Deck 50: Nursing Care of Patients with Sexually Transmitted Infections

Question 1

A female patient is experiencing intense vaginal itching with a cheese type discharge after using an over the counter vaginal cleanser daily for three weeks. The history suggests which vaginal disorder?

A)candidiasis
B)syphilis
C)gonorrhea
D)genital herpes

Answer 1

candidiasis

Question 2

A teenaged female patient tells the nurse that she has been sexually active with her boyfriend for two months. For which sexually transmitted infection should this patient be assessed?

A)genital herpes
B)human papillomavirus
C)condyloma acuminatum
D)chlamydia

Answer 2

chlamydia

Question 3

Of the following patients, the nurse would determine that which has a reportable sexually transmitted disease? Select all that apply.

A)aged 26 with bacterial vaginosis
B)aged 32 with syphilis
C)aged 16 with gonorrhea
D)aged 17 with trichomonas
E)aged 22 with vaginal candidiasis

Answer 3

aged 32 with syphilis
aged 16 with gonorrhea

Question 4

A patient recently treated for pelvic inflammatory disease asks how she can best prevent a recurrence of the disease. What information should be provided to the patient?

A)The physician will prescribe prophylactic antibiotic therapy.
B)The use of condoms will be beneficial.
C)Annual gynecological examinations should be scheduled.
D)Douching after intercourse will assist in removing potential pathogens from the genital area.

Question 5

Place in order of occurrence the pathophysiology of chlamydia trachomatis. Click and drag the options below to move them up or down.

A)Organism enters a cell and changes into a reticulate body.
B)Reticulate body divides within the cell.
C)The cell bursts.
D)Organism enters the body as an elementary body.
E)The reticulate body infects the adjoining cells.

Question 6

The nurse is providing community education to a large group of high school students about the characteristics of sexually transmitted infections (STIs). Which characteristics would be beneficial for the students to understand? Select all that apply.

A)Most can be prevented by the use of latex condoms.
B)STIs cannot occur after the first sexual experience.
C)For treatment to be effective, both partners must be treated.
D)There are few complications resulting from delayed treatment.
E)A person with multiple sexual partners is at a greater risk for STIs.

Question 7

A patient diagnosed with herpes simplex II is concerned about sexual relations. What information should be provided to the patient?

A)The infection can be transmitted only when the lesions present.
B)The infection can be prevented with condom use.
C)Sexual relations must be avoided during the prodromal period and for at least 10 days after the lesions are healed.
D)Sexual activity is permissible once the lesions have dried out.

Question 8

A patient asks which method of contraception will provide the greatest protection against sexually transmitted infections. What method can the nurse recommend?

A)oral contraceptives
B)male condoms
C)sponges
D)spermicides

Question 9

A male patient, experiencing a small, painless lesion on the side of his penis, is sexually active with multiple partners and does not use a condom. The history is an indication of what STI?

A)condyloma acuminatum
B)syphilis
C)gonorrhea
D)chlamydia

Question 10

A patient is prescribed Zovirax 300 mg. The medication is available in 200 mg tablets. How many tablets should the nurse provide to the patient?

Question 11

A female patient, diagnosed with a chlamydial infection, denies any symptoms of the disease, and asks when she contracted the disease. What information should be provided to the patient?

A)The patient has most likely had the infection for about 1-3 weeks.
B)The infection has been in her body for less than one month, since no symptoms are present.
C)The infection might have been in her body for an indefinite period of time.
D)Symptoms typically begin a few months after the infection enters the body.

Question 12

The nurse is planning to teach a group of adolescents about sexually transmitted infections. What information concerning genital warts should be included?

A)Hand washing will aid in the reducing the spread of genital warts.
B)Genital warts will result in cervical cancer for the majority of women who get them.
C)Women who have certain types of genital warts should be vaccinated against other types.
D)The risk for the development of penile cancer is high in men diagnosed with genital warts.

