concurrent infections. 3- The infections spread through the same medium, and therefore clients have concurrent infections. 4- It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).

4- It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).

A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe? 1- penicillin 2- tetracycline 3- levofloxacin 4- ceftriaxone

4- ceftriaxone

A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely? 1- foul-smelling discharge 2- vaginal bleeding 3- vesicles on the labia 4- chancres at the vaginal site

4- chancres at the vaginal site

A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent? 1- acyclovir 2- ceftriaxone 3- podophyllum resin 4- doxycycline

4- doxycycline

A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports: 1- headache and fever. 2- vaginal and urethral discharge. 3- dysuria and lymphadenopathy. 4- genital pruritus and paresthesia.

4- genital pruritus and paresthesia.

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 six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? 1- azithromycin 2- valacyclovir 3- penicillin 4- metronidazole

4- metronidazole

A pregnant client is complaining of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? 1- ceftriaxone IM 2- oral erythromycin 3- benzathine penicillin G IM 4- oral metronidazole

4- oral metronidazole

A 40-year-old woman is being discharged from the walk-in health care clinic after a diagnosis of pelvic inflammatory disease. Which health teaching topic should the nurse address? 1- symptoms of menopause 2- pain control for endometriosis 3- fertility issues 4- sexually transmitted infections

4- sexually transmitted infections

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? 1- kissing 2- sexual contact 3- giving vaginal birth 4- sharing contaminated needles

4- sharing contaminated needles

Common symptoms of Trichomoniasis include: SATA A) Asymptomatic (no symptoms at all) B) Dysuria (difficult/painful urination) C) Urinary frequency D) Heavy yellow/green/gray frothy or bubbly vaginal discharge E) Dyspareunia (painful intercourse) F) Irritation of the genital area G) Itching/burning labia

A) Asymptomatic (no symptoms at all) B) Dysuria (difficult/painful urination) C) Urinary frequency D) Heavy yellow/green/gray frothy or bubbly vaginal discharge E) Dyspareunia (painful intercourse) F) Irritation of the genital area

Therapeutic management for syphilis includes taking which of the following drugs? SATA A) Benzathine penicillin G IM or IV B) Doxycycline C) Furosemide D) Azythromycin

A) Benzathine penicillin G IM or IV B) Doxycycline (if allergic to penicillin)

Genital herpes presents itself with which of the following symptoms? SATA A) Blister-like genital lesions B) Dysuria C) Fever D) Headache E) Muscle aches F) Malaise G) Rash/hives

A) Blister-like genital lesions B) Dysuria C) Fever D) Headache E) Muscle aches F) Malaise

The 3 most common causes of vaginitis are: SATA A) Candida- a fungus B) Trichomonas- a protozoa C) Gardnerella- a bacterium D) Chlamydia- a bacterium

A) Candida- a fungus B) Trichomonas- a protozoa C) Gardnerella- a bacterium

The therapeutic regimen to treat chlamydia includes which of either antibiotics? (Can be combined for therapy if gonorrhea is present as well) A) Doxycycline B) Fluconazole C) Azythromycin D) Oxytocin

A) Doxycycline C) Azythromycin

Nursing management of clients with HIV/AIDS includes: SATA A) Education about drug therapy B) Compliance, prevention C) Care during pregnancy and childbirth D) Administering the medications to the patients

A) Education about drug therapy B) Compliance, prevention C) Care during pregnancy and childbirth

What should a nurse assess a client who may have HPV? SATA A) For visible genital warts/lesions B) Serial pap smears (for low-risk women) C) HPV test/screening D) Flu-like symptoms

A) For visible genital warts/lesions B) Serial pap smears (for low-risk women) C) HPV test/screening

Manifestations of PID include: SATA A) Lower abdominal tenderness B) Adnexal tenderness C) Cervical motion tenderness D) Fever above 101F E) Dysuria F) Dysmenorrhea G) Dyspareunia H) Nausea/Vomiting I) Abnormal cervical/vaginal mucopurulent discharge J) Greenish vaginal discharge

A) Lower abdominal tenderness B) Adnexal tenderness C) Cervical motion tenderness D) Fever above 101F E) Dysuria F) Dysmenorrhea G) Dyspareunia H) Nausea/Vomiting I) Abnormal cervical/vaginal mucopurulent discharge

Therapeutic management for HPV includes: SATA A) Preventative vaccine/education B) Treatment of warts and lesions C) Secondary prevention via education D) Antiviral medications

