Chapter 35: PrepU - Nursing Management: Patients With Sexually Transmitted Infections
A nurse provided health teaching to a patient with a STI. The nurse advised her patient that transmission of the organism was by three routes: sexual, percutaneous, and perinatal. Choose the STI that was diagnosed. 1- Herpes simplex 2- Chlamydia 3- Gonorrhea 4- Trichomoniasis
1
Which of the following describes microorganisms present without host interference or interaction? 1- Colonization 2- Infection 3- Infectious disease 4- Reservoir
1
Which of the following is the gold standard for herpes simplex virus (HSV) diagnosis? 1- Culture 2- Shave biopsy 3- Excisional biopsy 4- Punch biopsy
1
A client is being tested for gonorrhea. Based on the nurse's understanding of this STI, the nurse would anticipate that the client will also be tested for: 1- syphilis 2- chlamydia 3- HPV 4- Herpes simplex 2
2
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: 1- Cyanobacteria 2- Spirochetes 3- Proteobacteria 4- Green-sulphur bacteria
2
The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority? 1- Knowledge Deficit 2- Powerlessness 3- Anxiety 4- Impaired Skin Integrity
4
A nurse practitioner advised the mother of a 16-year-old girl, who was diagnosed with human papillomavirus (HPV), that the infection can cause cancer of the _______ in the future. 1- Vagina 2- Urethra 3- Cervix 4- Uterus
3
A gynecologist told a patient that she had chlamydia. The nurse expected the health care provider to prescribe a single dose of which of the following medications? 1- Tetracycline 2- Amoxicillin 3- Penicillin with benzathine 4- Zithromax
4
After initially presenting to a campus medical clinic after the emergence of a wart on her vulva, a 21-year-old woman is distraught to receive a diagnosis of human papillomavirus (HPV). The woman states, "I know I'm supposed to, but I really have no idea how I'm going to break this to my boyfriend. What will happen if I don't tell him?" What nursing diagnosis should the clinic nurse identify in this woman's care? 1- Complicated grieving 2- Situational low self-esteem 3- Hopelessness 4- Decisional conflict
4
Which of the following is the most effective treatment for trichomoniasis? 1- Metronidazole (Flagyl) 2- Penicillin G benzathine 3- Doxycycline (Adoxa) 4- Azithromycin (Zithromax)
1
The following outcome appears on the plan of care for a client with genital herpes: "Client demonstrates knowledge about measures to reduce the risk of transmission and recurrences." Which of the following, if reported by the client, would support achievement of this outcome? 1- Avoids sexual activity when lesions are present 2- Cleans lesions with strong anti-bacaterial soap 3- Applies occlusive dressings to lesions 4- Consistently uses condoms with sexual activity
4
A 20-year-old male client comes to the clinic for an evaluation. During the visit, the client mentions that he wants to make sure that he is using condoms properly. When reviewing the steps, which client statement would warrant additional instruction? 1- "I should put the condom on my penis before it becomes erect." 2- "I unroll the condom all the way on to my penis." 3- "I'll hold the condom on before I pull out." 4- "I will put on a new condom if I want to have sex again."
1
A nurse is preparing a presentation about STIs for a local community group. When describing chlamydia, which age group would the nurse identify as being at greatest risk for this infection? 1- Women younger than 24 years of age 2- Men between the ages of 18-28 years 3- Women in their 30s 4- Men between the ages of 25-30
1
A nurse practitioner assessed a patient's complaints about a vaginal discharge and prescribed Flagyl. The nurse was able to diagnose bacterial vaginosis because of this defining characteristic, a discharge that: 1- Has a fish-like odor. 2- Is burning and itching. 3- Is accompanied by vulvitis. 4- Is yellow-green and frothy.
1
Which of the following sexually transmitted infections (STIs) could be transmitted perinatally? 1- Herpes simplex 2- Chlamydia 3- Gonorrhea 4- Trichomoniasis
1
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
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? 1- Herpes virus 2- Human papilloma virus 3- Treponema pallidum 4- Haemophilus ducreyi bacillus
2
s/s of syphilis
primary- chancre (painless ulcer) secondary- fever malaise, rash ,HA, sore throat lymph node enlargement tertiary- tabes dorsalis, ataxia, neuropathic joint disease
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 female client recently diagnosed with chlamydia comes to the clinic for a check-up. During the visit, the client says, "I had no idea I had chlamydia. I didn't have any symptoms." The nurse would incorporate knowledge of which information when responding to the client? 1- Clients with chlamydia frequently are asymptomatic. 2- Clients typically overlook the symptoms because they are mild. 3- Clients often attribute the symptoms to the flu because they are similar. 4- Clients are usually in denial about the symptoms.
