Chapter 56 Caring For Clients with STIs
A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect to find which of the following once the microorganism disseminates throughout the body? A) Painful joints B) Sore throat C) Intermenstrual bleeding D) Painful urination
Ans: A
The nurse is caring for a female diagnosed with a sexually transmitted infection (STI). The client states that her sister also has an STI. Which instruction, by the nurse, provides the rationale for females obtaining infections more frequently than males? A) The vagina is more conducive to microbial growth. B) Menstrual flow provides a medium for growth. C) Females have a more difficult time with hygiene. D) Hormones alter the pH of the reproductive tract.
Ans: A
The nurse is caring for a group of clients at a public health clinic. Which sexually transmitted disease would the nurse focus the client education on curative goals? A) Chlamydia B) HIV C) HPV D) Genital herpes
Ans: A
The nurse is instructing a health class on the proper use of a condom. Place the steps of applying a condom in the proper order. Use all options. A) Obtain an erection. B) Check the expiration date of the condom. C) Unroll the condom over the penis leaving a 1/2-inch space at the top. D) Dispose of the used condom. E) Roll the condom up to the tip of the penis pinching the top.
Ans: A, B, C, D, E
Which nursing instruction is most helpful to prevent autoinoculation of a sexually transmitted disease? A) Pat lesions instead of scratching. B) Use different sections of a towel to dry areas with lesions. C) Perform thorough handwashing. D) Do not share personal items with others.
Ans: C
A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent? A) Acyclovir B) Ceftriaxone C) Podophyllum resin D) Tetracycline
Ans: D
The nurse is instructing an adolescent on ways to prevent sexually transmitted infections (STIs). When evaluating the options, which is best when the client states being sexually active? A) Having one sexual partner B) Abstinence C) Use a latex condom with a spermicide. D) Urinating after sexual intercourse
Ans: C
Which of the following nursing instructions is most important for the nurse to emphasize to the client with a new HSV-2 diagnosis? A) You must inform all sexual partners. B) Keep lesions dry with alcohol or peroxide. C) Wear loose underwear to promote air circulation. D) Use a condom during sexual activity.
Ans: A
The nurse is instructing an adolescent female on potential vaccinations available. Which vaccination would the nurse state that decreases the risk of cervical cancer? A) Hepatitis B B) Human papilloma viral (HPV) C) Herpes zoster D) Meningococcal
Ans: B
Which of the following should a nurse consider when assessing older clients with a sexually transmitted infection (STI)? A) Abandon biases that older adults are sexually inactive. B) Older clients, because of their maturity, are rarely embarrassed to talk about this. C) Older clients know the ways to prevent STIs. D) Older clients who are sexually active have less risk for STIs than other age groups.
Ans: A
The nurse is discussing information regarding the human papilloma viral (HPV) infection. Which statement, made by the client, requires clarification? A) "HPV transmission may occur when the client is asymptomatic." B) "HPV is spread during sexual intercourse." C) "HPV may be spread to a newborn at the time of delivery." D) "HPV can be spread by autoinoculation."
Ans: B
The experienced nurse is assisting the novice nurse in caring for a client with a newly acquired sexually transmitted infection. Which of the following infections does the experienced nurse stress to report to the Centers for Disease Control (CDC)? Select all that apply. A) Venereal warts B) Chlamydia C) Hepatitis B D) Syphilis E) HIV F) Gonorrhea
Ans: B, D, E, F
The nurse is caring for a client with genital herpes experiencing a reoccurrence. Which nursing diagnosis would be the priority? A) Knowledge Deficit B) Powerlessness C) Anxiety D) Impaired Skin Integrity
Ans: D
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? A) Genital herpes B) Hepatitis B C) Syphilis D) Condylomata acuminata
Ans: C
The nurse is counseling a client who has been diagnosed with two sexually transmitted infections. The client is shocked and states not knowing how this has happened. Which of the following statements is most appropriate by the nurse? A) "Your partner could have been asymptomatic at that time." B) "You should have asked your partner if they have any infections." C) "Sexually transmitted infections have obvious signs of their presence." D) "Your partner should have told you of a previous infection."
Ans: A
A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure? A) "One or two treatments should get rid of the warts." B) "I'm temporarily not contagious once the warts are destroyed." C) "Once the warts are gone, then I know I'm cured." D) "My partner doesn't need to be treated."
Ans: B
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? A) Herpes virus B) Human papilloma virus C) Treponema pallidum D) Haemophilus ducreyi bacillus
Ans: B
The nurse has just obtained a newborn for admission and assessment in the newborn nursery. Which of the following nursing actions is done as a result of potential contamination of the neonate when descending down the birth canal? A) Assessing the mouth for thrush B) Instilling erythromycin ointment in the eyes C) Providing an injection of vitamin K D) Completing hearing screening
Ans: B
The nurse is addressing a multidisciplinary panel stating the need for continued education on sexually transmitted infections (STI). One of the points is the fact that the statistics of infection are underreported. Which of the following is the main cause that statistics are underreported? A) Clients do not often seek treatment for STIs. B) Only certain STIs are reported to the Centers for Disease Control and Prevention. C) Poor communication is offered between the physician offices and reporting agency. D) Reporting physicians are afraid of being sued for a breach in confidentiality.
