Chapter 55 Sexually Transmitted Infections

A patient with Chlamydia trachomatis is most likely to be treated with which medication? A. Doxycycline B. Acyclovir C. Penicillin G/benzathine D. Hydrocortisone

A. Doxycycline

When the nurse teaches about "safer sex" practices, it should be stated that proper use of condoms includes using A. Petroleum jelly as a lubricant B. Saliva as a lubricant C. A spermicide containing nonoxynol-9 D. Lambskin condoms

C. A spermicide containing nonoxynol-9

21. What does chlamydial infection place a person at greater risk for? a. HIV if exposed to it b. Urinary infections c. Hepatitis B if exposed to it d. Opportunistic bacterial infections

a. HIV if exposed to it

The nurse is collecting information from a patient during her annual pelvic examination. The patient reports that she has noted a strong vaginal odor after intercourse. Which condition may be present? A. Gonorrhea B. Bacterial vaginosis C. Chlamydia D. Syphilis

C. Chlamydia

26. What body areas might systemic (disseminated) gonorrhea involve? (Select all that apply.) a. Heart b. Eyes c. Meninges d. Skin e. Joints

a. Heart c. Meninges d. Skin e. Joints

Which of these attitudes is essential for the LPN/LVN to have when obtaining a history on a patient who has an STI? A. Friendly B. Indifferent C. Nonjudgmental D. Complete acceptance of the patient's behavior

C. Nonjudgmental

After being stained with crystal violet, how will a gram-positive gonoccus react? A. Fluoresce after counterstain is applied B. Accept the counterstain C. Retain the original stain after the counterstain is applied D. Turn dark after the counterstain is applied

C. Retain the original stain after the counterstain is applied

A health care provider has ordered a Venereal Disease Research Laboratory (VDRL) test for a patient. Which condition do you recognize the provider is screening for? A. HIV B. HPV C. Syphilis D. Gonorrhea

C. Syphilis

The patient presents to the clinic complaining of severe vaginal itching, pain and burning on urination, and a white, cheese-like vaginal discharge. The nurse anticipates the provider will prescribe which treatment? A. Vaginal miconazole for one dose B. Oral metronidazole for 7 days C. Vaginal clotrimazole for 3 days D. Oral fluconazole for 5 days

C. Vaginal clotrimazole for 3 days

27. A nurse recognizes that a patient with an STI may not cooperate in reporting sexual contacts. What fears might prevent reporting? (Select all that apply.) a. Judgment by health care workers b. Identifying self as infected c. Rejection by contacts d. Infecting others e. Reprisal from identified contacts

a. Judgment by health care workers b. Identifying self as infected c. Rejection by contacts e. Reprisal from identified contacts

7. A patient at the outpatient clinic is reluctant to identify her sexual contacts. Why is the reporting of contacts essential? a. Slows transmission and spread of infections b. Increases public awareness c. Increases state funding for treatment d. Collects data for research

a. Slows transmission and spread of infections

13. Which method is used to identify organisms of gonorrhea? a. Smears and cultures b. Serologic tests c. Antibody screening d. Sensitivity testing

a. Smears and cultures

19. What is the preferred treatment of human papillomavirus (HPV) infection? a. topical antibiotics b. cryosurgery c. chemotherapy d. surgical removal under general anesthesia

b. cryosurgery

9. When a client is diagnosed with gonorrhea, which treatment regime is considered MOST effective? a. a single dose of ciprofloxacin, followed by a 7-day course of oral doxycycline b. a single injection of penicillin G benzathine c. doxycycline 100 mg orally, twice daily for 7 days d. treatment of symptoms only with acyclovir

a. a single dose of ciprofloxacin, followed by a 7-day course of oral doxycycline

1. Common diagnostic tests to determine the presence of sexually transmitted infections (STIs) include which of the following? (Select all that apply.) a. antigen for HSV b. Reiter's test c. CT scan d. Western blot e. biopsy f. urine specimen

a. antigen for HSV b. Reiter's test d. Western blot f. urine specimen

9. A patient with syphilis is seen at the clinic and complains of body aches, pustules, fever, and sore throat. Which stage of syphilis should the nurse recognize these symptoms identify? a. Primary b. Secondary c. Latent d. Late

b. Secondary

28. A patient who is using imiquimod (Aldara) for genital warts asks the outpatient clinic nurse how long she must use the medication. The nurse replies that she must apply the medication for _____ weeks.

