Chapter 52, Nursing Management: Sexually Transmitted Infections

When evaluating a patient for sexually transmitted infections (STIs), the nurse is aware that which STI is the most common bacterial STI? Gonorrhea Syphilis Chlamydia Trichomoniasis

Chlamydia

A patient has tested positive for syphilis. For which other condition should the patient be tested for, based on the positive syphilis test result? Tuberculosis Human immunodeficiency virus (HIV) Genital warts Diabetes type 2

HIV

A nurse is assessing a patient with a suspected sexually transmitted infection (STI). What questions about lifestyle patterns should a nurse include to assess high-risk behavior? Select all that apply. Illicit use of intravenous drugs Method of contraception used Sexual preference Diet and exercise regimen Number of sexual partners Smoking and alcohol consumption

Illicit use of intravenous drugs Method of contraception used Sexual preference Number of sexual partners

A woman with chlamydial infection complains of pelvic pain, nausea, vomiting, fever, and abnormal vaginal bleeding. What might be the possible cause of these symptoms? Pelvic inflammatory disease Ectopic pregnancy Infertility Reactive arthritis

PID

A patient who is sexually active with multiple partners is at the clinic with symptoms of purulent vaginal discharge, dysuria, and dyspareunia. What should the nurse explain to the patient as the rationale for screening her for chlamydia? Chlamydia frequently is comorbid with human immunodeficiency virus (HIV). Chlamydial infections may progress to sepsis. Untreated chlamydial infections can lead to infertility. Chlamydial infections are treatable only in the early stages of infection.

Untreated chlamydial infections can lead to infertility.

The nurse is assessing a patient suspected of being infected with gonorrhea. What symptom elicited by a nurse assessing a male patient correlates with this suspicion? Scrotal edema Urethral discharge A rash on the penis Enlarged inguinal lymph nodes

Urethral discharge

A clinic nurse is seeing a patient who is receiving treatment for condylomata. The patient asks the nurse, "Why is it important to get this treatment?" What is the best response by the nurse? "If you don't take this treatment, then it will turn into gonorrhea." "The human papillomavirus (HPV) also can cause you to develop a herpes outbreak." "Genital warts make you more likely to develop recurrent urinary tract infections (UTIs)." "Because this sexually transmitted infection increases the risk of developing cervical cancer."

"Because this sexually transmitted infection increases the risk of developing cervical cancer."

The nurse has instructed a male patient who has gonorrhea about self-care. Which statement made by the patient indicates the need for further teaching? "I should ask my partner to get tested." "I need to take the antibiotics until they're finished." "I can keep taking showers while I'm getting treated." "I can have sex tonight as long as I make sure to wear a condom."

"I can have sex tonight as long as I make sure to wear a condom."

When providing teaching to a patient with gonorrhea, which statement is indicative that further teaching is needed? "I'll take the medication until the discharge is gone." "I will wear cotton panties rather than a thong." "I will skip sex for the next week, then use a condom." "My partner has to come to the clinic to be treated too."

"I'll take the medication until the discharge is gone."

A nurse is assessing the risk behaviors for the spread of sexually transmitted infections (STIs) in a group of people. Which patients are at high risk of contracting an STI? Select all that apply. A woman who has not had a sexual relationship A man having sexual relationships with multiple partners A woman having polygamous relationships and who is on oral contraceptive pills A man having a monogamous relationship with his partner and using a condom A woman having a monogamous relationship, whose partner has a history of a recent STI A man having a monogamous relationship who uses condoms but often consumes drugs with shared needles

A man having sexual relationships with multiple partners A woman having polygamous relationships and who is on oral contraceptive pills A woman having a monogamous relationship, whose partner has a history of a recent STI A man having a monogamous relationship who uses condoms but often consumes drugs with shared needles

The nurse is caring for a patient with chlamydial infection. For which complications does the nurse monitor this patient on the basis of the current diagnosis? Select all that apply. Abscess Infertility Cold sores Atonic bladder Reactive arthritis

Abscess Infertility Reactive arthritis

The patient is being treated for a recurrent episode of chlamydia. What should the nurse include in this teaching? If you are treated, your sexual partner will not need to be treated. Abstain from sexual intercourse for seven days after finishing the treatment. You will probably get gonorrhea if you have another recurrence of chlamydia. Because you have been treated before, you do not need to take a full course of medication this time.

