NURS113 Exam 3: STI's and Contraception

The nurse is evaluating a female client's understanding of how to prevent sexually transmitted diseases (STDs). Which of the following statements indicates that the client understands how to protect herself? a) "I will be sure to take antibiotics to prevent an STD." b) "I need to be sure to take my birth control pills." c) "I will always douche after sexual intercourse." d) "I will be sure my partner uses a condom."

"I will be sure my partner uses a condom." Correct Explanation: Barrier contraceptives must be used to protect against STDs. Birth control pills and douching are not effective for prevention of STDs. Prophylactic antibiotics are not used to prevent the acquisition of STDs.

A nurse is conducting a healthy-living workshop with a group of female college students. Which of the following methods of contraception should the nurse recommend as a means of preventing both pregnancy and sexually transmitted infections? a) Condoms b) Coitus interruptus c) Intrauterine devices (IUD) d) Oral contraceptives

Condoms Correct Explanation: Coitus interruptus, oral contraceptives, and IUDs provide no protection against STIs, while condoms provide significant (but imperfect) protection against both pregnancy and STIs.

Other than abstinence, what is the only proven method of decreasing the risk for sexual transmission of HIV infection? a) Birth control pills b) Consistent and correct use of condoms c) Spermicides d) Vaginal lubricants

Consistent and correct use of condoms Correct Explanation: Other than abstinence, consistent and correct use of condoms is the only method proven to decrease the risk for sexual transmission of HIV infection. Vaginal lubricants, birth control pills, and spermicides do not decrease the risk for sexual transmission of HIV infection.

While teaching sex education to a group of high school students, the nurse talks about forms of birth control. Which of the following could the nurse say is 100% effective if practiced correctly and consistently? a) Oral contraceptives b) Withdrawal prior to ejaculation c) Abstinence d) Condoms

Abstinence Correct Explanation: Abstinence is not having sex. It is the most effective form of birth control, preventing pregnancy 100% of the time when practiced consistently.

The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is: a) Condoms. b) A cervical cap. c) A diaphragm. d) Spermicides.

Condoms. Correct Explanation: Condoms provide effective (though imperfect) protection against STIs. Spermicides, diaphragms, and cervical caps do not provide effective protection against STIs.

Which instructions should the nurse include in the teaching plan for a 30-year-old multiparous client who will be using an intrauterine device (IUD) for family planning? a) Amenorrhea is a common adverse effect of IUDs. b) Severe cramping may occur when the IUD is inserted. c) The client needs to use additional protection for conception. d) IUDs are more costly than other forms of contraception.

Severe cramping may occur when the IUD is inserted. Correct Explanation: Severe cramping and pain may occur as the device is passed through the internal cervical os. The insertion of the device is generally done when the client is having her menses, because it is unlikely that she is pregnant at that time. Common adverse effects of IUDs are heavy menstrual bleeding and subsequent anemia, not amenorrhea. Uterine infection or ectopic pregnancy may occur. The IUD has an effectiveness rate of 98%. Therefore, additional protection is not necessary to prevent pregnancy. IUDs generally are less costly than other forms of contraception because they do not require additional expense. Only one insertion is necessary, in comparison to daily doses of oral contraceptives or the need for spermicides in conjunction with diaphragm use.

A new patient has come to the clinic wanting a method of birth control. The patient asks about a diaphragm. What would the nurse teach this patient about a diaphragm? a) The diaphragm must be used during each episode of sexual activity. b) A diaphragm's effectiveness does not require spermicidal jelly. c) The diaphragm may be removed an hour following intercourse. d) One size fits all females.

The diaphragm must be used during each episode of sexual activity. Correct Explanation: The diaphragm must be used during each episode of sexual activity. It must be left in 6 hours after intercourse and should be used with spermicidal jelly. There are different sizes of diaphragms, and the patient needs to be fitted by the health care practitioner.

A nurse is teaching a group of clients about birth control methods. When providing instruction about subdermal contraceptive implants, the nurse should cite which feature as the main advantage of this method? a) The implants can be removed easily if pregnancy occurs. b) The implants require a lower hormonal dose than other hormonal contraceptive methods. c) The implants provide effective, continuous contraception that isn't user dependent. d) The implants cost less over the long term than other contraceptive methods.

The implants provide effective, continuous contraception that isn't user dependent. Correct Explanation: Although all of the options accurately describe features of subdermal contraceptive implants, the main advantage of this contraceptive method is effective, continuous contraception that isn't user dependent. The effectiveness of other methods, such as the condom, diaphragm, and oral contraceptives, depends at least partly on the user's knowledge, skills, and motivation.

