Deck 27: HIV Infection, Hepatitis, Tuberculosis, and Sexually Transmitted Diseases

Question 1

Which of the following best explains why chlamydia is a major focus of public health efforts?

A)It has more serious long-term outcomes than other STDs
B)It can cause problems in infants born to infected mothers
C)It is not frequently seen in the United States
D)It is so difficult and expensive to treat

Answer 1

It can cause problems in infants born to infected mothers

Question 2

The correctional health nurse is doing a quick assessment on a newly admitted inmate who is HIV positive. Which of the following diseases should the inmate receive screening for immediately?

A)Herpes zoster
B)Hepatitis B
C)Hepatitis C
D)Tuberculosis

Answer 2

Tuberculosis

Question 3

Which of the following best explains why some health clinics allow clients to be tested for HIV anonymously with no record of the client's name, address, or contact information?

A)Client doesn't actually ever have to be told the results of the test.
B)Client may be engaged in illegal activities (drug use).
C)Client plans on not paying for the test and collection agencies will not be able to harass them.
D)Client wants to be sure care providers don't share results with their family.

Answer 3

Client may be engaged in illegal activities (drug use).

Question 4

A student asks the nurse at the student health clinic how AIDS is diagnosed. Which of the following statements would be the best response by the nurse?

A)"A diagnosis of AIDS is made when a screening test called an enzyme-linked immunosorbent assay (ELISA) is confirmed by the Western blot test."
B)"A diagnosis of AIDS is made when antibodies to HIV are detected about 6 weeks to 3 months following possible exposure."
C)"A diagnosis of AIDS is made when antibodies to HIV reach peak levels of 1000/ml of blood."
D)"A diagnosis of AIDS is made when CD4 T lymphocytes drop to less than 200/ml."

Question 5

A client who is very upset says to the nurse, "But we always used a condom! How could I have genital warts?" Which of the following would be the best response by the nurse?

A)"Are you positive you always used a condom?"
B)"Condoms don't always work."
C)"The condom might have had a tear in the latex."
D)"Skin to skin contact to a wart may have occurred outside the area that the condom covers."

Question 6

A client is being treated for secondary syphilis. Which of the following signs and symptoms would the nurse anticipate the client would exhibit?

A)Chancre at the site of entry
B)Jaundice
C)Difficulty coordinating muscle movements
D)Skin rash without itching

Question 7

Which of the following statements best explains why many health care providers are more afraid of getting hepatitis B than HIV?

A)Everyone would assume the person infected with hepatitis B is a drug user.
B)Having HBV would mean no further employment in health care.
C)The fatality rate is higher and occurs sooner with HBV.
D)There is no treatment for HBV, which can be a very serious illness.

Question 8

A client with tuberculosis (TB) asks why the nurse is required to watch the client swallow the medication each day. Which of the following statements is the best response by the nurse?

A)"Clients with TB are often noncompliant, so if I directly observe, you will be sure to take the drugs that have been ordered."
B)"This therapy is recommended to make sure that you receive the treatment you need and the infection doesn't become resistant to the drugs."
C)"This is to make sure you take your medication if your condition becomes so advanced that you do not have enough cerebral oxygenation to remember."
D)"Tuberculosis medications are very expensive so this method ensures that government money doesn't get wasted on those who will not take the drugs."

Question 9

Which of the following statements best explains why HSV-2 infection is more challenging for a client than gonorrhea infection?

A)HSV-2 is a viral infection that is both chronic and incurable.
B)HSV-2 is extremely expensive to treat.
C)HSV-2, like HIV, is almost impossible to diagnosis in the early stages.
D)Once a person has been treated for HSV-2, the person is immune to further outbreaks.

Question 10

In the United States, which demographic group has the highest risk for HIV infection?

A)African-American homosexual men
B)Hispanic IV drug abusers
C)White homosexual men
D)White lesbians

Question 11

Which of the following sexually transmitted diseases can be prevented through immunization?

A)Chlamydia
B)Gonorrhea
C)Hepatitis B
D)Herpes

Question 12

When a nurse discovers that a woman has been treated for cervical cancer, the nurse asks the woman whether she has ever been tested for HIV or other STDs. The woman is offended and asks why the nurse would ask her such a thing. Which of the following statements would be the best response from the nurse?

A)"Cervical cancer treatments may decrease immunity, so that it is easier to acquire STDs."
B)"Cervical cancer usually is caused by HPV, and often the presence of one STD is accompanied by other STDs."
C)"The presence of an STD in women with cervical cancer may lead to congenital defects in offspring."
D)"The presence of an STD in a woman with a history of cervical cancer has been associated with a relapse of the cancer after treatment."

Question 13

Which of the following best describes the characteristic appearance of lesions of human papillomavirus (HPV)?

A)Solitary growth with elevated borders and a central depression
B)Elevated growths with a "cauliflower" appearance
C)Thin-walled pustules that rupture to form honey-colored crusts
D)Vesicles that ulcerate and crust within 1 to 4 days

Question 14

A school nurse asks a class about the ways HIV can be transmitted. Which of the following comments by a student indicates a need for additional teaching?

A)"I wouldn't sit next to someone with HIV."
B)"Having unprotected sex with someone who is infected spreads HIV."
C)"Sharing needles when shooting up drugs spreads HIV."
D)"Transfusions of blood products that are contaminated can spread HIV."

