RICCI Chapter 5

A nurse is providing care to a client with pediculosis pubis. Which information would the nurse include when teaching the client about this condition?

"Remove the nits with a fine-toothed comb."

A nurse who is conducting sessions on preventing the spread of sexually transmitted infections (STIs) discovers that there is a very high incidence of hepatitis B in the community. Which measure should the nurse take to ensure the prevention of the disease?

Instruct people to get vaccinated for hepatitis B.

When developing the teaching plan for a client who is HIV positive, the nurse would include which recommendation? a) Practice rigid adherence to drug schedule and dosage. b) Adhere to scheduled weekly bladder instillation of dimethyl sulfoxide. c) Avoid caffeine and artificial sweeteners. d) Use transcutaneous electrical nerve stimulation.

Practice rigid adherence to drug schedule and dosage. The nurse should teach the client infected with HIV to strictly adhere to the prescribed drug schedule and dosage. Avoiding caffeine and artificial sweeteners, using transcutaneous electrical nerve stimulation, and having weekly drug instillations of dimethyl sulfoxide into the bladder are suggested for clients with interstitial cystitis.

An instructor is teaching a group of students about the incidence of sexually transmitted infections (STIs) and those that must be reported by law. The instructor determines that the students have understood the information when they state that which STI must be reported?

Syphilis

A nurse has performed disease prevention teaching with a female client who has genital herpes. Which client behavior indicates that the teaching has been successful?

The client washes her hands before and after touching lesions.

Which woman is at greatest risk for developing cervical cancer?

a client whose high-risk HPV infection persists in genital skin cells

A 40-year-old woman with gray, runny vaginal discharge that has a foul, fishy odor has been told that she most likely has vaginosis. What most likely contributed to her present condition?

a sharp reduction in the number of lactobacilli in the client's vaginal flora

A client is diagnosed with chlamydia and is receiving azithromycin as treatment. In addition to this medication, the nurse anticipates that the client will also be prescribed which drug?

ceftriaxone

The nurse who is teaching STI prevention to college students states the risks associated with human papillomavirus (HPV). What would the nurse state as being the greatest danger with this disease?

cervical cancer

The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis?

irritation of vaginal walls

A 20-year-old male has been diagnosed with a chlamydial infection, and his primary care provider is performing teaching in an effort to prevent the client from infecting others in the future. Which statement by the client demonstrates understanding of his health problem? You Selected:

"Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

A woman seen in the emergency walk-in clinic is diagnosed with chlamydia trachomatis. She asks the nurse how this disease is different from other sexually transmitted infectious diseases. What is the nurse's best response?

"This STI is characterized by an infection of your cervix."

A client at 34 weeks' gestation has recently been diagnosed with human immunodeficiency virus (HIV). The client asks how HIV would be transmitted to the newborn. Which statement would be the nurse's best response? a) "It is only transmitted through the birth canal so a cesarean birth will be scheduled." b) "It is not transmitted to your newborn as it is protected in the uterus." c) It is recommended to formula-feed your newborn as it is transmitted through your breast milk." d) "The risk of your newborn being infected with HIV infection is about 1%."

It is recommended to formula-feed your newborn as it is transmitted through your breast milk."

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? a) candidasis b) gonorrhea c) trichomoniasis d) Gardnerella vaginalis vaginitis

trichomoniasis

Which medication is the most effective treatment for trichomoniasis? a) doxycycline b) penicillin G benzathine c) azithromycin d) metronidazole

metronidazole The most effective treatment for trichomoniasis is metronidazole and tinidazole. Penicillin G benzathine is used for syphilis. Doxycycline and azithromycin are used in the treatment of chlamydia.

At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include?

This infection is the most common infectious cause of infertility.

A pregnant client is diagnosed with chlamydia and is to receive antimicrobial therapy. Which drug would the nurse least likely expect to be prescribed?

azithromycin

A nurse is caring for clients who have a history of genital herpes infection. The client most at risk for an outbreak of genital herpes is the client who reports

genital pruritus and paresthesia.

