NUR 398 Sexually Transmitted Disease

Which condition is suspected in patients diagnosed with condylomata acuminata? 1 Lung cancer 2 Cervical cancer 3 Stomach cancer 4 Hodgkin's disease

2 Condylomata acuminata is caused by human papilloma virus (HPV). HPV causes the production of proteins, which turn off the tumor suppressor genes. This may allow the cervical lining cells to grow extensively, leading to cervical cancer. Lung cancer is caused by tobacco smoking. Stomach cancer is caused by Helicobacter pylori infection and interstitial metastasis. Hodgkin's disease may be caused by Epstein Barr virus infection.

Which groups of people are at greater risk for sexually transmitted infections (STIs)? Select all that apply. 1 Lesbian women 2 Pregnant women 3 Postmenopausal women 4 Adolescent boys and girls 5 Men who have sex with men (MSM)

2,3,4,5 Groups who are at greatest risk for acquiring STIs include MSM, postmenopausal and pregnant women, and adolescents. All heterosexual women are at risk for STIs, and that includes pregnant women. MSM are at high risk for HIV. Postmenopausal women are at risk because many avoid the use of barrier protection since pregnancy is unlikely. Adolescents are at risk because of their lack of knowledge about the risks for disease. It has been found that lesbian women are at decreased risk for STIs.

What organisms may cause genital ulcerations or warts? Select all that apply. 1 Candida albicans 2 Hepatitis C virus 3 Tryponema pallidum 4 Herpes simplex virus 5 Chlamydia trachomatis 6 Haemophyilus ducreyi

3,4,5,6 Organisms that may cause genital ulcerations in people are Tryponema pallidum, Chlamydia trachomatis, Haemophyilus ducreyi, and herpes simplex virus. Candida albicans causes vulvovaginitis, and hepatitis C virus causes hepatitis.

Which statement made by the patient with genital herpes requires further teaching about self-care management? 1 "I should avoid urinating." 2 "I should avoid a lot of sunlight or heat." 3 "I should use disposable gloves to apply medication." 4 "I should abstain from sexual contact until the lesions are healed."

1 A patient with genital herpes should not avoid urinating because voiding can be difficult when lesions are present. The patient must avoid a lot of sunlight or heat because they may cause more blisters. The use of disposable gloves to apply medication reduces spreading the infection. Abstaining from sexual contact until lesions are healed may help in reduced transmission of infection.Test-Taking Tip: Read the question carefully before looking at the answers: (1) Determine what the question is really asking; look for key words; (2) Read each answer thoroughly and see if it completely covers the material asked by the question; (3) Narrow the choices by immediately eliminating answers you know are incorrect.

The nurse is establishing a plan of care for a patient with newly diagnosed pelvic inflammatory disease (PID). Which problem does the nurse place as the patient's highest priority? 1 Infection 2 Infertility 3 Reduced sexual drive 4 Reduced self-esteem

1 The primary problem for patients with PID is infection; this is related to invasion of pelvic organs by pathogens. Although important, infertility (or the risk for the development of it), reduced sexual drive, and reduced self-esteem are not the patient's most important problems in this scenario.Test-Taking Tip: Become familiar with reading questions on a computer screen. Familiarity reduces anxiety and decreases errors.

What nursing interventions should be performed on an uninfected woman whose sexual partner is infected with genital herpes? Select all that apply. 1 Advise her to avoid unprotected sexual intercourse. 2 Advise her to avoid sexual intercourse if lesions are present. 3 Recommend that she abstain from sexual intercourse during pregnancy. 4 Explain that episodic therapy is recommended to the infected partner if the woman is pregnant. 5 Explain there is no risk from sexual intercourse if her infected partner is relieved of symptoms.

1,2,3 Avoiding unprotected sexual intercourse may reduce transmission of the infection. Abstaining from sexual intercourse if lesions are present helps to prevent transmission of infection. During pregnancy, abstaining from sexual intercourse with an infected partner may reduce the risk of infection to the fetus. There is a risk of transmission even if the infected partner is relieved of symptoms. Suppressive therapy is recommended to the infected partner if the uninfected woman is pregnant to reduce the risk of transmission.

The nurse is teaching a 19-year-old female with genital warts about her condition. Which patient statement requires further education from the nurse? 1 "There is no known treatment that will cure genital warts." 2 "The warts may actually disappear or resolve without any treatment at all." 3 "Genital warts may reappear at the same site." 4 "Wart remover treatment from the drugstore will help me get rid of them."

4 The nurse must teach patients that over-the-counter (OTC) wart treatments should not be used on genital tissue. There is no treatment that cures genital warts at the present time. The desired outcomes of management are to remove the warts and treat the symptoms. Warts may disappear or resolve on their own without treatment. They may occur once or recur at the original site.Test-Taking Tip: The following are crucial requisites for doing well on the NCLEX exam: (1) A sound understanding of the subject; (2) The ability to follow explicitly the directions given at the beginning of the test; (3) The ability to comprehend what is read; (4) The patience to read each question and set of options carefully before deciding how to answer the question; (5) The ability to use the computer correctly to record answers; (6) The determination to do well; (7) A degree of confidence.