16

The patient presents to the clinic with genitourinary complaints. Which symptoms, if reported by the male patient, indicates urethritis? A. Difficult, painful, and frequent urination with penile discharge B. Infrequent, inadequate urination with yellow urine and pain in the legs C. Chancres, gummas, and vesicles on the urethra D. Hot, tender scrotum

A. Difficult, painful, and frequent urination with penile discharge

The nurse is talking with a group of teens. Which statement(s) by the teens about STIs indicate(s) the need for further information? (Select all that apply.) A. "Everyone who can transmit an STI shows symptoms of it." B. "Most people who have STIs will be getting treatment already." C. "It doesn't really matter what type of condom I use, as long as I use one." D. "Condoms protect against STIs and unplanned pregnancy." E. "It doesn't really matter who your partner has had sex with before, because he or she is with you now."

A. "Everyone who can transmit an STI shows symptoms of it." B. "Most people who have STIs will be getting treatment already." C. "It doesn't really matter what type of condom I use, as long as I use one." E. "It doesn't really matter who your partner has had sex with before, because he or she is with you now."

The nurse is providing information to a patient who has recently been diagnosed with genital herpes. Which statements indicate the need for further instruction? (Select all that apply) A. "I am only contagious when I have open sores." B. "The infection is limited to only my genital region." C. "There is no permanent cure for this condition." D. "I will need to contact my physician for antibiotic cream for the open lesions whenever I have an outbreak." E. "I should wash my hands carefully to prevent the introduction of bacteria to the area."

A. "I am only contagious when I have open sores." B. "The infection is limited to only my genital region." D. "I will need to contact my physician for antibiotic cream for the open lesions whenever I have an outbreak."

Which statement made by a patient indicates an understanding of the information and teaching about genital herpes? A. "It is highly contagious, but it is only transmitted by sexual contact." B. "I am cured once vesicles in the genital area crust over and resolve." C. "Numbness and tingling may occur 24 hours before lesions appear." D. "If lesions are present, it is best to use a condom and spermicide."

A. "It is highly contagious, but it is only transmitted by sexual contact."

You are teaching a female patient about a new diagnosis of genital herpes. Which patient statement indicates that further teaching is necessary? A. "Once my lesions are healed I am no longer contagious." B. "Primary lesions will resolve in about 2 weeks." C. "This infection can spread to other parts of my body." D. "A cesarean section may be necessary if the infection is active during delivery."

A. "Once my lesions are healed I am no longer contagious."

A new nursing assistant expresses fear in caring for patients with HIV/AIDS. Later, the nurse observes this assistant helping a menstruating hepatitis B patient with toileting. She is not waring gloves. Which statement(s) would help the nursing assistant understand infection control precautions in caring for patients with STIs? A. "Use Standard Precautions for all patients, especially when body fluids are involved." B. "Good hand hygiene is adequate when caring for patients with STIs." C. "Hepatitis patients and HIV/AIDS patients deserve equal care and attention." D. "Hepatitis virus is actually more virulent than HIV/AIDS, so you should be more afraid of patients with hepatitis."

A. "Use Standard Precautions for all patients, especially when body fluids are involved."

You are caring for four female patients. Which patient do you identify as most at risk to have an STI? A. 19 year old with urinary tract infection B. 31 year old who is eight weeks pregnant C. 40 year old with breast tenderness D. 53 year old who reports vaginal dryness

A. 19 year old with urinary tract infection

How long after exposure does the incubation period for gonorrhea last? A. 2 to 6 days B. 1 week C. 2 weeks D. 4 weeks

A. 2 to 6 days

When a patient has primary genital herpes, it is likely that the lesions will resolve spontaneously in which time? A. 2 weeks B. 6 months C. 1 month D. 1 year

A. 2 weeks

A pregnant woman is concerned because she has genital herpes. This is a primary infection. The patient is at risk for which delivery? A. A spontaneous abortion B. Delivery of a small, full-term baby C. A post-term delivery D. Delivery of a large, full-term infant

A. A spontaneous abortion

To which factor(s) can rise in the number of sexually transmitted infections (STIs) be attributed? (select all that apply) A. An increase in the number of sexually active teenagers B. An increase in the opportunity to have multiple partners C. A knowledge deficit about signs and symptoms of STIs D. Teenagers being reluctant to report diseases E. Young people's increasing ability to acuire confidential health care

A. An increase in the number of sexually active teenagers B. An increase in the opportunity to have multiple partners C. A knowledge deficit about signs and symptoms of STIs D. Teenagers being reluctant to report diseases

You are assessing a patient for syphilis. which will you document as classic signs and symptoms of syphilis? (select all that apply) A. An open ulcer on the genitals B. A red rash on the palms of the hands C. A cough and fever D. A red rash on the soles of the feet E. Abdominal pain accompanied by vomiting