The nurse is addressing primary prevention with a group of college students. Which of the following is an example of a primary prevention measure? a) Testicular examinations for the male students b) HIV screening c) Use of condoms and safer sex practices d) Annual Pap smears for the female students

Use of condoms and safer sex practices Correct Explanation: Safer sex practices, which includes the use of condoms, is an example of primary prevention measures. HIV screening, annual Pap smears, and testicular examinations are secondary prevention measures.

A 22-year-old nulligravid client tells the nurse that she and her husband have been considering using condoms for family planning. Which of the following instructions should the nurse include about the use of condoms as a method for family planning? a) Using a spermicide with the condom offers added protection against pregnancy. b) Condom users commonly report penile gland sensitivity. c) Natural skin condoms protect against sexually transmitted diseases. d) The typical failure rate for couples using condoms is about 25%.

Using a spermicide with the condom offers added protection against pregnancy. Correct Explanation: The typical failure rate of a condom is approximately 12% to 14%. Adding a spermicide can decrease this potential failure rate because it offers additional protection against pregnancy. Natural skin condoms do not offer the same protection against sexually transmitted diseases caused by viruses as latex condoms do. Unlike latex condoms, natural skin (membrane) condoms do not prevent the passage of viruses. Most condom users report decreased penile gland sensitivity. However, some users do report an increased sensitivity or allergic reaction (such as a rash) to latex, necessitating the use of another method of family planning or a switch to a natural skin condom.

An antenatal G2, T1, P0, A0, L1 client is discussing her postpartum plans for birth control with her health care provider. In analyzing the available choices, which factor has the greatest impact on her birth control options? a) breast- or bottle-feeding plan b) desire for another child in 2 years c) satisfaction with prior methods d) preference of sexual partner

breast- or bottle-feeding plan Explanation: Birth control plans are influenced primarily by whether the mother is breast- or bottle-feeding her infant. The maternal milk supply must be well established prior to the initiation of most hormonal birth control methods. Low-dose oral contraceptives would be the exception. Use of estrogen-/progesterone-based pills and progesterone-only pills are commonly initiated from 4 to 6 weeks postpartum because the milk supply is well established by this time. Prior experiences with birth control methods have an impact on the method chosen as do the preferences of the client's partner; however, they are not the most influential factors. Desire to have another child in 2 years would make some methods, such as an IUD, less attractive but would still be secondary to the choice to breast-feed.

A nurse is planning care for a 25-year-old female client who has just been diagnosed with human immunodeficiency virus (HIV) infection. The client asks the nurse, "How could this have happened?" The nurse responds to the question based on the most frequent mode of HIV transmission, which is: a) sharing food utensils with an HIV-positive person without proper cleaning of the utensils. b) hugging an HIV-positive sexual partner without using barrier precautions. c) having sexual intercourse with an HIV-positive person without using a condom. d) inhaling cocaine.

having sexual intercourse with an HIV-positive person without using a condom. Correct Explanation: HIV infection is transmitted through blood and body fluids, particularly vaginal and seminal fluids. A blood transfusion is one way the disease can be contracted. Other modes of transmission are sexual intercourse with an infected partner and sharing IV needles with an infected person. Women now have the highest rate of newly diagnosed HIV infection. Many of these women have contracted HIV from unprotected sex with male partners. HIV cannot be transmitted by hugging, inhaling cocaine, or sharing utensils.

The nurse is instructing a male client about safer sexual behaviors. Which client statement indicates a need for additional instruction? a) "After having sex, I should hold onto the condom when pulling out." b) "I will apply baby oil to lubricate the condom." c) "My partner and I should avoid manual-anal intercourse." d) "I should use a new condom each time I have sex."

"I will apply baby oil to lubricate the condom." Correct Explanation: The client should use only water-soluble lubricant, such as K-Y jelly or glycerin. Baby oil can cause the condom to break. The client should use a new condom for each sexual activity and hold onto the condom so that it does not come off when pulling out. Manual-anal intercourse should be avoided.

Students in a health class are discussing birth control and prevention of sexually transmitted disease. The school nurse would know that teaching has been effective if the students state which of the following? a) "Safe sex means preventing pregnancy through use of birth control." b) "The rhythm method means not having sex just before menstruation." c) "Responsible sex involves using condoms and spermicides for protection and birth control." d) "The intrauterine device is the most effective way to prevent pregnancy."

"Responsible sex involves using condoms and spermicides for protection and birth control." Correct Explanation: This comment indicates an understanding of ways to lessen the incidence of sexually transmitted illnesses by condom use. It also indicates that use of a spermicide and condom will help to prevent unwanted pregnancies. The other choices are not accurate examples of safer sex.

A female client informs the nurse that she is considering beginning sexual relations and wants to know the best way to protect herself from a sexually transmitted infection and HIV. What is the best response by the nurse? a) "Using a lamb skin condom will be the most effective way to decrease transmission of STIs and HIV" b) "Using a condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV." c) "Douching immediately after intercourse will be the most effective way to kill bacteria and viruses." d) "Using a diaphragm with spermicidal jelly will also kill the bacteria and viruses that transmit STIs and HIV."

