MS2 Quiz 12: Ch. 69 Evolve Questions

The nurse is counseling a client and the client's sexual partner on safer sex practices. Which client comment indicates a need for further education? "Condoms are for vaginal and anal sex, but not for oral sex." "We heard that latex condoms were better than natural membrane condoms." "We only use condoms once, and then throw them away." "If a condom breaks, we should immediately stop and replace it."

"Condoms are for vaginal and anal sex, but not for oral sex." A condom needs to be used for all sexual encounters, including oral, vaginal, and anal.If a condom breaks, it should be immediately replaced. Latex or polyurethane condoms need to be used rather than natural membrane condoms. A condom is never be used more than once.

What teaching will the nurse provide to a client newly diagnosed with gonorrhea? "Do not engage in sexual activity for 48 hours after treatment has been initiated." "You are contagious even if you have no outward symptoms." "Close follow-up is required because treatment failure is common." "You are only infectious while the lesions are draining."

"You are contagious even if you have no outward symptoms." Gonorrhea can be asymptomatic in both men and women, but women have asymptomatic, or "silent," infections more often than men. Clients are still contagious even if they have no outward symptoms.Treatment failure is rare when clients adhere to gonorrhea treatment provided according to Centers for Disease Control and Prevention recommendations. Clients need to avoid sexual activity until antibiotic therapy is completed and they no longer have physical symptoms. Lesions are associated with other STIs but not with gonorrhea.

The nurse is creating a plan of care for a client with newly diagnosed pelvic inflammatory disease (PID). Which problem does the nurse identify as the client's highest priority? Decreased sexual drive Impaired self-esteem Bacterial infection Possible infertility

Bacterial infection The highest priority problem for clients with pelvic inflammatory disease (PID) is bacterial infection related to invasion of pelvic organs by sexually transmitted pathogens.Although important, infertility (or the risk for the development of it), decreased sexual drive, and impaired self-esteem are not the most important problems in this scenario.

The nurse is assessing a male client with Chlamydia trachomatis. What assessment finding does the nurse anticipate? Dysuria Pustules on the glans of the penis Maculopapular perineal rash Testicular edema

Dysuria Dysuria is a clinical finding associated with C. trachomatis in males.Painless maculopapular rash in the perineal area and testicular edema are not clinical findings associated with C. trachomatis. Pustules on the glans of the penis are a clinical finding associated with herpes simplex type 2.

The nurse is providing expedited partner treatment (EPT) to a client who is newly diagnosed with chlamydia. What is the appropriate nursing action? Give the drug and directions to the client for the partner. Provide condoms for the client and partner to use. Confirm the partner's diagnosis through appropriate testing Make an appointment at the clinic for the partner.

Give the drug and directions to the client for the partner. The initial nursing action is to give the drug or a prescription with specific instructions for administration to the client for the partner, without direct evaluation by a primary health care provider. EPT is successful in reducing chlamydia infection rates. It is not required for the nurse to confirm the diagnosis of the partner or to make an appointment for the partner. Providing condoms is not a component of EPT.

The nurse is administering benzathine penicillin G intramuscularly to a client with primary syphilis. What precaution does the nurse implement when the client reports never having received penicillin before? Applies an ice pack to the injection site to minimize skin trauma. Keeps the client in the clinic for 30 minutes after drug administration. Administers ibuprofen to decrease the pain associated with the injection. Teaches to refrain from all sexual activities for a minimum of 72 hours.

Keeps the client in the clinic for 30 minutes after drug administration. The nurse needs to keep all clients on-site for at least 30 minutes after they have received this antibiotic so that symptoms of an allergic reaction can be detected and treated immediately if such a reaction occurs.The application of ice to the injection site is not recommended because it slows the absorption of the drug into the muscular tissues. Clients do not usually need medication to cope with injection pain. The nurse will recommend sexual abstinence until the client and partner both complete treatment.

The nurse is evaluating a client's response to antibiotic treatment for pelvic inflammatory disease (PID). Which assessment finding indicates that the treatment is effective? Decreased vaginal discharge Returning libido Lessened pelvic tenderness Increased appetite

Lessened pelvic tenderness Pain management of PID begins with treatment of the infection. Antibiotic therapy relieves pain by decreasing the inflammation caused by infection.Vaginal discharge may be increased at first as the infection drains. Increased appetite and returning libido may be secondary findings but are not indicative of effective treatment.