A) Preventative vaccine/education B) Treatment of warts and lesions C) Secondary prevention via education

HIV can be transmitted through which of the following? SATA A) Sexual intercourse B) Sharing needles C) From mother to child during pregnancy D) Childbirth E) Breastfeeding F) Kissing

A) Sexual intercourse B) Sharing needles C) From mother to child during pregnancy D) Childbirth E) Breastfeeding

Nursing management for women with frequent VVC infections include: SATA A) Teaching preventative measures B) Wear white, 100% cotton underwear C) Avoid irritants D) Good body hygiene- washing with a mild soap and drying gently E) Avoidance of douching/super-absorbent tampons F) Reduce dietary intake of simple sugars/sodas G) Avoid wearing tight clothes or exercise clothes w/spandex H) Use a floral scented body wash

A) Teaching preventative measures B) Wear white, 100% cotton underwear C) Avoid irritants D) Good body hygiene- washing with a mild soap and drying gently E) Avoidance of douching/super-absorbent tampons F) Reduce dietary intake of simple sugars/sodas G) Avoid wearing tight clothes or exercise clothes w/spandex

A public health nurse is teaching a class on sexually transmitted infections (STIs). Which statements would the nurse include in the discussion? Select all that apply. A. "65 million people live with incurable STIs." B. "STIs are biologically sexist causing more complications among men." C. "After a single exposure, women are twice as likely as men to acquire a STI." D. "STIs contribute to cervical cancer." E. "STIs cannot be transmitted to the fetus or infant during childbirth."

A. "65 million people live with incurable STIs." C. "After a single exposure, women are twice as likely as men to acquire a STI." D. "STIs contribute to cervical cancer." Rationale: An estimated 65 million people live with an incurable STI. STIs are biologically sexist, presenting greater risk and causing more complications among women than among men. After only a single exposure, women are twice as likely as men to acquire infections. STIs may contribute to cervical cancer. Certain infections can be transmitted in utero to the fetus or during childbirth to the newborn. Reference: p. 172

A woman is diagnosed with gonorrhea. The client asks why she needs to take two medications. How should the nurse respond? Select all that apply. A. "The medicines are needed to kill the bacteria causing the infection." B. "The medications help prevent the spread of the bacteria to your female organs." C. "Taking two medications will cure the infection faster." D. "The bacteria causing the infection is very strong, so two medications are needed." E. "The medications will stop the bacteria before it can cause complications."

A. "The medicines are needed to kill the bacteria causing the infection." B. "The medications help prevent the spread of the bacteria to your female organs." E. "The medications will stop the bacteria before it can cause complications." Rationale: The antibiotic treatment for gonorrhea is a dual therapy with azithromycin and ceftriaxone. Dual therapy is recommended to prevent drug resistance and it is also effective against chlamydia. If left untreated or not treated adequately, gonorrhea can cause infertility, pelvic inflammatory disease, and ectopic pregnancy. The medications can cure the infection and help prevent spread to the pelvic organs. Taking two medications does not kill the bacteria faster nor is the bacteria so strong two medications are needed. Reference: p. 184-185

A woman has been prescribed doxycycline to treat a chlamydia infection. What instruction(s) should the nurse give this client? Select all that apply. A. "You must take all the 7 days of the medication." B. "You will need to be retested after you complete the medication." C. If the symptoms do not go away after the medication, you will need to return to the health care provider." D. "If you suspect you have another infection, you need to see the health care provider right away." E. "You will need to have a pregnancy test before starting the medication."

A. "You must take all the 7 days of the medication." C. If the symptoms do not go away after the medication, you will need to return to the health care provider." D. "If you suspect you have another infection, you need to see the health care provider right away." Rationale: Doxycycline belongs to the classification of tetracyclines. It is useful in the treatment of many types of infections and specifically chlamydia. The drug is given twice a day for 7 days. It is contraindicated with a known hypersensitivity to the drug. The medication may be taken during pregnancy. The client needs to be retested only if it is suspected or known the client did not complete the medication, if symptoms persist or if a reinfection is suspected. The client needs to return to the health care provider if treatment has been completed and symptoms persist. It is recommended for women to be screened annually for this infection. Reference: p. 183

A client has been diagnosed and treated for primary syphilis. What instruction should the nurse give this client about follow-up testing? A. "You will need to be retested again in 6 months." B. "You also will need to be tested for HIV in 6 months." C. "You do not need to be retested after treatment unless symptoms develop." D. "You need to retested if you have a new sexual partner."

