Question 1

Amale client who has been diagnosed with gonococcal urethritis tells the nurse about recent sexual contact with a woman but says she did not appear to have any disease. Which of the following information should the nurse provide in response to the client'sstatement?

A)Women do not develop gonorrhea infections but can serve as carriers to spread the disease to males.
B)Women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations.
C)Many women are not aware they have gonorrhea because they often do not have symptoms of infection.
D)When gonorrhea infections occur in women, the disease affects only the ovaries and not the genital organs.

Accepted Answer

Many women with gonorrhea are asymptomatic or have minor symptoms that are overlooked. The disease may affect both the genitals and the other reproductive organs and cause complications such as pelvic inflammatory disease (PID). Women who can transmit the disease have active infections.

Question 2

The nurse is teaching a client who has primary genital herpes about management of the disease. Which of the following client statements indicate that the teaching has been effective?&#10;A)&#34;I will use the acyclovir ointment on the area to relieve the pain.&#34;&#10;B)&#34;I will use condoms for intercourse until the medication is all gone.&#34;&#10;C)&#34;I will take the acyclovir every 8 hours for the next week.&#34;&#10;D)&#34;I will need to take all of the medication to be sure the infection is cured.&#34;

Accepted Answer

The treatment regimen for primary genital herpes infections includes acyclovir 400 mg three times daily for 7-10 days. The client is taught to abstain from intercourse until the lesions are gone. (Condoms should be used even when the client is asymptomatic.) Acyclovir ointment is not effective in treating lesions or reducing pain. Herpes infection is chronic and recurrent.

Question 3

The nurse is assessing a male client who has a profuse, purulent urethral discharge with painful urination. Which of the following information is most important for the nurse to obtain?&#10;A)Contraceptive use&#10;B)Sexual orientation&#10;C)Immunization history&#10;D)Recent sexual contacts

Accepted Answer

Information about sexual contacts is needed to help establish whether the client has been exposed to an STI and because sexual contacts will also need treatment. The other information may also be gathered but is not as important in determining the plan of care for the client's current symptoms.

Question 4

The nurse is caring for a client who is diagnosed with chlamydia and tells the nurse that she is very angry because her husband is her only sexual partner. Which of the following responses should the nurse make first?

A)"You may need professional counselling to help resolve your anger."
B)"It is understandable that you are angry with your husband right now."
C)"Your feelings are justified and you should share them with your husband."
D)"It is important that both you and your husband be treated for the infection."

Accepted Answer

This response expresses the nurse's acceptance of the client's feelings and encourages further discussion and problem-solving. The client may need professional counselling, but more assessment of the client is needed before making this judgement. The nurse should also assess further before suggesting that the client share her feelings with the husband because problems such as abuse might be present in the relationship. Although it is important that both partners be treated, the client's current anger suggests that this is not the appropriate time to bring this up.

Question 5

A client is treated for chlamydia that was detected during a routine pelvic examination. Which of the following client statements indicate that teaching regarding the management of the condition has been effective?

A)"Go ahead and give me the antibiotic injection so I will be cured."
B)"My boyfriend will need to take antibiotics at the same time I do."
C)"I will use condoms during sex until I finish taking all the antibiotics."
D)"Since I do not plan on having any children, treatment is not as important."

Accepted Answer

Sex partners should be treated simultaneously to prevent reinfection. Chlamydia is treated with oral antibiotics. Abstinence from sexual intercourse is recommended for 7 days after treatment, and condoms should be recommended during all sexual contacts to prevent infection. Chronic pelvic pain, as well as infertility, can result from untreated chlamydia.

Question 6

A client in the sexually transmitted infection (STI) clinic expresses concern about possible exposure to gonorrhea by her partner. Which of the following actions should the nurse take to determine if the client has gonorrhea?

A)Interview the client about symptoms of gonorrhea
B)Take a sample of cervical discharge for Gram staining
C)Draw a blood specimen or rapid plasma reagin (RPR) testing
D)Obtain vaginal secretions for a nucleic acid amplification test (NAAT)

Accepted Answer

NAAT has a high sensitivity (similar to a culture) for gonorrhea. Because women have few symptoms of gonorrhea, asking the client about symptoms is not helpful in making a diagnosis. Smears and Gram staining are not useful because the female genito-urinary tract has many normal flora that resemble N. gonorrhoeae. RPR testing is used to detect syphilis.

Question 7

The nurse is assessing a female client who being seen in the family medicine clinic for an annual physical exam. Which of the following information should the nurse plan to teach the client about?&#10;A)Testing for chlamydia infection&#10;B)Immunization for herpes simplex&#10;C)The relationship between the herpes virus and cervical cancer&#10;D)The risk of infertility associated with the human papillomavirus (HPV)

Accepted Answer

Gonorrheal and chlamydial testing during pelvic examinations and prenatal visits is becoming a major routine part of these programs. Mass application of screening programs for genital chlamydial infections, genital herpes, and HPV infections may also be possible with the advent of rapid, cost-effective tests. HPV infection does not cause infertility.
There is no vaccine available for herpes simplex, and herpes simplex infection does not cause cervical cancer.

