STDs Prep

Patients who have had PID are prone to which of the following complications? a) Ectopic pregnancy b) Ovarian cancer c) Multiple gestation d) Inguinal lymphadenopathy

a) 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

A pregnant client is diagnosed with Chlamydia and is to receive antimicrobial therapy. Which drug would the nurse expect to be least likely prescribed? a) Azithromycin b) Ofloxacin c) Levofloxacin d) Erythromycin

a) Azithromycin and doxycycline are contraindicated during pregnancy and thus would be least likely prescribed. Erythromycin, ofloxacin, or levofloxacin would be viable alternatives

The nurse explains to a client diagnosed with trichomoniasis that the disease is caused by the parasitic protozoan Trichomonas vaginalis. What would the nurse say is a factor that triggers growth of trichomoniasis? a) Irritation of vaginal walls b) Trauma to the bladder c) Being postmenopausal d) Spontaneous abortion

a) Factors that trigger growth of trichomoniasis include the following: irritation of vaginal walls, pregnancy, sexual activity, trauma to the vaginal walls, systemic illness, menstruation, and emotional upsets

Which of the following medications are used to suppress viral load of the HSV-2 infection? a) Clindamycin (Cleocin) b) Metronidiazole (Flagyl) c) Acyclovir (Zovirax) d) Penicillin

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

d) 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? a) Burning on urination b) Dry, hacking cough c) Painless chancre d) Diffuse skin rash

a) 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

Which of the following would be most appropriate to do when assisting in collecting a culture from a client infected with gonorrhea? a) Moistening the vaginal speculum with water b) Lubricating the vaginal speculum c) Having the client douche with water and then with alcohol before collection d) Collecting the specimen exactly 12 to 15 days after the menses

a) 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

Which of the following is the most effective treatment for trichominiasis? a) Azithromycin (Zithromax) b) Metronidazole (Flagyl) c) Penicillin G benzathine d) Doxycycline (Adoxa)

b) The most effective treatment for trichomoniasis is metronidazole and tinidazole. Penicillin G benzathine is used for syphilis. Doxycycline and Azithromycin are used in the treatment of Chlamydia

Which of the following would the nurse expect to assess in a client with bacterial vaginosis? a) Yellow-green vaginal discharge b) Purulent vaginal discharge with urination c) Decreased vaginal acidity d) Painful urination

c) Bacterial vaginosis is indicated by decreased vaginal acidity (pH > 4.5). Purulent discharge from the vagina during urination is observed in clients with a chlamydia infection. Painful urination and yellow-green vaginal discharge is observed in clients with trichomoniasis

A nurse is assessing a client diagnosed with bacterial vaginosis. Which of the following is a symptom of bacterial vaginosis? a) Warts in the vulva and labia b) Intense itching of the vulva c) Cottage cheese-like discharge d) Vaginal odor smelling of fish

d) Bacterial vaginosis causes a "stale fish" vaginal odor. Cottage cheese-like discharge is seen in candidiasis and not in bacterial vaginosis, in which the discharge is thin and gray-white. Intense itching of the vulva is associated with candidiasis, not vaginosis. Warts in the vulva and labia are seen in human papillomavirus infection, not in vaginosis

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? a) Genital herpes b) Condylomata acuminata c) Hepatitis B d) Syphilis

d) 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

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? a) Cervical cancer b) Muscular degeneration c) Infertility d) Throat cancer

a) 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 23-year-old sexually active woman tells the nurse practitioner that she is worried because she has been having abnormal vaginal bleeding, dysuria, and weird vaginal discharge. What sexually transmitted infection would the nurse suspect? a) Gonorrhea b) HSV c) Syphilis d) Chlamydia

a) Typical symptoms in women infected with gonorrhea include abnormal vaginal discharge, dysuria, cervicitis, abnormal vaginal bleeding, Bartholin's abscess, and PID.

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. a) Avoid douching vaginal area. b) Limit the number of sex partners. c) Increase fluid intake. d) Use an intrauterine device (IUD). e) Complete the antibiotic therapy.

a, b, e) 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.

