Ch 21

1. Which form of treatment should be administered to the patient at this time? A. Doxycycline B. Erythromycin C. Amoxicillin D. Amphotericin B E. Both doxycycline and amoxicillin 2. True or False: There is only one serotype of Leptospira interrogans to treat.

1. A 2. False

Select all of the correct statements concerning the female genital tract to test your understanding of the normalbiota present in the genitourinary tract.

After puberty, estrogen production leads to glycogen release in the vagina lowering the pH. After puberty, lactobacilli dominate discouraging growth of other microbes.

Which of the following is on the CDC's "Urgent Threat" list because of its potential resistance to antibiotics?

Enterobacteriaceae

The HPV vaccine prevents infection by all types of human papillomaviruses.

False

Which of the following bacteria is known to produce substances that raise the local pH?

Gardnerella

Label the image to review the anatomy of the female reproductive system.

Google Docs

Label the image to review the anatomy of the male reproductive system.

Google Docs

Label the image to review the effects of invasive gonorrhea in women.

Google Docs

The patient asks the nurse to keep his diagnosis confidential. What is the nurse's best response?

I am required by law to contact the health department, and you should notify any recent sexual partners.

Pregnant women are an important risk group for group B Streptococcus infections due to their ability to pass this dangerousorganism to the infant during the birthing process.

True

What disease is the patient likely to have given the history, manifestations, and direct observation?

Vaginitis caused by Trichomonas vaginalis

Warts produced by human papillomavirus infection range from tiny, flat bumps to extensive, branching, cauliflower-like masses called ________.

condyloma acuminata

Inflammation of a male reproductive gland known as _______ is accompanied by pain in the pelvic area and lower back,difficulty urinating, and painful ejaculation.

prostatitis

Select all of the correct descriptions of the protective characteristics of urine to test your understandingof the natural defenses of the genitourinary tract.

Has acidic pH Contains lysozyme, which breaks down peptidoglycan Contains lactoferrin, an iron-binding protein Contrains secretory IgA

Order the following structures, from where blood enters the urinary system to the expulsion of urine, to test your understanding of this tract.

Kidney Ureter Bladder Urethra

Choose the statement that best describes characteristics of leptosporosis.

Leptosporosis can be marked by the development of Weil's syndrome, a cluster of symptoms characterized by kidney invasion, hepatic disease, jaundice, anemia, and neurological disturbances.

How would the diagnosis of syphilis be confirmed?

All of these tests can be used in diagnosis

The physician in the clinic wrote a prescription for acyclovir when the student called him on the phone that morning. What is the most appropriate action by the nurse?

Call the physician, report the assessment findings, and suggest a prescription for penicillin G

Evaluate the statements below, and select those that correctly apply to the characteristics of infection by herpes simplex virus.

Initial infection with HSV-2 may be completely asymptomatic or may present with very painful vesicles and flu-like symptoms. HSV causing genital herpes enters a period of latency in the ganglion of the lumbosacral spinal nerve trunk where microRNAs are thought to regulate transcription of the viral genome. Transmission of HSV to a fetus or neonate is much more serious than transmission to an adult since it can enter the nervous system where it has a high mortality rate.

What treatment do you prescribe for her?

Metronidazole

1. Based upon these results alone, the pathogen appears to be a(n) ______. 2. Based upon the microscopic results, the pathogen appears to exhibit which morphology? 3. This pathogen appears to be a fastidious organism. What additional diagnostic test could be performed on the specimen to provide serologic information on the pathogen in a rapid manner?

1. Bacterium 2. Spirochete 3. Direct Antigen Testing

1. Based upon all of the information obtained through specimen testing, along with the patient's symptoms, the pathogen is most likely: A. Epstein Barr virus B. Influenza A C. Leptospira interrogans D. Plasmodium vivax 2. Based upon this identification, what was the most likely mode of transmission of this pathogen? 3. True or False: The patient most likely did not have influenza 4 weeks ago, but exhibited the signs and symptoms of initial (primary) infection with this pathogen.

