OB NCLEX - STI's

​Burning and frequency of urination Rationale: Common symptoms of an STI include burning and increased frequency of urination. Vaginal dryness and absence of expected menses are not symptoms of STI.​ Thick, cottage​ cheese-like vaginal discharge is indicative of a yeast​ infection, not an STI.

A client presents for evaluation of a possible sexually transmitted infection​ (STI). Which assessment finding should the nurse consider a potential indication of an​ STI? Burning and frequency of urination Absence of expected menses ​Thick, cottage​ cheese-like vaginal discharge Vaginal dryness

Increasing fluids ​Rationale: Drinking additional fluids helps dilute the urine and reduce the burning sensation. For dysuria and urinary​ retention, pouring water over the genitals to start urination and dilute the urine may be suggested. Sitz baths​ (with tepid​ water) for​ 15-30 minutes, several times a​ day, is soothing and decreases pain from ulcers and an irritated urethral meatus. Taking diuretics would not be an appropriate treatment for gonorrhea.

Which intervention by the nurse can help decrease the burning upon urination for a female client with​ gonorrhea? Taking diuretics Increasing fluids Running ice water over the perineal area Providing a Sitz bath

Lymphadenopathy Rationale: Lymphadenopathy is a swelling or abnormal number of lymph nodes in a specific area of the body. Lymphadenopathy is inflammatory and usually caused by an infection. Necrosis is death of tissue. Retention is holding pockets of fluid. An allergic reaction produces​ hives, rash,​ fever, difficulty​ breathing, and itching.

A client presents with a sore tip of the penis. The client reveals having sex with two partners. Upon examination the nurse notices swelling in the​ client's groin, along with chancre. How should the nurse interpret this swelling in the​ groin? Lymphadenopathy Retention Necrosis Allergic reaction

History of unprotected sex Allergies to any medications Length of time since symptoms presented History of fever or chills Rationale: The​ client's sexual​ history, assessment, and examination must be​ documented, including symptoms like​ fever, chills, burning on​ urination, vaginal​ drainage, and their onset and duration. It is critical to document allergies for every​ client, especially because antibiotics may be ordered. An STI has not yet been​ confirmed, so a list of sexual contacts is not needed.

A client reports burning on urination and a vaginal discharge. Which information should the nurse include in the​ client's documentation?​ (Select all that​ apply.) History of unprotected sex Allergies to any medications Names and phone numbers of all sexual contacts Length of time since symptoms presented History of fever or chills

Chlamydia Rationale: Reactive arthritis​ (formally Reiter​ syndrome) is a complication of​ chlamydia, which is most likely to occur in men. It does not occur secondary to​ gonorrhea, herpes simplex​ virus, or syphilis.

The nurse is caring for a client who has been diagnosed with reactive arthritis. The nurse notes symptoms of a sexually transmitted infection​ (STI). Which STI should the nurse​ suspect? Gonorrhea Chlamydia Syphilis Herpes simplex virus

First prenatal visit ​Rationale: Very few early manifestations of an infection are​ experienced, so clients may not know whether they are infected or not. All pregnant women should therefore be tested for​ STIs, including​ HIV, as part of routine medical care during their first prenatal visit.

The nurse explains the importance of testing for sexually transmitted infections​ (STIs) to a newly pregnant client. During which time period should the nurse explain that this test will take​ place? Immediately after finding out she is pregnant Second prenatal visit Only if the client has symptoms First prenatal visit

​​"I'll try to keep my stress level​ down." ​"I will notify my sex partners so they can get​ treatment." ​"I understand this antiviral medication will help shorten and prevent​ outbreaks." Rationale: The client acknowledging the need to keep stress levels​ down, planning to notify sexual​ partners, and understanding about the antiviral​ medication, which will help shorten and prevent​ outbreaks, indicates correct understanding. The​ client's ability to describe preventive​ behaviors, health​ practices, and treatment modalities indicates goal achievement. The conceptions that unprotected sex is safe and that the medication will cure herpes are​ incorrect; herpes is a virus and cannot be cured.

The nurse has completed discharge teaching for a client treated for genital herpes. Which statement by the client indicates teaching was effective​? ​(Select all that​ apply.) ​"I don't need to use a​ condom." ​"I'll try to keep my stress level​ down." ​"I will notify my sex partners so they can get​ treatment." ​"I'm glad the medication prescribed will cure this​ infection." ​"I understand this antiviral medication will help shorten and prevent​ outbreaks."