A female client is prescribed metronidazole for the treatment of trichomoniasis. Which instruction should the nurse give the client undergoing treatment? a) Avoid extremes of temperature to the genital area b) Use condoms during sex c) Avoid alcohol d) Increase fluid intake

c) The nurse should counsel the client taking metronidazole to avoid alcohol during the treatment because mixing the two causes severe nausea and vomiting. Avoiding extremes of temperature to the genital area is a requirement for clients with genital ulcers, not trichomoniasis. The nurse should instruct the client to avoid sex, regardless of using condoms, until she and her sex partners are cured, that is, when therapy has been completed and both partners are symptom-free. It is not required to increase fluid intake during treatment

A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent? a) Ceftriaxone b) Acyclovir c) Podophyllum resin d) Doxycycline

d) Clients who are allergic to penicillin are given doxycycline or erythromycin. Acyclovir is used to treat genital herpes. Ceftriaxone may be used for gonorrhea. Podophyllum resin is used to treat genital warts

A nurse needs to assess a female client for primary stage herpes simplex virus (HSV) infection. For which symptom related to this condition should the nurse assess? a) Yellow-green vaginal discharge b) Loss of hair or alopecia c) Rashes on the face d) Genital vesicular lesions

d) Genital herpes simplex is characterized by lesions, frequently located on the vulva, vagina, and perineal areas. Rashes on the face are not symptoms of HSV. Alopecia is one of the symptoms of syphilis, not of primary HSV. Vaginal discharge during the primary stage of herpes is mucopurulent, not yellow-green.

Which of the following instructions should the nurse give to a client with genital herpes to help control the infection? a) Apply antibacterial medication b) Avoid sexual contact until sores heal c) Avoid people with upper respiratory infections d) Apply imiquimod cream

b) 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.

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? a) Syphilis b) Genital herpes c) Chlamydia d) Gonorrhea Gonorrhea

c) 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

Which stage or period of syphilis occurs when the infected person has no signs or symptoms of syphilis? a) Secondary b) Tertiary c) Latency d) Primary

c) Secondary syphilis occurs when the hematogenous spread of organisms from the original chancre leads to generalized infection. A period of latency occurs when the infected person has no signs or symptoms of syphilis. Primary syphilis occurs 2 to 3 weeks after initial inoculation with the organism. Tertiary syphilis presents as a slowly progressive inflammatory disease with the potential to affect multiple organs

Which of the following would the nurse expect to assess in a client with bacterial vaginosis? a) Painful urination b) Yellow-green vaginal discharge c) Purulent vaginal discharge with urination d) Decreased vaginal acidity

d) Bacterial vaginosis is indicated by decreased vaginal acidity (pH > 4.5). Purulent discharge from the vagina during urination is observed in clients with a chlamydia infection. Painful urination and yellow-green vaginal discharge is observed in clients with trichomoniasis

A client is using high-dose estrogen oral contraceptives. The nurse would assess the client for which of the following? a) Yeast infections b) Hypertension c) Acidity and heartburn d) Loss of appetite

a) 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

Which of the following is the most common viral infection? a) Gonorrhea b) Trichomoniasis c) Chlamydia d) Human papillomavirus (HPV)

d) HPV infection is the most common viral infection. Millions of American are infected with HPV, many unaware that they carry the virus.

