OB: Chapter 5 Sexually Transmitted Infection
A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching?
"This drug will help to suppress any symptoms of the infection."
A group of students are reviewing information about STIs. The students demonstrate understanding of the information when they identify which of the following as the most common bacterial STI in the United States? A) Gonorrhea B) Chlamydia C) Syphilis D) Candidiasis
Ans: B Feedback:According to the CDC, chlamydia is the most common bacterial STI in the United States. Gonorrhea and syphilis are bacterial infections but not the most common ones. Candidiasis is a fungal infection.
A client is diagnosed with pelvic inflammatory disease (PID). When reviewing the client's medical record, which of the following would the nurse expect to find? (Select all that apply.) A) Oral temperature of 100.4 degrees F B) Dysmenorrhea C) Dysuria D) Lower abdominal tenderness E) Discomfort with cervical motion F) Multiparity
Ans: B, C, D, E Feedback:History and physical examination findings of PID include dysmenorrhea, dysuria, lower abdominal tenderness, and cervical motion tenderness. Typically the client has a fever above 101 degrees F and is nulliparous.
A group of nursing students are reviewing information about vaccines used to prevent STIs. The students would expect to find information about which of the following? (Select all that apply). A) HIV B) HSV C) HPV D) HAV E) HBV
Ans: C, D, E Feedback: Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. However, the only vaccines currently available are for prevention of HAV, HBV, and HPV infection.
The nurse is caring for clients who have STIs. Which client is most at risk for becoming infertile due to the infection? A) a woman diagnosed with syphilis B) a woman diagnosed with trichomoniasis C) a woman diagnosed with chlamydia D) a woman diagnosed with herpes simplex virus
C) a woman diagnosed with chlamydia
What is the gold standard for herpes simplex virus (HSV) diagnosis?
Culture
The nurse administers erythromycin ophthalmic ointment to a newborn. If noted hours after administration, which finding will the nurse report to the health care provider?
The newborn has small hives on the back.
A nurse is engaged in primary prevention activities for human papillomavirus (HPV). The nurse would be most likely involved with which activity?
administering HPV vaccine
Which infection as the most commonly reported bacterial STI in the United States?
chlamydia
Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection?
dysuria
Clients who have had PID are prone to which complication?
ectopic pregnancy
When developing a program for STI prevention, which action would need to be done first?
educating on how to promote sexual health
After teaching a group of students about sexually transmitted infections (STIs), the instructor determines that additional teaching is necessary when the students identify which STI as curable with treatment?
genital herpes
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
gonorrhea
What is the most common viral infection?
human papillomavirus (HPV)
Which stage of syphilis occurs when the infected person has no signs or symptoms of syphilis?
latency
What is the medication of choice for early syphilis?
penicillin G benzathine
A nurse is teaching a woman with genital ulcers how to care for them. Which statement by the client indicates a need for additional teaching? A) "I need to wash my hands after touching any of the ulcers." B) "I need to abstain from intercourse primarily when the lesions are present." C) "I should avoid applying ice or heat to my genital area." D) "I can try lukewarm sitz baths to help ease the discomfort."
Ans: B Feedback:For genital ulcers, the client needs to abstain from intercourse during the prodromal period and when lesions are present. The client should wash her hands after touching the lesions to avoid inoculation and avoid extremes of temperature such as ice packs or hot pads to the genital area. Comfort measures such as lukewarm sitz baths can be helpful.
The nurse encourages a female client with human papillomavirus (HPV) to receive continued follow-up care because she is at risk for: A) Infertility B) Dyspareunia C) Cervical cancer D) Dysmenorrhea
Ans: C Feedback:Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer. Therefore, the client needs continued follow-up for Pap smears. HPV is not associated with an increased risk for infertility, dyspareunia, or dysmenorrhea.
Which instructions would the nurse include when teaching a woman with pediculosis pubis? A) "Take the antibiotic until you feel better." B) "Wash your bed linens in bleach and cold water." C) "Your partner doesn't need treatment at this time." D) "Remove the nits with a fine-toothed comb."
Ans: D Feedback:The nurse should instruct the client to remove the nits from the hair using a fine-toothed comb. Permethrin cream and lindane shampoo, not antibiotics, are used as treatment. Bedding and clothing should be washed in hot water to decontaminate it. Sexual partners should be treated also, as well as family members who live in close contact with the infected person.
