PrepU chapter 66

Which term is used to describe microorganisms present in a host without host interference or interaction?

Colonization

Painless chancres or ulcerated lesions are associated with which systemic disease?

Syphilis

A client has been admitted with diarrhea. He has mild dehydration (less than 5%). The nurse is reviewing the laboratory report of the stool specimen, as indicated in the following:

Institute enteric precautions.

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?

The client washes her hands before and after touching lesions.

The nurse is assessing a client who reports stiff joints and alopecia. While taking the client's health history, the client reports having multiple sexual partners in the past 6 months and finding a lesion on her labia about 1 month before today's appointment. What should the nurse anticipate based on the signs and symptoms presented?

The client will require treatment for the secondary stage of syphilis.

You work on a long-term care unit. In the last two weeks more than half the clients on your unit have been diagnosed with gastroenteritis. What is the most likely reason?

The infection is being transmitted by healthcare personnel.

After demonstrating to a group of nursing students the proper technique for handwashing using soap and water, the nursing instructor determines that the teaching has been successful when the students demonstrate which of the following?

Vigorously scrubbing between the fingers

The nurse is caring for a client with secondary syphilis. What intervention should the nurse institute when caring for this client?

Wear gloves if contact with lesions is possible.

How often should women diagnosed with human papillomavirus (HPV) have Pap smears?

Yearly

Which of the following nursing instructions is most important for the nurse to emphasize to the client with a new HSV-2 diagnosis?

You must inform all sexual partners.

A client with syphilis is to receive penicillin G benzathine 1.2 million units IM as a single dose. The pharmacy supplies the medication, which is labeled as 2.4 million units/4 mL. How many milliliters would the nurse administer? Enter the number ONLY.

2

A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning?

Instruct the patient not to drink alcohol with this treatment.

The nurse recognizes the client is in which stage of syphilis when the client has no signs or symptoms of syphilis?

Latency

Which instruction should be given to a woman newly diagnosed with genital herpes?

Limit stress and emotional upset as much as possible.

Which of the following is the most effective treatment for trichomoniasis?

Metronidazole (Flagyl)

The nurse is providing education to a client who has a positive nontreponemal test (NTT). The client states, "If I've already had a positive test and I know I have syphilis, why do I need to have another test?" How should the nurse respond?

"A second test can help confirm the diagnosis, because the NTT can give a false-positive result."

The nurse is providing education to a client who has been diagnosed with chlamydia. The client will begin treatment with azithromycin today. Which teaching point should the nurse reinforce with this client?

"Abstain from any sexual activity for 1 week after the antibiotic is complete."

A 28-year-old sexually active male presented to a clinic because he was concerned about a round, painless sore on the shaft of his penis that had appeared 2 days prior to his visit. The nurse practitioner recognized the lesion as a "chancre," an indicator of primary syphilis. The nurse should tell the patient:

"An antibiotic injection is the best treatment since the lesion has just occurred."

A client is suspected of sepsis from a postsurgical incision infection. What characteristic of sepsis would the nurse recognize? Select all that apply.

Temperature of 102F Heart rate of 120 beats/minute Respiratory rate of 24 breaths/minute

A client comes to the emergency department complaining of sudden onset of diarrhea, anorexia, malaise, cough, headache, and recurrent chills. Based on the client's history and physical findings, the physician suspects legionnaires' disease. While awaiting diagnostic test results, the client is admitted to the facility and started on antibiotic therapy. What's the drug of choice for treating legionnaires' disease?

Azithromycin (Zithromax)

The nurse is discussing childhood immunization recommendations with a pediatric patient's parent. Where would the nurse find the most current information on this topic?

CDC

The nurse educator is teaching a group of young adult women about sexually transmitted infections. The nurse explains that which infection is most likely to be "silent" with no overt symptoms in women?

Chlamydia

The nurse has been teaching a client with genital herpes how to care for the lesions. Which of the following statements by the client indicates that she needs additional instruction?

"I'll wear occlusive underwear to prevent transmission of the virus."

A client the nurse is caring for has developed a bladder infection while in the hospital. The client has had a Foley catheter for two weeks. The client's family asks you how the client got this infection. What would be the nurse's best response?

"People in hospitals are often more susceptible to infections because they are already ill and they are exposed to germs while they are in the hospital."

An adolescent informs the school nurse that she is afraid of contracting an STI but her boyfriend does not want to use condoms. What is the best response by the nurse?

"The use of condoms is one of the best ways to reduce the risk of acquiring an STI."

The nurse is meeting with the mother of an 11-year-old girl to provide decision making support and education regarding human papillomavirus (HPV) vaccination. The mother states, "I am confused about why my 11 year old needs to be protected from a sexually transmitted infection. She is so young and not sexually active. Why does she need the vaccination now?" What is the nurse's best response?