1. C 2. Direct contact with contaminated water through skin abrasions 3. True

1. Which of the following is the most common causative organism for urinary tract infections? 2. The RN anticipates that any of these antibiotics may be ordered for treatment, except ________. 3. The physician orders phenazopyridine (Pyridium) for the patient. Which of the following should be included in the teaching by the RN? 4. The patient develops a high fever and flank pain. What complication may this indicate?

1. Escherichia coli 2. vancomycin 3. All of these choices are correct 4. Pyelonephritis

1. True or False: In January, there was more than one individual who was highly capable of transmitting syphilis. 2. Which of the following is a correct statement, based upon the information presented? 3. True or False: The cases of primary syphilis steadily increased over this time period, indicating that the disease was still actively spreading.

1. False 2. Syphilis was transmitted vertically in this population 3. False

1. Which of the following structures is involved in the increased pathogenicity of N. gonorrhoeae? 2. True or False: The roughly 350,000 cases of gonorrhea reported in the United States each year is an accurate representation of disease incidence in this country. 3. Which of the following drugs is commonly used for the treatment of gonorrhea today?

1. Fimbriae 2. False 3. There is no common treatment due to the development of resistance.

1. Which is a correct description of what the lab technician viewed under the microscope when analyzing a Gram stain of the patient's specimen? 2. True or False: The elevated white blood cell count and ESR level indicated the patient's condition was mostly likely due to a viral infection. 3. Transmission of gonorrhea occurs through

1. Gram-negative diplococci 2. False 3. childbirth and sexual contact

1. Which of the following is used for initial detection of C. trachomatis? 2. The patient asks the RN how she could have acquired the infection without noticeable symptoms. What is the most appropriate response by the RN? 3. Which antibiotic is prescribed for treatment of Chlamydia infection? 4. All of the following are important points of education by the RN, except ________. 5. All of the following are potential complications of untreated Chlamydia infection, except ________.

1. PCR or ElISA 2. The vast majority of people infected with Chlamydia do not have symptoms. 3. Azithromycin 4. requirement of the patient to report Chlamydia infection to the CDC 5. spontaneous abortion

1. Which of the following are possible symptoms of gonorrhea in males? 2. Which of the following are possible symptoms of gonorrhea in females? 3. All of the following are potential complications of gonorrhea, except ________. 4. Which of the following statements by a student demonstrates a proper understanding of gonorrhea transmission? 5. Which of the following is an effective form of gonorrhea prevention?

1. Painful urination and yellowish discharge or no symptoms 2. All of these choices are correct. 3. spontaneous abortion 4. If I am infected with gonorrhea and have no symptoms, I can still pass the disease to others 5. Use of condoms and abstinence

1. Sexually transmitted diseases can be passed from person to person through ______. 2. Which of the following is a correct statement regarding sexually transmitted diseases, also known as sexually transmitted infections (STIs)? 3.Which of the following is a correct statement regarding sexually transmitted diseases, also known as sexually transmitted infections (STIs)? 4. True or False: Nearly all sexually transmitted diseases can be transmitted vertically. 5. True or False: HPV can lead to the development of cancer.

1. kissing or oral and genital sexual activity 2. These infections can be caused by bacteria, viruses or other microbes. 3. Sexually transmitted diseases caused by bacteria are easier to test for than those caused by viruses. 4. True 5. True

Drag the images to their corresponding statement to test your knowledge of statistical information related to pathogens associated with genitourinary system infections.

75%: Percentage of Chlamydiainfections that are asymptomatic 10%: Percentage of males with gonorrhea who are asymptomatic 20-40%: Percentage of U.S. adults seropositive for HSV-2 95%: Percentage of UTIs caused by microbes that are considered normal biota

The nurse provides education about prevention of future gonorrheal infection. Which of the following topics would be included in the teaching?

Always use a condom for sexual contact

Conduct additional research as necessary to evaluate the statements below, and select those that correctly compare and contrast infections by Neisseria gonorrhea and Chlamydia trachomatis.