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis?

latency

A nurse is conducting an assessment of a client who is suspected of having pelvic inflammatory disease. Which finding would the nurse identify as mandatory for the diagnosis to be made? Select all that apply.

lower abdominal tenderness adnexal tenderness cervical motion tenderness

A nurse is providing care to a client diagnosed with genital/vulvovaginal candidiasis. As part of the client's plan of care, the nurse would teach the client about which medication?

miconazole

A nurse is teaching a local community group about STIs. When discussing syphilis, the nurse would identify which stages as being most infectious? Select all that apply.

primary secondary early latent

Which finding would alert the nurse to suspect that a client has a yeast infection?

vulvar burning and itching

A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which statement is most accurate?

"Even when I'm not having a recurrence, I could still pass the virus on to you."

A nurse educator is presenting to a prenatal class ways in which to prevent common yeast infections that may occur during pregnancy. Which statement made by participants indicates that the teaching has been effective? a) "Daily baths rather than showers will soothe irritation in the genital area." b) "Douching daily is recommended to keep the vaginal track clean." c) "I need to reduce my dietary intake of simple sugars and soda." d) "If I dry my underwear in a cool dryer, it kills the yeast on it."

"I need to reduce my dietary intake of simple sugars and soda." Genital/vulvovaginal candidiasis (yeast) infections nursing management includes the teaching of preventive measures to women with frequent vulvovaginal candidiasis infections, including: reducing dietary intake of simple sugars and soda; avoid douching (which washes away protective vaginal mucus); shower rather than taking tub baths; dry underwear in a hot dryer to kill the yeast that clings to the fabric.

A nurse is preparing a teaching plan for a female client diagnosed with genital ulcers. Which instructions would the nurse include in this teaching plan? Select all that apply.

"Use a condom when having sexual intercourse with any noninfected partner." "Avoid having sex when any ulcers are present." "Air dry any lesions with a hair dryer on the low setting."

A client with genital herpes asks the nurse about what to expect with the infection. Which response would be most appropriate? a) "Even though you don't have symptoms, you could still spread the infection." b) "You might have to try several different medications before finding one that works." c) "You can expect other outbreaks, each of which will be longer than the first." d) "Once you take the medication, the infection will be gone for good."

"even though you don't have symptoms, you could still spread the infection." Genital herpes can be transmitted during asymptomatic periods of viral shedding. Herpes recurs because after the initial infection, the virus remains dormant in the ganglia of the nerves that supply the area. Symptoms usually are more severe with the initial outbreak. Subsequent episodes usually are shorter and less intense. When the virus is active, shedding viral particles are infectious. Herpes infection is a highly contagious STI that is controllable but not curable. Herpes virus responds well to the antiviral drugs acyclovir, valacyclovir, and famciclovir.

A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? a) Taking the drug on an empty stomach b) Using a sunscreen when outside c) Reporting signs of an oral yeast infection d) Avoiding alcohol consumption

Avoid alcohol consumption.

A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community? a) Discuss limiting the number of sex partners. b) Promote use of oral contraceptives. c) Emphasize not sharing personal items with others. d) Emphasize the importance of good body hygiene.

Discuss limiting the number of sex partners. As a nursing strategy to prevent the spread of STIs, the nurse should discuss reducing the number of sex partners to diminish the risk of acquiring STIs. Oral contraceptives are not effective in preventing STIs, and barrier methods (condoms, diaphragms) should be promoted. The nurse should counsel and encourage sex partners of persons with STIs to seek treatment. Maintaining good body hygiene or not sharing personal items with others does not reduce the risk of spreading STIs.

When developing the teaching plan for a client who is HIV positive, the nurse would include which recommendation?

Practice rigid adherence to drug schedule and dosage.

During a presentation on sexually transmitted infections (STIs), a participant asks the nurse why STIs occur more often in women. What would the nurse address as a possible reason? a) Researchers really have no ideas or theories as to why women are more at risk. b) Women engage in sexual activity with multiple partners more frequently than men. c) Women have a genetic predisposition that increases their risk for infection. d) The woman's moist vaginal environment is highly conducive to microbial growth.

The woman's moist vaginal environment is highly conducive to microbial growth.