What manifestations does the nurse observe upon assessment in a patient with condylomata acuminata, or genital warts? 1 Generalized rash 2 Benign lesions of the skin 3 Squamous papules and pustules 4 Presence of cauliflower-like masses

4 The patient with condylomata acuminata has small, white or flesh-colored papillary growths that may grow into large cauliflower-like masses. Generalized rash, benign lesions of the skin, and squamous papules and pustules are seen in patients with secondary syphilis.

Which information in a patient's medical history is associated with a risk for pelvic inflammatory disease (PID)? Select all that apply. 1 Smoking 2 Age >30 years 3 History of chlamydia 4 Multiple sexual partners 5 Intrauterine device (IUD) in place since last year

1,3,4 Having had a previous sexually transmitted infection like chlamydia, multiple sexual partners, and smoking put a patient at greater risk for PID. Being younger than 26 years and a recently placed IUD (within the previous 3 weeks not in place for a year) are additional risk factors for PID.

Which type of human papilloma virus (HPV) is associated with a low risk for developing genital cancer? 1 HPV type 11 2 HPV type 16 3 HPV type 18 4 HPV type 31

1 HPV types 6 and 11 are considered low-risk human papilloma virus. HPV types 16, 18, 31, 33, and 35 are considered high-risk human papilloma virus. These high-risk viruses can be found on genitalia and increase the risk for genital cancers.

Which sexually transmitted infection is targeted by Healthy People 2020 for complete eradication in the United States? 1 Syphilis 2 Chlamydia 3 Genital herpes 4 Human papilloma virus

1 Healthy People 2020 has the stated objective of completely eliminating syphilis in the United States. The goal regarding chlamydia is to reduce the proportion of young adults and adolescents with it by 10%. It has an objective to reduce the proportion of young adults with genital herpes due to herpes simplex type 2 by 10%. It has a goal of reducing the proportion of females with human papilloma virus but not to a specified target number.

A registered nurse is teaching a student nurse regarding human papilloma virus (HPV) infection. Which statements made by the student nurse require further teaching? Select all that apply. 1 Fluid-filled blisters are found in HPV infection. 2 HPV infection is treated with podofilox and cryotherapy. 3 HPV infection is transmitted through oral, anal, and vaginal sex. 4 Cervarix vaccine provides immunity against HPV types 16 and 18 in males. 5 HPV infection is the primary risk factor for the development of cervical cancer.

1,4 Fluid-filled blisters are found in genital herpes. In HPV infection, large masses of papillary growth are found, and bleeding occurs when the wart is disturbed. Cervarix vaccine provides immunity against HPV type 16 and 18 only in females. Treatment of HPV infection includes topical use of podofilox, cryotherapy, podophyllin resin, and trichloroacetic acid. HPV is transmitted through oral, anal, and vaginal sex and skin-to-skin contact. HPV infection has been established as a primary risk factor for development of cervical cancer.

What is the causative organism of condylomata acuminata? 1 Herpes simplex virus 2 Human papilloma virus 3 Trichomonas vaginalis 4 Chlamydia trachomatis

2 Condylomata acuminata refer to genital warts, and this is caused by human papilloma virus infection. Herpes simplex virus is the causative organism of genital herpes. Trichomonas vaginalis is the protozoan parasite causing trichomoniasis. Chlamydia trachomatis is the bacterium that causes Chlamydia infection.

What does the nurse infer from a patient whose initial symptoms of genital herpes have subsided? 1 The virus is in an active state. 2 The infection has been cured. 3 The virus is in a dormant state. 4 There is now a decrease in viral shedding.

3 After symptoms subside from a primary infection of genital herpes, herpes simplex virus is still present in a dormant state in the sacral nerve ganglia. When the virus is in an active state, there may be a formation of blisters. Herpes simplex virus infection cannot be cured. A decrease in viral shedding in genital herpes indicates healing of the lesions.Test-Taking Tip: Multiple-choice questions can be challenging because students think that they will recognize the right answer when they see it or that the right answer will somehow stand out from the other choices. This is a dangerous misconception. The more carefully the question is constructed, the more each of the choices will seem like the correct response.

What findings does the nurse observe in a patient with pelvic inflammatory disease (PID)? 1 Urinary retention 2 Reddened throat 3 Hunched-over gait 4 Mucoid discharge

3 The patient with PID has severe pain in the lower abdomen and is uncomfortable with movement. The nurse would observe a hunched-over gait to protect her abdomen. The patient also has painful urination or dysuria. The patient does not experience urinary retention or reddened throat. A pelvic examination reveals a green cervical discharge and a friable cervix.

Postmenopausal women are especially at risk of becoming infected with sexually transmitted infections (STIs) because of which factors? Select all that apply. 1 Belief that they are not vulnerable to disease 2 Very vascular mucosal membranes of the vagina 3 Lack of barrier protection use during sexual intercourse 4 Predisposition to mucosal tears due to vaginal atrophy 5 Belief that nonbarrier contraceptive methods protect against STIs 6 Consumption of large amounts of alcohol, which leads to risky behavior

3,4 Postmenopausal women are not at risk for pregnancy and therefore may not use barrier protection during sexual intercourse, increasing their risk for infection. They also experience vaginal atrophy, which leads to mucosal tears and a risk for infection when exposed. All women are more at risk for STIs than men due to the vascularity of the mucosa of the vagina; this is not specific to postmenopausal women. Lack of vulnerability to disease and consuming large amounts of alcohol are traits of young women that put them at risk for STIs. Young women are also more likely to have the incorrect belief that nonbarrier contraceptives also protect against STIs.

