sexually transmitted diseases
A nurse is caring for a female client who is undergoing treatment for genital warts due to human papillomavirus (HPV). Which of the following information should the nurse include when educating the client about the risk of cervical cancer?
- Obtaining pap smears regularly helps early detection of cervical cancer. -Recurrence of genital warts increases risk of cervical cancer. -Use of latex condoms is associated with a lower rate of cervical cancer.
Which of the following medications are used to suppress viral load of the HSV-2 infection?
Acyclovir (Zovirax) Explanation: The antiviral agents acyclovir (Zovirax), valacyclovir (Valtrex), and famciclovir (Famvir) are recommended to suppress the viral load and decreases recurrence and shedding. Flagyl and Cleocin are not used for this action.
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?
An azole antifungal agent Explanation: 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.
A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which of the following nursing strategies should be adopted to prevent the spread of STIs in the community?
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.
Which of the following instructions should the nurse give to a client with genital herpes to help control the infection?
Avoid sexual contact until sores heal Explanation: The nurse should instruct the client to avoid sexual contact until sores heal completely and new skin forms. Application of antibacterial medication is suggested for wounds in case of lymphedema. Clients with HIV are advised to avoid people with upper respiratory infections. Application of imiquimod cream is suggested for clients infected with human papilloma virus
A client is receiving ceftriaxone as treatment for gonorrhea. Which of the following would be most important for the nurse to emphasize to the client?
Avoiding alcohol consumption If alcohol is ingested when taking ceftriaxone, the client can experience a disulfiram-like reaction. Therefore the nurse would need to emphasize avoiding alcohol consumption. Taking the drug on an empty stomach may be appropriate but not the most important consideration. Using a sunscreen would be appropriate if the client was receiving doxycycline or tetracycline. Reporting the appearance of an oral yeast infection would be appropriate for a client receiving tetracycline.
When describing the methods of transmission for herpes simplex virus, which method would be least likely?
Sharing contaminated needles Explanation: 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.
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 Explanation: The law mandates reporting of syphilis, chlamydia, gonorrhea, chancroid, and HIV/AIDS. Genital herpes, hepatitis B, venereal warts (condylomata acuminata), granuloma inguinale, and lymphoma venereum are not reportable by law.
A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent?
Tetracycline Explanation: Clients who are allergic to penicillin are given a 14-day regimen of tetracycline or doxycycline. Acyclovir is used to treat genital herpes. Ceftriaxone may be used for gonorrhea. Podophyllum resin is used to treat genital warts
Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?
Trichomoniasis Explanation: The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery, and frothy or purulent. The discharge associated with candidiasis is thick, white, and resembles cottage cheese in appearance while that associated with infection due to G. vaginalis is thin and grayish white, with a marked fishy odor. With gonorrhea, vaginal discharge is purulent when present but, in many women, gonorrhea produces no symptoms
An HIV-positive client who is on antiretroviral therapy complains of anorexia, nausea, and vomiting. Which of the following suggestions should the nurse offer the client to cope with this condition?
Use high-protein supplements. Explanation: The nurse should instruct the client to use high-protein supplements such as Boost to provide quick and easy protein and calories. The nurse should also instruct the client to eat dry crackers upon arising, not after every meal, and to eat six small meals a day, not three. Drinking fluids constantly while eating is not recommended. The nurse should instruct the client to separate the intake of food and fluids.
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." Explanation: Chlamydia is a common cause of pelvic inflammatory disease and infertility. It doesn't affect the kidneys or cause birth defects. It can cause conjunctivitis and respiratory infection in neonates exposed to infected cervicovaginal secretions during delivery. Use of a diaphragm isn't a risk factor
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 will wear loose cotton underwear." Correct Explanation: 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 shouldn't 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 isn't recommended.
A client has been admitted with primary syphilis. Which signs or symptoms should the nurse expect to see with this diagnosis?
A painless genital ulcer that appeared about 3 weeks after unprotected sex Explanation: 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 caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea?
Burning on urination Explanation: Burning on urination may be a symptom of gonorrhea or urinary tract infection. A dry, hacking cough is a sign of a respiratory infection, not gonorrhea. A diffuse rash may indicate secondary stage syphilis. A painless chancre is the hallmark of primary syphilis. It appears wherever the organisms enter the body, such as on the genitalia, anus, or lips.
