Chapter 46: Sexually Transmitted Infections

Which assessment question is most likely to address the causation of a woman's new case of candidiasis?

"Have you been on antibiotics recently?"

Select the most reliable test to diagnose syphilis.

Serology

Select the condition that contributes to the risk of infertility in males.

Trichomoniasis

A female client is diagnosed with chlamydia during a routine pelvic examination. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?

"My partner will need to take antibiotics at the same time I do."

A client asks why his partners need to know that he was diagnosed with syphilis. What is the nurse's best response?

"They will have to be treated prophylactically."

A male client is diagnosed with gonococcal urethritis. He tells the nurse he had recent sexual contact with a woman but states she did not appear to have any disease. What is the nurse's best response to the client?

"Women may not know they have gonorrhea because they may not have symptoms."

After inoculation with HPV, genital warts may begin to grow. They usually manifest as soft, raised fleshy lesions on the external genitalia of either male or female. What is the incubation period for HPV-induced genital warts?

6 weeks to 8 months

Within how many days it is important to test anyone who has had sex with an individual who tests positive for gonorrhea?

60

It is important to test anyone who has had sex with an individual tests positive for gonorrhea within how many days of the diagnosis?

60 days

A client presents with signs and symptoms of candidiasis and is concerned about why this occurs after taking antibiotics. The most appropriate information for the nurse to provide would be:

Antibiotics suppress the normal protective vaginal flora allowing overgrowth of C. albicans.

A client with painful genital herpes lesions relates pain as being a 7 out of 10. Which interventions should the nurse conduct? Select all that apply.

Apply cool compresses. Call the health care provider for oral analgesics. Apply topical anesthetic cream.

A nurse is caring for a client being treated for chlamydial infection. Which medication would the nurse anticipate being prescribed?

Azithromycin

A client presents to the outpatient clinic complaining of gray discharge that has a fishy odor. The health care provider sees "clue cells" on wet-mount microscopic exam. This would most likely lead to the diagnosis of:

BV

A woman and her male partner both have contracted gonorrhea. The nurse should monitor both clients for signs and symptoms of what complication?

Bacteremic heart valves

The nurse provides prophylactic treatment for a neonate to prevent conjunctival gonorrhea. The nurse is aware that the intervention will reduce the risk of:

Blindness

Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has:

C. albicans

A female receives a Papanicolaou (Pap) test result indicating she has human papillomavirus (HPV) infection. As part of her education, the nurse would emphasize the need for continued follow-up to monitor for which potential complication?

Cervical dysplasia

Which sexually transmitted infection exists in two morphologically distinct forms, elementary and reticulate bodies?

Chlamydia

A couple presents to an infertility clinic. The health care provider will focus testing on which sexually transmitted infection (STI) that is very damaging to the reproductive system but rarely exhibits symptoms of infection?

Chlamydial infection

Which statement is true concerning genital herpes?

Clients can have recurrent infections.

A client develops Reiter's syndrome. Which symptoms will the nurse assess? Select all that apply.

Conjunctivitis Pain in the joints

A client has been diagnosed with condylomata acuminata. The nurse recognizes that which treatment may be prescribed to removal visible warts?

Cryotherapy

Which phenomena is thought to underlie the decreased reported incidence of some sexually transmitted infections (STIs)?

Decreased reporting of cases of certain STIs

When is syphilis highly contagious?

During its primary stage

During infertility workup, the client is diagnosed with chlamydial infection. The health care provider will especially be looking for which complication of chlamydial infections that can interfere with egg transportation?

Fallopian tube damage

Which event is associated with the primary stage of syphilis?

Genital chancres

A 22-year-old female client states she has vaginal itching with pain and small vesicles that appear on the vagina when she is stressed. The health care provider suspects the client most likely is experiencing which condition?

Genital herpes

A female client is found to have genital warts during a routine pelvic examination. Which sexually transmitted infection will the nurse prepare to test for?

HPV

Which assessment finding is most clearly suggestive of initial genital herpes (herpes simplex virus, HSV) in a male client?

Itching, pain, and the emergence of pustules on the penis

Select the treatment of choice for syphilis

Long-acting penicillin in a single injection

A young woman is almost ready to deliver, and she has an outbreak of genital herpes. What is the nurse's best action?

Tell the woman about a cesarean section.

Which client will the nurse determine is a candidate for continuous antiviral suppressive therapy for genital herpes?

The client with more than six outbreaks this year

The nurse is reviewing the uses and side effects of azithromycin. For which infection is azithromycin the antibiotic of choice?

chlamydial

A 23-year-old diagnosed with syphilis presents with palmar rash, sore throat, fever, and a red-brown lesion on the genital area. The symptoms have been present for 3 weeks. Select the stage of syphilis this client is currently in.

secondary

The nurse caring for a client with syphilis notes the Venereal Disease Research Laboratory (VDRL) test result is elevated. Which stage of syphilis is this client likely experiencing?

secondary

A client asks how his condition, Condylomata acuminata, is caused. What is the nurse's best response?

"Human papillomavirus (HPV) is the cause of your condition."

A client is diagnosed with granuloma inguinale. Which question should the nurse ask the client?

"Have you traveled outside of the country recently?"

A client comes to the clinic and is diagnosed with genital herpes. Which statement by the client indicates that the nurse's teaching about management of the disease has been effective?

"I will take the acyclovir every 8 hours for the next week."