C. trachomatis is an obligate intracellular parasite whereas N. gonorrheae proliferates in the basement membrane. Overall, chlamydia is more prevalent than gonorrhea, but both diseases predominantly affect the 20- to 24-year-old age group. Individuals presenting with typical discharge symptoms are assumed to have a coinfection and are treated with azithromycin.

Which antibiotic(s) does the nurse anticipate will be ordered to treat the patient?

Ceftriaxone and azithromycin

Please match the disease descriptions to the correct pathogens to test your understandingof genitourinary tract diseases caused by microorganisms.

Escherichia coli: Caustive agent of the most common bacterial forms of cystitis and pyelonephritis Enterococcus: Another common cause of UTIs, but vancomycin-resistant forms of this agent are listed in the Serious Threat category Stapylococcus: Bacterium that causes a very small percentage of community UTIs and catheter-associated UTIs Leptospira interrogans: Spirochete bacterium shed in the urine of infected animals

In both genders, the kidneys, ureters, bladder, and the entire urethra are kept sterile by urine flow.

False

Based on the patient's clinical presentation and history alone, how could the nurse have distinguished gonorrhea from chlamydia?

Gonorrhea and chlamydia mimic each other in presentation.

Complete the sentences to review the life cycle of Chlamydia. Then put the sentences in the correct order.

Google Docs

Drag and drop the labels into the correct empty boxes to complete the concept map.

Google Docs

Drag the statements or images to their correct category to examine the various types of genital tract diseases.

Google Docs

Examine microbiological aspects of genital tract infections by completing each sentence.

Google Docs

Label the image to review important structures of the urinary system.

Google Docs

Label the image with the microbes listed to review the spectrum of genitourinary system diseases in females.

Google Docs

Label the image with the microbes listed to review the spectrum of genitourinary system diseases in males.

Google Docs

Move the descriptions to the correct disease to demonstrate your understanding of two major discharge diseases of the genitourinary system that can lead to PID.

Google Docs

Move the terms into the correct empty boxes to complete the concept map.

Google Docs

Move the terms into the correct empty boxes to complete this concept map describing urinary tract infections.

Google Docs

Select all of the statements that apply to gonorrhea to test your understanding of genitourinary tract diseases characterized by discharge.

It is caused by Neisseria gonorrhoeae, a gram-negative diplococcus. Infection can render both males and females sterile. It can result in eye and respiratory infections of neonates during birthing process.

How was the organism transmitted to her?

It is likely that her partner was asymptomatic and was not aware he was infected

Select all of the correct descriptions of vaginitis to test your understanding of vaginal diseases caused by microorganisms.

Most commonly caused by Candida albicans Most infections are opportunistic

Based upon the assessment of the lesion, what is the most likely diagnosis?

Primary syphilis

Match the stages of syphilis to their correct descriptions to test your understanding ofulcer-producing genitourinary tract infections.

Tertiary or latent syphilis: Neurosyphilis can be present as well as gummas Primary syphilis: Hard, painless chancre at site of spirochete entry Secondary syphilis: Fever, headache, and sore throat, followed by lymphadenopathy and a peculiar red or brown rash on all skin surfaces, including the palms and the soles Congenital syphilis: Syphilis spirochete passes through placenta to infect fetus

Select all of the statements that apply to Chlamydia infection to test your understanding of genitourinary tract diseases characterized by discharge.

The causative agent is an obligate intracellular parasite. The causative agent has two stages: elemental body and reticulate body. Neonate eye infections with Chlamydia are more prevalent than those associated with gonorrhea.

The student states, "My friend had syphilis, but the lesion healed without antibiotics. Do I really need to take medications?" What is the best response by the nurse?

The lesion will heal on its own, but latent syphilis will cause serious disease later on and must be treated.

The flushing action of urine is a defense mechanism that prevents microbial invasion of the urinary system.

True

An inflammation of the vagina most commonly caused by Candida, referred to as _______, is characterized by some degree of vaginal itching; ________, however, does not appear to induce vaginal inflammation and is most likely due to a reduction in Lactobacillus species.

vaginitis; vaginosis