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? a) Gonorrhea b) Genital warts c) Genital herpes d) Syphilis

a) 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? a) Gonorrhea b) Syphilis c) Candida albicans d) Human immunodeficiency virus

a) 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

Which factor in a client's history indicates she's at risk for candidiasis? a) Use of corticosteroids b) Nulliparity c) Use of spermicidal jelly d) Menopause

a) Small numbers of the fungus Candida albicans are commonly in the vagina. Because corticosteroids decrease host defense, they increase the risk of candidiasis. Pregnancy, not nulliparity, increases the risk of candidiasis. Candidiasis is rare before menarche and after menopause. The use of hormonal contraceptives, not spermicidal jelly, increases the risk of candidiasis

Patients who have had PID are prone to which of the following complications? a) Fibrosis b) Inguinal lymphadenopathy c) Pelvic abscess d) Ectopic pregnancy

a, c, d) 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 pelvic abscess fibrosis ans scarring. Patients who have PID are not prone to inguinal lymphadenopathy

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? a) Gonorrhea b) Syphilis c) Chlamydia d) Genital herpes

d) Besides AIDS, the five most common STIs are chlamydia, gonorrhea, syphilis, genital herpes, and genital warts. Of these, chlamydia, gonorrhea, and syphilis are easily cured with early and adequate treatment. Genital herpes recurs

Which of the following should a nurse consider when assessing older clients with a sexually transmitted infection (STI)? a) Abandon biases that older adults are sexually inactive b) Older clients know the ways to prevent STIs c) Older clients, because of their maturity, are rarely embarrassed to talk about this d) Older clients who are sexually active have less risk for STIs than other age groups

a) Nurses should abandon biases that older adults are sexually inactive. Therefore, when taking a health history, nurses should include questions about sexuality and behaviors that put them at risk for STIs. Older clients who are sexually active have the same risks of acquiring an STI as other age groups. Older adults who are not in monogamous relationships may not understand ways that are appropriate for preventing STIs. Some older adults with an STI are embarrassed and may not seek medical attention. Careful assessment is necessary to help the older adult receive medical treatment as quickly as possible

A nurse is engaged in primary prevention activities for HPV. With which would the nurse be most likely involved? a) Administering HPV vaccine b) Educating about HPV testing in women over age 30 c) Encouraging treatment for genital warts d) Teaching about the importance of regular Pap smears

a) Primary prevention is aimed at preventing the disease or condition before it occurs, so giving the HPV vaccine would be a primary prevention activity.If the woman does not receive primary prevention with the vaccine, then secondary prevention would focus on education about the importance of receiving regular Pap smears and, for women over age 30, including an HPV test to determine whether the woman has a latent high-risk virus that could lead to precancerous cervical changes

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

a) Stress, anxiety, and emotional upset seem to predispose a client to recurrent outbreaks of genital herpes. Sexual intercourse should be avoided during outbreaks, and a condom should be used between outbreaks; it isn't known whether the virus can be transmitted at this time. During an outbreak, creams and lubricants should be avoided because they may prolong healing. Because a relationship has been found between genital herpes and cervical cancer, a Pap test is recommended every year

A client with a family history of cervical cancer is to undergo a Pap test. During the client education, what group should the nurse include as at risk for cervical cancer? a) Clients who have genital warts b) Clients who have not had babies c) Clients with fibrocystic breast disease d) Clients with irregular menstrual cycles

a) The presence of genital warts (condyloma) increases the risk of developing cervical cancer. Women with metrorrhagia or irregular menstrual cycles are at an increased risk of developing breast cancer, not cervical cancer. Clients who have never had a baby or those with a history of fibrocystic breast disease have an increased risk of developing breast cancer, but not cervical cancer

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

a) The treatment of choice for Trichomonas vaginalis is oral metronidazole or tinidazole, medications that are effective against anaerobic protozoans. Antifungals are not a relevant treatment and eradication of the infection is possible with treatment.

A nurse is conducting an acquired immunodeficiency syndrome (AIDS) awareness program for women. Which instructions should the nurse include in the teaching plan to empower women to develop control over their lives in a practical manner so that they can prevent becoming infected with Human Immunodeficiency Virus (HIV)? Select all that apply. a) Encourage women to develop refusal skills. b) Support youth-development activities to reduce sexual risk-taking. c) Encourage women to use female condoms. d) Encourage women to lead a healthy lifestyle. e) Give opportunities to practice negotiation techniques.

