Chapter 5: Sexually Transmitted Infections

A woman who is HIV positive and receiving drug therapy comes to the clinic and says, "I have no appetite, and then when I do eat, I get sick to my stomach." Which suggestion would be least effective? a. "Drink fluids with anything that you eat." b. "Try some high-protein drinks or foods." c. "Try eating small meals spaced throughout the day." d. "Eat some dry crackers when you feel nauseated."

a. "Drink fluids with anything that you eat." (Rationale: Food and fluid intake should be separated to prevent overfilling. High-protein drinks and foods will provide quick and easy protein and calories. Dry crackers are helpful in alleviating nausea. Eating smaller meals spaced evenly throughout the day will prevent the client from feeling overfilled and bloated.)

The nurse emphasizes the importance of regular Pap smears and routine physical examinations due to the fact that __________ of women are asymptomatic when infected with chlamydia. a. 70% b. 50% c. 30% d. 90%

a. 70% (Rationale: The CDC estimates that 70% of women are asymptomatic when infected with chlamydia. Encouraging annual examinations will assist in identifying these women who need treatment and hopefully help reduce the spread of this STI.)

A nurse at the college health care clinic is developing a campaign to educate the students about HPV. She would emphasize that the primary prevention for HPV includes which of the following? a. Administering HPV vaccine b. Teaching about HPV testing in women over age 30 c. Recommending treatment of genital warts d. Educating about the importance of regular Pap smears

a. Administering HPV vaccine (Rationale: Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be primary prevention activity. Educating about the importance of regular Pap smears, teaching about HPV testing, and recommending treatment of genital warts would be secondary prevention activities.)

As a nurse working at the college health care clinic, you recognize the importance of educating the students that the human papillomavirus has been confirmed to be the cause of essentially all cases of: a. Cervical cancer b. Ovarian cancer c. Vaginal cancer d. Uterine cancer

a. Cervical cancer (Rationale: Clinical studies have confirmed that HPV is the cause of essentially all cases of cervical cancer, which is the fourth most common cancer in women in the United States.)

A 24-year-old female client presents with various complaints. She admits to having unprotected sexual intercourse. Which of the following findings would indicate a possible PID? (Select all that apply.) a. Cervical motion tenderness b. Constipation c. Adnexal tenderness d. Lower abdominal tenderness

a. Cervical motion tenderness c. Adnexal tenderness d. Lower abdominal tenderness (Rationale: Minimal criteria of PID as established by the CDC include lower abdominal tenderness, adnexal tenderness, and cervical motion tenderness.)

The client has been diagnosed with trichomoniasis. The nurse recognizes one of the treatments of choice is: a. Flagyl b. Monistat c. Diflucan d. Penicillin G

a. Flagyl (Rationale: Oral metronidazole [Flagyl] or tinidazole [Tindamax] are treatments of choice for trichomoniasis. Penicillin G is used to treat syphilis. Monistat and Diflucan are used to treat candidiasis.)

A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection? a. Gonorrhea b. Candida albicans c. Syphilis d. Human immunodeficiency virus

a. Gonorrhea (Rationale: Gonorrhea can be transmitted to the newborn in the form of ophthalmia neonatorum during birth by direct contact with gonococcal organisms in the cervix. The newborn would develop congenital syphilis if exposed in utero. Exposure to candida would cause thrush in the newborn. Exposure to HIV during gestation could lead to the birth of an HIV-positive newborn.)

The client is single, admits to not using condoms during sexual intercourse, and has had multiple partners over the past year. Which of the following symptoms would alert the nurse to a possible gonorrheal infection? (Select all that apply.) a. Mild sore throat b. Dysuria c. Abnormal uterine bleeding d. Abnormal vaginal discharge

a. Mild sore throat b. Dysuria c. Abnormal uterine bleeding d. Abnormal vaginal discharge (Rationale: All of the above complaints are possible symptoms of gonorrheal infection.)