Abstain from sexual intercourse for seven days after finishing the treatment.

The nurse is educating a patient about the advantages of acyclovir therapy for herpes infection. What information should the nurse include? Select all that apply. Acyclovir cures herpes infection. Acyclovir shortens the duration of viral shedding. Acyclovir shortens the healing time of genital lesions. Acyclovir makes the patient noninfectious. Acyclovir reduces outbreaks of the lesions.

Acyclovir shortens the duration of viral shedding. Acyclovir shortens the healing time of genital lesions. Acyclovir reduces outbreaks of the lesions.

A woman infected with gonorrhea has a vaginal birth. What precautions should the nurse follow to protect the baby from complications of gonorrhea? Select all that apply. Administer paracetamol drops to the baby. Administer amoxicillin solution to the baby. Administer silver nitrate aqueous solution to the baby. Administer erythromycin ophthalmic ointment to the baby. Administer an intramuscular dose of ceftriaxone to the baby.

Administer silver nitrate aqueous solution to the baby. Administer erythromycin ophthalmic ointment to the baby.

A patient reports tingling, burning, and itching in the genital area. Based on these symptoms, what type of medication does the nurse anticipate administering? Antivirals Antibiotics Vaccination Contraceptives

Antivirals

Upon examination of a male patient, the nurse notes profuse, purulent urethral discharge and the patient states that he has dysuria and "painful testicles." Based on these findings, which medication does the nurse anticipate the primary health care provider will prescribe? Acyclovir Penicillin G Podofilox Ceftriaxone

Ceftriaxone

The nurse is teaching a group of young women about prevention of sexually transmitted infections (STIs). Which method of contraception also helps give some protection against STIs? Condoms Intrauterine devices Oral contraceptive pills Medroxyprogesterone

Condoms

A patient is diagnosed with genital herpes infection. What symptoms assessed in the patient should be reported immediately? Select all that apply. Diarrhea Constipation Atonic bladder Disorientation or confusion Burning sensation in the vesicles

Constipation Atonic bladder Disorientation or confusion

The newborn nursery nurse administers Erythromycin ophthalmic ointment prophylactically to a neonate to prevent blindness. What is the nurse explanation to the parent as to why this is being done? Due to potential exposure to syphilis Due to potential exposure to gonorrhea Due to potential exposure to chlamydia Due to potential exposure to Pseudomonas

Due to potential exposure to gonorrhea

A patient is on intravenous acyclovir for management of genital herpes-related pneumonitis. For which symptoms should the nurse look in this patient? Select all that apply. Disorientation Loss of sense of taste Elevated creatinine levels Decreased urinary output Peripheral edema, especially in the feet

Elevated creatinine levels Decreased urinary output Peripheral edema, especially in the feet

The nurse is educating a patient about high-risk sexual behaviors. What should the nurse include when discussing what places them at a higher risk for contracting a sexually transmitted infection (STI)? Select all that apply. Greater sexual freedom Later reproductive maturity Limited number of susceptible hosts The media's increased emphasis on sexuality Substance abuse leads to unsafe sexual practices

Greater sexual freedom The media's increased emphasis on sexuality Substance abuse leads to unsafe sexual practices

A patient is infected with the herpes virus exhibiting lesions on the genital area. What instructions should the nurse give to this patient? Select all that apply. Maintain good hygiene. Keep the lesions clean and dry. Take frequent sitz baths. Burst the vesicles to drain the fluid. Use hot fomentation on the vesicles. Wear loose-fitting cotton undergarments.

Maintain good hygiene. Keep the lesions clean and dry. Take frequent sitz baths. Wear loose-fitting cotton undergarments.