Question 13

The nurse instructs a patient diagnosed with pelvic inflammatory disease regarding the use of tampons. Which of the following statements by the patient indicate the understanding of the content provided? Select all that apply.

A)"I will be able to wear tampons."
B)"The use of tampons is forever prohibited."
C)"Tampons must be changed at least every four hours."
D)"I should wear pads at night."
E)"I should immediately report any malodorous discharge, fever, or pelvic pain."

Question 14

A patient has contracted syphilis from another sexual partner and has infected his spouse. The couple wants to remain married. In which order should care for this patient and spouse be prioritized? Click and drag the options below to move them up or down.

A)Explain the need for follow up testing in three months and six months.
B)Refer to a marriage counselor.
C)Administer intramuscular injection of penicillin G as ordered.
D)Discuss abstaining from sexual activity until cured.

Question 15

A patient, diagnosed with latent syphilis, asks about transmitting the disease to his spouse. What information should be provided to the patient?

A)"You will need to abstain from sexual relations until treatment is completed."
B)"You will need to wear a condom."
C)"At this late stage, the disease is contained to only you."
D)"At this stage of the disease, transmission is by contact with blood."

Question 16

The nurse is determining diagnoses appropriate for a pregnant patient newly diagnosed with herpes simplex. Which of the following nursing diagnoses has the highest priority?

A)Risk for Injury related to the disease process
B)Deficient Knowledge related to the diagnosis
C)Anxiety related the diagnosis
D)Interrupted Family Processes related to the effects of the diagnosis on her relationship with her partner

Question 17

A 20-year-old patient is demonstrating small painful blisters on her labia that occurred after having sex with her new boyfriend about six days ago. The nurse would determine that the STI this patient is most likely experiencing would be which of the following?

A)syphilis
B)gonorrhea
C)chlamydia
D)genital herpes

Question 18

A patient is experiencing a painless, ulcerated area on her labia. Which of the following health problems are consistent with this patient's symptom?

A)herpes simplex II
B)syphilis
C)condylomata acuminata
D)gonorrhea

Question 19

A 15-year-old patient is seeking birth control information. Which are priority areas for instructing this patient? Select all that apply. Select all that apply.

A)multiple sex partners
B)no use of condoms
C)lives with grandmother
D)aged 15
E)allergic to penicillin

Question 20

A patient recently diagnosed with herpes simplex II asks how to best manage the lesions. What information should be given to the patient?

A)The use of soap should be restricted.
B)It is safe to use a solution of 50% rubbing alcohol and 50% water to clean the lesions.
C)Wearing nylon panties will reduce discomfort.
D)Gentle soap and water can be used to clean the lesions.

Question 21

$\begin{array}{|llcc|}\hline \text {PID in women, leading to internal abscesses, chronic pain, ectopic}\\ \text {pregnancy, and infertility}\\\text {Blindness, infection of joints, and potentially lethal infections of the blood in }\\\text {the newborn, contracted during delivery}\\\text {Epididymitis and prostatitis in men, resulting in infertility and dysuria}\\\text {Spread of the infection to the blood and joints}\\\text {Increased susceptibility to and transmission of HIV}\\\hline \end{array}$



-A male patient who has been diagnosed with gonorrhea twice over the last year states, "It's no big deal, I just come here and get antibiotics when it gets bad." A priority nursing diagnosis related to the complications of untreated gonorrhea (see above) is which of the following?

A)Noncompliance related to not reporting the disease
B)Pain related to appearance of chancres
C)Impaired Social Interaction related to low self-esteem
D)Risk for Injury for the patient and his partners related to the disease process

Question 22

A female patient is seen for a new onset of blisters on the labia majora. The nurse realizes that this patient is experiencing which of the following?

A)a drug reaction.
B)first episode of a herpes virus infection.
C)prodromal symptoms of the herpes virus.
D)latency period of the herpes virus infection.