Question 8

Aclient who has blood drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which of the following actions should the nurse take next?&#10;A)Ask the client about past treatment for syphilis.&#10;B)Discuss the need for blood and spinal fluid cultures.&#10;C)Obtain a specimen for fluorescent treponemal antibody absorption (FAT-ABS) testing.&#10;D)Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

Accepted Answer

Once antibody testing is positive for syphilis, the antibodies remain present for an indefinite period of time even after successful treatment, so the nurse should inquire about previous treatment before doing other assessments or testing. Culture, FAT-ABS testing, and assessment for symptoms may be appropriate, based on whether the client has been previously treated for syphilis.

Question 9

When a client returns to the clinic for follow-up after treatment for gonococcal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection, which of the following questions is best for the nurse to ask the client?

A)"Did you take the prescribed antibiotic for a week?"
B)"Did you drink at least 2 quarts of fluids every day?"
C)"Were your sexual partners treated with antibiotics?"
D)"Do you wash your hands after using the bathroom?"

Accepted Answer

All sexual contacts of patients with gonorrhea must be examined and treated to prevent reinfection after resumption of sexual relations. The "ping-pong" effect of re-exposure, treatment, and reinfection can cease only when infected partners are treated simultaneously. Because gonorrhea is treated with one dose of antibiotic, antibiotic therapy for a week is not needed. An adequate fluid intake is important, but a low fluid intake is not a likely cause for failed treatment. Poor hygiene may cause complications such as ocular trachoma but will not cause a failure of treatment.

Question 10

A client has genital warts around her external genitalia and perianal area. She tells the nurse that she has not had treatment until now because "the warts are so disgusting." Which of the following nursing diagnoses is best?

A)Disturbed body image related to alteration in self-perception (feelings about the genital warts)
B)Ineffective coping related to inadequate confidence in ability to deal with a situation
C)Risk for infection as evidenced by insufficient knowledge to avoid exposure to pathogens
D)Anxiety related to threat to current status (impact of condition on interpersonal relationships)

Accepted Answer

The client's statement that her lesions are disgusting suggests that disturbed body image is the major concern and is quite common in clients that have genital warts. There is no evidence to indicate ineffective coping or lack of knowledge about mode of transmission. The client may be experiencing anxiety, but there is nothing in the data indicating that the genital warts are impacting interpersonal relationships.

Question 11

Which of the following clients should the nurse plan on teaching about the Gardasil vaccine?&#10;A)A 50-year-old man who has multiple sexual partners&#10;B)A 23-year-old woman who is pregnant for the first time&#10;C)An 11-year-old female who has never been sexually active&#10;D)A 28-year-old male who is in a monogamous relationship

Accepted Answer

The answer of Which of the following clients should the...

Question 12

The nurse is caring for a client who is diagnosed with chlamydia and tells the nurse that she is very angry because her husband is her only sexual partner. Which of the following responses should the nurse make first?

A)"You may need professional counselling to help resolve your anger."
B)"It is understandable that you are angry with your husband right now."
C)"Your feelings are justified and you should share them with your husband."
D)"It is important that both you and your husband be treated for the infection."

Accepted Answer

The answer of The nurse is caring for a client...

Question 13

Aclient with positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-ABS) tests has a rash on the palms and the soles of the feet and moist papules in the anal and vulvar area. Which of the following actionsshould the nurse include in the plan of care?

A)Assess for arterial aneurysms.
B)Place the client in a private room.
C)Wear gloves when touching the client.
D)Apply antibiotic ointments to the perineum.

Accepted Answer

The answer of Aclient with positive Venereal Disease Research Laboratory...

Question 14

The nurse is counselling a client who is having difficulty in conceiving. Which of the following infections is of most concern to the nurse?&#10;A)Chlamydia&#10;B)Treponema pallidum.&#10;C)Condyloma acuminatum.&#10;D)Herpes simplex virus type 2.

Accepted Answer

The answer of The nurse is counselling a client who...

Question 15

The nurse is assessing a client at the community clinic who has a long history of IV drug use and reports difficulty walking because "I don't know where my feet are." Diagnostic screening reveals positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-ABS) tests. Which of the following assessments should the nurse implement based on the client history? (Select all that apply.)

A)Heart sounds
B)Genitalia for lesions
C)Joints for swelling and inflammation
D)Mental state for judgement and orientation
E)Skin and mucous membranes for gummas

Accepted Answer

The answer of The nurse is assessing a client at...

Question 16

Aclient with gonorrhea is treated with a single IM dose of ceftriaxone and is given a prescription for doxycycline 100 mg bid for 7 days. Which of the following explanations should the nurse tell the client about this combination of antibiotics?

A)Prevent reinfection during treatment
B)Treat any coexisting chlamydial infection
C)Eradicate resistant strains of N. gonorrhoeae
D)Prevent the development of resistant organisms

Accepted Answer

The answer of Aclient with gonorrhea is treated with a...

Deck 55: Nursing Management Sexually Transmitted Infections