1
A female patient tells the nurse that she thinks she has a vaginal infection because she has noted inflammation of her vulva and a yellow-green discharge. The nurse recognizes that the clinical manifestations described are typical of what vaginal infections? 1- Trichomonas vaginalis 2- Candidiasis 3- Gardnerella 4- Chlamydial infection
1
A nurse is developing a plan of care for a female client experiencing her first outbreak of genital herpes. Which nursing diagnosis would the nurse most likely identify as the priority? 1- Acute pain related to the development of the genital lesions 2- Deficient knowledge related to the disease and its transmission 3- Ineffective coping related to the increased stress associated with the infection 4- Hyperthermia related to body's response to an infectious process
1
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? 1- Primary 2- Secondary 3- Latency 4- Tertiary
1
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? 1- Instruct the patient not to drink alcohol with this treatment. 2- Counsel the patient to refrain from sex for 1 week. 3- Advise the patient to take medication with a glass of milk. 4- Reassure the patient further sexually transmitted infection (STI) testing is not indicated.
1
A public health nurse is facilitating a health forum at a high school and has presented the deleterious effects of Chlamydia trachomatis and Neisseriae gonorrhoeae infection. Why are these sexually transmitted infections (STIs) associated with a high risk of pelvic inflammatory disease and infertility among infected females? 1- Infection is often not accompanied by recognizable signs and symptoms. 2- The causative microorganisms are now resistant to all commonly used antibiotics. 3- Fewer individuals have innate immunity to the diseases than in the past. 4- Males are carriers of the diseases who do not experience infection.
1
After a routine physical exam, a female client is devastated to receive a diagnosis of the sexually transmitted infection, gonorrhea. What would contribute to the client's ignorance of this condition? 1- being asymptomatic 2- knowing the signs and symptoms of STIs 3- being sexually inactive 4- All options are correct.
1
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- Syphillis 3- Gonorrhea 4- Chlamydia
1
Patients who have had pelvic inflammatory disease (PID) are prone to which of the following complications? 1- Ectopic pregnancy 2- Bacteremia 3- Thrombophlebitis 4- Inguinal lymphadenopathy
1
The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session? 1- The effect of the vaccination is optimized if it is administered before the child becomes sexually active. 2- The vaccination is available only to girls but, in the long term, protects both genders from sexually transmitted infections. 3- The HPV vaccination prevents the future need for cervical cancer screening in women. 4- A Pap smear test is required prior to administration of the HPV vaccination.
1
Which of the following medications are used to suppress viral load of the HSV-2 infection? 1- Acyclovir (Zovirax) 2- Penicillin 3- Metronidazole (Flagyl) 4- Clindamycin (Cleocin)
1
Which of the following nursing instructions is most important for the nurse to emphasize to the client with a new HSV-2 diagnosis? 1- You must inform all sexual partners. 2- Keep lesions dry with alcohol or peroxide. 3- Wear loose underwear to promote air circulation. 4- Use a condom during sexual activity.
1
A male patient in his 20s has been diagnosed with a chlamydial infection and states that he is "terrified" at the prospect of having to inform his fiancée. In light of this patient's statement, what action should the nurse first perform? 1- Teach the patient assertiveness skills that he can utilize when informing his fiancée. 2- Assess the specific reasons why the patient fears this discussion with his fiancée. 3- Reiterate the patient's legal and moral obligations for having this discussion with his fiancée. 4- Role play the discussion with the patient.
2
A nurse practitioner who works for Planned Parenthood is responsible for health education seminars. During these presentations, the nurse always discusses the symptoms of the most common STI among young, sexually active people. This is: 1- Candidiasis. 2- Human papillomavirus. 3- Endocervicitis. 4- Salpingitis.