A. An open ulcer on the genitals B. A red rash on the palms of the hands D. A red rash on the soles of the feet

The nurse is aware that men with honorrhea are more likely to seek medical attention because their symptoms are more visible than those of wome. Which clinical manifestations is most consistent with symptoms of gonorrhea in men? A. Copious, purulent penile discharge B. Hematuria when initiating the stream of urine C. Penile ulcers with a foul odor D. Scale scrotal lesions

A. Copious, purulent penile discharge

Which factors indicate reasons why young patients are frequently reluctant to have their sexually transmitted infections (STIs) reported? (Select all that apply) A. Fear of parental reaction B. Embarrassment about their condition C. Fear of reprisal from identified contacts D. Fear of information becoming public E. Fear of rejection by peers

A. Fear of parental reaction B. Embarrassment about their condition C. Fear of reprisal from identified contacts D. Fear of information becoming public E. Fear of rejection by peers

An important nursing responsibility involves reporting certain sexually transmitted infections to the CDC and local health authorities. Which infection(s) should you prepare to report? (select all that apply) A. Gonorrhea B. Syphilis C. Bacterial vaginosis D. Candidiasis E. Chlamydia

A. Gonorrhea B. Syphilis E. Chlamydia

Which nursing responsibilities are related to collecting specimens for diagnosis of STIs? (Select all that apply) A. If antimicrobials have been started, note this on the lab slip B. Provide appropriate draping and privacy C. Female patients should douche before vaginal cultures or smears D. Document medication history E. Cultures and smears usually are obtained with a clean swab F. Label specimens and deliver to the lab according to facility policy

A. If antimicrobials have been started, note this on the lab slip B. Provide appropriate draping and privacy D. Document medication history E. Cultures and smears usually are obtained with a clean swab F. Label specimens and deliver to the lab according to facility policy

Which statement(s) is/are most accurate regarding transmission of human immunodeficiency virus (HIV) and development of acquired immune deficiency syndrome (AIDS)? (Select all that apply.) A. It is a bloodborne pathogen and can be transmitted by contaminated intravenous (IV) drug use supplies. B. It is treatable. C. Poor personal hygiene is a factor in its transmission. D. It cannot be transmitted if safer sexual practices are used. E. It enters the bloodstream through breaks in mucous membrane.

A. It is a bloodborne pathogen and can be transmitted by contaminated intravenous (IV) drug use supplies. B. It is treatable. E. It enters the bloodstream through breaks in mucous membrane.

When are women at a greater risk for contracting sexually transmitted infections (STIs) than men? A. Male secretions are in contact with female mucous membranes for longer periods of time B. Estrogens increase susceptibility of vaginal membranes C. Penile friction to the vaginal wall encourages STIs D. Changing hormonal levels create a vaginal environment conducive to bacterial growth

A. Male secretions are in contact with female mucous membranes for longer periods of time

During an assessment of an older adult patient, the nurse observes a red rash on the palms of the hands and the soles of the feet. What should the nurse do next? A. Notify the charge nurse B. Float the patient's heels on a pillow C. Apply a prescribed emolient D. Reposition the patient on the left side

A. Notify the charge nurse

A female patient comes to the emergency department with severe abdominal pain, a temperature of 101 F, and a foul smelling, purulent vaginal discharge. The nurse recognizes that these findings are consistent with which infection? A. Pelvic inflammatory disease (PID) B. Gonorrhea C. Syphilis D. Vaginosis

A. Pelvic inflammatory disease (PID)

The nurse urges a female patient with gonorrhea to seek medical care. Which complication(s) can occur if gonorrhea is left untreated? (select all that apply) A. Pelvic inflammatory disease (PID) B. Sterility C. Obstructed fallopian tubes D. Ectopic pregnancy E. Ophthalmia neonatorum in the newborn

A. Pelvic inflammatory disease (PID) B. Sterility C. Obstructed fallopian tubes D. Ectopic pregnancy E. Ophthalmia neonatorum in the newborn

Which routes are ways in which sexually transmitted infections (STIs) are transmitted? (select all that apply) A. Sexual intercourse B. Oral-genital route C. Contact with infected blood D. Placenta to infant E. Contact with infected body fluids

A. Sexual intercourse B. Oral-genital route C. Contact with infected blood D. Placenta to infant E. Contact with infected body fluids

In females, testing for Chlamydia is done by A. low vaginal swab for culture and identification B. blood test for VDRL C. Pap smear D. vaginal swab for gram stain

A. low vaginal swab for culture and identification

A patient who has been diagnosed with chlamydia is started on a protocol of doxycycline. Which information is important for the nurse to include in the teaching? (select all that apply) A. The partner does not need treatment B. Use a condom to protect partners from disease C. Chlamydia can develop into pelvic inflammatory disease (PID) D. Take the entire prescription of antibiotics E. Chlamydia can result in an ectopic pregnancy