At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include? a) This infection is the most common infectious cause of infertility. b) Antiviral drug regimes will cure this infection. c) The new recombinant human papillomavirus vaccine will prevent the infection. d) This infection is lifelong as it cannot be treated with medication.

This infection is the most common infectious cause of infertility.

A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent?

doxycycline Clients who are allergic to penicillin are given doxycycline or erythromycin. Acyclovir is used to treat genital herpes. Ceftriaxone may be used for gonorrhea. Podophyllum resin is used to treat genital warts.

A nurse educator is teaching a client about sexually transmitted infections. The client would learn that which medications are appropriate to treat chlamydia? Select all that apply.

doxycycline azithromycin ceftriaxone

A nurse is teaching a young adult woman about sexually transmitted infections. The nurse determines that the teaching was successful when the woman identifies which infection as being characterized by genital ulcers? a) chlamydia B) bacterial vaginosis c) gonorrhea d) genital herpes simplex

genital herpes simplex Genital herpes simplex is a sexually transmitted infection associated with genital ulcers. Gonorrhea and chlamydia are associated with cervicitis. Bacterial vaginosis is associated with a vaginal discharge.

A 23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect?

gonorrhea

A primary care provider tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This prescription would be appropriate for a woman with which condition?

gonorrhea

The community health nurse is teaching sexually transmitted infections to a high school health class. The nurse determines that the teaching was successful when the group identifies what potential cause for cognitive challenges in the newborn? a) human papillomavirus b) chlamydia c) herpes type II (genital herpes) d) trichomoniasis

herpes type II (genital herpes

A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? a) penicillin b) azithromycin c) metronidazole d) valacyclovir

metronidazole The character of the discharge, lack of recent sexual activity, and current antibiotic treatment point to infection with Trichomonas vaginalis, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, enable the protozoan to proliferate. Trichomoniasis responds well to treatment with metronidazole.

A nurse is conducting a program about genital herpes infection at a community clinic. The nurse determines that additional discussion is needed when the group identifies which activity as a means of transmission?

sharing contaminated needles

The nurse is assessing a 15-year-old female who reports extreme itching in the genital area, dysuria, and foul-smelling, yellow, foamy, vaginal discharge. What would most likely be responsible for these symptoms? a) trichomoniasis b) human papillomavirus c) herpes simplex II d) syphilis

trichomoniasis

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques on observed on the vaginal wall. The nurse suspects which condition? a) chlamydia b) bacterial vaginosis c) trichomoniasis d) vulvovaginal candidiasis

vulvovaginal candidiasis Pruritus, a thick, curd-like vaginal discharge, and white plaques on the vaginal wall are characteristic of vulvovaginal candidiasis. Trichomoniasis is characterized by a heavy yellow or green or gray frothy or bubbly discharge. Bacterial vaginosis is characterized by a thin white homogeneous vaginal discharge. Chlamydia is usually manifested by a mucopurulent vagina discharge.

A client is suspected of having herpes simplex viral infection. The nurse would expect to prepare the client for which diagnostic test to confirm the infection?

viral culture of vesicular fluid

A nurse is working as part of a team to address the prevention of sexually transmitted infections in the community. Based on the nurse's understanding of the groups at highest risk, the team would most likely focus their efforts on which population?

those under age 25

The nurse in a sexual health clinic is reviewing the history of a 30-year-old homosexual client who is an IV drug addict and diagnosed with a sexually transmitted infection. Which therapy would the nurse expect to include in his care?

hepatitis A and hepatitis B recombinant vaccine

A woman comes to the clinic reporting intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques on observed on the vaginal wall. The nurse suspects which condition?

vulvovaginal candidiasis

A client with genital herpes asks the nurse about what to expect with the infection. Which response would be most appropriate?

"Even though you don't have symptoms, you could still spread the infection."

