Deck 52: Disorders of Skin Integrity and Function

Question 1

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) Gonorrhea
C) Condylomata acuminata
D) Candidiasis

Answer 1

Condylomata acuminata

Question 2

A campus-based peer counseling group is conducting an information blitz on sexually transmitted diseases. Which of the following statements about genital warts requires correction?

A) "Genital warts can take up to a month after exposure to first become visible."
B) "There is no existing treatment that can eradicate the virus once it's contracted."
C) "Condoms do not necessarily prevent the transmission of the virus that causes genital warts."
D) "There are a number of subtypes of the virus that cause genital warts, but current vaccines protect against most common causes of them."

Answer 2

"Genital warts can take up to a month after exposure to first become visible."

Question 3

A 31-year-old male was diagnosed with genital herpes of the HSV-2 type 5 years ago. He is now broaching the subject with a woman he has recently formed a relationship with. Which of his statements is most accurate?

A) "If you've been exposed to the herpes virus in the past, then there's no significant risk of reinfection."
B) "The worst case scenario is that you'll develop cold sores, since this is the type of herpes virus that I've got."
C) "If you've had cold sores when you were younger, it means that you've got antibodies against this type of herpes virus."
D) "Even when I'm not having a recurrence, I could still pass the virus on to you."

Answer 3

"Even when I'm not having a recurrence, I could still pass the virus on to you."

Question 4

A male college student has arrived at the student clinic complaining of tingling, itching, and pains in his groin. Upon inspection, the nurse notices some pustules and vesicles. While taking a detailed sexual history, the nurse should ask which of the following questions to rule out further complications?

A) "Do you get cold sores very often?"
B) "Do you have pain when you urinate or have difficulty starting the stream?"
C) "Have you noticed excessive swelling in your scrotum the last few days?"
D) "Have you been experiencing flank pain and bloody urine?"

Question 5

A pregnant 23-year-old diagnosed with herpes simplex virus (HSV) is receiving prenatal care from her family physician. To prevent transmission of the virus to her baby, the physician will educate to include which of the following accurate statements?

A) "After your caesarean section, it will be safest if you don't breast-feed your child."
B) "If there aren't any visible lesions when you enter labor, a vaginal delivery will be safe to go ahead with."
C) "A vaginal delivery will be safe as long as you are consistent with taking your valacyclovir."
D) "We'll have to book you a caesarian delivery in order to ensure your baby isn't exposed to the virus."

Question 6

A 20-year-old male has presented to a health clinic with multiple genital lesions that are filled with a viscous, creamy exudate and has subsequently been diagnosed with molluscum contagiosum. What is his care provider most likely to tell him about the plan for treating the diagnosis?

A) "This kind of infection often subsides on its own and doesn't grow more serious over time."
B) "These lesions usually respond well to oral antiviral medications."
C) "Treatment of this problem is usually successful, but if untreated, it can lead to sterility."
D) "The bacteria that cause this disease are often latent for several years at a time, and you would be contagious for the entire period."

Question 7

After hearing horror stories about the signs, symptoms, and course of lymphogranuloma venereum (LGV), a high school student has asked a visiting sexual health educator about the odds of acquiring the disease among sexually active Americans. Which of the following facts will most accurately underlie the educator's response?

A) LGV has been eradicated in the United States but still has significant prevalence and incidence in Southeast Asia and Central America.
B) This disease is not common in the United States, but existing cases disproportionately affect women.
C) Men who have sex with men are at particular risk of LGV.
D) The virus that causes LGV is rare outside the tropics.

Question 8

Which of the following factors are known to contribute to vaginal yeast infections? Select all that apply.

A) Inflammation of the Skene and Bartholin glands.
B) Poorly controlled diabetes
C) Recent antibiotic therapy
D) Excessive physical exercise
E) Use of oral contraceptives
F) High hormone levels during pregnancy

Question 9

A patient with a yeast infection asks the nurse how they diagnose this infection. The nurse will base her response knowing this is primarily diagnosed by

A) the look and smell of the secretions.
B) looking at the spores on a wet-mount slide using 20% potassium hydroxide.
C) looking for Lactobacillus species under the microscope.
D) sending a blood test to lab for DNA testing on the specimen.

