Adult Nuring Medsurge Chapter 5: Sexually Transmitted Infections

The nurse is caring for a client diagnosed with candida vaginitis. The nurse knows additional teaching is needed when the client makes which statement?

"Douching is an effective way to cleanse the vaginal area after intercourse."

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?

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

The nurse is educating a client newly diagnosed with genital herpes. Which statement by the client indicates teaching has been successful?

"I can spread this infection if I have unprotected anal, vaginal, or oral sex."

After teaching a client diagnosed with candidiasis about preventive measures, the nurse determines additional teaching is needed when the client makes which statement?

"I can wear any style of pants as long as I wear cotton underwear."

The nurse is teaching a woman diagnosed with genital herpes. The nurse will provide additional teaching if the client makes which statement?

"I should apply warm compresses to my lesions to relieve pain and itching."

A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective?

"I will wear loose cotton underwear."

A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure?

"I'm temporarily not contagious once the warts are destroyed."

The nurse is caring for a client diagnosed with genital herpes who is prescribed acyclovir for treatment. Which statement by the client indicates to the nurse that additional teaching is needed?

"If I forget a dose, it is still important to take it. I can take a double dose if needed."

The clinic nurse is treating a client diagnosed with HIV. Which statement made by the client indicates an understanding of the diagnosis?

"If my T-cell count drops below 200 cells/mm3 (0.2 × 109/l), my HIV has progressed to AIDS."

After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students make which statement?

"It's okay to use petroleum jelly with a latex condom."

The nurse is caring for a female client newly diagnosed with gonorrhea. The client's current male sexual partner tested negative. The client asked the nurse how this is possible. Which response by the nurse is most appropriate?

"The moist, warm vaginal environment is a perfect breeding ground for microbes."

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 infections. What is the nurse's best response?

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

During a health education session, a teenage client asks the nurse when she should have her first "Pap test." How should the nurse reply?

"When you turn 21 years old."

A client with genital herpes asks the nurse about what to expect with the infection. Which response by the nurse is appropriate?

"You have to be extremely careful in the future. Even if you do not have symptoms, you could still spread the infection to others."

The nurse is educating a female client diagnosed with human papillomavirus (HPV). Which information will the nurse include in the client's education plan?

"You should be sure to receive consistent testing for cervical cancer."

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?

25

A nurse is reading a journal article about chlamydia. The nurse would expect to find that what percentage of women are asymptomatic when infected with chlamydia?

70%

The nurse is providing education on the prevention of sexually transmitted infections (STIs) to clients. The nurse understands which client is at the highest risk of contracting an STI?

A 30-year-old client who consumes alcohol multiple times per week, uses cocaine, and has a history of prostitution.

A nurse is caring for a client with vaginitis. What teaching(s) should the nurse provide to the client to prevent recurrent vaginal infections? Select all that apply.

Avoid using deodorant tampons. Avoid douching. Wear only cotton panties and ventilated pantyhose.

What is the most common early symptom of a sexually transmitted infection?

Dysuria

A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response?

It is recommended to formula-feed your newborn as it is transmitted through your breast milk."

The nurse is preparing a presentation for a group of adolescents and young adults about sexually transmitted infections and the use of condoms. Which information will the nurse include?

Leave space at the tip of the condom.

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

Limit stress and emotional upset as much as possible.

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?

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

A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?

Safety of antiviral therapy during pregnancy has not been established.

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

The nurse is developing a teaching plan for a client diagnosed with genital herpes simplex (HSV). Which would the nurse include? Select all that apply.

The management of genital herpes includes antiviral therapy. Little can be done to control the occurrences of infection. The need to use good handwashing technique to prevent spread. Educate the client to abstain from sexual activity until HSV lesions resolve. The goal is for recurrences to be less frequent over time.

A nurse is caring for a client positive for human immunodeficiency virus (HIV). The client is on triple-combination highly active antiretroviral therapy (HAART). What should the nurse include in the teaching plan when educating the client about the treatment? Select all that apply.

Unpleasant side effects such as nausea and diarrhea are common. Provide written materials describing diet, exercise, and medications. Ensure that the client understands the dosing regimen and schedule.