During unprotected sex, a 17-year-old female high school senior has been exposed to the human papillomavirus (HPV). The school nurse would recognize that the student is at a considerable risk of developing which diagnosis?

condylomata acuminata

A 24-year-old female presents with vulvar pruritus accompanied by irritation, pain on urination, erythema, and an odorless, thick, acid vaginal discharge. She denies sexual activity during the last six months. Her records show that she has diabetes mellitus and uses oral contraceptives. Which category of antimicrobial medication is most likely to clear her symptoms? a) an antiviral agent b) a penicillin antibiotic c) a quinolone antibiotic d) an azole antifungal agent

an azole antifungal agent The character of the discharge and the lack of recent sexual activity suggest infection with Candida, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, diabetes, or oral contraceptive use, enable the fungus to proliferate. Candidiasis responds well to treatment with azole antifungal agents.

The nurse is developing a teaching plan for a client diagnosed with genital herpes simplex (HSV). Which would the nurse include? Select all that apply.

The management of genital herpes includes antiviral therapy. The need to use good hand washing technique to prevent spread. Educate the client to abstain from sexual activity until HSV lesions resolve. The goal is for recurrences to be less frequent over time.

A 24-year-old woman has presented to an inner city free clinic because of the copious, foul vaginal discharge that she has had in recent days. Microscopy has confirmed the presence of Trichomonas vaginalis. What is the woman's most likely treatment and prognosis?

Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease.

A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection?

Safety of antiviral therapy during pregnancy has not been established.

Which statement made by a client with a chlamydial infection indicates understanding of the potential complications?

"I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."

A nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? "I should rub rather than scratch in response to itching." "I will apply a water-based lubricant to my lesions." "I can pour hydrogen peroxide and water over my lesions." "I will wear loose cotton underwear."

"I will wear loose cotton underwear" Wearing loose cotton underwear promotes drying and helps avoid irritation of the lesions. The use of lubricants is contraindicated because they can prolong healing time and increase the risk of secondary infection. Lesions should not be rubbed or scratched because of the risk of tissue damage and additional infection. Cool, wet compresses can be used to soothe the itch. The use of hydrogen peroxide and water on lesions is not recommended.

A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response? a) "The lumps on your cervix can be cured by cryosurgery." b) "This can be cured with medications such as the recombinant human papillomavirus quadrivalent vaccine." c) "The health care provider will prescribe antibiotics to cure this infection." d) "There is currently no medical treatment to cure HPV."

"There is currently no medical treatment to cure HPV."

A woman is being treated for human immunodeficiency virus (HIV) at an inpatient health clinic. Which statement made by the woman shows she understands the progression of the infections? a) "When my symptoms go away I know the disease has too." b) "I will never get a break from the symptoms of this infections." c) "When my T-cell count drops below 200 cells, the HIV turns to AIDS." d) "I won't be contagious unless the infection turns to AIDS."

"When my T-cell count drops below 200 cells, the HIV turns to AIDS." After the acute phase, the infected person becomes asymptomatic, but the HIV virus begins to replicate. Even though there are no symptoms, the person is considered contagious, and the virus is replicating. When the CD4 T-cell count reaches 200 or less, the person has reached the stage of AIDS. After initial exposure, there is a period of 3 to 12 months before seroconversion. The person is considered infectious during this time.

During a health education session, a teenage client asks the nurse when she should have her first "Pap test." How should the nurse reply?

"When you turn 21 years old."

A nurse is preparing for a class discussion on sexually transmitted infections (STIs) to be given at a local high school. Which would the nurse include as a discussion priority? a) College students are more likely to engage in risky sexual behaviors leading to an STI. b) Adults aged 21 to 30 years are at greater risk of contracting an STI. c) Adolescents and young adults are the largest age group diagnosed with an STI. d) More single mothers are diagnosed with an STI causing sterility.

Adolescents and young adults are the largest age group diagnosed with an STI. Individuals aged 15 to 24 years represent almost half of all cases of new STIs. Four in ten sexually active teen girls, not single mothers, have an STI that can cause infertility. In the United States, teens who are sexually active, not college-aged students, experience high rates of STIs.

Which STI could be transmitted perinatally?

herpes simplex

A female client is prescribed metronidazole for the treatment of trichomoniasis. Which instruction should the nurse give the client undergoing treatment? Increase fluid intake. Avoid alcohol. Avoid extremes of temperature to the genital area. Use condoms during sex.