B. Use a condom to protect partners from disease C. Chlamydia can develop into pelvic inflammatory disease (PID) D. Take the entire prescription of antibiotics E. Chlamydia can result in an ectopic pregnancy

A patient has come to the clinic after having been notified of exposure to gonorrhea. He states this his exposure occurred 11 days ago. If he is infected, signs and symptoms that would be expected are A. headache, rash, stiff neck, irritability, and joint pain and stiffness B. urinary frequency, and burning with purulent discharge from the urethra C. nausea, diarrhea, fever, and urinary frequency and urgency D. burning sensation of the penis and swollen lymph nodes in the groin

B. urinary frequency, and burning with purulent discharge from the urethra

You are caring for a pregnant patient who has active genital herpes. When the patient asks about delivering her baby, which nursing response is appropriate? A. "You will receive antiviral medication to put the infection into remission before delivery." B. "A Cesarean section will be scheduled." C. "You can still deliver your baby vaginally because there is no risk to a neonate associated with genital herpes. D. "A nurse will bathe your baby immediately after delivery to reduce the risk of transmission."

B. "A Cesarean section will be scheduled."

Which patient statement is true about STIs? A. "One nice thing about current medical practice is that there is a cure for every STI." B. "Barrier protection should be used during intercourse with new partners, even if pregnancy is not a concern." C. "Chlamydia is the most common sexually transmitted viral infection." D. "Syphilis has been conquered and it is no longer possible to contract it."

B. "Barrier protection should be used during intercourse with new partners, even if pregnancy is not a concern."

A mother brings her 12 year old daughter in for an annual check-up. You recommend administration of one of the HPV vaccines. The mother replies, "My daughter does not need the vaccine because she is not sexually active." What is the appropriate nursing response? A. "You can bring her back when she becomes sexually active." B. "Studies have shown that the earlier the vaccine is given, the more effective it is. When she does become sexually active, the vaccine will be protecting her." C. "If you wait until your daughter is sexually active, it will be too late. How will you know?" D. "The vaccine must be given before your daughter is sexually active, or it will not work."

B. "Studies have shown that the earlier the vaccine is given, the more effective it is. When she does become sexually active, the vaccine will be protecting her."

You talk with the parents of a 9 year old girl about the HPV vaccinations. The information session must include which statement(s)? (Select all that apply) A. "The vaccine is a one-dose immunization." B. "The vaccine prevents genital warts." C. "The vaccine prevents some precancerous lesions of the cervix." D. "The vaccine protects against some other diseases caused by HPV." E. "The vaccine eliminates the need for routine cervical cancer screening."

B. "The vaccine prevents genital warts." C. "The vaccine prevents some precancerous lesions of the cervix." D. "The vaccine protects against some other diseases caused by HPV."

The nurse instructs a sexually active teenager that frequent douching can cause which infection? A. Syphilis B. Bacterial vaginosis C. Pelvic inflammatory disease (PID) D. Purulent vaginitis

B. Bacterial vaginosis

Which sexually transmitted infections (STIs) must be reported? (Select all that apply) A. Vaginitis B. Gonorrhea C. Pelvic inflammatory disease D. Chlamydia E. Lymphogranuloma

B. Gonorrhea C. Pelvic inflammatory disease D. Chlamydia E. Lymphogranuloma

The patient has been diagnosed with primary stage syphilis. The nurse would anticipate the patient to display which symptom? A. Sore throat B. Hard sore on mucous membrane of genitalia C. Patchy loss of hair from the scalp D. Skin rash on arms and back

B. Hard sore on mucous membrane of genitalia

The nurse is caring for a homosexual man with a rectal tear and inflamed rectal tissue. The nurse understands that these findings increase the patient's risk for which disorder? A. An abscess B. Human immunodeficiency virus (HIV) infection C. Hemorrhoids D. Rectal hemorrhage

B. Human immunodeficiency virus (HIV) infection

While inserting an indwelling urinary catheter, you notice raised, rough, cauliflower-like growths on the vulva and vaginal walls. Which causative agent do you anticipate? A. Herpes simplex virus B. Human papillomavirus C. Treponema pallidum D. Neisseria gonorrhoeae

B. Human papillomavirus

How can the use of oral contraceptives increase the risk of acquiring a sexually transmitted infection (STI) (select that all apply) A. Oral contraceptives cause bone-marrow suppression B. Oral contraceptives cause an alkaline vaginal environment C. Oral contraceptives may reduce the perception of the need for condom use D. Oral contraceptives decrease the inflammatory response E. Oral contraceptives must be taken regularly in order to be effective