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 medication is used to suppress viral load of the HSV-2 infection?

acyclovir

The nurse is caring for a male client diagnosed with gonorrhea and chlamydia. Which health care provider order will the nurse question?

acyclovir 400 mg orally BID

A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity?

administering HPV vaccine

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?

candidiasis

A nurse is assisting with a pelvic exam on a client who is suspected of having trichomoniasis. Which findings would the nurse note as helping to confirm this diagnosis? Select all that apply.

cervical bleeding when touched cervical petechiae vaginal erythema

A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely?

chancres at the vaginal site

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 for developing which diagnosis?

condylomata acuminata

What is the gold standard for herpes simplex virus (HSV) diagnosis?

culture

A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent?

doxycycline

Clients who have had PID are prone to which complication?

ectopic pregnancy

When developing a program for STI prevention, which action would need to be done first?

educating on how to promote sexual health

A nurse is conducting a class for high school students on preventing sexually transmitted infections (STIs). Which information would the nurse emphasize as the sole method for not contracting STIs?

engaging in abstinence

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?

genital herpes

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?

genital warts

A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit?

heart disease and inflammation of the aorta, eyes, brain, central nervous system, and skin

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?

human papillomavirus

What is the most common viral infection?

human papillomavirus (HPV)

Which stage of syphilis occurs when the infected person has no signs or symptoms of syphilis?

latency

A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate possible pelvic inflammatory disease (PID)? Select all that apply.

lower abdominal tenderness adnexal tenderness cervical motion tenderness

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?

metronidazole

Which medication is the most effective treatment for trichomoniasis?

metronidazole

Which medications are appropriate to treat vaginal candidiasis? Select all that apply.

miconazole fluconazole

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.

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

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would most likely correlate with this diagnosis?

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?

the possibility of a chlamydia infection

Which factor in a client's history indicates she is at risk for candidiasis?

use of corticosteroids

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?

viral culture of vesicular fluid

Which finding would alert the nurse to suspect that a client has a yeast infection?

vulvar burning and itching

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques are observed on the vaginal wall. The nurse suspects which condition?

vulvovaginal candidiasis

A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding?

yeast infections

A client diagnosed with genital herpes asks the nurse about future sexual experiences. Which response by the nurse is appropriate?

"If you plan to have future sexual relationships, you need to let your partner know of your history prior to intercourse."

The nurse is caring for a female client diagnosed with vulvovaginal candidiasis. Which instruction will the nurse include in the teaching session with the client?

"It is best for you to wear cotton underwear."

A female client, who has been newly diagnosed with herpes simplex virus (HSV) ask the nurse how long it will take for the "sores" to go away. How should the nurse respond?

"It will take about 2 weeks for the outbreak to fully heal."

A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply.

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

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby?

Instill a prophylactic agent in the eyes of the newborn.

Which recommendation would the nurse give to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection?

Participate in early prenatal care.

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?

metronidazole

A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe?

Ceftriaxone

The nurse is caring for clients in a community health clinic. Which clients does the nurse recognize need screening for sexually transmitted infections? Select all that apply.

An incarcerated 28-year-old client. A pregnant client in the third trimester. Initial examination after a sexual assault. Annual exam for a 24-year-old sexually active client.

A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease?

Instruct people to get vaccinated for hepatitis B.

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?

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

A client is being discharged from the gynecological unit after treatment for acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include?

Discuss the necessity of completing the antibiotic therapy.

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?

Fluconazole

A client presents with the possible symptoms of genital herpes simplex virus (HSV). When assessing the client, the nurse would anticipate which assessment measure as being least likely to aid in confirming the diagnosis?

Papanicolaou test

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?

Practice monogamy.

The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis?

irritation of vaginal walls

The nurse in the sexual health clinic is obtaining a health history of a client who suffers form heroin use disorder. The client reports chronic flulike symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect?

hepatitis A

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?

gonorrhea

The nurse is caring for a client diagnosed with trichomoniasis. The health care provider has prescribed a single dose of metronidazole. Which information will the nurse provide this client?

"Avoid alcohol consumption for at least 24 hours after you take this medication."

A client diagnosed with human papillomavirus (HPV) asks the nurse if she will be at risk for developing cervical cancer. The nurse best responds by making which statement?

"Certain strains of the human papillomavirus (HPV) have been associated with causing cervical cancer."

A client at 32 weeks' gestation has recently been diagnosed with acute herpes type 2. The client asks what can happen to the baby as a result of this infection. How should the nurse best respond?

"There is a chance your baby may have a form of intellectual disability."

A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response?

"There is currently no medical treatment to cure HPV."

A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client?

Avoid alcohol consumption.

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?

sharing contaminated needles

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?

Discuss limiting the number of sex partners.