Question 23

A male patient tells the nurse that he is not concerned about sexually transmitted diseases because he is in a monogamous relationship. The nurse realizes that this patient would benefit from education because

A)he currently has a sexually transmitted disease.
B)all sexually active persons are at risk for a sexually transmitted disease.
C)sex means different things to different people.
D)he is having difficulty with sperm production.

Question 24

A patient positive for syphilis is allergic to penicillin and is being treated with tetracycline for 28 days. The healthcare provider orders tetracycline 500 mg to be taken every six hours. The prescription is filled with 250 mg tablets. How many tablets will the patient need to take every day to achieve the ordered dosing?

Question 25

A male patient is concerned about a "smooth growth" that appeared on his penis. The nurse suspects this patient is experiencing which type of genital wart?

A)condyloma acuminatum
B)keratotic wart
C)papular wart
D)flat wart

Question 26

When educating a young college student about STIs the nurse should take the following into account. Select all that apply.

A)One in twenty sexually active persons will contract an STI by age 2
B)Many STIs are more easily transmitted from a man to a woman than from a woman to a man.
C)Oral contraceptives do not protect against STIs.
D)Research supports that there is a relationship between domestic violence and STI infections.
E)Sexual activity with multiple partners is associated with increased incidence of STIs.

Question 27

The nurse is preparing discharge instructions for a patient with syphilis. Place in priority order the following instructions. Click and drag the options below to move them up or down.

A)Complete the prescribed medications.
B)Referral of partners for treatment.
C)Follow up testing in 3-6 months.
D)Abstinence from sexual contract until cured.

Question 28

When implementing nursing care for a patient with a diagnosis of syphilis, the nurse must take into consideration the disease process. Rank in order of occurrence the following stages of the disease process. Click and drag the options below to move them up or down.

A)appearance of a chancre and regional enlargement of lymph nodes
B)localized development of gummas
C)asymptomatic period
D)skin rash on palms and feet

Question 29

Penicillin G benzathine, 2.4 million units is ordered for an adult patient with syphilis. Place an "X" on the area where it would be appropriate for the nurse to give the injection.

Question 30

A female patient is having difficulty accepting the diagnosis of a sexually transmitted disease because she has "been on the pill" for years. Which piece of information can the nurse provide to aid this patient?

A)Skipping doses could have caused the disease.
B)She possibly needs to change the type of birth control pill being used.
C)Some diseases are virulent and the pill will not protect her.
D)Oral contraceptives do not protect against sexually transmitted diseases.

Question 31

$\begin{array}{c}\begin{array}{|l|}\hline \text {Chief complaints}\\\hline \text {Pelvic pain, irregular }\\\text {periods}\text {Abnormal amount of}\\\text { vaginal discharge}\\\text {Lower abdominal }\\\text {tenderness}\\\\\hline\end{array}\begin{array}{l|}\hline \text {Lab work}\\\hline \text {Preg test neg}\\ \text {WBC 12,000}\\ \text {Pap smear-pending}\\ \text {Cultures-pending}\\\\\\\hline\end{array}\begin{array}{lll}\hline \text {Physical exam}\\\hline \text {Pharyngeal and }\\\text {cervical inflammation }\\\text {T \( 98.5^{\circ} \mathrm{F} \)}\\\text {No vaginal lesions or}\\\text { blisters noted}\\\\\hline \end{array}\end{array}$


-A 17-year-old, sexual active female patient comes to the clinic requesting a pelvic exam. She has complaints of pelvic pain and a heavy amount of vaginal discharge. She states she has had a sore throat for about a week. In reviewing her chief complaints and lab work (see chart above) the nurse suspects the possibility of a STI diagnosis. To complete the necessary patient assessment, the nurse needs to assess which of the following? Select all that apply.

A)risk factors, including having unprotected sex
B)list of names of all sexual partners
C)estimated time frame of presenting symptoms
D)name of the high school patient attends

Question 32

A patient with secondary syphilis may present with a rash. On the diagram above indicate the areas of the rash with an "X."