In preparing a talk about STIs for high school students, the nurse should emphasize which of the following as high-risk groups? (Select all that apply.) a. Multiple or new sex partners b. Consistent barrier use c. Single women d. Women younger than 25 years old

a. Multiple or new sex partners c. Single women d. Women younger than 25 years old (Rationale: High-risk groups include single women, women younger than 25 years, African American women, women with a history of STIs, those with new or multiple sex partners, those with inconsistent use of barrier contraception, and women living in communities with high infection rates.)

When describing the methods of transmission for herpes simplex virus to a group of college students, which method would be least likely? a. Sharing contaminated needles b. Vaginal birth c. Kissing d. Sexual contact

a. Sharing contaminated needles (Rationale: Herpes simplex virus is transmitted primarily by direct contact with an infected individual who is shedding the virus and may include kissing, sexual contact, and vaginal birth. Sharing contaminated needles is a means of transmitting HIV.)

A client has presented with complaints that suggest a gonorrheal infection. After laboratory test confirm this diagnosis, the nurse understands that the client should also be treated for: a. HPV b. Chlamydia c. Syphilis d. Candidiasis

b. Chlamydia (Rationale: The CDC recommends that any client being treated for gonorrhea should also be treated for chlamydia, due to the common occurrence of co-infection of these two organisms.)

When teaching a woman diagnosed with genital ulcers, which of the following would the nurse include? a. Applying ice packs to the area for comfort b. Washing hands with soap and water after touching lesions c. Refraining from using condoms during sexual intercourse d. Drying lesions with a hair dryer set on high

b. Washing hands with soap and water after touching lesions (Rationale: Handwashing with soap and water after touching lesions is essential to avoid autoinoculation. Extremes of temperature, such as ice or hot packs, to the genital area should be avoided. Drying the lesions is appropriate, but the hair dryer should be set on a low setting. Condoms should be used with all new or noninfected partners.)

The nurse is caring for a 14-year-old who fears she might have a sexually transmitted infection. Which of the following assessments would be most indicative of trichomoniasis? a. Urinary incontinence b. Lesions on the vulva c. Green vaginal discharge d. Flu-like symptoms

c. Green vaginal discharge (Rationale: Symptoms of trichomoniasis include a yellow, green, or gray vaginal discharge with a foul odor. Urinary incontinence is not a symptom of trichomoniasis, but dysuria is. Syphilis, not trichomoniasis, may cause flu-like symptoms. Lesions on the vulva are a sign of venereal warts.)

When educating clients about the dangers of STIs, it is important that they understand some STIs can result in damage to other organs if left untreated. The STI that can result in liver damage is: a. HAV b. HCV c. HBV d. HPV

c. HBV (Rationale: Hepatitis B virus can result in serious, permanent liver damage. Treatment is generally supportive as no specific treatment for acute HBV infection exists. HAV is usually self-limiting and does not result in chronic infection. HCV is not transmitted sexually. HPV has been linked to cervical cancer.)

The nurse should encourage all new clients who present for their initial prenatal screening to include screening for: a. HPV b. HCV c. HBV d. HAV

c. HBV (Rationale: Nurses should encourage women to undergo HBV screening at their first prenatal visit and repeat screening in the last trimester for women with high-risk behaviors to comply with the U.S. Preventive Services Task Force recommendations.)

The nurse is preparing to administer medication therapy to a woman diagnosed with syphilis. The nurse would expect to administer: a. Miconazole b. Doxycycline c. Penicillin G d. Metronidazole

c. Penicillin G (Rationale: Penicillin G is the drug of choice for treating syphilis. Miconazole is used to treat chlamydia. Metronidazole is used to treat trichomoniasis. Doxycycline is used to treat chlamydia.)