Which bacterial infection may result in inflammation of the fallopian tubes? 1 Treponema pallidum 2 Haemophilus ducreyi 3 Trichomonas vaginalis 4 Chlamydia trachomatis

4 Chlamydia trachomatis is a bacterium that may cause inflammation of the fallopian tubes. Treponema pallidum is an organism that causes syphilis, resulting in the formation of chancres on the skin or mucous membranes. Haemophilus ducreyi is an organism that causes chancroid, resulting in the formation of sores on the genital organs. Trichomonas vaginalis is a sexually transmitted infection; the infection occurs in the urethra, prostate, or vagina.

The nurse is caring for four patients who are diagnosed with sexually transmitted infections. Cryotherapy (freezing) will be beneficial for which patient? 1 Patient A 2 Patient B 3 Patient C 4 Patient D

4 Cryotherapy, usually with liquid nitrogen, can be used every 1 to 2 weeks until lesions are resolved. Patient D has condylomata acuminata and will be treated effectively using cryotherapy with liquid nitrogen. Patient A has syphilis and will be treated effectively with benzathine penicillin G. Patient B has gonorrhea and will be treated effectively with ceftriaxone or cefixime. Patient C has chlamydia infection and will be treated effectively with azithromycin.

Gonorrhea can potentially progress without warning and can commonly lead to which disorder in women? 1 Arthritis 2 Hepatitis 3 Meningitis 4 Endometritis

4 Endometritis is a common progression of gonorrhea. Meningitis, arthritis, and hepatitis can be the result of gonorrhea, but these occur rarely.

Which type of sexually transmitted infection has the risk of cervical cancer? 1 Syphilis 2 Gonorrhea 3 Herpes simplex virus infection (HSV) 4 Human papilloma virus infection (HPV)

4 HPV infection may lead to the formation of precancerous lesions in the genital area, especially the cervix. Syphilis, gonorrhea, and HSV infection are not associated with the risk of cervical cancer.

What are the stages of genital herpes infection in their correct order of progression? 1. Small blisters occur on the genitals. 2. Blisters rupture, leaving a painful ulceration. 3. Fluid-filled clusters of blisters appear on the genitals. 4. Redness and bulging of the skin occurs on the genitals. 5. Active virus moves toward the skin, causing an outbreak.

5, 4, 1, 3, 2 The active virus moves toward the skin, causing an itching or tingling sensation that is called prodrome. The affected skin will turn red and bulge, and at this stage, the virus is highly contagious. The redness of the skin is usually followed by small blisters or vesicles. As the blisters grow, they will become filled with fluid and form clusters. These blisters rupture in a day or two, leaving a painful ulceration.Test-Taking Tip: In this question type, you are asked to prioritize (put in order) the options presented. For example, you might be asked the steps of performing an action or skill such as those involved in medication administration.

Which is considered a primary tool in the prevention of sexually transmitted infections (STIs) in the Healthy People 2020 initiative? 1 Education 2 Motivation 3 Abstinence 4 Sexual orientation

1 In the Healthy People 2020 initiative, one of the primary tools for the prevention of STIs is education. Motivation is a factor that can affect the health status of any patient, but it is not considered a tool for prevention. Abstinence is a safer sex practice. All people, regardless of their sexual orientation, are susceptible to STIs, and this is not considered a tool for prevention.

The nurse is discussing the prevention of sexually transmitted infections (STIs) with a group of young adults. What information does the nurse include? 1 The risk of STIs increases with the number of sexual partners. 2 Female condoms are not effective in preventing the transmission of STIs. 3 Spermicidal agents, when used with condoms, will prevent the transmission of STIs. 4 Using latex condoms always keeps STIs from spreading and infecting others.

1 STI risk factors for sexually active people include multiple sexual partners. Female condoms (polyurethane sheaths in the vagina) are effective for preventing transmission of STIs, including human immunodeficiency virus. 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; they do substantially decrease the risk.Test-Taking Tip: Look for answers that focus on the patient or that are directed toward the patient's feelings.

Which bacterial sexually transmitted infection (STI) would the nurse suspect if a laboratory examination of a specimen collected from a patient's indurate lesion revealed the presence of spirochete? 1 Syphilis 2 Chancroid 3 Chlamydia 4 Gonorrhea

1 Syphilis is an STI caused by a spirochete, Treponema pallidum. Chancroid is caused by a rod-shaped bacterium, Haemophilus ducreyi. Chlamydia is an STI caused by a rod-shaped bacterium, Chlamydia trachomatis. Gonorrhea is an STI caused by the gram-negative bacterium, Neisseria gonorrhea.

The public health nurse manager is working on a policy designed to decrease the number of recurrences of gonorrhea and chlamydia. Which approach is most effective? 1 Provide patients with oral antibiotic treatment for their partners. 2 Advise patients to return to the clinic if symptoms persist or return. 3 Give patients written information about treatment of these infections. 4 Administer a one-dose intramuscular antibiotic therapy whenever possible.