a, c, e) The nurse should give opportunities to practice negotiation techniques and encourage women to develop refusal skills so that they can respond positively in situations where they might be at risk for HIV infection. To reduce risk of HIV infection, the nurse should encourage the use of female condoms. Supporting youth-development activities to reduce sexual risk-taking and identifying or encouraging women to lead a healthy lifestyle may not be effective enough in empowering women to develop control over their lives

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 of the following statements by the client demonstrates the best understanding of his health problem? a) "Even though I couldn't end up sterile, a woman that I give it to certainly could." b) "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it." c) "Each of the 3 stages of the disease seems to be worse than the previous one." d) "Either me or a partner could end up with an eye infection from chlamydia that could make us blind."

b) 75% of woman with chlamydial infections are asymptomatic. Blindness is rare complication in adults who live in industrialized countries and both men and women can become sterile from the effects. Syphilis, not chlamydial infections, has a course of three distinct stages.

Which of the following is the medication of choice for early syphilis? a) Rocephin b) Penicillin G benzathine c) Tetracycline d) Doxycyline

b) A single dose of Penicillin G benzathine intramuscular injection is the medication of choice for early syphilis or early latent syphilis of less than 1 year's duration. Patients who are allergic to penicillin are usually treated with doxycycline or tetracycline. Rocephin is not the medication of choice for syphilis

A client with genital herpes asks the nurse about what to expect with the infection. Which of the following responses would be most appropriate? a) "Once you take the medication, the infection will be gone for good." b) "Even though you don't have symptoms, you could still spread the infection." c) "You might have to try several different medications before finding one that works." d) "You can expect other outbreaks, each of which will be longer than the first."

b) Genital herpes can be transmitted during asymptomatic periods of viral shedding. Herpes recurs because after the initial infection, the virus remains dormant in the ganglia of the nerves that supply the area. Symptoms usually are more severe with the initial outbreak. Subsequent episodes usually are shorter and less intense. When the virus is active, shedding viral particles are infectious. Herpes infection is a highly contagious STI that is controllable but not curable. Herpes virus responds well to the antiviral drugs acyclovir, valacyclovir, and famciclovir

In which group is it most important for the client to understand the importance of an annual Papanicolaou test? a) Clients with a history of recurrent candidiasis b) Clients infected with the human papillomavirus (HPV) c) Clients with a long history of hormonal contraceptive use d) Clients with a pregnancy before age 20

b) HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal contraceptives don't increase the risk of cervical cancer

In which group is it most important for the client to understand the importance of an annual Papanicolaou test? a) Clients with a pregnancy before age 20 b) Clients infected with the human papillomavirus (HPV) c) Clients with a long history of hormonal contraceptive use d) Clients with a history of recurrent candidiasis

b) HPV causes genital warts, which are associated with an increased incidence of cervical cancer. Recurrent candidiasis, pregnancy before age 20, and use of hormonal contraceptives don't increase the risk of cervical cancer

After teaching a group of college-aged students about condom use, the nurse determines that additional teaching is needed when the students state which of the following? a) "Latex condoms are the best protection from STIs." b) "It's okay to use petroleum jelly with a latex condom." c) "Condoms should be applied before any genital contact." d) "Condoms should be stored in a cool, dry place."

b) If external lubricants are used, use only water-based lubricants such as K-Y® jelly with latex condoms. Oil-based or petroleum-based lubricants, such as body lotion, massage oil, or cooking oil, can weaken latex condoms. Latex condoms are the best protetion from STIs. Condoms are applied before any genital contact because sperm is present in preejactulate fluid. Condoms also should be stored in a cool, dry place away from direct sunlight to prevent deterioration

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) A client who complains of a headache and fever b) A client who complains of genital pruritus and paresthesia c) A client who complains of vaginal and urethral discharge d) A client who complains of dysuria and lymphadenopathy

b) 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.