When performing an assessment of a patient with anorectal gonorrhea, what are the symptoms that the nurse is likely to find? Select all that apply. Mucopurulent anal discharge Bleeding Tenesmus Loose watery stools Hemorrhoids

Mucopurulent anal discharge Bleeding Tenesmus

A patient is suspected to have syphilis. Which stage of syphilis is most infectious and may have chancres? Primary Secondary Latent Tertiary

Primary

A nurse is screening a person for syphilis. What are the behavior patterns that contribute to an increased risk for developing syphilis? Select all that apply. Consumption of polluted water in an area with a high incidence of syphilis Sexual intercourse with an infected person Sharing of intravenous needles for drugs Consumption of food prepared by a person who has syphilis Contact with lesions of a person with syphilis

Sexual intercourse with an infected person Sharing of intravenous needles for drugs Contact with lesions of a person with syphilis

The nurse working in the emergency department has seen several patients with sexually transmitted infections (STIs) that must be reported to state or local health departments. Which STIs must the nurse report? Select all that apply. Syphilis Gonorrhea Herpes simplex virus (HSV) Human papilloma virus (HPV) Condylomata acuminate

Syphilis Gonorrhea

There are several pregnant women ready to deliver their babies. Which woman should the nurse expect to require a cesarean section to deliver her baby? The woman who had contact with an individual with syphilis two weeks ago The woman who had treatment for gonococcal pharyngitis before conception The woman who has herpes simplex virus type 2 vesicles on her cervix at the time of delivery The woman who received treatment for Chlamydia trachomatis at her 20th week of gestation

The woman who has herpes simplex virus type 2 vesicles on her cervix at the time of delivery

A patient suspected of having syphilis tests positive on the Venereal Disease Research Laboratory (VDRL) test. Which other diseases can give false-positive results when testing for syphilis? Select all that apply. Hepatitis Hyperlipidemia Infectious mononucleosis Systemic lupus erythematosus Type 2 diabetes mellitus

HepatitiS Infectious mononucleosis Systemic lupus erythematosus

What instructions should the nurse include when teaching a patient about ways to prevent reinfection by gonorrhea? Select all that apply. Avoid alcohol. Receive a vaccine to prevent gonorrhea. Abstain from sexual intercourse until the treatment is complete. Avoid going out in public and minimize physical contact with people. Avoid squeezing the penis to look for a discharge.

Avoid alcohol. Abstain from sexual intercourse until the treatment is complete. Avoid squeezing the penis to look for a discharge.

A patient comes to the clinic after being informed by a sexual partner of possible recent exposure to syphilis. The nurse will examine the patient for what characteristic finding of syphilis in the primary clinical stage? Chancre Alopecia Condylomata lata Regional adenopathy

Chancre

A patient who does not exhibit signs or symptoms of syphilis receives a positive treponemal antibody test result. On the basis of these data, which stage of syphilis does the nurse suspect? Late Latent Primary Secondary

Latent

A patient with neurosyphilis is being discharged after treatment. What follow-up care should the nurse advise for the patient? Select all that apply. Periodic serologic testing Clinical evaluation at six-month intervals Periodic cerebrospinal fluid examinations for at least three years Continued use of oral acyclovir Viral cultures of active lesions

Periodic serologic testing Clinical evaluation at six-month intervals Periodic cerebrospinal fluid examinations for at least three years

A patient is receiving treatment for a sexually transmitted infection prior to culture results being obtained. The nurse is to administer ceftriaxone intramuscularly. What sexually transmitted infection does the nurse recognize is being treated? Gonorrhea Candidiasis Herpes simplex virus type 2 Human immunodeficiency virus

Gonorrhea

A patient reports dysuria and profuse purulent urethral discharge. During the assessment, the nurse finds that the patient's testicles are swollen and performs a nucleic acid amplification test as prescribed. Which disease does nurse anticipate on the basis of the assessment data? Syphilis Gonorrhea Genital warts Chlamydial infection

Gonorrhea

A patient is diagnosed with human papillomavirus (HPV) infection. What teaching should the nurse provide to the patient? The importance of taking Gardasil after diagnosis. Being sure to take all antibiotic therapy Wart removal options Treatment with antiviral drugs