1 The most common cause of recurrence of gonorrhea and chlamydia is reinfection by an infected partner. Research indicates that giving patients antibiotics to take to their partners will decrease recurrence rates. Although administering a one-dose intramuscular antibiotic therapy, having patients return to the clinic if symptoms persist or return, and providing written information to patients may help improve the treatment of STDs, the most common cause of recurrence is reinfection by an infected partner.Test-Taking Tip: Look for options that are similar in nature. If all are correct, either the question is poor or all options are incorrect, the latter of which is more likely. Example: If the answer you are seeking is directed to a specific treatment and all but one option deal with signs and symptoms, you would be correct in choosing the treatment-specific option.

The nurse is administering benzathine penicillin G intramuscularly to a patient with primary syphilis. The patient has never been treated with this particular form of the drug. What precaution does the nurse implement? 1 Keeps the patient for 30 minutes to monitor for a possible allergic reaction 2 Tells the patient to refrain from all sexual activities for a minimum of 72 hours 3 Applies an ice pack to the injection site to minimize trauma to the patient's skin 4 Makes certain the patient has a skin test for penicillin allergy prior to the injection

1 The nurse should keep all patients on-site for at least 30 minutes after they have received this antibiotic so that manifestations of an allergic reaction can be detected and treated. The application of ice to the injection site is not recommended because it would actually slow the absorption of the drug into the muscular tissues. The nurse must be sure that the patient who has never had penicillin has a skin test before receiving the injection. The nurse should recommend sexual abstinence until the treatment of both the patient and his or her partner(s) is completed.Test-Taking Tip: When using this program, be sure to note if you guess at an answer. This will permit you to identify areas that need further review. Also it will help you to see how correct your guessing can be.

The nurse is instructing a patient with genital herpes (GH) about the use of condoms. What statement made by the patient indicates the need for further instruction? 1 "I should use natural-membrane condoms." 2 "I should keep condoms in a cool, dry place." 3 "I should use a water-based lubricant with condoms." 4 "I should use a condom during all sexual exposures."

1 The patient with GH should use latex or polyurethane condoms rather than natural-membrane condoms. If using a lubricant with condoms, then water-based lubricant is preferred over an oil-based lubricant in order to avoid damage to the condom. Condoms should be kept in a cool, dry place away from direct sunlight. Condoms should be used for all forms of sexual exposure.

The nurse is discussing methods of preventing sexually transmitted infections (STIs). Which approaches does the nurse suggest for sexually active patients? Select all that apply. 1 Abstinence 2 Latex condoms 3 Mutual monogamy 4 Polyurethane condoms 5 Cervical cap with spermicidal cream

1,2,3,4 Abstinence, latex condoms, polyurethane condoms, and mutual monogamy all decrease the risk for acquiring an STI. Barrier contraceptive devices like the cervical cap do not ensure protection from STIs.

What are the desired treatment outcomes of patient diagnosed with herpes simplex virus (HSV) who is prescribed acyclovir? Select all that apply. 1 Reduces viral shedding 2 Promotes the healing process 3 Cures the infection completely 4 Reduces the severity of painful ulcers 5 Causes cessation of recurrent outbreaks

1,2,4 The action of the antiviral drug is to inhibit replication of the HSV's deoxyribonucleic acid, thus reducing viral shedding, promoting the healing process, and also reducing the severity of painful ulcers. The HSV infection is not cured since the virus remains in a dormant state after healing in the sacral nerve ganglia. When the virus is activated by the triggering factors, the symptoms recur. The drug does not stop the recurrence of outbreaks, but it reduces the frequency of recurrent outbreaks.Test-Taking Tip: Be alert for details about what you are being asked to do. In this question type, you are asked to select all options that apply to a given situation or patient. All options likely relate to the situation, but only some of the options may relate directly to the situation.

What manifestations does the nurse expect to find on assessment in a patient with gonorrhea? Select all that apply. 1 Dysuria 2 Rectal bleeding 3 Dry, chapped lips 4 Blisters in the throat 5 Green vaginal discharge

1,2,4,5 The patient with gonorrhea has blisters in the throat, green vaginal discharge, dysuria, and rectal bleeding. The patient also has reddened throat, ulcerated lips, and tender gingivae. Though the infection can be asymptomatic, men can notice dysuria if symptoms are present. Dry, chapped lips are not a common symptom of gonorrhea.

Which sexually transmitted infections (STIs) are vaginal infections? Select all that apply. 1 Syphilis 2 Proctitis 3 Chlamydia 4 Gonorrhea 5 Endometritis 6 Epididymitis

1,3,4 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). 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. Proctitis is an inflammation of the rectum that causes discomfort, bleeding, and occasionally, a discharge of mucus or pus.

What complications may result if a patient discontinues the treatment of chlamydia infection without completing the full course of antibiotics? Select all that apply. 1 Infertility 2 Meningitis 3 Endocarditis 4 Ectopic pregnancy 5 Pelvic inflammatory disease

1,4,5 Inadequate treatment resulting from discontinuation of therapy may make chlamydia infection persistent and resistant. As a result of reinfection or continuing chlamydia infection, the patient may have infertility, ectopic pregnancy, or pelvic inflammatory disease. Meningitis and endocarditis are not associated with chlamydia infection, but these are rare complications of gonorrhea infection.