A. "You will need to be retested again in 6 months." Rationale: For the client treated for primary or secondary syphilis, retesting needs to occur at 6 months and at 12 months. If the client was treated for latent syphilis, then testing needs to be done at 6 months, 12 months, and 24 months. For latent syphilis, the testing also needs to include testing for HIV. The client does not to be retested if there is a new sexual partner, but the client should be instructed in safer sex methods to prevent a sexually transmitted infection. Reference: p. 188

The school public health nurse is teaching a high school class on sexually transmitted infections (STIs). The nurse would include what information in the presentation? Select all that apply. A. Fifteen- to twenty-four-year-olds represent almost half of all cases of new STIs. B. Two in five sexually active teen girls have an STI. C. Adolescent females make up more than three-quarters of HIV diagnoses. D. Teens who are sexually active experience high rates of STIs. E. All groups of teens are at the same risk. F. Adolescent males make up more than four-fifths of HIV diagnosis.

A. Fifteen- to twenty-four-year-olds represent almost half of all cases of new STIs. B. Two in five sexually active teen girls have an STI. D. Teens who are sexually active experience high rates of STIs. F. Adolescent males make up more than four-fifths of HIV diagnosis. Rationale: Individuals aged 15 to 24 years represent almost half of all cases of new STIs acquired. Two in five sexually active teen girls have a STI. Adolescent males make up more than three-quarters of HIV diagnoses among 13- to 19-year-olds. In the United States, teens who are sexually active experience high rates of STIs, and some groups are at higher risk, including African American and Hispanic youths, youths living in poverty, and those with limited educational attainment. Reference: p. 172

A young adult woman who is HIV-positive is receiving anti-retroviral therapy (ART) and is having difficulty with adherence. To promote adherence, which area would be most important for the nurse to assess? A. beliefs and education B. financial situation and insurance C. activity level and nutrition D. family and living arrangements

A. beliefs and education Rationale: The most important area to assess initially would be the client's beliefs and knowledge about the disease and its treatment. A common barrier is a lack of understanding about the link between drug resistance and nonadherence. Once this area is assessed, the nurse can assess for other barriers, such as finances and insurance, nutrition and activity level, and family issues, including living arrangements (for example, the client may be afraid that his or her HIV status would be revealed if others see the client taking medication). Reference: p. 198

An female adolescent is diagnosed with gonorrhea. When developing the plan of care for this adolescent, the nurse would expect that she would also receive treatment for: A. chlamydia. B. syphilis. C. genital herpes. D. trichomoniasis.

A. chlamydia Rationale: Clients with gonorrhea usually receive treatment for chlamydia as well because they often are coinfected. Coinfection with syphilis, genital herpes, or trichomoniasis is uncommon. Reference: p. 184

After teaching a group of adolescents about HIV, the nurse asks them to identify the primary means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which means of exposure? A. sexual intercourse B. sharing needles for IV drug use C. perinatal transmission D. blood transfusion

A. sexual intercourse Rationale: HIV infections are increasing in adolescents and young adults aged 13 to 24 years predominantly transmitted by sexual intercourse. Millions of US adolescents between the ages of 10 and 19 are living with HIV, and many do not receive the care and support they need to stay in good health. This is particularly significant because the risk of HIV transmission increases substantially if either partner is infected with an STI. Sharing of needles, perinatal transmission, and blood transfusions are less often means of transmission in adolescents. Reference: p. 196

Nursing management of clients with chlamydia and gonorrhea include: SATA A) Treatment strategies B) Referrals C) Preventative measures D) Education and counseling E) Assess sexual history/ # of sexual partners F) Public education G) Educate on safe-sex practices

ALL OF THE ABOVE A) Treatment strategies B) Referrals C) Preventative measures D) Education and counseling E) Assess sexual history/ # of sexual partners F) Public education G) Educate on safe-sex practices

A sexual health public health nurse is presenting information on sexually transmitted infections (STIs) to adolescent girls and is asked, "Why are females more at risk for STIs?" Which statements by the nurse would best answer this question? Select all that apply. A. "Teenage females have sex as they feel they have power to control the sex act." B. "Teenage females lack communication skills to negotiate for safer sex." C. "The teenage female anatomy is mature, leaving them more susceptible to STIs." D. "The female genital tract makes you more sensitive to specific STI organisms." E. "Teenage girls are more susceptible to STIs due to their genital anatomy."