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate the client by making which statement?

"If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."

A client is diagnosed with trichomoniasis. Which information is appropriate for the nurse to tell the client?

"We need to contact your sexual partners."

Which client is at highest risk of developing trichomoniasis?

A client who is sexually active

There is no known cure for genital herpes, and methods of treatment are often symptomatic. Pharmacologic management of genital herpes includes which drugs?

Acyclovir

In assessing a client, the nurse notes a grayish discharge from the vaginal area accompanied by a foul odor. What is the nurse's best action?

Asking about other symptoms

A nurse is attempting to culture a lesion to determine if a client has genital herpes. What is the nurse's best action?

Attempt to culture a lesion as soon as it develops.

An older adult client may be experiencing symptoms of tertiary syphilis. Which characteristic would the nurse associate with tertiary syphilis years after the initial infection?

Dementia

Which assessment finding correlates to advanced (tertiary) syphilis?

Dementia

What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.

Dementia Blindness Ataxia

While in its dormant state, what structure provides residence for herpes simplex virus to allow for replication?

Dorsal root ganglia

A client is diagnosed with chronic vulvovaginal candidiasis. Which assessment finding would be present to confirm this diagnosis?

Four episodes of vulvovaginal candidiasis (confirmed symptoms) so far this year

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 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

Metronidazole

A client with herpes simplex virus (HSV) states, "I can stop taking my drugs because I'm cured. My lesions are gone." Knowing the pathophysiology behind the disappearance of HSV symptoms, the health care provider suspects the client is experiencing which phase of infection

Periods of latency in the nervous system

A client with herpes simplex virus (HSV) states, "I can stop taking my drugs because I'm cured. My lesions are gone." Knowing the pathophysiology behind the disappearance of HSV symptoms, the health care provider suspects the client is experiencing which phase of infection?

Periods of latency in the nervous system

A client presents with copious, frothy, malodorous green/yellow vaginal discharge. A diagnosis of Trichomoniasis is made. The client tells the nurse that she has not been sexually active and is concerned. Select the possible modes of transmission. Select all that apply.

Sexual contact Fomites Swimming pools Hot tubs

Which assessment finding helps the nurse confirm that the client has genital warts?

Soft, raised lesions on external genitalia

A client has been diagnosed with candidiasis. Which symptom was present to diagnose this condition?

Thick white secretions

A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women?

Trichomoniasis

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 6 months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of medication is most likely to resolve her symptoms?

An azole antifungal agent

A male client presents to the clinic with profuse, purulent urethral discharge with painful urination. Which information will be most important for the nurse to obtain?

Recent sexual contacts

A client presents with gonorrhea. Which of the following is a primary nursing action?

Reporting the case to the Centers for Disease Control and Prevention

A female client presents to the clinic with a rash on the palms of her hands, symptoms of hair loss, and the development of elevated, red-brown lesions that have begun to ulcerate and produce a foul discharge. Based on these symptoms, the nurse plans to test the client for which sexually transmitted infection?

Syphilis

A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice.

Azithromycin

The primary reason genital herpes has reached epidemic proportions throughout the world relates to the fact that:

a large percentage (70%) of those infected experience no symptoms of the disease.

For a woman, what is the most serious long-term outcome of an infection resulting from exposure to the N. gonorrhoeae bacteria?

Sterility

An male client presents with urethral itching, burning, pain, and a creamy, yellow discharge following unprotected sex with a new partner 3 days ago. The nurse anticipates the client to be diagnosed with which sexually transmitted infection?

Neisseria gonorrhoeae

A client asks the nurse how he will know if he has syphilis after sexual contact. What is the nurse's best response?

"You will develop a sore on your penis or scrotum."

Tertiary syphilis is a delayed response of untreated primary syphilis and can occur as late as 20 years after the primary disease. When tertiary syphilis progresses to a symptomatic stage, it can produce localized necrotic lesions. What are these lesions called?

Gummas

A male client presents at the clinic with flulike symptoms and reports a weight loss of 10 pounds without trying. On physical examination, the client is found to have splenomegaly and large, tender, fluctuant inguinal lymph nodes. While taking the nursing history, it is discovered that the client prefers male sexual partners, and that 2 weeks ago the client had small, painless papules. What disease would the nurse suspect the client has?

Lymphogranuloma venereum

After being diagnosed with bacterial vaginosis, the client is at risk for developing which potential complications? Select all that apply.

Pelvic inflammatory disease (PID) Preterm labor Postpartum endometritis Premature rupture of membranes

A nurse is assessing a male who is reporting nonspecific symptoms of prostate and periurethral gland pain. Which characteristic discharge makes the nurse suspect gonorrhea?

Purulent exudates

A male reports urethral pain and a creamy yellow, bloody discharge from the penis. The provider suspects the client has which sexually transmitted infection?

Gonorrhea

Bacterial vaginosis is the most common vaginal infection seen by health care providers. What is the predominant symptom of bacterial vaginosis?

Grayish white discharge with a fishy odor

A sexually active female presents to the clinic with white copious vaginal discharge, itch, swelling, and dysuria. The nurse anticipates the client will be treated for the overgrowth of which organism?

Candida albicans

A client presents to an STI clinic. Her primary complaint is related to purulent exudate and bleeding after intercourse. The health care worker will primarily focus on the diagnosis of which STI?

Gonorrhea