Chapter 28: PrepU - Infections

Clients who have had PID are prone to which complication? 1 -ectopic pregnancy 2- multiple gestation 3- ovarian cancer 4- inguinal lymphadenopathy

1

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? 1- Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy. 2- Oral antibiotics can prevent complications such as infertility and pelvic inflammatory disease. 3- Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection. 4- Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.

2

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? 1- Provide the client with brochures on sexually transmitted disease prevention. 2- Arrange for follow-up visits to her health care provider. 3- Discuss the necessity of completing the antibiotic therapy. 4- Refer the client to the women's sexual health clinic.

3

A client is receiving ceftriaxone as treatment for gonorrhea. What would be most important for the nurse to emphasize to the client? 1- Taking the drug on an empty stomach 2- Using a sunscreen when outside 3- Avoiding alcohol consumption 4- Reporting signs of an oral yeast infection

3

The nurse is giving a presentation about chlamydia to a group of adult women. The nurse would emphasize the need for annual screening for this infection in all sexually active women younger than which age? 1- 40 2- 32 3- 25 4- 28

3

A client is being treated for gonorrhea. Which agent would the nurse expect the primary care provider to prescribe? 1- penicillin 2- tetracycline 3- levofloxacin 4- ceftriaxone

4

A woman is to receive penicillin G 3,000,000 units IM q6h as syphilis treatment. The medication is available as 1,500,000 units/mL. How many milliliters will be administered in 24 hours? Record your answer using a whole number.

8

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? 1- an azole antifungal agent 2- a penicillin antibiotic 3- a quinolone antibiotic 4- an antiviral agent

1

A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis? 1- a painless genital ulcer that appeared about 3 weeks after unprotected sex 2- copper-colored macules on the palms and soles that appeared after a brief fever 3- patchy hair loss and red, broken skin involving the scalp, eyebrows, and beard areas 4- one or more flat, wartlike papules in the genital area that are sensitive to touch

1

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? 1- viral culture of vesicular fluid 2- Papinicolaou smear 3- IgG/IgM antibody testing 4- treponemal testing

1

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? 1- Fluconazole 2- Tetracycline 3- Clindamycin 4- Acyclovir

1

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? 1- Instruct the client not to drink alcohol with this treatment. 2- Counsel the client to refrain from sex for one week. 3- Advise the client to take medication with a glass of milk. 4- Reassure the client further STI testing is not indicated.

1

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? 1- the possibility of a chlamydia infection 2- an acute stage of the gonorrheal infection 3- a reaction to the gonorrheal medications 4- a positive pregnancy test

1

A female sex trade worker has been diagnosed with secondary syphilis. Which findings would mostlikely correlate with this diagnosis? 1- sore throat and flu-like symptoms 2- pain-free crusty genital lesions 3- yellow vaginal discharge 4- painful dysurea

1

A male client appears in the walk-in clinic and requests treatment for trichomoniasis as his girlfriend was recently diagnosed with it. What medication would the health care provider mostlikely prescribe? 1- metronidazole 2- acyclovir 3- clotrimazole 4- penicillin G

1

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? 1- burning on urination 2- dry, hacking cough 3- diffuse skin rash 4- painless chancre

1

A nurse is caring for a client undergoing treatment for bacterial vaginosis. Which instruction should the nurse give the client to prevent recurrence of bacterial vaginosis? 1- Practice monogamy. 2- Use oral contraceptives. 3- Avoid smoking. 4- Undergo colposcopy tests frequently.

1

A nurse is presenting a program for a local women's group about STIs. When describing the information, the nurse would identify which infection as the most common cause of vaginal discharge? 1- candidiasis 2- syphilis 3- gonorrhea 4- chlamydia

1

A pregnant client is diagnosed with chlamydia and is to receive antimicrobial therapy. Which drug would the nurse least likely expect to be prescribed? 1- azithromycin 2- erythromycin 3- ofloxacin 4- levofloxacin

1

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? 1- "This STI is characterized by an infection of your cervix." 2- "This STI is an infection that will cause itching in the genital area." 3- "This STI is an infection that results in ulcers in the genital area." 4- "This STI is an infection that will result in the formation of genital warts."