Wart removal options

A patient is suspected of having a sexually transmitted disease. What are the possible routes through which the patient may have contracted the infection? Select all that apply. Blood transfusion Sharing of intravenous needles or syringes Consuming contaminated water Inhaling air in contact with an affected person Sexual contact with any person with a sexually transmitted infection (STI)

Blood transfusion Sharing of intravenous needles or syringes Sexual contact with any person with a sexually transmitted infection (STI)

The nurse is caring for a patient with genital herpes. What should the nurse emphasize while providing psychologic support to this patient? Select all that apply. Encourage the patient to verbalize feelings. Instruct the patient to avoid interaction with others. Help the patient realize that he or she should never be sexually active henceforth. Help the patient understand that the treatment could run for a long duration. Help the patient identify and avoid the factors that precipitated the condition.

Encourage the patient to verbalize feelings. Help the patient understand that the treatment could run for a long duration. Help the patient identify and avoid the factors that precipitated the condition.

A nurse is administering a human papillomavirus vaccine to an adolescent. What precaution does the nurse need to take while administering this vaccine? Ensure that the patient is lying down or sitting during vaccine administration. Ensure that the patient has an intravenous line placed before vaccine administration. Ensure that the patient has a complete liver profile done before receiving the vaccine. Ensure that the patient takes the vaccine on an empty stomach.

Ensure that the patient is lying down or sitting during vaccine administration.

When collecting health history from a patient with chlamydial infection, what symptoms is the patient likely to report? Select all that apply. Bleeding from the anus Tenesmus Frequent and painful urination Pain during intercourse Menstrual abnormalities

Frequent and painful urination Pain during intercourse Menstrual abnormalities

A female patient reports the recent appearance of itchy lesions on her vulva, some of which have burst recently. What problem should the nurse first suspect related to the patient's description of her problem? Gonorrhea Chlamydia Genital herpes Human immunodeficiency virus (HIV)

Genital herpes

A pregnant woman with a sexually transmitted infection (STI) is admitted in labor. Which STIs would support the need for a cesarean delivery? Select all that apply. Chlamydial infection Genital warts blocking the cervix Active lesions of genital herpes Syphilis Gonorrheal infection with purulent discharge from the cervix

Genital warts blocking the cervix Active lesions of genital herpes

When performing an assessment of a patient with herpes simplex virus (HSV) type 1, which body parts would the nurse find to be affected? Select all that apply. Gingiva Upper respiratory tract Central nervous system Genital tract Perineum

Gingiva Upper respiratory tract Central nervous system

A patient with genital herpes reports severe pain and a burning sensation during urination. What are the measures that a nurse can implement to ease this discomfort? Select all that apply. Catheterize the patient. Give frequent sitz baths to sooth the area. Advise the patient to void urine in a warm tub of water or a warm shower. Keep the patient on a fluid-only diet and do not allow the patient to move about. Use drying agents, such as colloidal oatmeal and aluminum salts, and local anesthetics, such as lidocaine.

Give frequent sitz baths to sooth the area. Advise the patient to void urine in a warm tub of water or a warm shower. Use drying agents, such as colloidal oatmeal and aluminum salts, and local anesthetics, such as lidocaine.

A patient suspected of neurosyphilis underwent cerebrospinal fluid (CSF) analysis. What changes in the CSF does the nurse recognize will indicate neurosyphilis? Select all that apply. Increased sugar levels Increased white blood cell count Increased total proteins A positive treponemal antibody test Increased creatinine levels

Increased white blood cell count Increased total proteins A positive treponemal antibody test

The nurse is assessing a patient suspected of having a chlamydial infection. What diagnostic tests should the nurse prepare the patient for? Select all that apply. Nucleic acid amplification test Direct fluorescent antibody test Venereal Disease Research Laboratory test Enzyme immunoassay test Western blot test

Nucleic acid amplification test Direct fluorescent antibody test Enzyme immunoassay test