B. Oral contraceptives cause an alkaline vaginal environment C. Oral contraceptives may reduce the perception of the need for condom use E. Oral contraceptives must be taken regularly in order to be effective

When teaching a patient who is being treated for Chlamydia trachomatis, the nurse should stress that A. Medication must be taken every day for a month B. Partner(s) must be treated concurrently C. Swimming and hot0tubbing are contraindicated while under treatment D. Lesions must be kept clean and dry to prevent secondary infections

B. Partner(s) must be treated concurrently

The nurse is caring for a patient with syphilis. Which manifestation indicates that the syphilis has progressed to the secondary stage?A. Foul-smelling penile discharge B. Positive serology C. Purulent skin rash D. Scrotal swelling

B. Positive serology

The nurse is educating a sexually active female patient about infection prevention. Which change during the premenstrual period increases the patient's risk of infection? A. Cervical secretions become more alkaline B. The cervical mucous plug becomes more permeable C. Higher estrogen levels increase vaginal lubrication D. Lower antibody levels increase risk for infection

B. The cervical mucous plug becomes more permeable

The nurse is caring for a patient with genital herpes. Which manifestation alerts the nurse to a potential signal of an impending outbreak? A. Elevation in temperature B. Tingling sensation in the vagina C. Copious vaginal discharge D. Migraine-like headache

B. Tingling sensation in the vagina

When obtaining a history from a female patient suspected of having a sexually transmitted infection (STI), as a way to determine how much at risk the patient is, which of these questions is most important? A. "How often do you have sex?" B. "Are you married?" C. "How many sexual partners have you had in the past year?" D. "Have you ever had an abortion?"

C. "How many sexual partners have you had in the past year?"

Which statement indicates that a patient needs additional education about the vaccine for human papillomavirus (HPV)? A. "I know I must have three doses of the vaccine." B. "Girls as young as 9 years of age may be vaccinated." C. "I am relieved that the vaccine protects me from all HPV infections. D. '"I know I should continue having regular Pap smears

C. "I am relieved that the vaccine protects me from all HPV infections.

You are caring for an adolescent who has been diagnosed with gonorrhea. When the patient refuses to notify recent sexual partners, what is your appropriate response? A. "Do you not feel responsible for infecting other people?" B. "You do not have to notify anyone that you don't wish to contact." C. "I am still accountable to report this disease through required channels." D. "It is considered a felony offense if you do not disclose b=names of your sexual partners."

C. "I am still accountable to report this disease through required channels."

Which patient is exhibiting manifestations consistent with the primary stage of syphilis? A. A female patient with copious vaginal discharge B. A male patient with a generalized skin rash C. A female patient with a painless nodule on her vagina D. A male patient with a gumma

C. A female patient with a painless nodule on her vagina

The patient is reluctant to talk about his sexual history. Which statement by the nurse would be the most appropriate to complete the task of obtaining a sexual history, while considering the psychological comfort of the patient? A. "This will only take a few minutes to complete these questions." B. "Let's take a short break; then we can continue." C. "Don't be embarrassed. I ask everybody these same questions." D. "Let's start with your kidneys. Are you having trouble with urination?"

D. "Let's start with your kidneys. Are you having trouble with urination?"

The nurse is educating a young woman newly diagnosed with genital herpes. Which information is most important for the nurse to include in the teaching plan? A. Take the entire course of antibiotics B. Increase fluid intake to diulte urine C. Wash hands after applying ointment to lesions D. Avoid all sexual contact until lesions completely resolve

D. Avoid all sexual contact until lesions completely resolve

A patient has been diagnosed with chlamydia for the seconds time in a 5 month period. Data collection reveals that the patient was not compliant with the plan of treatment with the last infection. Which medication does the nurse anticipate that the provider will prescribe? A. Docycline B. Erythromycin C. Diflucan D. Azithromycin

D. Azithromycin

The nurse is educating a pregnant patient who is human immunodeficiency virus (HIV) positive. Which information is most important for the nurse to include in the teaching plan? A. Breast-feeding is always best B. Talk with your doctor about a vaginal delivery C. Engage in oral, rather than vaginal, sex D. Remain on the medication protocol

D. Remain on the medication protocol

Once a diagnosis of syphyilis is confirmed, the nurse understands that she must report the illness to which entity? A. The World Health Organization (WHO) B. The Centers for Disease Control and Prevention (CDC) C. The hospital infection control department D. The local public health agency

D. The local public health agency

When caring for a male patient with suspected gonorrheal infection, which action is most important for the nurse to take? A. Report the infection to the local public health agency B. Assess the patient's temperature hourly C. Administer antibiotics before cultures are drawn D. Wait 1 hour after the patient voids to collect a uretral swab

D. Wait 1 hour after the patient voids to collect a uretral swab

5. A woman diagnosed with gonorrhea is astounded and states that she had no idea that she had an STI. What should the nurse explain about gonorrhea? a. It produces no symptoms in half of those in the early stages of the infection. b. It always produces a foul vaginal discharge. c. It causes a vaginal chancre that is not easily detected. d. It may appear to be an upper respiratory infection in the early stages of the infection.

a. It produces no symptoms in half of those in the early stages of the infection.