After teaching a client diagnosed with candidiasis about preventative measures, the nurse determines that the teaching was effective when the client states she will do which of the following? a) Use sunscreen regularly b) Avoid tight pants c) Avoid exposure to sun d) Exercise to prevent fatigue

b) The nurse should inform the client to avoid tight pants to prevent recurrence of candidiasis. Clients with systemic lupus erythematosus are advised to avoid exposure to sun, use sunscreen regularly, and exercise to prevent fatigue

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? a) Have regular cancer screening examinations b) Participate in early prenatal care c) Pat or blot the skin dry d) Take tub baths regularly

b) 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

A pregnant client has been diagnosed with gonorrhea. Which nursing interventions should be performed to prevent gonococcal ophthalmia neonatorum in the baby? a) Administer an antiretroviral syrup to the newborn b) Instill a prophylactic agent in the eyes of the newborn c) Administer cephalosporins to mother during pregnancy d) Perform cesarean delivery to prevent infection

b) To prevent gonococcal ophthalmia neonatorum in the baby, the nurse should instill a prophylactic agent in the eyes of the newborn. Cephalosporins are administered to the mother during pregnancy to treat gonorrhea but not to prevent infection in the newborn. Performing a cesarean delivery will not prevent gonococcal ophthalmia neonatorum in the newborn. An antiretroviral syrup is administered to the newborn only if the mother is human immunodeficiency virus-positive and will not help prevent gonococcal ophthalmia neonatorum in the baby.

A patient presents with vulvar itching and diffuse green vaginal discharge. Upon evaluation, she is prescribed metronidazole (Flagyl). What is the paramount nursing intervention in discharge planning? a) Counsel the patient to refrain from sex for one week b) Instruct the patient not to drink alcohol with this treatment c) Advise the patient to take medication with a glass of milk d) Reassure the patient further STI testing is not indicated

b) While counseling to abstain from sex for one week is appropriate, the most important intervention is counseling to avoid alcohol during Flagyl treatment. Alcohol consumption while taking Flagyl creates a severe gastrointestinal reaction of nausea, vomiting, and flushing. Flagyl does not have to be taken with milk and further STI testing is indeed recommended with the diagnosis of an STI

The nurse is caring for clients who have STIs. Which of the following clients is most at risk for becoming infertile due to the infection? a) A woman diagnosed with syphilis b) A woman diagnosed with trichomoniasis c) A woman diagnosed with chlamydia d) A woman diagnosed with herpes simplex virus

c) Chlamydia trachomatis is the bacterium that is the leading cause of preventable infertility in women and the most common STI in the United States. Chlamydia is transmitted during vaginal, anal, or oral sex, leading to infections in the associated tissues of these areas. Lymphogranuloma venereum (LGV) is an STI that results from the three strains of Chlamydia

The nurse is assessing a female client with genital herpes. Which of the following would the nurse expect to find? a) Soft fleshy growths on the perineum b) Painful genital ulcer c) Multiple vesicles on the introitus d) Lower abdominal pain

c) Genital herpes causes single or multiple vesicles on the penis, prepuce, buttocks, thighs, introitus, or cervix that burn and itch before becoming fluid filled blisters. Lower abdominal pain is typically associated with Chlamydia infection. Soft fleshy growths on the perineum suggest genital warts. A painful genital ulcer suggests chancroid

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

c) 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

Which of the following is the gold standard for HSV diagnosis? a) Excisional biopsy b) Shave biopsy c) Culture d) Punch biopsy

c) The gold standard for HSV diagnosis is a culture of the lesion. Serology may help determine new versus chronic infection when obtained concurrently with positive culture of the lesion. The other diagnostics may be used for diagnosis of skin disorders, but would not be used for HSV

A client is being treated for gonorrhea. Which agent would the nurse expect the physician to prescribe? a) Levofloxacin b) Tetracycline c) Ceftriaxone d) Penicillin

c) The microorganism N. gonorrhoeae has become increasingly resistant to penicillin and tetracyclines, and fluoroquinolones (such as levofloxacin). Therefore, the current CDC (2006) recommendation for treating gonorrhea is a single intramuscular dose of a broad-spectrum cephalosporin such as ceftriaxone (Rocephin) or oral dosing with cefixime (Suprax