Primary stage Rationale: During the primary stage of​ syphilis, the client will experience​ chancre-like, painless ulcerations that last for up to 5 weeks. The second stage occurs up to 10 weeks after initial infection. The client will experience​ fever, malaise,​ lymphadenopathy, patchy​ alopecia, and a diffuse rash. During the latent​ stage, the client is asymptomatic for years to a lifetime. The tertiary stage can occur 2 years after the onset of symptoms and includes changes in the cardiovascular​ system, bone,​ skin, and viscera.

The nurse is assessing a client with syphilis. Which stage of syphilis is characterized by a​ chancre, painless ulcerations on the genital​ area? Secondary stage Latent stage Primary stage Tertiary stage

Secondary stage ​Rationale: Manifestations of secondary syphilis after the initial chancre include a​ rash, especially on the palms of the hands or soles of the​ feet; mucous patches in the oral​ cavity; sore​ throat; generalized​ lymphadenopathy; condyloma lata​ (flat, broad-based​ papules) on the​ labia, anus, or corner of the​ mouth; flulike​ symptoms; and alopecia. The primary stage of syphilis is characterized by the appearance of a chancre and by regional enlargement of lymph​ nodes; little or no pain accompanies these warning signs. During the latent period a client has no​ symptoms, however, during the early part of this​ stage, sexual transmission is possible. Roughly​ 15% of untreated individuals progress to​ late-stage or tertiary syphilis.

The nurse is caring for a client diagnosed with syphilis. The client has a rash covering both palms of the hands. The nurse explains that the client is in which stage of​ syphilis? Secondary stage Tertiary stage Latent stage Primary stage

Contact any potentially exposed sexual partners. ​Rationale: Contacting sexual partners who may have been exposed to sexually transmitted infections​ (STIs) is a part of the care plan for a client who has been diagnosed with a sexually transmitted infection like gonorrhea. Drinking fluids is​ important, but would not be the next intervention. The antibiotics would need to be taken for the prescribed amount of​ time, not just until symptoms resolve. A physical examination is done initially as a part of diagnosis

The nurse is caring for a client who has been diagnosed with gonorrhea. Following the​ diagnosis, which intervention should the nurse perform​ next? Encourage the client to drink extra fluids to flush system. Contact any potentially exposed sexual partners. Instruct the client to take antibiotics until symptoms resolve. Perform a physical exam.

​Reporting the sexually transmitted infection Rationale: Sexually transmitted infections like​ chlamydia, gonorrhea, and syphilis are all reportable​ STIs, so the nurse may be involved with the reporting process. The nurse would not visit the​ client's home to follow up. Contacting sexual partners and filling prescriptions are the responsibility of the client.

The nurse is caring for a client who was diagnosed with chlamydia. Which action by the nurse is appropriate for this​ client? Visiting the home to follow up Contacting sexual partners Tracking that the client filled a prescription Reporting the sexually transmitted infection

​Treating the client with an antibiotic Rationale: Syphilis is a bacterial infection and can be safely treated and cured during pregnancy with an antibiotic. An antifungal does not treat bacterial infections. The​ client's partner should be screened and​ treated, but treating the client is a priority. There is no need to wait until the baby is born to treat the​ client; the client can safely take antibiotics during pregnancy.

The nurse is caring for a pregnant client who has syphilis. Which is a priority ​intervention? Screening and treating the​ client's partner Treating the client with an antifungal Scheduling treatment after birth of the baby Treating the client with an antibiotic

​Pain Disturbed body image Impaired skin integrity Deficient knowledge Rationale: The nurse should assess the client for​ pain, deficient​ knowledge, disturbed body​ image, and impaired skin integrity. There is no need to assess the client for risk of altered parenting.

The nurse is caring for an adolescent client who has been diagnosed with a sexually transmitted infection​ (STI). Which problem should the nurse assess in this​ client? (Select all that​ apply.) Pain Risk of altered parenting Disturbed body image Impaired skin integrity Deficient knowledge

​Engaging in sex with a diaphragm with a​ non-monogamous partner Rationale: While a diaphragm prevents​ pregnancy, it does not prevent transmission of infection. This method of birth control should not be used alone in​ non-monogamous relationships. This statement would be concerning. A person can be infected with HIV and able to infect others for 6 months before seroconversion. Practicing abstinence for the first 6 months of a monogamous​ relationship, then being retested would be ideal. Asking a partner in a monogamous relationship to be tested for STDs is not a concerning behavior. Verbalizing how to identify the warning signs of dating violence and date rape would demonstrate that the client is exhibiting responsible sexual behavior.