When teaching about HPV vaccination (Gardasil/Cervarix), which facts should be included? (Select all that apply) A. Only one dose is required B. The vaccine should not be given to children under 14 years old C. Two vaccines are effective in preventing genital warts D. The vaccine is effective in preventing STIs' E. Three vaccines are available

E. Three vaccines are available

18. What is characteristic of the primary stage syphilis? a. Chancre b. Alopecia c. Pruritus d. Dry skin

a. Chancre

11. A couple comes to the emergency department for the treatment of an STI. The man's presenting symptoms include a creamy penile discharge and frequent urination. The woman has lower abdominal pain and a vaginal discharge. What should the nurse recognize these symptoms to characterize? a. Chlamydial infection b. Gonorrhea infection c. HSV type B d. Trichomoniasis

a. Chlamydial infection

25. A nurse explains that STIs must be reported to the local public health department. Which are considered reportable diseases? (Select all that apply.) a. HIV b. Acquired immunodeficiency syndrome (AIDS) c. Gonorrhea d. Chlamydia e. Viral hepatitis

a. HIV b. Acquired immunodeficiency syndrome (AIDS) c. Gonorrhea e. Viral hepatitis

16. A nurse asks a patient to repeat the instructions to evaluate her knowledge about safe sex practices. Which statement indicates an understanding? a. "Body massage would be considered safe." b. "Mutual open-mouth kissing is safe." c. "Vaginal intercourse with a properly used condom is safe." d. "Anal sex with a condom made of latex is a safe sex practice."

a. "Body massage would be considered safe."

1. In addition to the use of nonbarrier methods of birth control, which factor has led to the dramatic increase of sexually transmitted infections (STIs) in the last two decades? a. asymptomatic disease carriers b. careful reporting of STIs c. antibiotic-resistant organisms d. more sex education programs in schools

a. asymptomatic disease carriers

4. Which sexually transmitted infection (STI) is known as the "silent STI" because 50% of cases are asymptomatic? a. chlamydia b. herpes genitalis virus c. HIV d. syphilis

a. chlamydia

6. The nurse should be aware that which sexually transmitted infection (STI) is often seen in combination with chlamydia? a. gonorrhea b. herpes genitalis c. syphilis d. trichomoniasis

a. gonorrhea

8. The nurse caring for a newborn administers silver nitrate or antibiotic solution to prevent an eye infection. This transmission may occur as the baby travels through the birth canal that is infected with: a. gonorrhea b. herpes genitalis c. human immunodeficiency virus (HIV) d. syphilis

a. gonorrhea

11. The destructive, inflammatory changes occurring in the tertiary stage of syphilis involves which organ system? a. multiple b. central nervous c. epidermal d. reproductive

a. multiple

24. What is the primary route of transmission of hepatitis B? a. sexual contact b. oral-fecal c. blood d. water

a. sexual contact

18. To reduce risk of developing cervical cancer, a client who has human papillomavirus (HPV) infection should be advised to avoid: a. smoking b. use of oral contraception c. use of barrier methods of contraception d. use of condoms for future sexual partners

a. smoking

15. What instruction should be included by a health educator giving a presentation on how to use condoms correctly? a. Condoms are 100% effective when used correctly. b. The effectiveness of condoms deteriorates in heat. c. Any style and material of condom is safe to use. d. Use of petroleum jelly will ease application.

b. The effectiveness of condoms deteriorates in heat.

23. For a pregnant client who has trichomoniasis, when will treatment occur? a. mother and baby will be treated after birth b. after the first trimester c. immediately d. once the repeat test is also positive

b. after the first trimester

8. A patient with gonorrhea is taking a protocol of tetracycline antibiotics. Which statement by the nurse is most likely to help overcome patient noncompliance? a. "You should take all of this medicine." b. "Failing to take the entire medicine amount will make your disease resistant to it." c. "You will become sterile if you do not complete the supply of medicines." d. "The doctor wants you to take all of this medication."

b. "Failing to take the entire medicine amount will make your disease resistant to it."