A pregnant client arrives at the community clinic reporting fever blisters and cold sores on the lips, eyes, and face. The health care provider has diagnosed it as the primary episode of genital herpes simplex virus (HSV), for which antiviral therapy is recommended. Which information should the nurse offer the client when educating her about managing the infection? a) Kissing during the primary episode does not transmit the virus. b) Antiviral drug therapy cures the infection completely. c) Safety of antiviral therapy during pregnancy has not been established. d) Recurrent HSV infection episodes are longer and more severe.

c) The nurse should inform the client that there is no evidence to suggest that antiviral therapy is completely safe during pregnancy. HSV cannot be cured completely, even with timely antiviral drug therapy, and there may be recurrences. The viral shedding process continues for 2 weeks during the primary episode, and kissing during this period may transmit the disease. Recurrent HSV-infection episodes are shorter and milder

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? a) The client keeps the affected area moist. b) The client wears tight-fitting jeans. c) The client keeps her fingernails long. d) The client washes her hands before and after touching lesions.

d) Because hand-to-body contact is a common method of transmitting the herpes simplex virus, the client should wash her hands before and after touching the lesions to prevent the spread of the disease. To promote lesion drying and client comfort, the client should keep the affected area dry. To prevent scratching of the lesions, the client should keep her fingernails short, instead of long. Because tight-fitting clothes help retain heat and moisture, which can delay healing and cause discomfort, the client should wear loose-fitting garments

Which statement made by a client with a chlamydial infection indicates understanding of the potential complications? a) "If I had known a diaphragm would put me at risk for this, I would have taken birth control pills." b) "I'm glad I'm not pregnant; I'd hate to have a malformed baby from this disease." c) "I hope this medicine works before this disease gets into my urine and destroys my kidneys." d) "I need to treat this infection so it doesn't spread into my pelvis because I want to have children some day."

d) 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 group of students are reviewing class material on sexually transmitted infections in preparation for a test. The students demonstrate understanding of the material when they identify which of the following as the cause of condylomata? a) Herpes virus b) Haemophilus ducreyi bacillus c) Treponema pallidum d) Human papilloma virus

d) Genital warts or condylomata are caused by the human papilloma virus (HPV). Herpes virus causes genital herpes. Treponema pallidum is the cause of syphilis. Haemophilus ducreyi bacillus is the cause of chancroid

Which of the following STIs could be transmitted perinatally? a) Gonorrhea b) Chlamydia c) Trichomoniasis d) Herpes simplex

d) Herpes simplex and syphilis can be transmitted perinatally and sexually. Chlamydia, gonorrhea, and trichomoniasis are transmitted sexually

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 of the following as a means of transmission? a) Kissing b) Sexual contact c) Giving vaginal birth d) Sharing contaminated needle

d) 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

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

d) Penicillin G is the drug of choice for treating syphilis. Miconazole is used to treat candidiasis. Metronidazole is used to treat trichomoniasis. Doxycycline is used to treat chlamydia

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? a) Azithromycin b) Penicillin c) Valacyclovir d) Metronidazole

d) 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

A female client with an anal gonorrheal infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would expect to find which of the following once the microorganism disseminates throughout the body? a) Painful urination b) Sore throat c) Intermenstrual bleeding d) Painful joints

d) The client with an anal gonorrheal infection experiences symptoms of gonorrhea where the microorganism has invaded the rectum. After the microorganism disseminates throughout the body, the client may manifest a skin rash, fever, and painful joints. Other symptoms such as infections of the urinary tract or vagina, sore throat, intermenstrual bleeding due to cervicitis, and painful urination are associated with the organism's invasion of those structures, depending on the nature of the sexual contact