The nurse is teaching a group of men about sexually transmitted infections. What sign does the nurse identify that may appear in the primary stage of syphilis? Painless chancre Urethral discharge Scrotal swelling Rash in the genital area

Painless chancre The appearance of an ulcer called a chancre is the first sign of primary syphilis.Genital rash is a common symptom of the secondary stage of syphilis. Scrotal swelling is not a symptom of syphilis. Urethral discharge is a symptom of gonorrhea.

Which intervention does the nurse suggest for a sexually active client to reduce chances of getting an STI? (Select all that apply.) Polyurethane condoms Spermicidal cream Abstinence Mutual monogamy Latex condoms

Polyurethane condoms Abstinence Mutual monogamy Latex condoms Abstinence, latex condoms, polyurethane condoms, and mutual monogamy all decrease the risk for acquiring an STI.Spermicidal creams do not provide protection from STIs.

The nurse is planning care for a client who has a sexually transmitted infection (STI). Which intervention addresses the client's psychosocial needs? (Select all that apply.) Ensure that the client's sexual partner is aware of the diagnosis. Refer the client to the appropriate support groups. Approach the client with a nonjudgmental attitude. Report the STI to the public health department. Allow the client to express fears and anxieties. Share experiences about working with clients with STIs.

Refer the client to the appropriate support groups. Approach the client with a nonjudgmental attitude. Allow the client to express fears and anxieties. Many clients with STIs have fears and anxieties about having such diseases. They are reluctant to share a very private and personal side of their lives. It is therapeutic for a nurse to encourage clients' expressions about these feelings. Nurses must always be completely nonjudgmental about communicating with clients. Support groups can be very helpful to clients with STIs.Nurses have a responsibility to encourage clients with STIs to contact their sexual partners. However, if the client will not disclose this information, the nurse has no means of "ensuring" that the partner is aware of the diagnosis, nor does this action support the client's psychosocial needs. Reporting the occurrence to a public health agency is a nursing responsibility and is not be categorized as meeting the client's psychosocial needs. Nurses do not share personal experiences about their contacts with other clients. This is a breach of confidentiality that is illegal and unethical.

Which sexually transmitted infection does the nurse identify that can result in a vaginal infection? (Select all that apply.) Endometritis Syphilis Chlamydia Epididymitis Proctitis Gonorrhea

Syphilis Chlamydia Gonorrhea Chlamydia can be transmitted during vaginal, anal, or oral sex. Gonorrhea is spread through contact with the penis, vagina, mouth, or anus. Both gonorrhea and chlamydia can also be spread from an infected mother to her baby during vaginal childbirth. Syphilis is a bacterial infection usually spread by sexual contact which starts as a painless sore, typically on the genitals, rectum, or mouth. Syphilis spreads from person to person via skin or mucous membrane contact, such as vaginally.Endometritis is the infection of the innermost lining of the uterus (the endometrium); it does not result in a vaginal infection. Epididymitis is an inflammation of the coiled tube (epididymis) at the back of the testicle that stores and carries sperm. Pain and swelling are the most common signs and symptoms of epididymis. Proctitis is an inflammation of the rectum that causes discomfort, bleeding, and, occasionally, a discharge of mucus or pus. Sexually transmitted infections, spread particularly by people who engage in anal intercourse, can result in proctitis.

The nurse is discussing the prevention of sexually transmitted infections (STIs) with a group of young adults. What information does the nurse include? Spermicidal agents, when used with condoms, prevent the transmission of STIs. Female condoms are ineffective in preventing the transmission of STIs. The risk of STIs increases with the number of sexual partners. Use of latex condoms always keeps STIs from spreading and infecting others.

The risk of STIs increases with the number of sexual partners. The risk for contract an STI increases with the number of sexual partners.Female condoms (polyurethane sheaths in the vagina) are somewhat effective for preventing transmission of STIs. The use of spermicide with condoms, either lubricated condoms or vaginal application, has not been proved to be more or less effective against STIs than use without spermicide. Latex condoms do not completely prevent the spread of STIs, but they do substantially decrease the risk.

The nurse is collecting a client history prior to a gynecologic examination. Which comment by the nurse needs to be reworded to show respect for the client's personal values and beliefs?? "Have you participated in homosexual relationships?" "How many sexual partners do you currently have?" "What type of protection do you use when you have sex?" "How often do you have intercourse?"