A woman gives birth to a healthy newborn. As part of the newborn's care, the nurse instills erythromycin ophthalmic ointment as a preventive measure related to which STI? A) Genital herpes B) Hepatitis B C) Syphilis D) Gonorrhea
Ans: D Feedback:To prevent gonococcal ophthalmia neonatorum, erythromycin or tetracycline ophthalmic ointment is instilled into the eyes of all newborns. This action is required by law in most states. The ointment is not used to prevent conditions related to genital herpes, hepatitis B, or syphilis.
The nurse cares for a client recently diagnosed with syphilis who has no known drug allergies. Which medication will the nurse expect the health care provider to prescribe?
benzathine penicillin G
A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent?
doxycycline
After teaching a group of adolescents about HIV, the nurse asks them to identify the major means by which adolescents are exposed to the virus. The nurse determines that the teaching was successful when the group identifies which of the following? A) Sexual intercourse B) Sharing needles for IV drug use C) Perinatal transmission D) Blood transfusion
Ans: A Feedback:Nurses can play a key role in preventing and controlling HIV infection by promoting risk-reduction counseling and offering routine HIV testing to adolescents. Most sexually active youth do not feel that they are at risk of contracting HIV and have never been tested. Obtaining a sexual history and creating an atmosphere that promotes nonjudgmental risk counseling is a key component of the adolescent visit. In light of increasing numbers of people with HIV/AIDS and missed opportunities for HIV testing, the CDC recommends universal and routine HIV testing for all clients seen in health care settings who are 13 to 64 years of age. Sharing contaminated needles, perinatal transmission, and blood transfusions are not associated with adolescents and HIV.
Which findings would the nurse expect to find in a client with bacterial vaginosis? A) Vaginal pH of 3 B) Fish-like odor of discharge C) Yellowish-green discharge D) Cervical bleeding on contact
Ans: B Feedback:Manifestations of bacterial vaginosis include a thin, white homogenous vaginal discharge with a characteristic stale fish odor, vaginal pH greater than 4.5, and clue cells on wet-mount examination. A yellowish-green discharge with cervical bleeding on contact would be characteristic of trichomoniasis.
After teaching a class on sexually transmitted infections, the instructor determines that the teaching was successful when the class identifies which statement as true? A) STIs can affect anyone if exposed to the infectious organism. B) STIs have been addressed more on a global scale. C) Clients readily view the diagnosis of STI openly. D) Most individuals with STIs are over the age of 30.
Ans: A Feedback:STIs know no gender, class, racial, ethnic, or social barriers—all individuals are vulnerable if exposed to the infectious organism. The problem of STIs has still not been tackled adequately on a global scale, and until this is done, numbers worldwide will continue to increase. Given the high value some cultures place on virginity and fidelity, a diagnosis of an STI can be devastating to the woman and her family. Even to suggest a test for STIs can appear inappropriate or offensive. An estimated two thirds of all STIs occur among persons under the age of 25.
A nurse is preparing a presentation for a group of women at the clinic who have been diagnosed with genital herpes. Which of the following would the nurse expect to include as a possible precipitating factor for a recurrent outbreak? (Select all that apply.) A) Exposure to ultraviolet light B) Exercise C) Use of corticosteroids D) Emotional stress E) Sexual intercourse.
Ans: A, C, D, E Feedback:Recurrent genital herpes outbreaks are triggered by precipitating factors such as emotional stress, menses, ultraviolet light exposure, illness, surgery, fatigue, genital trauma, immunosuppression such as from drugs like corticosteroids, and sexual intercourse, but more than half of recurrences occur without a precipitating cause
When developing a teaching plan for a community group about HIV infection, which group would the nurse identify as an emerging risk group for HIV infection? A) Native Americans B) Heterosexual women C) New health care workers D) Asian immigrants
Ans: B Feedback:According to statistics, more than 90% of all HIV infections have resulted from heterosexual intercourse, making heterosexual women particularly vulnerable due to substantial mucosal exposure to seminal fluids. HIV disproportionately affects African American and Hispanic women, but together they represent less than 25% of all U.S. women. New health care workers and Asian immigrants account for only a very small number of HIV-positive cases.