Copious amounts of frothy, greenish vaginal discharge would be a symptom of which infection? a) Trichomoniasis b) Candidasis c) Gardnerella vaginalis vaginitis d) Gonorrhea

a) 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 nurse is teaching personal hygiene care techniques to a client with genital herpes. Which statement by the client indicates the teaching has been effective? a) "I will wear loose cotton underwear." b) "I will apply a water-based lubricant to my lesions." c) "I can pour hydrogen peroxide and water over my lesions." d) "I should rub rather than scratch in response to itching."

a) 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

Which woman is at greatest risk for developing cervical cancer? a) A client who lacks access to or use of health care b) A client who comes from lower socioeconomic status c) A client whose high-risk HPV infection persists in genital skin cells d) A client who has high intake of alcohol and nicotine

c) Women whose high-risk HPV infection persists in genital skin cells are at greatest risk for subsequently developing cervical cancer. Women who lack access to or use of health care, come from lower socioeconomic status, or have a high intake of alcohol and nicotine do not face an increased risk of developing cervical cancer

A nurse is required to assess a client complaining of unusual vaginal discharge for bacterial vaginosis. For which classic manifestation of this condition should the nurse assess? a) Characteristic "stale fish" odor b) Heavy yellow discharge c) Dysfunctional uterine bleeding d) Erythema in the vulvovaginal area

a) 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

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? a) An azole antifungal agent b) A penicillin antibiotic c) A quinolone antibiotic d) An antiviral agent

a) 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 client is being treated for gonorrhea. Which agent would the nurse expect the physician to prescribe? a) Ceftriaxone b) Penicillin c) Levofloxacin d) Tetracycline

a) The microorganism N. gonorrhoeae has become increasingly resistant to penicillin and tetracyclines, and fluoroquinolones (such as levofloxacin). Therefore, the current CDC (2006) recommendation for treating gonorrhea is a single intramuscular dose of a broad-spectrum cephalosporin such as ceftriaxone (Rocephin) or oral dosing with cefixime (Suprax).

A nurse is caring for a female client who is undergoing treatment for genital warts due to human papillomavirus (HPV). Which information should the nurse include when educating the client about the risk of cervical cancer? Select all that apply. a) Recurrence of genital warts increases risk of cervical cancer. b) Obtaining Pap smears regularly helps early detection of cervical cancer. c) Use of latex condoms is associated with a lower rate of cervical cancer. d) Use of broad-spectrum antibiotics increases risk of cervical cancer. e) Abnormal vaginal discharge is a sign of cervical cancer.

a, b, c) When educating the client about cervical cancer, the nurse should inform the client that recurrence of genital warts increases the risk of cervical cancer and that she should obtain regular Pap smears to detect cervical cancer. Use of latex condoms reduces the risk of cervical cancer. Abnormal vaginal discharge does not necessarily indicate cervical cancer. There is no significant link between use of broad-spectrum antibiotics and increased risk of cervical cancer

A nurse is caring for a client in the clinic. Which sign or symptom may indicate that the client has gonorrhea? a) Dry, hacking cough b) Burning on urination c) Diffuse skin rash d) Painless chancre

b) 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 is caring for clients who have STIs. Which of the following clients is most at risk for becoming infertile due to the infection? a) A woman diagnosed with syphilis b) A woman diagnosed with chlamydia c) A woman diagnosed with trichomoniasis d) A woman diagnosed with herpes simplex virus

b) Chlamydia trachomatis is the bacterium that is the leading cause of preventable infertility in women and the most common STI in the United States. Chlamydia is transmitted during vaginal, anal, or oral sex, leading to infections in the associated tissues of these areas. Lymphogranuloma venereum (LGV) is an STI that results from the three strains of Chlamydia trachomatis

A client is admitted in the healthcare facility with pelvic inflammatory disease (PID). When reviewing the client's history, which of the following would the nurse identify as a risk factor? a) Gestational diabetes b) Frequent douching c) Genetic predisposition d) Environmental exposure

b) One of the risk factors associated with pelvic inflammatory disease is frequent douching. Women with gestational diabetes are at an increased risk for developing type 2 diabetes later in life. Genetic predisposition and environmental exposure are risk factors associated with breast cancer