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 Explanation: Condylomata acuminate,more commonly known as genital warts (or venereal warts), are caused by HPV, a large group of viruses. About 30 viruses in this group are sexually transmitted, infecting the genital area, vulva, labia, or anus, and surrounding tissues. At least 10 of the known 30 HPV types can lead to development of cervical cancer. Two strains account for about 70% of HPV-related cancer cases and are linked with abnormal Pap smears, indicating cancer of the cervix. Cancer of the anus and penis is also possible with HPV.
A physician tells a client to return 2 to 3 months after treatment to have a repeat culture done to verify the cure. This order would be appropriate for a woman with which condition?
Gonorrhea Explanation: Gonococcal infections can be completely eliminated by drug therapy. Genital warts aren't curable and are identified by appearance, not culture. Genital herpes isn't curable and is identified by the appearance of the lesions or cytologic studies. The diagnosis of syphilis is done using dark-field microscopy or serologic tests
A newborn is diagnosed with ophthalmia neonatorum. The nurse understands that this newborn was exposed to which infection?
Gonorrhea Explanation: 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 nurse is caring for a 14-year-old girl who fears she might have a sexually transmitted infection. Which of the following assessments would be most indicative of trichomoniasis?
Green vaginal discharge Explanation: 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
Which of the following would the nurse recommend to a pregnant client with a sexually transmitted infection who is at risk for transmitting the infection?
Participate in early prenatal care Explanation: The nurse should recommend that a pregnant client with a sexually transmitted infection who is at risk of infection transmission receive early prenatal care because some STIs can be transmitted during childbirth. Patting or blotting the skin dry is helpful in reducing friction and itch-scratch-itch cycle. The nurse should recommend clients infected with carcinogenic viruses to have regular cancer screening examinations to facilitate early diagnosis and optimistic prognosis. Taking tub baths regularly would have no effect on infection transmission
Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection?
Trichomoniasis Explanation: The discharge associated with infection caused by Trichomonas organisms is homogenous, greenish gray, watery, and frothy or purulent. The discharge associated with candidiasis is thick, white, and resembles cottage cheese in appearance while that associated with infection due to G. vaginalis is thin and grayish white, with a marked fishy odor. With gonorrhea, vaginal discharge is purulent when present but, in many women, gonorrhea produces no symptoms.
A woman comes to the clinic complaining of intense pruritus and a thick curd-like vaginal discharge. On examination white plaques on observed on the vaginal wall. The nurse suspects which of the following?
Vulvovaginal candidiasis Explanation: 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 using high-dose estrogen oral contraceptives. The nurse would assess the client for which of the following?
Yeast infections Explanation: The nurse should closely monitor for yeast infections in a client who uses high-dose estrogen oral contraceptives. 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. Use of high-dose estrogen oral contraceptives does not maximize risk of loss of appetite, hypertension, acidity, or heartburn
A client complaining of genital ulcers has been diagnosed with syphilis. Which of the following 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. Explanation: The nurse should instruct the client to wear nonconstricting clothes and to wash her hands with soap and water after touching lesions to avoid autoinoculation. If urination is painful because of the ulcers, instruct the client to urinate in water but to avoid extremes of temperature such as ice packs or hot pads to the genital area. The client should abstain from intercourse during the prodromal period and when lesions are present. The ulcer disappears during the latency period.
The high school nurse is teaching a class of adolescents the characteristics of sexually transmitted infections (STIs). Which of the following are considerations related to STIs? Select all that apply.
• They cause infections that lead to PID • They can cause infertility • They cause significant side effects and/or death in newborns Explanation: STIs cause infections that lead to PID and/or infertility and cause significant side effects and/or death in newborns. STIs increase chances of infection with HIV and have few, inconsistent, confusing, or no symptoms. They can occur at any age, but are most common in sexually active young adults.
A nurse is caring for the following clients who have a history of genital herpes infection. Which client is most at risk for an outbreak of genital herpes?
A client who complains of genital pruritus and paresthesia Explanation: Pruritus and paresthesia as well as redness of the genital area are prodromal symptoms of recurrent herpes infection. These symptoms occur 30 minutes to 48 hours before the lesions appear. Headache and fever are symptoms of viremia associated with the primary infection. Vaginal and urethral discharge is also a local sign of primary infection. Dysuria and lymphadenopathy are local symptoms of primary infection that may also occur with recurrent infection
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. Which of the following phenomena most likely contributed to her present condition?