Question 15

A male client visits the clinic office complaining of a yellow, green discharge from his penis. Which of the following STDs has the client most likely contracted?

A)Gonorrhea
B)Syphilis
C)Herpes simplex virus 2
D)Human papillomavirus

Question 16

A nurse explained to a new mother that because she had tested positive for the hepatitis B virus, her newborn son would need the hepatitis B vaccine immediately and then also an immune globulin injection. "Wait," said the new mother. "Why is my son getting two shots?" Which of the following statements would be the best response by the nurse?

A)"One injection protects your son, while the other encourages his body to build up immunity."
B)"One shot keeps your son from getting sick, while the other is a typical vaccine to prevent you from accidentally infecting him."
C)"Since you've already been infected with the virus, your son needs twice as much protection."
D)"The second shot is just to make sure the first one works."

Question 17

Which of the following provides the best explanation as to why people do not immediately seek medical treatment when they first become ill with HIV?

A)They are afraid to get tested for fear results will be positive.
B)They avoid the problem (maybe it will go away).
C)They don't recognize their symptoms as possibly being due to HIV.
D)It is too expensive to get an HIV test.

Question 18

A nurse is concerned about the prevalence of tuberculosis among migrant farmworkers. Which of the following activities would be best to use when implementing tertiary prevention?

A)Administer purified protein derivative (PPD) to contacts of those with tuberculosis.
B)Initiate directly observed therapy (DOT) for tuberculosis treatment.
C)Provide education about the prevention of tuberculosis to members of the migrant community.
D)Use skin tests to screen migrant health workers for tuberculosis infection.

Question 19

A client was clearly very relieved when an HIV test came back negative. "Thank goodness. I've had sex several times without a condom, and when one of my friends said he was sick, I think I panicked." Which of the following would be most important to emphasize to the client immediately?

A)Abstinence is the only way to be certain you are HIV-free.
B)Sex should be restricted to one partner.
C)The test could be wrong and the client might still have an HIV infection.
D)The test would not cover any recent infection, so if the client has had recent unprotected sex, the test should be repeated in 3 months.

Question 20

A nurse is providing education to a client about the use of PrEP. Which of the following statements would the nurse include as part of this teaching?

A)"Side effects of PrEP include extreme lethargy and joint pain."
B)"PrEP has been shown to be effective in preventing transmission of the disease from sharing needles."
C)"The effectiveness of PrEP will depend on your adherence to the medication regimen."
D)"PrEP will prevent you from contracting HIV and Hepatitis B."

Question 21

In which of the following cases would the school nurse be correct to advise the parents of an HIV-infected child to keep the child home from school? (Select all that apply.)

A)The child develops allergies with sneezing.
B)The child persists in biting behavior or is unable to control body secretions.
C)The nurse is not comfortable with being responsible for the child.
D)There is an outbreak of chickenpox in the school.

Question 22

The public health nurse comes to the hospital to see a client just diagnosed with hepatitis A. The nurse says, "I'm sorry to bother you when you're not feeling well, but I need to ask you a few questions." Which of the following questions would be most appropriate for the nurse to ask the client? (Select all that apply.)

A)"Do you know how you got this infection?"
B)"Who lives with you?"
C)"Where are you employed?"
D)"Where do you usually eat?"

Question 23

A mother felt very guilty that her baby was born HIV positive. When the nurse suggested the usual DPT and MMR immunizations, the mother was extremely upset. "Don't you know HIV children are immunosuppressed?" she exclaimed. Which of the following would be the nurse's best response?

A)"All children have to have these immunizations before they can attend school."
B)"Being HIV positive, your child is more likely to catch an infection and be very ill if not immunized."
C)"I'm so sorry; I forgot for a moment your child was HIV positive."
D)"The American Pediatric Association requires all health care providers to offer these immunizations to all parents; it is your choice whether or not to accept them."

Question 24

A woman and man who have come to the health clinic begin to argue loudly. "You gave me an STD!" the man yells. The woman screams back, "Not me. I don't have an STD!" Which of the following statements would be most appropriate for the nurse to say to them? (Select all that apply.)

A)"Actually, you're very fortunate to have been tested so you and your partner can begin treatment before more serious damage is done."
B)"Some STDs may not have any symptoms, so you need to be tested for other conditions and treated if necessary."
C)"Sometimes the test is inaccurate, so before getting too upset, you should ask to be tested again."
D)"You may be able to get treatment from your pharmacist so you won't have to be embarrassed like this again."

Question 25

A high school student is planning to volunteer at the hospital after school, so she needs to have a Mantoux test before beginning. Which of the following information should the nurse provide to the new volunteer?

A)"I will be using tiny tines to administer the TB antigen to the skin on your arm."
B)"Notify the clinic immediately if you experience any redness or itching at the test site."
C)"The areas should be kept dry until you return; cover it with plastic wrap when bathing."
D)"You will need to return in 2 to 3 days to have any reaction interpreted."

Question 26

A nurse was reading PPD tests 24 hours after another nurse had administered them. Which of the following findings would cause the nurse to interpret the test as positive?

A)15 mm of erythema in a client with HIV infection
B)5 mm of induration in an immigrant from a country where TB is endemic
C)A 5-mm ruptured pustule with purulent drainage in a homeless client
D)10 mm of swelling and increased firmness in a client recently released from a correctional facility