"Have you participated in homosexual relationships?" Asking the client if she participates in homosexual relationships is not an appropriate assessment question. The nurse needs to allow opportunities for the client to discuss sexual orientation and gender preference. While it is appropriate to determine the client's sexual orientation during completion of the health history, a more culturally sensitive open-ended question is required, such as: "How would you describe your sexual orientation?"Asking the client about how many sexual partners she has is an appropriate assessment question because it demonstrates certain risk factors for sexually transmitted diseases (STIs) and other sexually related problems. Monogamous clients generally have fewer risk factors. The client's level of sexual activity is also appropriate for the nurse to question because it relates to the number of possible risk factors that the client may have. Asking the client what type of protection she uses is appropriate because the nurse can tailor teaching about becoming pregnant or possible exposure to an STI.

The nurse is teaching a group of young women about screening for chlamydia. Which client statement demonstrates that nursing teaching has been effective? "If I am a 40-year-old woman with a 'new' partner, I need to be screened again." "As a sexually active 19 year old, I need to be screened every 2 years." "At age 30, I need yearly testing, even if I have been monogamous for several years." "My partner got tested and treated for an STI so I don't need to be tested."

"If I am a 40-year-old woman with a 'new' partner, I need to be screened again." Women older than 25 years with new or multiple partners, or a partner with an STI, need to be screened annually for chlamydia.All sexually active women 25 years old or younger, and all women older than 25 years with a new partner, multiple partners, or a partner with an STI need to be screened annually for chlamydia. The 30-year-old woman who is monogamous for several years does not need to be screened.

The nurse is counseling a client who has tested positive for syphilis. What teaching will the nurse provide regarding the client's partner? "You must notify your sexual partners and encourage them to seek treatment." "Please share accurate information about your partners so prophylactic, expedited care can be initiated." "Syphilis is not reportable to the local health agency and follow-up is voluntary." "The clinic will provide information about you to potential partners until you have completed treatment".

"Please share accurate information about your partners so prophylactic, expedited care can be initiated." Prophylactic care for all sexual partners of clients infected with syphilis is necessary to prevent spread and long-term effects of the disease. Expedited partner therapy makes this possible. The client must provide accurate information so that all partners may be notified.Asking the client to suggest to partners that treatment may be necessary doesn't facilitate expedited treatment. Syphilis is a reportable sexually transmitted infection. The clinic will keep the client's information confidential due to HIPAA law.

A client with newly diagnosed pelvic inflammatory disease (PID) is prescribed an antibiotics as an outpatient. What teaching does the nurse provide about the treatment regimen? "If you engage in sexual activity, be certain to use a latex condom." "A rise in your temperature is expected for the first several days." "Return to the clinic in 7 to 10 days after completing treatment for a checkup." "Rest in a semi-Fowler position to help with the infection and pain."

"Rest in a semi-Fowler position to help with the infection and pain." The client must be instructed to maintain rest in a semi-Fowler position to promote gravity drainage of the infection. This may also help relieve the pain involved with PID.A rise in temperature is not expected and clients must be taught to report any increase in temperature to their primary health care provider. Nurses need to instruct women to stop sexual activity until antibiotic therapy is completed and they no longer have symptoms. The client must be seen by the primary health care provider within 72 hours of starting the antibiotics and then 1 and 2 weeks from the time of the initial diagnosis.

The nurse is teaching a female client about antibiotic treatment for pelvic inflammatory disease (PID). Which client statement indicates that teaching has been effective? "I can resume having sex 24 hours after the first dose of antibiotics." "Antibiotics are always to be taken with food." "These antibiotics must be taken for 14 days." "When I take the antibiotic, I also need to take an antacid."

"These antibiotics must be taken for 14 days." The CDC recommends oral and/or parenteral antibiotics for PID for 14 days. The nurse needs to stress that antibiotics must be taken as prescribed and continued until all have been taken, even if the client begins feeling better.Sexual intercourse must be avoided until after antibiotic therapy is completed. If the client's partner is being treated, sex can resume after the partner also completes his or her treatment. Antacids containing calcium, magnesium, or aluminum (Tums, Maalox, or Mylanta) are not be taken with antibiotics because they may decrease their effectiveness. Antibiotics need to be taken on an empty stomach unless the health care provider instructs the client to take them with food.

The nurse is teaching a 19-year-old female with genital warts. Which client statement requires further education from the nurse? "The warts may actually disappear or resolve without any treatment at all." "There is no known treatment that will cure genital warts." "Wart remover treatment from the drugstore will help me get rid of them." "Genital warts may reappear at the same site."

"Wart remover treatment from the drugstore will help me get rid of them." The nurse must teach clients that over-the-counter wart treatments must not be used on genital tissue.There is no treatment that cures genital warts at the present time. Warts may disappear or resolve on their own without treatment. They mayoccur once or recur at the original site.