1

A woman with a history of genital lesions caused by herpes simplex virus (HSV) has been admitted to the labor unit at 39 weeks' gestation. She said she was given medicine prophylaxically a few weeks ago to prevent lesions at the time of birth. Which medication is safe to give to a pregnant women with HSV? 1- acyclovir 2- benzathine penicillin 3- chloroquine 4- mefloquine

1

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? 1- genital herpes 2- syphilis 3- gonorrhea 4- chlamydia

1

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? 1- Use high-protein supplements. 2- Eat dry crackers after meals. 3- Limit number of meals to three a day. 4- Constantly drink fluids while eating.

1

At a health education class for teenagers, the nurse discusses the sexually transmitted infection chlamydia trachomatis. Which information would the nurse most likely include? 1- This infection is the most common infectious cause of infertility. 2- This infection is lifelong as it cannot be treated with medication. 3- Antiviral drug regimes will cure this infection. 4- The new recombinant human papillomavirus vaccine will prevent the infection.

1

Pelvic infection is most commonly caused by: 1- sexual transmission. 2- surgical abortion. 3- hysteroscopy. 4- insertion of intrauterine device.

1

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? 1- trichomoniasis 2- herpes simplex II 3- human papillomavirus 4- syphilis

1

The nurse is teaching a group of middle school students about sexually transmitted infections (STIs). Which statement by the students indicates a need for additional teaching about condom use? 1- "Put the condom on just before orgasm." 2- "Latex condoms provide the best protection against STIs." 3- "Putting the condom on just before insertion defeats the purpose." 4- "Don't store condoms in your wallet."

1

What is the gold standard for HSV diagnosis? 1- culture 2- shave biopsy 3- excisional biopsy 4- punch biopsy

1

What is the medication of choice for early syphilis? 1- penicillin G benzathine 2- doxycycline 3- tetracycline 4- ceftriaxone

1

Which medication is the most effective treatment for trichomoniasis? 1- metronidazole 2- penicillin G benzathine 3- doxycycline 4- azithromycin

1

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? 1- latency 2- secondary 3- primary 4- tertiary

1

Working at the local health clinic, the nurse recognizes that STIs can often result in PID. When a client with a history of repeat STIs presents to the clinic reporting severe abdominal cramping and bleeding, the immediate concern is to ensure the client does not have: 1- ectopic pregnancy. 2- genital herpes simplex. 3- endometriosis. 4- secondary urinary tract infection.

1

A client is returning with a third vaginal infection within a six-month period. During the health assessment, the nurse should ask about the client's use of which products? Select all that apply. 1- douches 2- deodorants 3- yogurt 4- herbs

1,2

A woman comes to the clinic reporting vaginal discharge. The nurse suspects trichomoniasis based on which symptoms? Select all that apply. 1- urinary frequency 2- yellow/green discharge 3- joint pain 4- blister-like lesions 5- muscle aches

1,2

Which medications are appropriate to treat vaginal candidiasis? Select all that apply. 1- miconazole 2- fluconazole 3- azithromycin 4- gentamicin 5- penicillin G benzathine

1,2

A 24-year-old female client reports various issues. She admits to having unprotected sexual intercourse. Which findings would indicate a possible PID? Select all that apply. 1- lower abdominal tenderness 2- adnexal tenderness 3- cervical motion tenderness 4- constipation

1,2,3

A nurse is assessing a client who has a history of pelvic inflammatory disease (PID). The nurse would be alert for which complication? Select all that apply. 1- ectopic pregnancy 2- pelvic abscess 3- fibrosis 4- inguinal lymphadenopathy

1,2,3

Which medications are appropriate to treat chlamydia trachomatis? Select all that apply. 1- azithromycin 2- ofloxacin 3- valacyclovir 4- doxycycline 5- acyclovir

1,2,4

A nurse is assessing a client diagnosed with pelvic inflammatory disease (PID). Which finding would the nurse most likely assess? Select all that apply. 1- oral temperature of 102°F (39°C) 2- painful urination 3- right upper quadrant pain 4- tenderness with cervical motion 5- negative pregnancy history 6- clear vaginal discharge

1,2,4,5

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. 1- "The virus remains quiet until a stressful event occurs to reactivate it." 2- "Your baby is protected from this infection by the placenta." 3- "Many recognize they have the infection and seek treatment immediately." 4- "Infections may be transmitted by individuals unaware that they have it." 5- "Transmission is through contact of infected mucous membranes."