A client with a history of HSV-2 infection asks the nurse about future sexual activity. Which of the following responses would be most appropriate? a) "Refrain from all sexual activity until you don't have another outbreak for a year." b) "Inform all potential sexual partners about the infection, even if it is inactive." c) "Use a condom during sexual activity if the infection becomes active again." d) "If the infection has healed, you probably don't have to use a condom."

b) The nurse should advise the client to inform all potential sexual partners of the HSV infection, even if it is in an inactive state. The nurse should also advise the client to use a condom during sexual activity, even if the disease is dormant, and to avoid sexual contact if the infection is active. Condoms do not protect skin and mucous membranes left exposed

A client is experiencing situational low self-esteem about acquiring a sexually transmitted infection. Which of the following nursing interventions may help foster the client's self-esteem? a) Explain the cause of the sexually transmitted infection (STI) b) Affirm the client's good judgment in seeking treatment c) Provide the client with a telephone number for obtaining accurate information d) Schedule an appointment for follow-up care

b) The nurse should affirm the client's good judgment in seeking treatment. Acknowledging positive action helps increase the client's self-esteem. Explaining the cause of the STI and how to avoid potential consequences or complications dispels inaccurate beliefs and misconceptions and helps the client to acquire realistic information. It does not help the client's self-esteem to be positive. Providing the client with a telephone number for obtaining objective and authoritative information helps the client to ask more questions about an STI and its treatment. Medical follow-up promotes compliance with therapeutic regimen and does not help the client's self-esteem to be positive

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? a) Limit number of meals to three a day b) Use high-protein supplements c) Constantly drink fluids while eating d) Eat dry crackers after meals

b) 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.

A client reports genital ulcers and a diagnosis of syphilis. Which nursing interventions should the nurse implement when caring for the client? Select all that apply. a) Suggest the client apply ice packs to the genital area for comfort. b) Instruct the client to wash her hands with soap and water after touching lesions. c) Instruct the client to wear nonconstricting, comfortable clothes. d) Have the client urinate in water if urination is painful. e) Instruct the client to abstain from sex during the latency period.

b, c, d) 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

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? a) Promote use of oral contraceptives b) Emphasize the importance of good body hygiene c) Discuss limiting the number of sex partners d) Emphasize not sharing personal items with others

c) 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

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? a) Chlamydia b) Bacterial vaginosis c) Vulvovaginal candidiasis d) Trichomoniasis

c) 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 nurse is caring for a client positive for human immunodeficiency virus. The client is on triple-combination highly active antiretroviral therapy (HAART). Which should the nurse include in the teaching plan when educating the client about the treatment? Select all that apply. a) Exposure of fetus to antiretroviral agents is completely safe. b) Successful antiretroviral therapy may prevent acquired immunodeficiency syndrome (AIDS). c) Unpleasant side effects such as nausea and diarrhea are common. d) Ensure that the client understands the dosing regimen and schedule. e) Provide written materials describing diet, exercise, and medications.

c, d, e) The nurse should ensure that the client understands the dosing regimen and schedule. The client should be informed that unpleasant side effects such as nausea and diarrhea are common. The nurse should provide written material describing diet, exercise, and medications to promote compliance and ensure a healthy lifestyle. There is no evidence to suggest that exposure of the fetus to antiretroviral agents during pregnancy is completely safe in the long run. HIV is a lifelong condition, and antiretroviral therapy may delay the onset of AIDS but not prevent it

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 of the following diagnoses? a) Genital herpes b) Candidiasis c) Gonorrhea d) Condylomata acuminata

d) HPV is an identified precursor to condylomata acuminate, or genital warts. Herpes, gonorrhea and candidiasis are not likely to result directly from HPV

When developing a program for STI prevention, which action would need to be done first? a) Increasing the availability of resources b) Getting individuals to change their behaviors c) Interfering with the mode of transmission d) Educating on how to promote sexual health

d) 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