Which medication does the nurse expect to be prescribed by the primary health care provider for a patient who has clusters of vesicles on the genitals, painful urination, and pain in the groin? 1 Cefixime 2 Acyclovir 3 Doxycycline 4 Azithromycin

2 Clusters of vesicles on the genitals indicates genital herpes. Genital herpes is caused by infection with herpes simplex virus. Acyclovir is an antiviral drug prescribed for herpes simplex virus infection. Cefixime, doxycycline, and azithromycin are antibacterials; therefore, these drugs are not indicated for genital herpes.Test-Taking Tip: Make certain that the answer you select is reasonable and obtainable under ordinary circumstances and that the action can be carried out in the given situation.

A patient diagnosed with genital warts asks the nurse how it can be treated. What does the nurse suggest? 1 Oral antibiotics 2 Liquid nitrogen 3 Topical antiviral cream 4 Human papilloma virus (HPV) vaccine

2 Genital warts can be treated with cryotherapy (freezing them with liquid nitrogen). They are treated every 1 to 2 weeks until the lesions resolve. Antibiotics are used with syphilis and gonorrhea. Topical antiviral creams can be used to treat genital herpes. The HPV vaccine prevents acquiring the human papilloma virus, which is responsible for genital warts, but it does not treat an outbreak.

The nurse is caring for a patient who is diagnosed with a sexually transmitted infection (STI). The nurse assesses the patient for discharge from the urethra, cervix, and rectum and also examines the mouth for a reddened throat, ulcerated lips, and tender gingivae. The assessments that the nurse performed relate to which STI? 1 Syphilis 2 Gonorrhea 3 Chlamydia 4 Genital warts

2 Gonococcal infections are associated with oral problems and changes in vaginal discharge; therefore, the nurse inspects the patient for discharge from the urethra, cervix, and rectum and also examines the mouth for a reddened throat, ulcerated lips, and tender gingivae. Patients with syphilis, genital warts, and chlamydia do not show any changes in vaginal discharge, nor do they have oral problems. A patient with syphilis should be assessed for inguinal node enlargement resulting from chancre in the vagina or cervix. A patient with genital warts should be assessed for small, white or flesh-colored papillary growths, which may grow into large cauliflower-like masses. A patient with chlamydia should be assessed for pelvic pain and irregular bleeding.

The nurse is teaching a patient with gonorrhea. What does the nurse tell the patient about the disease? 1 "You are only infectious while the lesions are draining." 2 "You are contagious even if you have no outward symptoms." 3 "Close follow-up is required because treatment failure is common." 4 "Do not engage in sexual activity until your blood tests are negative."

2 Gonorrhea can be asymptomatic in both men and women, but women have asymptomatic, or "silent," infections more often than men. Treatment failure is rare when gonorrhea is treated according to Centers for Disease Control and Prevention recommendations. Patients should avoid sexual activity until antibiotic therapy is completed and they no longer have physical symptoms. Lesions are not associated with gonorrhea.Test-Taking Tip: Study wisely, not hard. Use study strategies to save time and be able to get a good night's sleep the night before your exam. Cramming is not smart, and it is hard work that increases stress while reducing learning. When you cram, your mind is more likely to go blank during a test. When you cram, the information is in your short-term memory so you will need to relearn it before a comprehensive exam. Relearning takes more time. The stress caused by cramming may interfere with your sleep. Your brain needs sleep to function at its best.

What is the most important nursing intervention during an interview with a patient suspected of having gonorrhea? 1 Asking about sexual partners 2 Building a trusting relationship 3 Providing privacy while interviewing 4 Keep all the forms ready to record the data

2 Gonorrhea is a sexually transmitted disease, and the patient may be hesitant to talk about it. Building a trusting relationship helps the nurse to obtain all required information for diagnosis and treatment. The patient may not reveal details about the sexual partners if trust has not been established between the nurse and the patient. Privacy is important during any interview. Keeping the forms ready may help in recording data but may not be beneficial in establishing a trusting nurse-patient relationship.

A patient reports painful urination and profuse yellowish-green urethral discharge. What might these symptoms indicate? 1 Chancre 2 Gonorrhea 3 Candidiasis 4 Genital herpes

2 Gonorrheal infection usually presents with dysuria (painful urination) and profuse yellowish-green discharge from the urethra, cervix, and rectum. Candidiasis of the vagina usually manifests with vulvar irritation and white vaginal discharge. In primary syphilis, chancres manifest as painless, indurated (hard), smooth, weeping lesions on the genital area. Vesicles (blisters) in typical clusters on the genital regions that later rupture into painful erosions are indicative of genital herpes.

Which nursing student statement regarding safer sex practices set forth in the Healthy People 2020 campaign against sexually transmitted infections (STIs) indicates a need for further education? 1 "Practice mutual monogamy." 2 "Increase the number of sexual partners." 3 "Wear gloves for contact between the hands and the vagina or rectum." 4 "Use a latex or polyurethane condom for any genital or anal intercourse."

