Question 1

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 infection on the baby.What is the most appropriate response to the patient's concern?

Accepted Answer

The most appropriate response is that a single intramuscular injection of penicillin at this point in pregnancy will cure both the mother and fetus of syphilis. Syphilis can cross the placental barrier and affect the developing fetus, leading to serious congenital syphilis. Erythromycin eye ointment is used to prevent eye infections in newborns but does not prevent congenital syphilis. A Caesarean delivery may be necessary if active genital lesions are present during labour, but it does not prevent the transmission of syphilis to the fetus during pregnancy.

Question 2

Which of the following is the recommended therapy for treatment of small external genital warts?

Accepted Answer

B

Question 3

A patient with gonorrhea is treated with a single intramuscular dose of ceftriaxone (Rocephin)and is given a prescription for doxycycline (Vibramycin)100 mg twice daily for 7 days.What should the nurse explain to the patient about this combination of antibiotics?

Accepted Answer

The combination of ceftriaxone and doxycycline is typically prescribed for the treatment of gonorrhea, but it is also effective against chlamydial co-infections, which are common in individuals with gonorrhea. This combination does not necessarily prevent the development of resistant organisms or reinfection, but it is effective in treating the original infection and any coexisting infections.

Question 4

Which virus is responsible for genital warts?

Accepted Answer

HPV is the virus responsible for genital warts. It is a sexually transmitted infection that can cause visible warts on the genital area, as well as cancer in some cases.

Question 5

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?

Accepted Answer

Acyclovir (Zovirax) is an antiviral medication commonly prescribed for the treatment of primary genital herpes. It is typically taken orally every 8 hours for a period, such as a week, to manage the symptoms of the outbreak. This regimen helps reduce the severity and duration of the symptoms.

Question 6

The nurse should inform women who have a history of STIs that the risk of infertility or ectopic pregnancies is highest following infection by which of the following STIs?

Accepted Answer

N.gonorrhoeae infection can lead to tubal scarring and blockage, increasing the risk of infertility and ectopic pregnancy. Women with a history of gonorrhea should be routinely screened for tubal patency. While other STIs can also lead to infertility or ectopic pregnancy, N.gonorrhoeae has the highest risk.

Question 7

A Gram-stained smear of a patient's urethral discharge reveals the presence of N.gonorrhoeae.The patient tells the nurse that he had sexual contact with a new girlfriend but does not think he was exposed to gonorrhea because she did not appear to have any infection.In responding to the patient,what should the nurse explain?

Accepted Answer

Many women are not aware they have gonorrhea because they often do not have symptoms of infection. This is a common reason for the spread of gonorrhea and other sexually transmitted infections. The nurse should explain to the patient that his girlfriend may have had a subclinical case of gonorrhea, meaning she had the infection but did not show any visible signs or symptoms. Therefore, it is important to always practice safe sex to prevent the spread of infections.

Question 8

A patient who has undergone laboratory tests for an insurance screening has a positive Venereal Disease Research Laboratory test.What is the nurse's first action?

Accepted Answer

The nurse's first action should be to ask the patient about past treatment for syphilis. This will help determine the patient's history of the disease and aid in planning appropriate treatment.

Question 9

A patient with secondary syphilis has a rash on her palms and the soles of her feet and moist papules in the anal and vulvar area.While caring for the patient,what is it important for the nurse to do?

Accepted Answer

The nurse should wear gloves to prevent transmission of the disease to themselves and to other patients.

Answer: B 
 The nurse should wash the perianal area with an antiseptic solution to help prevent the spread of the disease.

Answer: C 
 Protective isolation is not necessary for patients with syphilis, as it is not transmitted through casual contact. Standard precautions should be followed.

Answer: D 
 Although gummas can occur in tertiary syphilis, they are not typically present in secondary syphilis. The nurse should focus on preventing transmission and providing appropriate treatment for the current symptoms.

Question 10

Which of the following is the most appropriate question for the nurse to ask when obtaining a detailed and accurate sexual history?

Accepted Answer

Option C is the most appropriate question as it allows the patient to disclose their sexual orientation and gender identity, without assuming heterosexuality or homosexuality. The question is open-ended and allows the patient to provide as much detail as they are comfortable with. Option A is inappropriate as it assumes the patient's sexual orientation, while option B assumes heterosexuality. Option D is too specific and may not provide a comprehensive understanding of the patient's sexual history.

Question 11

A patient returns to the clinic for follow-up after treatment for nongonococcal urethritis.Direct fluorescent antibody tests are positive for chlamydia.What should the nurse recognize is the most likely cause of the continued infection?

Accepted Answer

The most likely cause of continued infection is that the patient's sexual partners were not treated, leading to reinfection.

Question 12

Cervarix,an HPV vaccine,is recommended for which of the following populations?

Accepted Answer

Cervarix is recommended for males and females between the ages of 9 and 26.

Question 13

During the nursing assessment of a 23-year-old female patient,the nurse considers the patient's risk for sexually transmitted infections (STIs).Which of the following findings indicates a need for patient teaching?

Accepted Answer

Having multiple sex partners increases the risk of STIs, and oral contraceptives do not protect against STIs. Patient teaching should include information on safer sex practices, such as using condoms.

Question 14

The incidence of syphilis has steadily increased in Canada since 1999.Which of the following groups would be at highest risk of contracting syphilis?

Accepted Answer

Men who have sex with men have consistently been identified as the group with highest rates of syphilis in Canada. This is due to high rates of risky sexual behavior, such as unprotected anal intercourse, which increases the risk of transmission of syphilis.

Question 15

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

Accepted Answer

Gathering information about recent sexual contacts is crucial for identifying potential sources of sexually transmitted infections and for contact tracing to prevent further spread.

Quiz 55: Nursing Management: Sexually Transmitted Infections