1,4,5

A client is to receive 3 million units of penicillin G intramuscular to treat gonorrhea. The drug is available in 1,500,000 units/mL. How many milliliters should the nurse administer? Record your answer using a whole number.

2

A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure? 1- "One or two treatments should get rid of the warts." 2- "I'm temporarily not contagious once the warts are destroyed." 3- "Once the warts are gone, then I know I'm cured." 4- "My partner doesn't need to be treated."

2

A female client comes to the clinic for an evaluation. Assessment reveals flu-like symptoms and a maculopapular rash on her trunk, and the palms of her hands and the soles of her feet. The client also reports hair loss and fatigue. She states, "I had a small ulcer near my vagina about 6 weeks ago that went away." Based on these findings, the nurse suspects that the client has syphilis at which stage? 1- primary 2- secondary 3- early latent 4- late latent

2

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? 1- herpes virus 2- human papillomavirus 3- Treponema pallidum 4- Haemophilus ducreyi bacillus

2

A woman is diagnosed with a vaginal infection. After teaching the client about measures to reduce her risk, the nurse determines that the client needs additional teaching when she states which factor as increasing her risk? 1- antibiotic therapy 2- menstruation 3- douching 4- use of feminine hygiene sprays

2

The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common STI in the United States would the nurse expect to include? 1- gonorrhea 2- chlamydia 3- syphilis 4- genital herpes

2

The nurse is preparing to administer medication therapy to a woman diagnosed with syphilis. The nurse would expect to administer: 1- miconazole. 2- penicillin G. 3- metronidazole. 4- doxycycline.

2

When preparing a teaching plan for a female adolescent with a sexually transmitted infection (STI), the nurse plans to address the fact that the adolescent is at increased risk for cervical cancer. Which STI would the adolescent most likely have? 1- genital warts 2- genital herpes 3- syphilis 4- chlamydia

2

Which finding would alert the nurse to suspect that a client has a yeast infection? 1- changes in skin color 2- vulvar burning and itching 3- lymphadenopathy 4- acidic vaginal secretions

2

Which finding would the nurse expect in a client with bacterial vaginosis? 1- vaginal pH of 3 2- fish-like odor of discharge 3- yellowish-green discharge 4- cervical bleeding on contact

2

Which finding would the nurse most likely find in a male diagnosed with a chlamydia trachomatis infection? 1- erectile dysfunction 2- dysuria 3- painful ejaculation 4- hematuria

2

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. 1- 29 years of age 2- multiple sex partners 3- intrauterine contraceptive device inserted 3 weeks ago 4- vaginal douching approximately once a week 5- residence in a suburban area

2,3,4

A 19-year-old female client has been diagnosed with pelvic inflammatory disease (PID) caused by untreated gonorrhea. Which instructions should the nurse offer when caring for the client? Select all that apply. 1- Use an intrauterine device (IUD). 2- Avoid douching vaginal area. 3- Complete the antibiotic therapy. 4- Increase fluid intake. 5- Limit the number of sex partners.

2,3,5

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? 1- Promote use of oral contraceptives. 2- Emphasize the importance of good body hygiene. 3- Discuss limiting the number of sex partners. 4- Emphasize not sharing personal items with others.

3

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? 1- genital warts 2- genital herpes 3- gonorrhea 4- syphilis

3

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? 1- trichomoniasis 2- bacterial vaginosis 3- vulvovaginal candidiasis 4- chlamydia

3

A young sexually active woman asks the nurse what type of birth control would help prevent sexually transmitted infections as well as pregnancy. Which type would the nurse recommend? 1- oral contraceptives 2- withdrawal 3- condom 4- intrauterine device

3

After teaching a group of young adult women on preventing pelvic inflammatory disease, the nurse determines that the teaching was successful when the group identifies which method as effective? 1- using hormonal contraception 2- using a vaginal douche weekly 3- having infected sexual partners receive treatment 4- obtaining routine treatment if at risk and asymptomatic

3

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? 1- genital herpes 2- gonorrhea 3- condylomata acuminata 4- candidiasis

3

The nurse is assessing a primigravida woman who reports vaginal itching, a great deal of foamy yellow-green discharge, and pain during intercourse. The nurse suspects the woman has contracted which disorder? 1- Chlamydia 2- Simple yeast infection 3- Trichomoniasis 4- Gonorrhea

3

The nurse is developing a plan of care for a client who is receiving aggressive drug therapy for treatment of HIV. The goal of this therapy is to: 1- promote the progression of disease. 2- intervene in late-stage AIDS. 3- improve survival rates. 4- conduct additional drug research.