2 Per the Healthy People 2020 guidelines regarding safer sex practices, the number of sexual partners should be decreased, not increased. Mutual monogamy is a safer sex practice. To adhere to safer sex practices, one should wear gloves for any contact between the hands and the vagina or rectum, and a latex or polyurethane condom should be worn during genital or anal intercourse.Test-Taking Tip: Identify option components as correct or incorrect. This may help you identify an incorrect answer.

Which statement made by the patient indicates a need for further teaching about self-management of genital herpes? 1 "I should not use a condom more than once." 2 "I should use a spermicide with lubricated condoms." 3 "I have to use a water-based lubricant with condoms." 4 "I will use condoms even after the infection is healed."

2 Spermicide-coated condoms may cause vulvovaginal epithelial disruption and increase the risk of human immunodeficiency virus acquisition. Condoms should not be used more than once because it makes the condom weak and susceptible to tears. The use of a water-based lubricant makes the condom less prone to breakage than does an oil-based lubricant. Use of condoms even after the lesions are healed reduces the risk of transmission.

What information should the nurse provide to a patient who has been prescribed podofilox? 1 Use twice daily for 3 days with no treatment for the next 4 days, and repeat for two cycles. 2 Use twice daily for 3 days with no treatment for the next 4 days, and repeat for four cycles. 3 Use thrice daily for 3 days with no treatment for the next 4 days, and repeat for four cycles. 4 Use twice daily for 3 days with no treatment for the next 4 days, and repeat for three cycles.

2 The recommended dosage regimen of podofilox in genital warts is to use twice daily for 3 days with no treatment for the next 4 days, and repeated for four cycles. Podofilox must be administered for 3 days and none for 4 days, repeated for four cycles, not two. It should not be used three times daily. Podofilox should not be administered for three cycles, but for four.

Which information is provided to the patient for the use of condoms that reduce the risk of genital herpes transmission? 1 Use natural membrane condoms. 2 Use a new condom for each sexual act. 3 Avoid using a condom on erect penis. 4 Use oil-based lubricant with latex condoms.

2 Using a condom more than once makes a condom weak and susceptible to tearing. Latex or polyurethane condoms should be used because natural membrane condoms are more likely to break or slip off during intercourse or withdrawal. A condom should be used on an erect penis; otherwise, it may break during erection. Oil-based lubricants can make latex condoms less effective, so water-based lubricants are preferred.

A patient reports lower abdominal pain and has an elevated white blood cell (WBC) count, erythrocyte sedimentation rate, and C-reactive protein. The nurse suspects pelvic inflammatory disease (PID) and anticipates that which test will be performed to rule out tubo-ovarian abscesses and confirm the diagnosis? Select all that apply. 1 Endometrial biopsy 2 Transvaginal sonography 3 Abdominal ultrasonography 4 Magnetic resonance imaging 5 Microscopic examination of vaginal discharge

2,3,4 The presence of pelvic or lower abdominal pain is associated with PID. The patient with this condition has an elevated WBC count, erythrocyte sedimentation rate, and C-reactive protein levels. The primary care provider orders transvaginal sonography, magnetic resonance imaging, and abdominal ultrasonography to rule out appendicitis and tubo-ovarian abscesses to confirm the diagnosis of PID. Transvaginal sonography and magnetic resonance imaging techniques show thickened fluid-filled tubes with or without free pelvic fluid or tubo-ovarian complex. Microscopic examination of vaginal discharge is ordered to evaluate for the presence of more than 10 WBCs per high-power field, which correlates with infection. Endometrial biopsy is ordered to obtain histopathological evidence of endometritis.

The nurse is developing a plan of care for a patient with genital herpes (GH). What does the nurse teach the patient about managing the infection? Select all that apply. 1 Use a sitz bath once a day. 2 Pour water over the genitalia while voiding. 3 Wash hands thoroughly after applying ointments. 4 Apply ice packs or warm compresses to the lesions. 5 Abstain from sexual activity when lesions are present. 6 Increase intake of fluids to replace fluids lost through lesions.

2,3,4,5,6 The management of GH infection is directed toward reducing the discomfort from painful ulcerations, promoting healing, decreasing viral shedding, and preventing transmission of the infection. This is achieved by applying ice packs or warm compresses to lesions and increasing the intake of fluids to replace fluids lost through open lesions. Even though the patient should use gloves when applying ointments or making direct contact with lesions to avoid recurrence or transmission of infection, the patient must wash their hands afterward. Pouring water over the genitalia while voiding will reduce discomfort. Abstaining from sexual activity when lesions are present prevents transmission of the infection. A sitz bath should be used three to four times a day to decrease discomfort from painful ulcerations.

Which statements are true about the vaccine Gardasil? Select all that apply. 1 The use of Gardasil is approved only for male adults. 2 Gardasil is preferred in immunocompromised patients. 3 Gardasil is encouraged for males who have sex with males. 4 Gardasil is recommended soon after the onset of sexual activity. 5 Gardasil provides immunity against human papilloma virus (HPV) types 6 and 11.

2,3,5 Gardasil is preferred in immunocompromised patients to protect them against the virus and other complications. This vaccine is encouraged for males who have sex with males to reduce the risk of acquiring HPV. It provides immunity against HPV types 6, 11, 16, and 18. Gardasil use is approved for both males and females under the age of 26 years. The vaccine is recommended before the onset of sexual activity in order to increase the effectiveness of the vaccine.