20. Which antiviral drug is commonly used to relieve symptoms of herpes simplex virus (HSV)? a. Tetracycline (Achromycin) b. Acyclovir (Zovirax) c. Erythromycin (E-Mycin) d. Metronidazole (Flagyl)

b. Acyclovir (Zovirax)

2. A nurse is completing a history of illnesses for a young woman who suspects she may have a sexually transmitted infection (STI). What specific symptom(s) should the nurse ask this patient if she experienced? a. Lethargy and fatigue b. Genital discharge c. Abdominal cramps d. Heavy menses

b. Genital discharge

6. A nurse giving instruction to a patient with an STI says, "I am supposed to tell you about STIs, but you probably know more about them than I do." What is this nurse doing? a. Admitting her own ignorance about STIs b. Trying to get the patient's attention c. Referencing current statistics d. Making a judgmental statement

d. Making a judgmental statement

24. A patient with a chlamydial infection is taking a 7-day course of doxycycline (Vibramycin). What information should the nurse provide? a. Return in 1 month for a follow-up culture. b. Take the drug on an empty stomach with a minimum of fluid. c. Delay sexual activity until cured. d. Expect genital or anal itching or burning.

c. Delay sexual activity until cured.

4. A nurse is caring for a patient taking acyclovir (Zovirax). Which side effects of this drug should the nurse be alert for? a. Fever and bone marrow suppression b. Vaginal burning and skin irritation c. Dizziness, headache, and nausea d. Leukopenia and peripheral neuropathy

c. Dizziness, headache, and nausea

10. Doxycycline (Vibramycin) has been prescribed for a patient who has gonorrhea. What instruction should the nurse provide to the patient before beginning the medication? a. Take the medication with food or crackers. b. Refrain from sexual relations for 4 weeks. c. Follow up to determine if the treatment was effective. d. Keep the medication in the refrigerator.

c. Follow up to determine if the treatment was effective

1. A nurse in the outpatient clinic notes that a patient has been treated for syphilis three separate times in the past 2 years. What should the antibiotic treatment for this patient consist of this time?a. Penicillin G b. Penicillin G today and a follow-up with another injection in 1 month c. Penicillin G today and 3 months of oral tetracycline antibiotic medications d. Penicillin G today and a 2-month protocol of oral antiviral agents

c. Penicillin G today and 3 months of oral tetracycline antibiotic medications

3. Why do males generally seek health care more readily for symptoms of sexually transmitted infections (STIs)? a. They are more health conscious than women. b. Their symptoms are more severe, and they are more likely to suffer complications. c. Their symptoms are usually more obvious at the onset of the disease. d. The male is more likely to transmit the disease to his partner.

c. Their symptoms are usually more obvious at the onset of the disease.

3. A patient has been diagnosed with herpes simplex virus, type 2 (HSV type 2). What instruction should the nurse provide? a. Avoid telling anyone about the condition. b. Wear close-fitting undergarments. c. Wash towels and personal items daily. d. Soak the sores with peroxide every day.

c. Wash towels and personal items daily.

20. In addition to sexual contact, client teaching should include that the human immunodeficiency virus (HIV) virus can be transmitted by which mode? a. respiratory b. from baby to mother c. blood d. fecal

c. blood

2. When teaching the client about proper condom use, which of the following should the nurse include? (Select all that apply.) a. is just as effective as other birth control methods b. should be discarded after two ejaculations c. disposal includes by holding at the base of the penis after ejaculation d. can be used to prevent oral-genital membrane contact e. store in a cool, dry place away from sunlight f. provides the most protection against sexually transmitted infections (STIs)

c. disposal includes by holding at the base of the penis after ejaculation d. can be used to prevent oral-genital membrane contact e. store in a cool, dry place away from sunlight

15. Client teaching should include that human papillomavirus (HPV) can lead to the formation of: a. chancres b. enlarged inguinal lymph nodes c. genital warts d. herpetic lesions

c. genital warts

26. What is the MOST important nursing consideration when collecting information about a client's sexual history? a. recording each of the client's sexual contacts accurately b. noting any recent antibiotic treatment for infections that were not sexually transmittedinfections (STIs) c. maintaining a relaxed, nonjudgmental attituded. d. recognizing personal attitudes and beliefs regarding persons with STIs

c. maintaining a relaxed, nonjudgmental attituded.