B. "Teenage females lack communication skills to negotiate for safer sex." D. "The female genital tract makes you more sensitive to specific STI organisms." E. "Teenage girls are more susceptible to STIs due to their genital anatomy." Rationale: Female adolescents are more susceptible to STIs due to their anatomy. During adolescence and young adulthood, women's columnar epithelial cells are especially sensitive to invasion by sexually transmitted organisms, such as chlamydia and gonococci. Adolescent females may perceive that they have limited power over when and where intercourse occurs with their partners. They typically lack negotiating skills and self-con

The sexual health nurse is presenting to a group of adolescents the government initiative that proposes to reduce the numbers of adolescents with sexually transmitted infections (STIs). What is the name of this initiative? A. Health For All B. Healthy People 2030 C. Onward to Health D. Healthy Communities 2030

B. Healthy People 2030 Rationale: Healthy People 2030 proposes to reduce the proportion of adolescents and young adults with STIs. It also proposes to increase the proportion of sexually active persons aged 15 to 19 years who use condoms. Reference: p. 173

What is the most important consideration for the nurse when communicating with an adolescent about sexually transmitted infections (STI)? A. Adjust information to the client's developmental level B. Use communication techniques that are direct and nonjudgmental C. Utilize audio and visual aids to reinforce teaching D. Design teaching for the best effect in the shortest time

B. Use communication techniques that are direct and nonjudgmental Rationale: All of the answers are correct, but the most important consideration for a nurse communicating with an adolescent about STIs is to be direct and nonjudgmental. The style, content, and the message has to be aimed at the adolescent's developmental level. Any aids to help the adolescent learn should be used. The content should be designed to be delivered in the shortest amount of time because many clinics and health care provider offices are busy and do not lend themselves to long class times. Reference: p. 173

A sex trade worker is seen at the sexual health clinic reporting dysuria, mucopurulent vaginal discharge with bleeding between periods, conjunctivitis, and a painful rectal area. What sexually transmitted infection would the nurse suspect? A. syphilis B. chlamydia C. genital herpes D. gonorrhea

B. chlamydia Rationale: Chlamydial symptoms include dysuria, mucopurulent vaginal discharge, and dysfunctional uterine bleeding. It can cause inflammation of the rectum and conjunctiva. Syphilis starts with a chancre on vulva or vagina but can develop in other parts of the body. Secondary infection is maculopapular rash on hands and feet with a sore throat. Genital herpes symptoms include itching, tingling, and pain in genital area followed by small pustules and blister-like genital lesions. Gonorrhea vaginal discharge is yellowish color and very foul smelling. Reference: p. 183

When obtaining the health history from an adolescent client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A. hive-like rash for the past 2 days B. five different sexual partners C. weight gain of 5 lb (2.3 kg) in 1 year D. clear vaginal discharge

B. five different sexual partners Rationale: The number of sexual partners is a risk factor for the development of STIs. A rash could be related to numerous underlying conditions. A weight gain of 5 lb (2.3 kg) in 1 year is not a factor increasing one's risk for STIs. A change in the color of vaginal discharge such as yellow, milky, or curd-like, not clear, would suggest an STI. Reference: p. 172

A client is admitted in the health care facility with pelvic inflammatory disease (PID). When reviewing the client's history, what would the nurse identify as a risk factor? A. gestational diabetes B. frequent douching C. genetic predisposition D. environmental exposure

B. frequent douching Rationale: One of the risk factors associated with pelvic inflammatory disease is frequent douching. Women with gestational diabetes are at an increased risk for developing type 2 diabetes later in life. Genetic predisposition and environmental exposure are risk factors associated with breast cancer. Reference: p. 190

When developing a teaching plan for a community group about HIV infection, which group would the nurse identify being most vulnerable for HIV infection? A. Native American/First Nations people B. heterosexual women C. new health care workers D. Asian immigrants

B. heterosexual women Rationale: The number of women with HIV infection and AIDS has been increasing steadily worldwide. Today, women account for one in four (25%) new HIV infections in the United States. Women of color have been especially hard hit and represent the majority of women living with the disease and newly infected ones. African American women suffer disproportionately from the HIV/AIDS epidemic. New health care workers, Native American/First Nations members, and Asian immigrants are not among those considered at high risk. Reference: p. 196

A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A. amniotic fluid. B. placenta. C. birth canal. D. breast milk.