Avoid alcohol. The nurse should counsel the client taking metronidazole to avoid alcohol during the treatment because mixing the two causes severe nausea and vomiting. Avoiding extremes of temperature to the genital area is a requirement for clients with genital ulcers, not trichomoniasis. The nurse should instruct the client to avoid sex, regardless of using condoms, until she and her sex partners are cured, that is, when therapy has been completed and both partners are symptom-free. It is not required to increase fluid intake during treatment.

A client reporting genital warts has been diagnosed with human papillomavirus (HPV). The genital warts have been treated, and they have disappeared. Which information should the nurse include in the teaching plan when educating the client about the condition?

Even after warts are removed, HPV still remains.

A woman comes into the health clinic complaining of thick, cottage cheese-like vaginal discharge, with white patches on her labia that worsens before her menses. She complains of intense pruritus and dyspareunia. The health care provider would order which preparation for treatment?

Fluconazole

A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which response would be most appropriate? a) "Inform all potential sexual partners about the infection, even if it is inactive." b) "Use a condom during sexual activity if the infection becomes active again." c) "Refrain from all sexual activity until you don't have another outbreak for a year." d) "If the infection has healed, you probably don't have to use a condom."

Inform all potential sexual partners about the infection, even if it is inactive. The nurse should advise the client to inform all potential sexual partners of the HSV infection, even if it is in an inactive state. The nurse should also advise the client to use a condom during sexual activity, even if the disease is dormant, and to avoid sexual contact if the infection is active. Condoms do not protect skin and mucous membranes left exposed.

A client presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole. What is the paramount nursing intervention in discharge planning? a) Reassure the client further STI testing is not indicated. b) Instruct the client not to drink alcohol with this treatment. c) Counsel the client to refrain from sex for one week. d) Advise the client to take medication with a glass of milk.

Instruct the client not to drink alcohol with this treatment.

An HIV-positive client who is on antiretroviral therapy reports anorexia, nausea, and vomiting. Which suggestion should the nurse offer the client to cope with this condition?

Use high-protein supplements. to provide quick and easy protein and calories.

A nurse is caring for a client who has just given birth to a baby. Which information should the nurse give the client regarding hepatitis B vaccination for the baby? a) Vaccine is required only if mother is identified as high-risk for hepatitis B. b) Vaccine may not be safe for underweight or premature babies. c) Vaccine is administered only after the infant is at least 6 months old. d) Vaccine consists of a series of three injections given within 6 months.

Vaccine consists of a series of three injections given within 6 months. The hepatitis B vaccine consists of a series of three injections given within 6 months. The vaccine is safe and well tolerated by most babies, including those who are underweight or premature. Vaccines are given after birth in most hospitals, not 6 months later. All babies are vaccinated, not just those whose mothers are identified as at high risk for hepatitis.

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? a) copper-colored macules on the palms and soles that appeared after a brief fever b) patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas c) one or more flat, wartlike papules in the genital area that are sensitive to touch d) a painless genital ulcer that appeared about 3 weeks after unprotected sex

a painless genital ulcer that appeared about 3 weeks after unprotected sex. A painless genital ulcer is a symptom of primary syphilis. Macules on the palms and soles after fever are indicative of secondary syphilis, as is patchy hair loss. Wartlike papules are indicative of genital warts.

A nurse is teaching a group of pregnant young women about sexually transmitted infections (STIs) and the possible effects that may occur in the fetus or newborn. Which STIs would the nurse describe as being transmitted to the newborn during birth? Select all that apply.

chlamydia gonorrhea genital herpes HIV

A client with a family history of cervical cancer is to undergo a Pap test. During the client education, what group should the nurse include as at risk for cervical cancer? a) clients with fibrocystic breast disease b) clients with irregular menstrual cycles c) clients who have not had babies d) clients who have genital warts

clients who have genital warts

A group of students is reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which cause of condylomata? a) human papillomavirus b) Treponema pallidum c) Haemophilus ducreyi d) bacillus herpes virus

human papillomavirus Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Haemophilus ducreyi bacillus is the cause of chancroid.

