Deck 53: Nursing Management: Sexually Transmitted Diseases

Question 1

A 38-year-old married woman seeks health care for a change in vaginal discharge and pain on urination. When she is diagnosed with chlamydia, she is furious, saying that her husband is her only sexual contact, so he must have other sexual contacts. Which response by the nurse is most appropriate?

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

Answer 1

"It is understandable that you are angry with your husband right now."

Question 2

A 23-year-old diabetic patient has large masses of genital warts around her external genitalia and perianal area. She tells the nurse she just tries to ignore them but knows the reason her boyfriend left her was because they are so disgusting. Based on the patient's remarks, the nurse identifies the nursing diagnosis of

A) ineffective coping related to denial of increased risk for infection.
B) anxiety related to impact of condition on interpersonal relationships.
C) risk for infection related to lack of knowledge about mode of transmission.
D) disturbed body image related to genital warts secondary to human papilloma virus (HPV) infection.

Answer 2

disturbed body image related to genital warts secondary to human papilloma virus (HPV) infection.

Question 3

A Gram stain smear of a patient's urethral discharge reveals the presence of Neisseria gonorrhoeae. The patient tells the nurse about recent sexual contact with a woman but says she did not appear to have any disease. In responding to the patient, the nurse explains that

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

Answer 3

many women are not aware they have gonorrhea because they often do not have symptoms of infection.

Question 4

During the nursing assessment of a 23-year-old female patient, the nurse considers the patient's risk for sexually transmitted diseases (STDs). Which statement by the patient indicates the most need for patient teaching?

A) "I have an IUD and have had the same boyfriend for 3 years."
B) "I have never been tested for syphilis or chlamydia."
C) "I make an appointment every year for a pelvic exam."
D) "I use the birth control pill because I am not ready to settle down yet."

Question 5

A patient who has labs drawn for an insurance screening has a positive VDRL test. The nurse's first action should be to

A) ask the patient about past treatment for syphilis.
B) discuss the need for blood and spinal fluid cultures.
C) obtain a specimen for fluorescent treponemal antibody absorption (FAT-Abs) testing.
D) assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

Question 6

A patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin) and is given a prescription for doxycycline (Vibramycin) 100 mg bid for 7 days. The nurse explains to the patient that this combination of antibiotics is prescribed to

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.

Question 7

A man seeks care at the health clinic because he has developed a profuse, purulent urethral discharge with painful urination. During assessment of the patient, it is most important that the nurse gather information related to

A) sexual contacts.
B) a history of previous similar symptoms.
C) condom use.
D) a history of bladder infections or orchitis.

Question 8

A patient is treated for chlamydia that was detected during a routine pelvic examination. The nurse knows that teaching regarding the management of the condition has been effective when the patient says,

A) "Go ahead and give me the antibiotic injection so I will be cured."
B) "I will use condoms during sex until I finish taking all the antibiotics."
C) "My immune system will eventually be able to fight off the infection."
D) "My sexual partner will need to take antibiotics at the same time I do."

Question 9

A 37-year-old patient with a long history of IV drug use is seen at a community clinic, where the patient reports difficulty walking because "I don't know where her feet are." Diagnostic screening reveals a positive VDRL and fluorescent treponemal antibody absorption (FAT-Abs) test. Based on the patient history, the nurse will assess (Select all that apply.)

A) visual acuity.
B) genitalia for lesions.
C) heart sounds and aortic pulsations.
D) joints for swelling and inflammation.
E) skin and mucous membranes for gummas.
F) mental state for judgment and orientation.

Question 10

Primary genital herpes is diagnosed in a patient seeking care for lesions on her vulva and perineum. After the nurse teaches the patient about management of the disease, which statement by the patient indicates that the teaching has been effective?

A) "I will take the acyclovir (Zovirax) every 8 hours for the next week."
B) "I will use condoms for intercourse until the medication is all gone."
C) "I will use the acyclovir ointment on the area to relieve the pain."
D) "I will need to take all of the medication to be sure the infection is cured."

Question 11

A woman who is 20 weeks pregnant is diagnosed with primary syphilis. She tells the nurse that she is very worried about the effect of the disease on the fetus. The most appropriate response by the nurse to the patient's concern is

A) "Instillation of erythromycin into the eyes of the newborn will prevent any problems of transmission to the baby."
B) "A single intramuscular injection of penicillin at this point in your pregnancy will cure both you and the fetus of syphilis."
C) "If you have active genital lesions at the time you begin labor, a cesarean delivery will be performed to prevent transmission to the baby."
D) "Syphilis will not affect the baby in any way because the microorganism does not cross the placental barrier."

Question 12

A woman in the STD clinic tells the nurse that she is concerned she may have been exposed to gonorrhea by her partner. To determine whether the patient has gonorrhea, the nurse will plan to

A) interview the patient about symptoms of gonorrhea.
B) take a sample of vaginal discharge for Gram staining.
C) draw a blood specimen or rapid plasma regain (RPR) testing.
D) obtain a cervical specimen for an enzyme immunoassay (EIA).

Question 13

When the nurse is talking to a group of young adults about prevention of sexually transmitted diseases (STDs), one of the participants states "I will just plan to take antibiotics if I get an STD." Which response by the nurse is appropriate?

A) "STDs can be treated with antibiotics, but it is still important to avoid infection through the use of condoms."
B) "The microorganism that causes syphilis is frequently resistant to treatment with the commonly used antibiotics."
C) "Some STDs can not be treated with antibiotics and these may lead to recurrent infection and increased cancer risk."
D) "The treatment for bacterial STDs is complex and potentially painful, so avoidance of infection is important."

Question 14

A patient 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. While caring for the patient, it is important for the nurse to

A) wear gloves when touching the patient.
B) apply antibiotic ointments to the perineum.
C) place the patient in a private room.
D) monitor the heart sounds for new murmurs.

Question 15

When counseling a woman who is having difficulty conceiving, the nurse will be most concerned about a history of infection with

A) Treponema pallidum.
B) N. gonorrhoeae.
C) condyloma acuminatum.
D) herpes simplex virus type 2.

Question 16

When a patient returns to the clinic for follow-up after treatment for nongonococcal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection, which question is most appropriate for the nurse to ask the patient?

A) "Have you noticed an increase in pain or burning?"
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?"