When performing a physical examination of a male patient with suspected gonorrhea, what symptoms is the nurse likely to find? Select all that apply. Pain during urination Purulent discharge from the urethra Warts and growths on the penis Swollen testicles Erectile dysfunction

Pain during urination Purulent discharge from the urethra Swollen testicles

The nurse is assessing a patient suspected of having syphilis. What medication should the nurse prepare to administer? Podophyllin resin Acyclovir Azithromycin Penicillin G benzathine

Penicillin G benzathine

The nurse is educating a patient with genital warts about treatment options. Which treatment options are patient-managed? Select all that apply. 80% to 90% trichloroacetic acid Podophyllin resin (10% to 25%) Podofilox (5%) liquid Podofilox (5%) Imiquimod (5%) cream

Podofilox (5%) liquid Podofilox (5%) Imiquimod (5%) cream

The health care provider advises expedited partner therapy (EPT) to a patient with a sexually transmitted infection (STI). What should the nurse explain to this patient about EPT? The patient should cut off all ties with the partner because the patient will become reinfected. Prescription or medications can be given to the patient's partner; no examination is required. The partner of the concerned patient will be examined and will be advised if treatment is needed. The partner of the patient will be given a vaccine to prevent transmission of the sexually transmitted infection.

Prescription or medications can be given to the patient's partner; no examination is required.

The nurse is teaching a group of parents at a local high school about the importance of the human papilloma virus vaccine. Which strategies by the nurse would help address religious concerns? Select all that apply. Providing accurate and current information about the vaccine Discussing the prevention of cancer as the major role of vaccine Discussing why religious concerns are not important enough to prevent use of the vaccine Allowing parents to ask questions and express concerns about the vaccine in an open, supportive environment Informing parents that they will be responsible for their children's death from a preventable cancer if they do not vaccinate

Providing accurate and current information about the vaccine Discussing the prevention of cancer as the major role of vaccine Allowing parents to ask questions and express concerns about the vaccine in an open, supportive environment

A patient comes to the clinic with a chancre on the penis. Which diagnostic test does the nurse anticipate preparing the patient for? Rapid plasma region test Human papillomavirus DNA tests Treponema pallidum particle agglutination test Fluorescent treponemal antibody absorption test

Rapid plasma region test

A parent is deciding whether to allow an adolescent child to receive the Gardasil vaccine. What information should the nurse provide to the parent? Select all that apply. The vaccine provides protection against certain types of cancer. Often persons with human papillomavirus (HPV) are asymptomatic. The vaccine protects against HPV types 6, 11, 16, 18. One dose of the vaccine protects against HPV. The vaccine is used to treat active infections. It is recommended because one does not know if one's child is sexually active.

The vaccine provides protection against certain types of cancer. Often persons with human papillomavirus (HPV) are asymptomatic. The vaccine protects against HPV types 6, 11, 16, 18.

A patient with a chlamydial infection has completed the course of treatment. What advice should the nurse provide to this patient to avoid reinfection? Select all that apply. Avoid heavy exercise. Use oral contraceptive pills. Use condoms in the future during sexual activity. Have the sexual partner or partners screened and treated. Avoid sexual intercourse for seven days after finishing treatment.

Use condoms in the future during sexual activity. Have the sexual partner or partners screened and treated. Avoid sexual intercourse for seven days after finishing treatment.

A patient had successful treatment for an existing sexually transmitted infection (STI). What instructions should the nurse provide to this patient to prevent reinfection or complications? Select all that apply. Use condoms. Avoid using tampons. Use an intrauterine device. Avoid having multiple sexual partners. Make sure to get periodic Pap smears.

Use condoms. Avoid having multiple sexual partners. Make sure to get periodic Pap smears.

The nurse is educating a patient with a sexually transmitted infection about hygiene tips. What should the nurse include when discussing this with the patient? Select all that apply. Perform regular douching Avoid using public toilets Use cotton underwear Frequently wash hands and regularly bathe Avoid any physical contact with strangers

Use cotton underwear Frequently wash hands and regularly bathe