Clients who have had PID are prone to which complication? a) multiple gestation b) ovarian cancer c) ectopic pregnancy d) inguinal lymphadenopathy

ectopic pregnancy

A 23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect? syphilis HSV chlamydia gonorrhea

gonorrhea Typical symptoms in women infected with gonorrhea include abnormal vaginal discharge, dysuria, cervicitis, abnormal vaginal bleeding, Bartholin's abscess, and PID.

The nurse in the sexual health clinic is obtaining a health history of a client who is addicted to heroin, reporting chronic flu-like symptoms accompanied by pruritis, fatigue, anorexia, and constant upper right quadrant pain. Which sexually transmitted infection would the nurse suspect? a) trichamonias b) syphilus c) hepatitis A d) herpes simplex

hepatitis A Hepatitis A produces flulike symptoms with malaise, skin rashes, fatigue, anorexia, nausea, pruritus, fever, and upper right quadrant pain. Symptoms of hepatitis B are similar to those of hepatitis A, but with less fever and skin rash involvement. The other STIs do not present with these types of symptoms.

Pelvic infection is most commonly caused by: surgical abortion. hysteroscopy. insertion of intrauterine device. sexual transmission.

sexual transmission Pelvic infection is most commonly caused by sexual transmission but can also occur with invasive procedures such as endometrial biopsy, surgical abortion, hysteroscopy, or insertion of an intrauterine device.

A client who has been treated for recurring gonorrhea visits the sexual health clinic reporting dysuria, urinary frequency, and whitish-yellow vaginal discharge. A pelvic examination reveals cervicitis. How would the nurse interpret these findings?

the possibility of a chlamydia infection Any woman suspected of having gonorrhea should be tested for chlamydia also because coinfection (45%) is extremely common. The nursing management of chlamydia and gonorrhea includes treatment of both. The prevalence of chlamydia and gonorrhea is increasing dramatically.

A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis? a) vaginal odor smelling of fish b) cottage cheese-like discharge c) intense itching of the vulva d) warts in the vulva and labia

vaginal odor smelling of fish. Bacterial vaginosis causes a "stale fish" vaginal odor. Cottage cheese-like discharge is seen in candidiasis and not in bacterial vaginosis, in which the discharge is thin and gray-white. Intense itching of the vulva is associated with candidiasis, not vaginosis. Warts in the vulva and labia are seen in human papillomavirus infection, not in vaginosis.

A client reports genital ulcers and a diagnosis of syphilis. Which nursing interventions should the nurse implement when caring for the client? Select all that apply

Have the client urinate in water if urination is painful. Instruct the client to wash her hands with soap and water after touching lesions. Instruct the client to wear nonconstricting, comfortable clothes.

A client has been recently diagnosed with genital herpes and asks, "Why am I having so many recurring outbreaks of the infection?" What is the nurse's best response? a) "Your body is responding to the bacterial infection." b) "The antibiotic medication requires adjusting." c) "This is the expected course of the infection." d) "Stress-reducing strategies may help prevent the outbreaks."

"Stress-reducing strategies may help prevent the outbreaks." Recurrent genital herpes outbreaks are triggered by precipitating factors such as emotional stress and stress-reducing exercises may help. No cure exists, but antiviral drug therapy not antibiotics helps to reduce or suppress symptoms, shedding, and recurrent episodes. Genital herpes is a recurrent, lifelong "viral" not bacterial infection.

A pregnant woman recently diagnosed with the genital herpes virus asks the nurse for more information on the virus. Which responses by the nurse would be appropriate? Select all that apply.

"The virus remains quiet until a stressful event occurs to reactivate it." "Infections may be transmitted by individuals unaware that they have it." "Transmission is through contact of infected mucous membranes."

A school health nurse is providing education to a group of adolescents regarding the proper procedure for male condom use. The nurse knows the teaching has been effective when which statement is made by a student? a) "It is important to put the condom on just before the penis is erect." b) "Withdraw the penis erect, holding the condom firmly against the penis." c) "Use only petroleum-based lubricants, such as body lotion or massage oil." d) "Ensure your condom is always available, so store condoms in your wallet."