"The vaccination helps to prevent cervical cancer in adult women. It works better if she has it before she becomes sexually active. Let's talk about some of the concerns you have about the vaccination"

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?

A painless genital ulcer that appeared about 3 weeks after unprotected sex

Which of the following medications are used to suppress viral load of the HSV-2 infection?

Acyclovir (Zovirax)

A client is diagnosed with a methicillin-resistant staphylococcus aureus (MRSA) infection. When developing the client's plan of care, the nurse would include which of the following?

Administration of prescribed vancomycin

A nurse is having a yearly employee tuberculin skin test. Which skin test results would indicate a positive result?

An induration of 12mm

A client is admitted with bacterial meningitis. Which hospital room is the best choice for this client?

An isolation room three doors from the nurses' station

A long-term care facility is the site of an outbreak of infectious diarrhea. The nurse educator has emphasized the importance of hand hygiene to staff members. The use of alcohol-based cleansers may be ineffective if the causative microorganism is identified as what?

Clostridium difficile

Which of the following describes microorganisms present without host interference or interaction?

Colonization

A group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata?

Human papilloma virus

Which of the following is the most common sexually transmitted infection (STI) among young, sexually active people?

Human papillomavirus (HPV)

When a hospitalized client requires contact precautions, which responses is necessary?

The client should be placed in a private room when possible.

Which organism is responsible for impetigo?

Staphylococcus aureus

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

Syphilis

Painless chancres are associated with which systemic disease?

Syphilis

A male client comes to the clinic and is diagnosed with gonorrhea. Which symptom most likely prompted him to seek medical attention?

Discharge from the penis and burning during urination

A client diagnosed with influenza is admitted to the hospital. Which transmission-based precautions should the nurse initiate?

Droplet

A nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention?

Foul-smelling discharge from the penis

A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the physician orders diagnostic testing of the vaginal discharge. Which STD must be reported to the public health department?

Gonorrhea

A nurse has heard that there have been three cases of pertussis in the community and wants to make sure his or her inoculations are up to date. What action should the nurse take?

Have a single-dose Tdap administered.

A nurse who provides care in a busy ED is in contact with hundreds of clients each year. The nurse has a responsibility to receive what vaccine?

Hepatitis B vaccine

Which of the following sexually transmitted infections (STIs) could be transmitted perinatally?

Herpes simplex

The nurse is seeing a client in the community health clinic who reports finding "sores" in the mouth. On assessment, the nurse notes the lesions appear flat, flesh colored and papillary. What should the nurse do next?

Obtain a health history that includes inquiring about sexual health practices

The nurse is caring for a client who has acquired immunodeficiency disease (AIDS) and has developed oral thrush. What type of infection is the nurse aware that has developed due to the immunocompromised state of the client?

Opportunistic

Which of the following is the medication of choice for early syphilis?

Penicillin G benzathine

The nurse is caring for a client who is colonized with methicillin-resistant Staphylococcus aureus (MRSA). What infection control measure has the greatest potential to reduce transmission of MRSA and other nosocomial pathogens in a health care setting?

Performing hand hygiene before and after contact with every client

The nurse is working in the labor and delivery suite when a client with active herpes simplex virus type 2 (HSV-2) appears in active labor. Which adjustment in the plan of care will the nurse prepare for?

Prepare for a cesarean section.

A patient comes to the clinic with complaints of a painless sore on her lip 2 weeks after she had oral sex with her boyfriend. The nurse observes a chancre on the lips and the physician orders testing for syphilis. If results are positive, what is the likely stage the patient is in?

Primary

A client reports nausea, vomiting, and diarrhea for 5 days. The nurse assesses the mucous membranes as pale and dry. The client has sunken eyes with the following vital signs: pulse 122 and thready, respirations 23, blood pressure 78/55, temperature 101.8°F oral. Which is the priority nursing intervention?

Request an order from the physician for IV rehydration therapy.

To confirm a diagnosis of syphilis, the nurse would identify the gram-negative bacteria, Treponema palladium, on the laboratory report. The nurse knows that this bacteria is classified among:

Spirochetes

The nurse is presenting a community lecture about STIs, and emphasizes that some STIs are easily cured with early and adequate treatment. Which is not among these easily treated diseases?

genital herpes

The six elements necessary for infection include a causative organism, a reservoir of available organisms, a portal or mode of exit from the reservoir, a mode of transmission from reservoir to host, a susceptible host, and

mode of entry into the host.

An 82-year-old client is admitted to the hospital with a diagnosis of pneumonia. The nurse learns that the client lives alone and hasn't been eating or drinking properly. When assessing the client for dehydration, the nurse would expect to find:

tachycardia

The nurse teaches the parent of a child with chickenpox that the child is no longer contagious to others when

the vesicles and pustules have crusted.

A nurse is assessing a client who may be in the early stages of dehydration. Early manifestations of dehydration include:

thirst or irritability.