3

The nurse is developing a plan of care for a client who is receiving highly active antiretroviral therapy (HAART) for treatment of HIV. What would the nurse identify as the goal of this therapy? 1- promote the progression of disease 2- intervene in late-stage AIDS 3- improve morbidity and mortality rates 4- conduct additional drug research

3

The nurse is reviewing medication orders for a pregnant patient diagnosed with a urinary tract infection. Which medication order should the nurse question for this patient? 1- Ampicillin 2- Amoxicillin 3- Tetracycline 4- Cephalosporin

3

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? 1- "Either me or a partner could end up with an eye infection from chlamydia that could make us blind." 2- "Even though I couldn't end up sterile, a woman that I give it to certainly could." 3- "Each of the 3 stages of the disease seems to be worse than the previous one." 4- "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

4

A 40-year-old woman is being discharged from the walk-in health care clinic after a diagnosis of pelvic inflammatory disease. Which health teaching topic should the nurse address? 1- symptoms of menopause 2- pain control for endometriosis 3- fertility issues 4- sexually transmitted infections

4

A client with primary syphilis is allergic to penicillin. The nurse would expect the primary care provider to prescribe which agent? 1- acyclovir 2- ceftriaxone 3- podophyllum resin 4- doxycycline

4

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? 1- The client keeps the affected area moist. 2- The client keeps her fingernails long. 3- The client wears tight-fitting jeans. 4- The client washes her hands before and after touching lesions.

4

A nurse is assessing a client diagnosed with bacterial vaginosis. What is a symptom of bacterial vaginosis? 1- cottage cheese-like discharge 2- intense itching of the vulva 3- warts in the vulva and labia 4- vaginal odor smelling of fish

4

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: 1- headache and fever. 2- vaginal and urethral discharge. 3- dysuria and lymphadenopathy. 4- genital pruritus and paresthesia.

4

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? 1- kissing 2- sexual contact 3- giving vaginal birth 4- sharing contaminated needles

4

A pregnant client is complaining of a large amount of malodorous vaginal discharge that is foamy and yellow-green in color, vaginal itching and painful intercourse. When asked, she also reports that urination is somewhat painful. She is diagnosed with trichomoniasis. What treatment would the nurse anticipate the client receiving? 1- ceftriaxone IM 2- oral erythromycin 3- benzathine penicillin G IM 4- oral metronidazole

4

A woman seen in the emergency department is diagnosed with primary syphilis. What finding is most likely? 1- foul-smelling discharge 2- vaginal bleeding 3- vesicles on the labia 4- chancres at the vaginal site

4

A young couple are disappointed that they are not yet pregnant and are seeking assistance at the health clinic. After assessing their medical history, the nurse discovers the female has a history of several episodes of PID. The nurse predicts this may be a source of the infertility related to which factor? 1- It causes anovulation due to interference with secretion of pituitary hormones. 2- It causes changes in cervical mucus that make it less receptive to penetration by sperm. 3- It causes sperm-agglutinating antibodies to be produced in the vagina. 4- It interferes with the transport of ova due to tubal scarring.

4

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? 1- azithromycin 2- valacyclovir 3- penicillin 4- metronidazole

4

The nurse reviews the CD4 cell count of a client who is HIV-positive. A result less than which count would indicate to the nurse that the client has AIDS? 1- 1,000 cells/mm3 2- 700 cells/mm3 3- 450 cells/mm3 4- 200 cells/mm3

4

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? 1- The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client. 2- The infecting bacterium in all cases is the same, and therefore clients have concurrent infections. 3- The infections spread through the same medium, and therefore clients have concurrent infections. 4- It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).

4

Which instruction should be given to a woman newly diagnosed with genital herpes? 1- Obtain a Papanicolaou test every 3 years. 2- Have your partner use a condom when lesions are present. 3- Use a water-soluble lubricant for relief of pruritus. 4- Limit stress and emotional upset as much as possible.

4