"Withdraw the penis erect, holding the condom firmly against the penis." The teaching guidelines for proper condom use include: ensure the condom has been stored in a cool, dry place away from direct sunlight. Do not store condoms in wallet; put the condom on before any genital contact; put the condom on when penis is erect; ensure adequate lubrication during intercourse. If external lubricants are used, use only water-based lubricants. Oil-based or petroleum-based lubricants, such as body lotion or massage oil, can weaken latex condoms. Withdraw while penis is still erect, and hold condom firmly against base of penis. Remove carefully to ensure no semen spills out.

A client is being discharged from the gynecological unit after treatment for an acute pelvic inflammatory disease (PID). What priority instruction regarding disease management should the nurse include? a) Arrange for follow-up visits to her health care provider. b) Refer the client to the women's sexual health clinic. c) Discuss the necessity of completing the antibiotic therapy. d) Provide the client with brochures on sexually transmitted disease prevention.

Discuss the necessity of completing the antibiotic therapy.

A nurse is conducting an acquired immunodeficiency syndrome (AIDS) awareness program for women. Which instructions should the nurse include in the teaching plan to empower women to develop control over their lives in a practical manner so that they can prevent becoming infected with the human immunodeficiency virus (HIV)? Select all that apply.

Give opportunities to practice negotiation techniques. Encourage women to develop refusal skills. Encourage women to use female condoms.

When describing sexually transmitted infections and testing, the nurse explains that a client is typically tested for chlamydia, gonorrhea, and syphilis at the same time for which reason? a) The infections spread through the same medium, and therefore clients have concurrent infections. b) It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI). c) The infecting bacterium in all cases is the same, and therefore clients have concurrent infections. d) The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client.

It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI). It is common practice to test clients for chlamydia, gonorrhea, and syphilis because it is not unusual for clients to have concurrent infections with more than one STI. For chlamydia, the causative microorganism is a bacterium named Chlamydia trachomatis. For gonorrhea, the infection is caused by a bacterium named Neisseria gonorrhoeae. The spirochete Treponema pallidum is the causative microorganism of syphilis. The symptoms of these conditions are not identical. The causative microorganisms do not spread through the same medium

Which instruction should be given to a woman newly diagnosed with genital herpes? Have your partner use a condom when lesions are present. Obtain a Papanicolaou (Pap) test every 3 years. Use a water-soluble lubricant for relief of pruritus. Limit stress and emotional upset as much as possible.

Limit stress and emotional upset as much as possible Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it is not known whether the virus can be transmitted at this time. During an outbreak, creams and lubricants should be avoided because they may prolong healing. Because a relationship has been found between genital herpes and cervical cancer, a Pap test is recommended every year.

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? a) "This drug will help reduce my risk for a recurrence after discontinuing it." b) "The severity of future attacks will be much less after using this drug." c) "If I use this drug, I will be cured of the infection." d) "This drug will help to suppress any symptoms of the infection."

This drug will help to suppress any symptoms of the infection. No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. Advances in treatment with acyclovir 400 mg orally three times daily for 7 to 10 days, famciclovir 250 mg orally three times daily for 7 to 10 days, or valacyclovir 1 g orally twice daily for 7 to 10 days have resulted in an improved quality of life for those infected with HSV. However, according to the CDC, these drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued.

A nurse is engaged in primary prevention activities for HPV. The nurse would be most likely involved with which activity? a) encouraging treatment for genital warts b) administering HPV vaccine c) teaching about the importance of regular Pap smears d) educating about HPV testing in women over age 30

administering HPV vaccine

A young woman comes to the walk-in clinic seeking treatment for chronic chlamydia trachomatis. Which finding is most likely because it often correlates with this diagnosis? a) anemic disorder b) central nervous system disorder c) liver disease d) gonorrhea

gonorrhea There is a common co-infection of chlamydia and gonorrhea when chlamydia is not treated with the necessary antibiotic medication combination. Anemia does not correlate with chlamydia, and there is no evidence that it precipitates liver disease. CNS disorders would be from syphilis.