Question 10

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 6 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) Clotrimazole, an antifungal agent
B) Penicillin V potassium, a broad-spectrum antibiotic
C) Ciprofloxacin, a fluoroquinolone antibiotic
D) Tenofovir, an antiviral agent

Question 11

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 6 months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms?

A) Azithromycin
B) Valacyclovir
C) Penicillin
D) Metronidazole

Question 12

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 are the woman's most likely treatment and prognosis?

A) Abstinence will be required until the infection resolves, since treatments do not yet have proven efficacy.
B) Oral antiprotozoals to the patient and sexual partners to help prevent complications.
C) Antifungal medications are effective against the anovulation and risk of HIV that accompany the infection.
D) Vaginal suppositories and topical ointments can provide symptom relief but cannot eradicate the microorganism.

Question 13

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) Unprotected sex with a new partner who is a carrier of the relevant bacteria.
B) Autoinoculation from a cold sore, wart, or oral fungal infection.
C) A sharp reduction in the number of lactobacilli in the client's vaginal flora.
D) Proliferation of sexually transmitted protozoa.

Question 14

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) "Either me or a partner could end up with an eye infection from chlamydia that could make us blind."
B) "Even though I couldn't end up sterile, a woman that I give it to certainly could."
C) "Each of the three stages of the disease seems to be worse than the previous one."
D) "Even if I spread it to someone else, there's a good chance she won't have any symptoms or know she has it."

Question 15

The health nurse is dealing with a case of untreated chlamydial infection. The nurse suspects the patient has developed Reiter syndrome. Which of the following clinical manifestations would support this diagnosis? Select all that apply.

A) Diffuse pinkness of the conjunctiva along with watery and itchy eyes
B) Asymmetric complaints of stiffness and pain in knees and sacroiliac joints
C) Cervical tissue very friable and bleeds easily
D) Pain when urinating
E) Fatigue and tiredness from heart valve vegetation

Question 16

While working in a sexually transmitted disease (STD) clinic, the nurse should be aware that which of the following diagnostic tools are available for diagnosing chlamydial infections? Select all that apply.

A) Gram stain where polymorphonuclear leukocytes are identified
B) Direct fluorescent antibody testing
C) Enzyme-linked immunosorbent assay (ELISA)
D) Western blot testing
E) Nucleic acid amplification tests (NAATs)

Question 17

A 55-year-old male has presented to the emergency department because he is alarmed at the genitourinary symptoms he has experienced over the last several days. He reveals that he has had a number of new sexual relationships during a tropical vacation that ended 5 days ago. Over the last several days, he has had increasing pain in his urethra and a creamy yellow discharge from his penis. For the last 2 days, the discharge has been occasionally blood tinged. What differential diagnosis would be the care team's first priority?

A) Chancroid
B) Syphilis
C) Chlamydia
D) Gonorrhea

Question 18

In a busy STD clinic on a large university campus, a group of students have developed tetracycline- and penicillin-resistant strains of N. gonorrhoeae. Given these results, the nurse can expect that which of the following medications will be prescribed?

A) Single injection of Rocephin (ceftriaxone)
B) A 7-day supply of Augmentin (amoxicillin and clavulanate)
C) Nizoral (ketoconazole), an antifungal medication
D) Fluconazole (Diflucan), for yeast infections

Question 19

A pregnant teenager has arrived at a free clinic seeking care. She has had no prenatal care and is currently 27 weeks' gestation. Upon testing for a sexually transmitted disease (STD), it is found that she has active T. pallidum (syphilis). Given the fact that she has active syphilis at this stage in her pregnancy, it is very likely her fetus is at risk for: Select all that apply.

A) being born prematurely.
B) congenital defects.
C) unstable blood glucose levels.
D) cyanosis in limbs after delivery.
E) blindness.

Question 20

Unbeknownst to him, a 30-year-old male has contracted Treponema pallidum during a sexual encounter the night before. Place the following manifestations of the microorganism in the chronological order that they would occur in the absence of treatment. Use all the options.

A) Formation of aneurysms
B) Appearance of a rash on the man's palms and feet
C) Development of painless chancres on the man's scrotum.
D) Latency