Which patient with a history of genital herpes does the nurse identify to be at high risk for recurrence of an outbreak? Select all that apply. 1 A patient with diarrhea 2 A patient with pain in the groin 3 A patient with fever and dizziness 4 A patient with purulent discharge from penis 5 A patient with itching and tingling of the genitals

2,3,5 Pain in the groin indicates swelling of the lymph nodes, which is seen in genital herpes. Fever may trigger the recurrence of an outbreak. The prodromal symptoms of genital herpes involve itching and tingling sensation of the genitals. Diarrhea and purulent discharge from the penis do not lead to an outbreak in genital herpes.

Which statements about sexually transmitted infections (STIs) are accurate? Select all that apply. 1 The use of latex or polyurethane condoms eliminates all STI transmission. 2 Sexual partners of patients treated for gonorrhea must be treated to prevent reinfection. 3 Genital herpes is successfully treated with a 10-day course of oral antibiotics. 4 Gardisil is a vaccine used to prevent cervical cancer in women over 35 years of age. 5 Abstinence from sex until the partner and patient with Chlamydia have completed treatment is recommended.

2,5 All sexual partners of patients diagnosed with gonorrhea must be evaluated and tested to prevent reinfection. Many patients who receive treatment for gonorrhea do not advise their partners of the need for treatment and end up being reinfected after sexual activity. It is advised that patients with Chlamydia abstain from all forms of sexual activity until the 7-day course of antibiotics is finished. The use of latex or polyurethane condoms decreases the risk of STIs, but only abstinence and mutual monogamy totally eliminate the risk of transmission. Herpes simplex is treated with antivirals, not antibiotics. Gardasil provides immunity from the strains of human papilloma virus that leads to cervical cancer; it is given to women ages 10 to 25 years.

Which statement made by the student nurse indicates a need for further teaching about Papanicolaou (Pap) tests in patients with genital warts? 1 "A Pap test is used to screen for dysplasia of the cervix." 2 "After three normal annual Pap tests, repeat every 3 years." 3 "A Pap test alone is used in the diagnosis of cervical cancer in patients with genital warts." 4 "A Pap test should be done annually in women starting at the age of 21 years."

3 Pap tests are used to screen for precancerous changes in the lining of the cervix and to diagnosis cervical cancer. However, the diagnosis of cervical cancer is also confirmed by other tests, such as biopsy. It is used in screening of cervical dysplasia, which determines abnormal changes in the cells on the surface of cervix. A Pap test should be done annually starting at the age of 21 years, and after three normal smears, a repeat of the tests must be done every 3 years so as to treat cancer in its initial stages.

Which statement is true regarding condylomata acuminata? 1 They are treated with azithromycin. 2 They are not often seen with other infections. 3 They are caused by certain types of human papilloma virus (HPV). 4 Polymerase chain reaction (PCR) assay is used to confirm the diagnosis.

3 Condylomata acuminata (also known as genital warts) are caused by certain types of HPV. Genital warts are treated with podofilox gel and cryotherapy. Azithromycin is used to treat chlamydial infections. Genital warts are the most common viral disease that is sexually transmitted and are often seen with other infections. Diagnosis is made by examination of the lesions; PCR assay is used to confirm genital herpes.

Which treatment regimen is preferred in patients with severe genital herpes simplex virus (HSV) infection? 1 Acyclovir oral (PO) administration with hospitalization 2 Acyclovir oral (PO) administration without hospitalization 3 Acyclovir intravenous (IV) administration with hospitalization 4 Acyclovir intramuscular (IM) administration with hospitalization

3 IV acyclovir therapy should be provided for patients who have severe genital HSV disease. Hospitalization is required in these patients because severe HSV infection is complicated with disseminated infections and also central nervous system complications. Oral acyclovir is preferred for patients who have recurrent outbreaks. Acyclovir should not be given intramuscularly.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.

Which guidance would the nurse provide to a pregnant patient with a history of genital herpes? 1 There is a little risk for infection to the neonate. 2 A vaginal delivery reduces the transmission of infection to the neonate. 3 Presence of lesions during the third trimester may indicate a need for a caesarean delivery. 4 There is no need to abstain from sexual contact if the lesions are healed.

3 If a pregnant woman experiences formation of lesions during the third trimester, caesarean delivery is preferred to reduce the risk of neonatal transmission. There is a high risk of neonatal transmission if there is an outbreak during the pregnancy. Vaginal delivery increases the risk of neonatal transmission. Abstinence from sexual activity during pregnancy reduces the risk of complications to the neonate.

Which organism is a primary risk factor for cervical cancer? 1 Hepatits B virus 2 Herpes simplex virus 3 Human papilloma virus (HPV) 4 Human immunodeficiency virus (HIV)

3 Infection by the human papilloma virus (HPV) is considered to be the primary risk factor for the development of cervical cancer. Hepatitis B virus causes hepatitis infection and is associated with perinatal infections. Herpes simplex virus can cause either cold sores or genital herpes infection. HIV causes acquired immune deficiency syndrome (AIDS).

The nurse is evaluating a patient's response to antibiotic treatment for pelvic inflammatory disease (PID). Which finding indicates that the treatment is effective? 1 Increased libido 2 Increased appetite 3 Decreased pelvic tenderness 4 Decreased vaginal discharge

3 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 increased libido may be secondary findings but are not indicative of effective treatment.Test-Taking Tip: Do not read information into questions, and avoid speculating. Reading into questions creates errors in judgment.