The nurse is obtaining a history on an adolescent client. Which reported behavior should be​ concerning? Verbalizing how to identify the warning signs of dating violence and date rape Asking a partner in a monogamous relationship to be tested for STDs Engaging in sex with a diaphragm with a​ non-monogamous partner Practicing abstinence for the first 6 months of a monogamous relationship

Antimicrobial resistance ​Rationale: The goals of treatment for the client with gonorrhea include eradication of the organism and any coexisting​ disease, and prevention of reinfection or transmission. Due to concerns about antimicrobial resistance in N. gonorrhoeae​, the Centers for Disease Control and Prevention​ (CDC) recommends dual treatment that includes a single injection of an antibiotic and a single oral dose of another antibiotic. These medications should be administered at the same​ time, if possible.

The nurse is preparing to administer an intramuscular injection of one antibiotic and an oral dose of another antibiotic for a client with gonorrhea. The client wants to know why both are needed. Which rationale for dual treatment should the nurse include in the​ explanation? Specific portal of entry Antimicrobial resistance Strength of the bacteria ​Client's immunity

​"I should dry the lesions with a hair dryer on a cool​ setting." Rationale: Teach the client how to keep herpes blisters clean and dry. The area should be washed daily with mild soap and water. Lesions should be dried using a hair dryer turned to a cool setting. The client should wear loose cotton clothing that will not trap moisture and avoid wearing panty hose and tight jeans. Keeping the lesions clean and dry reduces the possibility of secondary infection and speeds the healing process.

The nurse is teaching a client about caring for herpes lesions. Which statement made by the client expresses​ understanding? ​"I should wash the lesions with antibacterial​ soap." ​"I should wear​ jeans, not​ shorts, to keep the lesions​ covered." ​"I should dry the lesions with a hair dryer on a cool​ setting." ​"I should wear nylon​ underwear."

Ulcerations Itching Burning Rationale: Itching and burning in the affected area are common manifestations of an HSV outbreak. The lesions are small ulcerations.​ Small, flat,​ flesh-colored warts are a symptom of HPV.

The nurse is teaching a client diagnosed with genital herpes simplex virus​ (HSV). How should the nurse describe the signs of an​ outbreak? (Select all that​ apply.) Ulcerations Itching ​Small, flat,​ flesh-colored warts Bleeding Burning

​It is contracted by unprotected sex. It has an incubation period of 10 to 90 days. It spreads through the body by way of blood and lymph nodes. Rationale: Syphilis is a sexually transmitted​ infection, wherein the microorganisms invade the body and spread through blood and lymph nodes. The incubation period is 10 to 90 days. Both men and women can be infected with​ syphilis; however, it is not only anal sex through which this infection can be contracted.

The nurse is teaching at a community health clinic about the risk factors for syphilis. Which statement should the nurse​ include? (Select all that​ apply.) Only women are at risk for syphilis. It is contracted by unprotected sex. It is only contracted through anal sex. It has an incubation period of 10 to 90 days. It spreads through the body by way of blood and lymph nodes.

Ensure that this case is reported to the public health system. Verify the​ client's drug allergies. Recommend that a pregnancy test be obtained. Initiate client teaching regarding sexually transmitted infections and their consequences.​ Rationale: In the event of a positive syphilis​ test, the nurse would report the case to the public health​ system, initiate client teaching regarding​ STIs, verify the​ client's drug allergies in preparation for the prescribed treatment​ regime, and if the client is female --arrange for a pregnancy test. Syphilis is​ contagious, and it is critical to treat the infection to avoid​ complications, even when there are no symptoms present.

The nurse receives notification from the lab that a client tests positive for syphilis. Which nursing action should the nurse​ implement? (Select all that​ apply.) Ensure that this case is reported to the public health system. Verify the​ client's drug allergies. Inform the client that syphilis is not contagious if there are no symptoms of infection. Recommend that a pregnancy test be obtained. Initiate client teaching regarding sexually transmitted infections and their consequences.

​Not sharing bath towels Rationale: Health teaching for clients with genital herpes involves helping them manage their condition with the least possible disruption in lifestyle and relationships. The use of hygiene​ practices, including not sharing towels or other personal​ items, and the use of latex​ condoms, will protect others from viral shedding. Abstaining from sex will help keep the virus from​ spreading, but there is still risk involved with viral shedding. A​ low-protein diet is not related to viral shedding. Taking antivirals helps decrease the length of the outbreak but is not related to viral shedding.

Which intervention should the nurse discuss with a client newly diagnosed with herpes regarding viral​ shedding? Abstaining from sex Taking antivirals Not sharing bath towels Following a​ low-protein diet