B. placenta. Rationale: The syphilis spirochete can cross the placenta after 9 weeks gestation. It is not transmitted via amniotic fluid, passage through the birth canal, or breast milk. Reference: p. 188

While obtaining a health history from a male adolescent during a well checkup, the nurse assesses his sexual behavior and risk for sexually transmitted infections. Based on the information, the nurse plans to teach the adolescent about using a condom. What statement would the nurse include in the teaching plan? A. "You can reuse a condom if it's within 3 hours." B. "Store your condoms in your wallet so they are ready for use." C. "Put the condom on before engaging in any genital contact." D. "Use petroleum jelly with a latex condom for extra lubrication."

C. "Put the condom on before engaging in any genital contact." Rationale: When teaching an adolescent about condom use, the nurse should tell the adolescent to put the condom on before any genital contact. A new condom should be used with each act of sexual intercourse; a condom should never be reused. Condoms should be stored in a cool, dry place away from direct sunlight and never stored in wallets, automobiles, or anywhere they could be exposed to extreme temperatures. Only water-soluble lubricants should be used with latex condoms. Oil-based or petroleum-based lubricants can weaken latex condoms. Reference: p. 199-200

A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? A. "There is a new vaccine available that prevents the infection from returning." B. "All you need is a dose of penicillin and the infection will be gone." C. "There is no cure, but drug therapy helps to reduce symptoms and recurrences." D. "Once you have the infection, you develop an immunity to it."

C. "There is no cure, but drug therapy helps to reduce symptoms and recurrences." Rationale: Genital herpes is a lifelong viral infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. A vaccine is available for HPV infection but not genital herpes. Penicillin is used to treat syphilis. No immunity develops after a genital herpes infection. Reference: p. 186

Assessment of a female client reveals a thick, white vaginal discharge. The client also reports intense itching and dyspareunia. Based on these findings, the nurse would suspect that the client has: A. trichomoniasis. B. bacterial vaginosis. C. candidiasis. D. genital herpes simplex.

C. candidiasis. Rationale: A thick, white vaginal discharge accompanied by intense itching and dyspareunia suggest vulvovaginal candidiasis. Trichomoniasis is characterized by a heavy yellow, green, or gray frothy or bubbly discharge. Bacterial vaginosis is manifested by a thin, white homogenous vaginal discharge with a characteristic stale fish-like odor. Genital herpes simplex involves genital ulcers. Reference: p. 179

The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for: A. infertility. B. dyspareunia. C. cervical cancer. D. dysmenorrhea.

C. cervical cancer. Rationale: Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer. Therefore, the client needs continued follow-up for routine Papanicolaou testing. HPV is not associated with an increased risk for infertility, dyspareunia, or dysmenorrhea. Reference: p. 191

The nurse is developing a plan of care for a client who is receiving aggressive drug therapy for treatment of HIV. The goal of this therapy is to: A. promote the progression of disease. B. intervene in late-stage AIDS. C. improve survival rates. D. conduct additional drug research.

C. improve survival rates. Rationale: Aggressive anti-retroviral therapy aims to reduce HIV morbidity and mortality, thereby improving survival rates. Drug therapy also aims to decrease the HIV viral load, restore the body's ability to fight off infection, and improve the quality of life. Drug therapy does not promote the progression of the disease. It is started at the time of the first infection, not in latestage AIDS. Treatment advances have been based on research, but drug therapy is not prescribed to conduct additional research. Reference: p. 197

A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure for which sexually transmitted infection (STI)? A. genital herpes B. hepatitis B C. syphilis D. gonorrhea

D. gonorrhea Rationale: To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most states. The ointment is not used to prevent conditions related to genital herpes, hepatitis B, or syphilis. Reference: p. 184

A 40-year-old woman is being discharged from the walk-in health care clinic after a diagnosis of pelvic inflammatory disease. Which health teaching topic should the nurse address? A. symptoms of menopause B. pain control for endometriosis C. fertility issues D. sexually transmitted infections

D. sexually transmitted infections Rationale: STIs are responsible for genital tract infections that may lead to later complications in women such as pelvic inflammatory disease (PID). The other topics do not relate to PID. Reference: p. 189-190

This STI is a recurrent, lifelong viral infection that has potential for transmission throughout the lifespan

Genital Herpes Simplex

This STI can be infected during birth. Intellectual disability, blindness, seizures, low weight birth, premature birth, death

Genital herpes

May develop warts in the throat (laryngeal papillomatosis); uncommon but life-threatening.

Genital warts

The most exposed group of people to HIV/AIDS currently is who?

Women- One in four people in the U.S. living with HIV are women. They are particularly vulnerable to heterosexual transmission of HIV due to substantial mucosal exposure to seminal fluids. It disproportionally affects African American and Hispanic women- they account for the majority of HIV infection cases.