Question 33

The community health nurse is asked to develop a STI educational program to target at-risk peoples in the community. After reviewing the risk factors for chlamydial infections (see box above), the educational plan should target which of the following?

A)males at the adult senior center
B)groups of teenagers from the local high school
C)married couples attending Lamaze classes
D)children from the local 4H Club

Question 34

A patient has been diagnosed with salpingitis. Place an "X" over the internal organ affected by this infectious process.

Question 35

A patient diagnosed with gonorrhea has not been adhering to the prescribed medication regime. Which of the following would indicate the patient is experiencing complications of the disease? Select all that apply.

A)WBC 22,000
B)complaints of severe abdominal pain
C)ambulating slowly with legs apart
D)tenderness upon palpation of the abdomen
E)serum potassium of 3.8

Question 36

A male patient is "relieved" to learn that he has a sexually transmitted disease and is not HIV positive. Which of the following would be an appropriate response for the nurse to make to this patient?

A)"Having a sexually transmitted infection does predispose the body to be infected with HIV if exposed to the virus."
B)"You are lucky."
C)"I told you not to be concerned."
D)"You would know if you had HIV."

Question 37

A female patient who was just diagnosed with a sexually transmitted infection is beginning treatment. The nurse should remind the patient to do which of the following?

A)Avoid all sexual activity in the future.
B)Begin birth control pills to prevent future disease transmission.
C)Be pleased that she was not diagnosed with HIV.
D)Inform all sexual partners about the diagnosis so they can also be treated.

Question 38

A patient with genital herpes is experiencing increased pain with urination. The nurse should suggest that the patient do which of the following?

A)Drink more water.
B)Drink more cranberry juice.
C)Drink more orange juice.
D)Restrict fluids.

Question 39

The healthcare provider orders doxycyline 100 mg po every 12 hours for 7days. The pharmacy fills the prescription with 0.1 g doxycyline capsules. The nurse should instruct the patient to take ____ capsules per day.

Question 40

A young female patient has just been diagnosed with a trichomonas infection. What symptoms would you expect the patient to exhibit? Select all that apply.

A)greenish-yellow vaginal discharge
B)smooth lesions on labia majora
C)itching and irritation of the genitalia
D)dysuria
E)fever

Question 41

A female patient says that she has been using "the medication for a yeast infection" but it is not "getting any better." The nurse realizes that this patient most likely

A)has not used the medication long enough.
B)might be using a treatment that is not appropriate for the cause.
C)is not using the medication correctly.
D)is not washing her hands before applying the medication.

Question 42

A female patient continues to develop vaginal infections. Which of the following can the nurse provide to assist this patient? Select all that apply.

A)"Wear only nylon underwear."
B)"Be sure to wash the perineal region daily and as necessary throughout the day."
C)"Avoid wearing tight jeans or pants."
D)"Douche daily."
E)"Use condoms when engaging in sexual activity."

Question 43

A female patient is seen for a recurrence of a vaginal infection. The nurse realizes that this patient might benefit from instruction about which of the following?

A)personal hygiene
B)wearing tight underwear
C)saving some of the prescribed medication for use when symptoms return
D)avoiding sexual contact until the infection heals

Question 44

A female patient is complaining of a "watery" vaginal discharge with a "really strong fishy" odor. The nurse suspects that this patient is experiencing which of the following?

A)bacterial vaginosis
B)yeast infection
C)trichomoniasis infection
D)genital warts

Question 45

After the removal of genital warts, the male patient says, "Now I can have sex again." Information that the nurse should provide to this patient includes which of the following?

A)efforts to prevent reinfection now that he is cured of the warts
B)the need to always use a chemical barrier to avoid impregnating his partner
C)ask every partner if they have a diagnosed sexually transmitted disease
D)remind to always use a condom with sexual activity