A patient reports her sexual partner was recently diagnosed with syphilis. For what does the nurse observe in assessing the patient? 1 Small white or flesh-colored papillary growths 2 Generalized rash, fever, malaise, and muscle pains 3 Painless, indurated (hard), smooth, weeping lesions 4 Benign lesions (gummas) of the skin and mucous membranes

3 The first manifestation of primary syphilis is an ulcer called a chancre that develops 10 to 90 days after exposure. Chancres appear as painless, indurated (hard), smooth, weeping lesions. Secondary syphilis develops 6 weeks to 6 months after the onset of primary syphilis and appears as a generalized rash with fever, malaise, muscle pains and aches along with headache and sore throat. Benign lesions (gummas) of the skin and mucous membranes are the manifestations of tertiary or late syphilis, which occurs after a highly variable period, from 4 to 20 years. The appearance of small white or flesh-colored papillary growths is characteristic of condylomata acuminate, or genital warts.

The nurse is caring for a patient with a chlamydia infection. What does the nurse teach the patient and partner? 1 Screen for reinfection every month. 2 Avoid reporting to the local health department. 3 Avoid sexual activity for 7 days from the start of treatment. 4 Remember that the incubation period ranges from 5 to 10 days.

3 The patient and partner should be instructed to abstain from sexual activity until both of them have completed treatment. Azithromycin 1 g is administered orally in a single dose, or 100 mg of doxycycline is orally administered twice daily for 7 days. The treatment period is 7 days from day one of treatment, including the single-dose regimen. All women must be rescreened for reinfection 3 to 12 months after treatment because of the high risk for pelvic inflammatory disease. The incubation period ranges from 1 to 3 weeks, but the pathogen may be present in the genital tract for months without producing symptoms. C. trachomatis (chlamydia) is reportable to local health departments in all states.

The nurse is educating a patient who is receiving treatment for syphilis. What action must the nurse instruct the patient to take during the treatment period? 1 Keep follow-up evaluations every month. 2 Receive benzathine penicillin G twice a week. 3 Notify partners about infection and treatment. 4 Ensure adequate protection during sexual activity.

3 The patient must be instructed about the importance of notifying partners about infection and treatment. There is high risk for reinfection if a partner goes untreated. All sexual partners must be prophylactically treated within 90 days of the syphilis diagnosis. The patient must maintain sexual abstinence until all partners are completely treated. Benzathine penicillin G is administered as a single 2.4 million-unit dose every week for 3 weeks. The Centers for Disease Control and Prevention recommends follow-up evaluation, including blood tests every 6, 12, and 24 months.

The nurse is preparing a patient with pelvic inflammatory disease (PID) for discharge. What information is most important for the nurse to provide? 1 Instruct the patient to sleep in a side-lying position. 2 Tell the patient to check her temperature once a day. 3 Ensure oral antibiotic treatment is taken for 14 days. 4 Report to the provider a week after antibiotics are started.

3 The patient must be instructed to take the antibiotics for 14 days. The patient must check her temperature twice daily and maintain the Fowler's position (rather than supine position) to promote gravity drainage of the infection. The patient must report to the health care provider within 72 hours from the start of antibiotics to determine the progress of the treatment.

What would be the appropriate duration for antibodies to develop in a patient with genital herpes? 1 6 weeks 2 8 weeks 3 10 weeks 4 12 weeks

4 It takes 12 weeks from the date of exposure for the herpes simplex virus to reach detectable levels of antibodies. False negative tests can occur if the patient is tested before 12 weeks after the primary infection.

Which action does the RN delegate to an unlicensed assistive personnel (UAP) who is helping with care for a patient with pelvic inflammatory disease? 1 Asking the patient if she has concerns about infertility 2 Assessing the patient for signs of guilt or depression 3 Checking the abdomen for signs of rebound tenderness 4 Keeping the head of the bed elevated at least to 30 degrees

4 Positioning patients is included in the scope of training for UAPs and is frequently delegated to them. Patient assessment requires more education and scope of practice and should be done by licensed nursing staff.Test-Taking Tip: Attempt to select the answer that is most complete and includes the other answers within it. For example, a stem might read, "A child's intelligence is influenced by:" and three options might be genetic inheritance, environmental factors, and past experiences. The fourth option might be multiple factors, which is a more inclusive choice and therefore the correct answer.

What is the drug of choice in the treatment of primary, secondary, and latent syphilis? 1 Doxycycline 2 Ceftriaxone 3 Azithromycin 4 Benzathine penicillin G

4 The drug of choice for treating primary, secondary, and latent syphilis is benzathine penicillin G. It is administered as a single intramuscular dose of 2.4 million-unit dose. A combination drug of doxycycline and azithromycin is used in the treatment of chlamydia infection. Ceftriaxone is used in the treatment of gonorrhea.Test-Taking Tip: You have at least a 25% chance of selecting the correct response in multiple-choice items. If you are uncertain about a question, eliminate the choices that you believe are wrong and then call on your knowledge, skills, and abilities to choose from the remaining responses.