What is the most common viral infection? a) gonorrhea b) chlamydia c) trichomoniasis d) human papillomavirus (HPV)

human papillomavirus (HPV)

Which medications are appropriate to treat vaginal candidiasis? Select all that apply

miconazole fluconazole

A nurse is reviewing the history of a client diagnosed with pelvic inflammatory disease. Which factors would the nurse identify as placing the client at increased risk for this condition? Select all that apply.

multiple sex partners intrauterine contraceptive device inserted 3 weeks ago vaginal douching approximately once a week

What is the medication of choice for early syphilis? a) ceftriaxone B) doxycycline c) penicillin G benzathine d) tetracycline

penicillin G benzathine

A nurse is caring for a client positive for human immunodeficiency virus. The client is on triple-combination highly active antiretroviral therapy (HAART). What should the nurse include in the teaching plan when educating the client about the treatment? (Select all that apply.)

Unpleasant side effects such as nausea and diarrhea are common. Provide written materials describing diet, exercise, and medications. Ensure that the client understands the dosing regimen and schedule.

A community health nurse is conducting a class on sexually transmitted infections (STIs). She states that "STIs are discriminatory." What would the nurse most likely use to support this statement? Select all that apply.

"Women are diagnosed with two thirds of the new cases of STIs annually." "After only a single exposure, women are twice as likely as men to acquire STIs." "Certain infections can be transmitted to the newborn."

Which instruction should the nurse give to a client with genital herpes to help control the infection? a) Apply antibacterial medication. b) Avoid people with upper respiratory infections. c) Avoid sexual contact until sores heal. d) Apply imiquimod cream.

Avoid sexual contact until sores heal.

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby? a) Instill a prophylactic agent in the eyes of the newborn. b) Perform cesarean birth to prevent infection. c) Administer an antiretroviral syrup to the newborn. d) Administer cephalosporins to mother during pregnancy.

Instill a prophylactic agent in the eyes of the newborn. To prevent gonococcal ophthalmia neonatorum in the baby, the nurse should instill a prophylactic agent in the eyes of the newborn. Cephalosporins are administered to the mother during pregnancy to treat gonorrhea but not to prevent infection in the newborn. Performing a cesarean birth will not prevent gonococcal ophthalmia neonatorum in the newborn. An antiretroviral syrup is administered to the newborn only if the mother is human immunodeficiency virus-positive and will not help prevent gonococcal ophthalmia neonatorum in the baby.

A nurse is caring for a female client who has a history of recurring vulvovaginal candidiasis. Which instruction should the nurse include in the teaching session with the client?

Wear white, 100% cotton underpants.

Which medications are appropriate to treat chlamydia trachomatis? Select all that apply.

azithromycin ofloxacin doxycycline

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?

burning on urination

A client has been diagnosed with condylomata acuminata and requires treatment for the condition. What would be the treatment of choice?

cryotherapy

What is the gold standard for HSV diagnosis?

culture

Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? a) hematuria b) painful ejaculation c) erectile dysfunction d) dysuria

dysuria

When developing a program for STI prevention, which action would need to be done first? a) educating on how to promote sexual health b) increasing the availability of resources c) interfering with the mode of transmission d) getting individuals to change their behaviors

educating on how to promote sexual health. The key to successful treatment and prevention of STIs is education to promote sexual health. Behavior changes, increasing the availability of resources, and interfering with modes of transmission are important, but all of these require education.

A nurse is assisting with a pelvic exam on a client who is suspected of having trichomoniasis. Which findings would the nurse note as helping to confirm this diagnosis? Select all that apply. a) vaginal erythema b) enlarged lymph nodes locally c) curd-like discharge in the vagina d) cervical petechiae e) cervical bleeding when touched

vaginal erythema cervical petechiae cervical bleeding with touched. With trichomoniasis, findings include cervical bleeding on contact, cervical petechiae, and vaginal or vulvar erythema. Curdlike vaginal discharge is associated with candidiasis. Locally enlarged lymph nodes are associated with gonorrhea.

A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which finding?

yeast infections Hormonal changes when using high-dose estrogen oral contraceptives can change the environment of the vagina and make it conducive to the growth of yeast cells.