2
The nurse educator is discussing pathogens responsible for various sexually transmitted infections. When teaching about bacterial vaginosis (BV), the nurse educator is correct when stating the overgrowth of which bacteria is responsible for this infection? 1- Lactobacillus acidophilus 2- Gardnerella vaginalis 3- Trichomonas vaginalis 4- Chlamydia trachomatis
2
The nurse educator, who is teaching a class on sexually transmitted infections, recognizes that teaching has been effective when students indicate which statement is true about the difference between colonization and infection? 1- "Colonization and infection are interchangeable terms used to describe a bacterial invasion." 2- "Colonization becomes infection when the host and organism interact." 3- "Colonization results in symptoms such as redness and swelling, infection results in fever." 4- "Both colonization and infection require treatment with different antibiotics."
2
The nurse is caring for a client who has just been diagnosed with chlamydia and is very upset. The client says, "I don't understand this. The person I had sex with did not have any symptoms at all. How could I have known?" What is the best response by the nurse to this client? 1- "It is very hard to see signs of infection in the heat of passion." 2- "Many people with chlamydia won't have symptoms for up to 3 weeks after being infected." 3- "I think you realize that if you had used some form of a barrier protection such as a condom, it would have helped prevent this situation." 4- "It is really important that you know the sexual history of every potential lover. It may be uncomfortable but it will prevent the situation you are dealing with right now."
2
The nurse is completing a community education via a pamphlet on sexually transmitted diseases. Which key point would the nurse place in bold letters? 1- Common age-groups for clients with sexually transmitted diseases are in their late teens and 20s. 2- Many people are asymptomatic and show no symptoms contributing to the spread of the disease. 3- Some sexually transmitted diseases can cause infertility caused by scarring of reproductive organs. 4- Some sexually transmitted diseases can be transmitted to newborns through the birth canal.
2
A young male patient of a free clinic has been diagnosed with gonorrhea and has begun treatment. The nurse at the clinic is providing the man with relevant health education and has emphasized the importance of using condoms. The man replies, "I can't stand using condoms because I can't feel anything if I use one. I'll have to think about that." The nurse should consequently identify which of the following nursing diagnoses? 1- Anxiety related to diagnosis with an sexually transmitted infection (STI) 2- Ineffective coping related to necessary health promotion measures 3- Risk for infection transmission related to lack of STI prevention measures 4- Deficient knowledge about the disease and risk for spread of infection
3
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? 1- "You are too young to be having sex at all." 2- "If he won't use a condom, then he doesn't care about you." 3- "The use of condoms is one of the best ways to reduce the risk of acquiring an STI." 4- "I can understand your concern and you should bring him here so that I can talk with him about STIs."
3
The nurse has received several laboratory studies back at the clinic. Which of these results should be reported to the local health department? 1- Wound infection with MRSA 2- Positive influenza 3- Positive gonorrhea 4- Positive mononucleosis
3
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? 1- Administer an intravenous antibiotic to the mom while in labor. 2- Complete a full assessment of the newborn on delivery. 3- Prepare for a cesarean section. 4- Place an antibacterial ointment on the mother's lesions.
3
A nurse is reading a journal article about STIs and risk factors. The nurse demonstrates understanding of the article by identifying which factor as increasing the risk? Select all that apply. 1- age over 30 years 2- monogamous relationship 3- engagement in sex at an early age 4- multiple sex partners 5- use of illicit drugs
3,4,5
A client is diagnosed with latent syphilis. It is unknown when the client contracted the infection. When developing the plan of care for this client, the nurse would anticipate administering the prescribed medication using which regimen? 1- oral penicillin daily for 10 days 2- single dose of an oral suspension of penicillin 3- monthly injections of penicillin G for 1 year 4- an injection of penicillin G weekly for 3 weeks
4
A patient has herpes simplex 2 viral infection (HSV-2). The nurse recognizes that which of the following should be included in teaching the patient: 1- The virus causes "cold sores" of the lips. 2- The virus may be cured with antibiotics. 3- The virus when active may not be contracted during intercourse. 4- Treatment is aimed at relieving symptoms.
4
A patient with genital herpes is having an acute exacerbation. What medication would the nurse expect to be ordered to suppress the symptoms and shorten the course of the infection? 1- Clotrimazole (Gyne-Lotrimin) 2- Metronidazole (Flagyl) 3- Podophyllin (Podofin) 4- Acyclovir (Zovirax)
4
A nurse is developing the plan of care for a client with genital warts who will be receiving treatment. Which treatment regimen that the client can self-administer would the nurse anticipate as being prescribed? Select all that apply. 1- trichloroacetic acid 2- podophyllin 3- interferon 4- podofilox 5- imiquimod
4,5