14. Transmission of cytomegalovirus to an unborn fetus can result in what condition in the neonate? a. cataracts b. choanal atresia c. mental retardation d. jaundice

c. mental retardation

13. Cytomegalovirus can be misdiagnosed as what illness due to similarity of symptoms? a. AIDS b. herpes genitalis c. mononucleosis d. syphilis

c. mononucleosis

17. Symptoms of infection with human papillomavirus (HPV) include: a. fever, chills, aches, and fatigue b. painful wartlike growths on internal or external genitalia c. painless, soft, fleshy growths appearing in the genital area d. white, cheesy discharge from the vagina

c. painless, soft, fleshy growths appearing in the genital area

16. Which population group is MOST at risk for developing the human papillomavirus (HPV) infection? a. males between the ages of 17 and 25 years old b. males or females in their early 20s who have had multiple sexual partners c. teenage girls or young women in their 20s d. females in their mid-20s to 30s

c. teenage girls or young women in their 20s

10. At which stage does syphilis become noninfectious? a. primary b. secondary c. tertiary d. There is no stage at which the disease is not infectious.

c. tertiary

22. What is the preferred treatment of a client who has trichomoniasis? a. 1 week of Cipro b. 3 days of doxycycline c. up to 1 week of Flagyl d. a single penicillin injection

c. up to 1 week of Flagyl

17. A female patient, newly diagnosed with gonorrhea, screams, "I am going to kill my husband. I mean it." What is the nurse's best response? a. "Are you sure it is your husband who gave you gonorrhea?" b. "Yikes! Killing your spouse seems extreme." c. "Shall I report your spouse as a sexual contact?" d. "I can understand your anger. How best can you deal with it?"

d. "I can understand your anger. How best can you deal with it?"

23. What should a nurse caution a patient taking Flagyl for Trichomonas to do? a. Double the dose if any doses are missed. b. Report dark urine. c. Take the drug on an empty stomach. d. Abstain from alcohol while taking the drug.

d. Abstain from alcohol while taking the drug.

14. A gynecologist caring for a pregnant patient who has gonorrhea prescribed cefixime (Suprax) instead of the more common tetracycline hydrochloride (Achromycin). What is the rationale for this decision? a. Gonorrhea is less likely to be resistant to Suprax. b. Achromycin requires a longer treatment protocol than Suprax. c. Suprax is a more potent drug that Achromycin. d. Achromycin is contraindicated in a patient who is pregnant.

d. Achromycin is contraindicated in a patient who is pregnant.

19. What does diagnosis with the human papilloma virus (HPV) increase a person's risk for? a. Uterine fibroids b. Chronic vaginitis c. Premature menopause d. Cervical cancer

d. Cervical cancer

22. A patient at the outpatient clinic who has received an intramuscular dose of ceftriaxone sodium (Rocephin) calls and complains of pain and induration at the injection site. What should the nurse advise the patient to do? a. Undergo 30 minutes of active exercise to speed absorption of the drug. b. Make an appointment at the clinic for evaluation to initiate another drug. c. Immediately come to the clinic for treatment of the allergic reaction. d. Place a warm compress on the area.

d. Place a warm compress on the area

12. A pregnant patient with HSV type 2 has a Herp-Test performed in the physician's office 1 day before she is due to deliver by cesarean section. The test result is negative. What should the nurse know this means? a. The delivery must be by cesarean section. b. The patient must start on an antiviral protocol today. c. The baby will have to have antiviral medication 24 hours after birth. d. The delivery may be accomplished vaginally.

d. The delivery may be accomplished vaginally.

2. Which statement regarding sexually transmitted infections (STIs) is TRUE? a. Guidelines for reporting STIs are often ignored. b. Statistics on STIs are kept only by individual states. c. Reporting is required for STIs such as herpes and trichomoniasis. d. There is no uniformity in the reporting requirements for STIs.

d. There is no uniformity in the reporting requirements for STIs.

12. Which treatment will cure herpes genitalis? a. acyclovir taken orally twice daily for 2 weeks b. an injection of penicillin G benzathine c. doxycycline 100 mg orally, twice daily for 7 days d. none

d. none

25. In addition to prior treatment for sexually transmitted infections (STIs) and sexual orientation, which of the following is a pertinent part of a client history when screening for sexually transmitted diseases? a. year of first sexual intercourse b. racial origin c. attendance at sex education classes d. number of sexual partners over the last 6 months

d. number of sexual partners over the last 6 months

5. It is MOST important to remind a pregnant woman being treated for chlamydia to: a. take the prescribed medication with milk b. prepare for treatment of the baby after delivery c. notify her health care provider if symptoms reoccur d. repeat cultures when treatment is complete

d. repeat cultures when treatment is complete

21. Which sexually transmitted disease is caused by a parasitic protozoan and is often seen in combination with gonorrhea? a. chlamydia b. herpes genitalis c. syphilis d. trichomoniasis

d. trichomoniasis

7. What is the MOST common symptom of gonorrheal infection in women? a. grayish-white mucopurulent vaginal discharge b. infertility c. painful sexual intercourse d. yellow or bloody vaginal discharge

d. yellow or bloody vaginal discharge