"Using a condom (latex) and spermicidal jelly is one of the most effective ways to decrease the risk of transmission of an STI and HIV." Correct Explanation: Using a condom is one of the most effective ways to reduce the risk of HIV infection. Condoms are available for both men and women. A diaphragm would not be the most effective way because there is no protection for the penis or vagina. A lamb skin condom is not effective to prevent the transmission of HIV. Douching after intercourse is not an effective method to avoid transmission and does not offer protection from secretions that are already present.

The nurse educator is presenting a lecture on clients at risk for developing urinary tract infections (UTIs). Which response made by the staff nurse would indicate to the educator a need for further teaching? a) ?Due to the physiological changes with aging, the elderly are at risk for developing an UTI.? b) ?Having sexual relationships does not put a woman at risk for developing an UTI.? c) ?I will make sure to teach my clients with diabetes mellitus to control their glucose level to help prevent an UTI.? d) ?A woman using an intrauterine device for contraceptive reason is at risk for developing an UTI.?

?Having sexual relationships does not put a woman at risk for developing an UTI.? Correct Explanation: During sexual intercourse, bacteria from the perineal area may travel into the urethra and urinary bladder. The spermicide used with the diaphragm (IUD) decreases the vagina?s normally protective flora. The glucose in the urine acts an excellent medium for bacteria to proliferate in the client with diabetes mellitus. The elderly are predisposed to development of UTI due to the physiological changes associated with aging.

The nurse instructs a female client about contraceptive options. The nurse explains that the intrauterine device (IUD) is a good contraceptive option for women who: a) Are in a monogamous relationship. b) Desire short-term use of a contraceptive. c) Have a history of sexually transmitted diseases (STDs). d) Have had a history of ectopic pregnancies.

Are in a monogamous relationship. Correct Explanation: The IUD is suitable for clients who desire long-term contraceptive use and are in a monogamous relationship. Because of the increased risk of infection with an IUD if an STD occurs, the device is not appropriate for women with multiple partners or a history of STDs. Previous ectopic pregnancy is also a contraindication for an IUD because the incidence of ectopic implantation is slightly higher.

Which of the following is the first barrier method that can be controlled by the woman? a) Diaphragm b) Birth control pills c) Female condom d) IUD

Female condom Correct Explanation: The female condom has the distinction of being the first barrier method that can be controlled by the woman. The IUD may increase the risk for HIV transmission through an inflammatory foreign body response. The female condom is as effective in preventing pregnancy as other barrier methods, such as the diaphragm and the male condom. Birth control pills are not a barrier method.

The nurse is conducting a health history of a preoperative client. The client shares that she experienced vaginal itching and burning and labial swelling after her partner tried a new brand of condoms. The nurse suspects that the client: a) May have a latex allergy. b) Is susceptible to the lubricant. c) Needs to change her position during intercourse. d) May have a sexually transmitted disease.

May have a latex allergy. Correct Explanation: Most condoms are made of latex. The client who experiences itching, swelling, hives, or other symptoms after contact with a condom may have a latex allergy.

A client is asking for information about using an intrauterine device (IUD). Which question when asked by the nurse would provide pertinent information on whether or not a client is a candidate for an IUD? a) "Do you smoke?" b) "Do you have hypertension?" c) "Are you in a monogamous relationship?" d) "How often do you have sex?"

"Are you in a monogamous relationship?" Correct Explanation: Due to the increased risk of pelvic inflammatory disease, candidates for the IUD should be in a monogamous relationship. Smoking and hypertension are not contraindications for an IUD. The frequency of sexual relations will not affect IUD use.

Which of the following substances may be used to lubricate a condom? a) K-Y jelly b) Petroleum jelly c) Skin lotion d) Baby oil

K-Y jelly Correct Explanation: K-Y jelly is water-based and will provide lubrication while not damaging the condom.The oil in skin lotion will cause the condom to break. Baby oil and the oil in petroleum jelly will cause the condom to break.

What is most important for the nurse to teach a client newly diagnosed with genital herpes? a) A urologist should be seen only when lesions occur. b) Determine if your partner has received a vaccine against herpes. c) Oral sex is permissible without a barrier. d) Use condoms at all times during sexual intercourse.

Use condoms at all times during sexual intercourse. Correct Explanation: The client should be taught to abstain from sexual intercourse while lesions are present. Condoms should be used at all times as the virus can be shed without lesions present. Multiple partners would promote the spread of genital herpes. There is no vaccine available to prevent genital herpes. Although periodic examinations should be advised, a urologist does not necessarily need to be seen when lesions occur.