A nurse is assessing a client for possible risk factors for chlamydia and gonorrhea. Which of the following would the nurse identify? A) Asian American ethnicity B) Age under 25 years C) Married D) Consistent use of barrier contraception
Ans: B Feedback:High-risk groups for chlamydia and gonorrhea include single women, women younger than 25 years, African American women, women with a history of STIs, those with new or multiple sex partners, those with inconsistent use of barrier contraception, and women living in communities with high infection rates.
A nurse at a local community clinic is developing a program to address STI prevention. Which of the following would the nurse least likely include in the program? A) Outlining safer sexual behavior B) Recommending screening for symptomatic individuals C) Promoting the use of barrier contraceptives D) Offering education about STI transmission
Ans: B Feedback:Strategies to prevent STIs include providing basic information about STI transmission, outlining safer sexual behaviors, screening asymptomatic persons with STIs, and promoting the use of barrier contraceptives.
A mother brings her 12-year-old daughter in for well-visit checkup. During the visit, the nurse is discussing the use of prophylactic HPV vaccine for the daughter. The mother agrees and the daughter receives her first dose. The nurse schedules the daughter for the next dose, which would be given at which time? A) In 1 month B) In 2 months C) In 3 months D) In 4 months
Ans: B Feedback:The HPV vaccine is administered intramuscularly in three separate 0.5-mL doses. The first dose may be given to any individual 9 to 26 years old prior to infection with HPV. The second dose is administered 2 months after the first, and the third dose is given 6 months after the initial dose.
When obtaining the health history from a client, which factor would lead the nurse to suspect that the client has an increased risk for sexually transmitted infections (STIs)? A) Hive-like rash for the past 2 days B) Five different sexual partners C) Weight gain of 5 lbs in 1 year D) Clear vaginal discharge
Ans: B Feedback:The number of sexual partners is a risk factor for the development of STIs. A rash could be related to numerous underlying conditions. A weight gain of 5 lbs in one year is not a factor increasing one's risk for STIs. A change in the color of vaginal discharge such as yellow, milky, or curd-like, not clear, would suggest an STI.
A pregnant woman diagnosed with syphilis comes to the clinic for a visit. The nurse discusses the risk of transmitting the infection to her newborn, explaining that this infection is transmitted to the newborn through the: A) Amniotic fluid B) Placenta C) Birth canal D) Breast milk
Ans: B Feedback:The syphilis spirochete can cross the placenta at any time during pregnancy. It is not transmitted via amniotic fluid, passage through the birth canal, or breast milk.
After teaching a class on preventing pelvic inflammatory disease, the instructor determines that the teaching was successful when the class identifies which of the following as an effective method? A) HIV B) HSV C) HPV D) HAV E) HBV
Ans: C Feedback: Vaccines are under development or are undergoing clinical trials for certain STIs, including HIV and HSV. However, the only vaccines currently available are for prevention of HAV, HBV, and HPV infection.
A client with genital herpes simplex infection asks the nurse, "Will I ever be cured of this infection?" Which response by the nurse would be most appropriate? A) "There is a new vaccine available that prevents the infection from returning." B) "All you need is a dose of penicillin and the infection will be gone." C) "There is no cure, but drug therapy helps to reduce symptoms and recurrences." D) "Once you have the infection, you develop an immunity to it."
Ans: C Feedback:Genital herpes is a lifelong viral infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. A vaccine is available for HPV infection but not genital herpes. Penicillin is used to treat syphilis. No immunity develops after a genital herpes infection.
The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. The goal of this therapy is to: A) Promote the progression of disease B) Intervene in late-stage AIDS C) Improve survival rates D) Conduct additional drug research
Ans: C Feedback:The use of HAART aims to improve the prognosis of HIV/AIDS. Dramatic advances with antiretroviral medication have turned a disease that used to be a death sentence into a chronic, manageable one for individuals who live in countries where antiretroviral therapy is available. Drug therapy does not promote the progression of the disease. It is started at the time of the first infection, not in late-stage AIDS. Treatment advances have been based on research, but drug therapy is not prescribed to conduct additional research.