A sharp reduction in the number of lactobacilli in the client's vaginal flora Explanation: Vaginosis is a disorder characterized by a shift in the vaginal flora from one dominated by hydrogen peroxide-producing lactobacillus to one with greatly reduced numbers of lactobacillus species and an overgrowth of other organisms. Autoinoculation or sexual transmission of bacteria or protozoa is unlikely to contribute
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. Which of the following phenomena most likely contributed to her present condition?
A sharp reduction in the number of lactobacilli in the client's vaginal flora Explanation: Vaginosis is a disorder characterized by a shift in the vaginal flora from one dominated by hydrogen peroxide-producing lactobacillus to one with greatly reduced numbers of lactobacillus species and an overgrowth of other organisms. Autoinoculation or sexual transmission of bacteria or protozoa is unlikely to contribute.
A nurse is required to assess a client complaining of unusual vaginal discharge for bacterial vaginosis. Which of the following is a classic manifestation of this condition that the nurse should assess for?
Characteristic "stale fish" odor Explanation: Symptoms of bacterial vaginosis include a characteristic "stale fish" odor and thin, white homogeneous vaginal discharge, not heavy yellow discharge. Dysfunctional uterine bleeding is a sign of Chlamydia, not bacterial vaginosis. Erythema in the vulvovaginal area is a symptom of vulvovaginal candidiasis, not bacterial vaginosis.
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which of the following would the nurse expect to include as the most common STI in the United States?
Chlamydia Explanation: Chlamydia is the most common and fastest-spreading bacterial STI in the United States, with 2.8 million new cases occurring each year. Gonorrhea is the second most frequently reported communicable disease in the U.S. The incidence of syphilis had been increasing for the past 6 years. One in five people older than age 12 is infected with the virus that causes genital herpes.
A patient has been diagnosed with condylomata acuminata and requires treatment for the condition. Which of the following would be the treatment of choice?
Cryotherapy Explanation: The treatment of choice would be cryotherapy because it can penetrate deeper than other forms of therapy to eliminate the lesion. The patient would be encouraged to stop sexual contact until the lesions are resolved.
Patients who have had PID are prone to which of the following complications?
Ectopic pregnancy Explanation: All patients who have had PID need to be informed of the signs and symptoms of ectopic pregnancy because they are prone to this complication.
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?
It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI) Explanation: 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.
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?
Metronidazole Explanation: 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
Which of the following would be most appropriate for detecting a yeast infection in a client with irritation of the vagina and vulva?
Microscopic examination of a swab sampling Explanation: Culture and microscopic examination of a swab sampling from the upper vagina may diagnose and confirm yeast forms in the client with vaginal irritation. Enzyme-linked immunosorbent assay is a test to diagnose HIV. Hormone receptor assay test is used to diagnose the tumor's dependency on estrogen and progesterone in the client with breast cancer. Transvaginal ultrasound is the screening test for endometrial cancer
Which of the following would be most appropriate to do when assisting in collecting a culture from a client infected with gonorrhea?
Moistening the vaginal speculum with water Explanation: When a culture is collected from a woman with gonorrhea, the vaginal speculum is moistened with water rather than be lubricated, which may destroy the gonococci and cause inaccurate test results. Menstrual cycle would not have an effect on the specimen collected. Douching with water and then with alcohol may destroy the gonococci.
A 19-year-old female client has been diagnosed with pelvic inflammatory disease (PID) due to untreated gonorrhea. Which of the following instructions should the nurse offer when caring for the client? Select all that apply.
• Avoid douching vaginal area. • Complete the antibiotic therapy. • Limit the number of sex partners. Explanation: The nurse should instruct the client with pelvic inflammatory disease to avoid douching, limit the number of sex partners, and complete the antibiotic therapy. Use of an intrauterine device is one of the risk factors associated with PID and should be avoided. Increasing fluid intake does not help alleviate the client's condition
Patients who have had PID are prone to which of the following complications?
• Ectopic pregnancy • Bacteremia • Thrombophlebitis Explanation: All patients who have had PID need to be informed of the signs and symptoms of ectopic pregnancy because they are prone to this complication. Other complications include bacteriemia with septic shock and thrombophlebitis with possible embolization. Patients who have PID are not prone to inguinal lymphadenopathy