Ans: B
The nurse is completing a community education via a pamphlet on sexually transmitted diseases. Which key point would the nurse place in bold letters? A) Common age-groups for clients with sexually transmitted diseases are in their late teens and 20s. B) Many people are asymptomatic and show no symptoms contributing to the spread of the disease. C) Some sexually transmitted diseases can cause infertility caused by scarring of reproductive organs. D) Some sexually transmitted diseases can be transmitted to newborns through the birth canal.
Ans: B
The nurse is providing education to the client newly diagnosed with three different types of sexually transmitted infections. Which of the following does the nurse identify to the client as the most common sexually transmitted infection? A) Genital warts B) Chlamydia C) Gonorrhea D) Syphilis
Ans: B
The nurse is reviewing the chart of a client newly diagnosed with syphilis. Which question is most important to ask next? A) Have you had sexual relations with anyone? B) Are you allergic to penicillin? C) When did you first notice symptoms? D) Are you having any pain?
Ans: B
The nurse is working at a public health clinic. Which symptoms does the nurse anticipate prior to assessing a client with secondary syphilis? A) A chancre on the genitals B) Fever, sore throat, lymph node enlargement C) Urethral drainage, dysuria D) Dementia, central nervous system involvement
Ans: B
When evaluating the therapeutic outcome of medication therapy for a client with a recurrent sexually transmitted disease, which client statement best confirms medication use? A) "I take my medication per physician's order." B) "I seem to have less breakouts with fewer symptoms." C) "I am able to take the medication with food to prevent nausea." D) "I feel that things are going better in my life."
Ans: B
Which type of sexually transmitted disease is the nurse most accurate to highlight in the client's history as it remains dormant in the body and can reoccur at any time? A) Chlamydia B) Herpes infection C) Gonorrhea D) Syphilis
Ans: B
A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which of the following responses would be most appropriate? A) "Use a condom during sexual activity if the infection becomes active again." B) "If the infection has healed, you probably don't have to use a condom." C) "Inform all potential sexual partners about the infection, even if it is inactive." D) "Refrain from all sexual activity until you don't have another outbreak for a year."
Ans: C
The client states a history of lymphogranuloma venereum diagnosed 6 months ago. When completing the head-to-toe assessment, which area should be a focus? A) Mental status B) Lesions on the genitals C) Lymph nodes of the genital area D) Lower extremities for edema
Ans: C
The nurse is caring for a client in the tertiary stage of a syphilis infection. Which assessment finding is anticipated? A) The client has ulcers in the genital region. B) The client has arthritis symptoms making ambulation difficult. C) The client has dementia and cannot care for himself or herself. D) The client complains of a headache and sore throat.
Ans: C
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? A) 35 B) 32 C) 24 D) 18
Ans: C
The nurse is instructing a client on proper procedures to protect herself from sexually transmitted infections (STIs). Which statement, made by the client, needs clarification? A) "If I use barrier protection, it will protect me from STIs." B) "You cannot always know everything about a person." C) "I consider myself protected because I am on birth control pills." D) "I refrain from sexual contact or use protection to keep myself safe."
Ans: C
The nurse is providing discharge instructions to a female client following inpatient therapy for a gonorrhea infection. The client is being discharged on doxycycline (Vibramycin) for 7 days. Which nursing instruction is essential for a therapeutic outcome? A) Obtain a pulse prior to administering medication. B) Use an alternate form of birth control. C) Complete all prescribed medication. D) Take medication on an empty stomach.
Ans: C
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? A) Administer an intravenous antibiotic to the mom while in labor. B) Complete a full assessment of the newborn on delivery. C) Prepare for a cesarean section. D) Place an antibacterial ointment on the mother's lesions.
Ans: C
A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which of the following would the nurse expect the client to exhibit? A) Ulcerated chancre, aortic valve insufficiency, lymphadenopathy B) Fever, malaise, sore throat C) Papular lesion, rash, headache D) Tabes dorsalis, ataxia, and Charcot's joints
Ans: D
During a sexual history, the client states that she has had multiple sex partners. Which statement by the nurse is most correct? A) "You are putting yourself at risk when you have multiple sex partners." B) "The chance of acquiring a sexually transmitted disease increases with multiple sex partners." C) "It is hard to find a good partner these days." D) "What do you do to prevent sexually transmitted infections?"
Ans: D
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? A) The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client. B) The infecting bacterium in all cases is the same, and therefore, clients have concurrent infections. C) The infections spread through the same medium, and therefore, clients have concurrent infections. D) It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).
Ans: D
Which of the following types of condoms is appropriate only if the client is in a long-standing relationship? A) Latex condom B) Lubricated condom C) Ribbed condom D) Natural membrane condom
Ans: D