The nurse is teaching a class about sexually transmitted infections to a middle school class. Which of the following is a misconception about condom use that needs to be clarified? a. Use a water-based lubricant with latex condoms. b. Latex condoms protect best against disease. c. Put the condom on just before orgasm. d. Don't store condoms in your wallet.

c. Put the condom on just before orgasm. (Rationale: Putting the condom on just before orgasm may defeat the purpose of using one at all. Condoms should be placed on the penis before genital contact occurs. Latex condoms protect best against disease. Condoms should be stored in a cool, dry place away from direct sunlight, not in a wallet. Only water-based lubricants should be used with condoms.)

A woman comes to the clinic complaining of intense pruritus and a thick curd-like vaginal discharge. On examination, white plaques are observed on the vaginal wall. The nurse suspects which of the following? a. Chlamydia b. Bacterial vaginosis c. Vulvovaginal candidiasis d. Trichomoniasis

c. Vulvovaginal candidiasis (Rationale: 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 homogenous vaginal discharge. Chlamydia is usually manifested by a mucopurulent vagina discharge.)

The nurse recognizes that one of the most common causes of vaginal discharge is: a. Chlamydia b. Gonorrhea c. Syphilis d. Candidiasis

d. Candidiasis (Rationale: Genital/vulvovaginal candidiasis is one of the most common causes of vaginal discharge. It is also referred to as yeast, monilia, and a fungal infection. It is not considered an STI because candida is a normal constituent in the vagina and becomes pathogenic only when the vaginal environment becomes altered.)

The CDC has identified the most common bacterial STI in the United States to be: a. Syphilis b. Gonorrhea c. Vaginosis d. Chlamydia

d. Chlamydia (Rationale: Chlamydia is recognized to be the most common bacterial STI in the United States by the CDC. The CDC estimates there are 2.8 million new cases each year.)

A child presents with the possible symptoms of HSV. Which of the following would not be used by the nurse to confirm the diagnosis? a. Clinical signs b. Viral culture c. Physical examination d. Pap smear

d. Pap smear (Rationale: Herpes simplex virus [HSV] is confirmed by clinical signs, a viral culture, and physical examination. A Pap smear is not used to confirm herpes.)

After a discussion on the HPV vaccine, the nurse recognizes the discussion was successful because the students understand: a. They will only need one injection for lifetime protection. b. They will need two injections over a 3-month period. c. They will need one injection every 5 years. d. They will need three injections over a 6-month period.

d. They will need three injections over a 6-month period. (Rationale: The vaccine is administered intramuscularly in three separate 0.5 mL doses over a 6-month period. The first dose is given prior to infection with HPV. The second dose is administered 2 months later, and the third dose is given 4 months later.)

As a nurse at the local health clinic, you recognize that STIs can often result in PID. When a client with history with repeat STIs presents to the clinic with complaints of severe abdominal cramping and bleeding, the immediate concern is to ensure the client does not have: a. PID b. Endometriosis c. An ectopic pregnancy d. Secondary urinary tract infection

c. An ectopic pregnancy (Rationale: A large proportion of the ectopic pregnancies occurring every year are due to the consequences of PID. PID is frequently caused by untreated chlamydia or gonorrhea.)

Which of the following measures would be most effective for a nurse to utilize in preventing STIs? a. Increasing the availability of resources b. Interfering with the mode of transmission c. Education to promote sexual health d. Getting individuals to change their behaviors

c. Education to promote sexual health (Rationale: 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.)

During a routine examination, the nurse suspects a teenage is having unprotected sex. To encourage discussion, the nurse must: a. Lecture the teen on the dangers of unprotected sex b. Alert the parents c. Report the teen to Child Protective Services d. Appear nonjudgmental but direct in the conversation

d. Appear nonjudgmental but direct in the conversation (Rationale: Health care providers have a unique opportunity to provide counseling and education to their clients. Identify risk factors and risk behaviors and guide the client to develop specific individualized actions of prevention. The nurse's interaction with the client needs to be direct and nonjudgmental.)