Multiple Choice
Identify the choice that best completes the statement or answers the question.
____ 1. During data collection the nurse notes the presence of a chancre on a male patient’s penis. For which sexually transmitted infection should the nurse focus additional data collection?
a. Herpes
b. Syphilis
c. Gonorrhea
d. Chlamydia
____ 2. A patient is diagnosed with a parasitic infection caused by close contact with another person’s genitals. For which infection should the nurse plan care?
a. Phthirus pubis
b. Treponema pallidum
c. Neisseria gonorrhoeae
d. Chlamydia trachomatis
____ 3. It is documented in the medical record that a patient has gummas. For which sexually transmitted infection should the nurse plan care?
a. Syphilis
b. Gonorrhea
c. Chlamydia
d. Genital herpes
____ 4. The nurse is assisting with teaching a 22-year-old female patient who is diagnosed with a sexually transmitted infection (STI). She says, “I don’t understand. My boyfriend always wears a condom.” Which understanding by the nurse should guide teaching in this situation?
a. Condoms are a reliable source of protection against STIs.
b. It is a myth that condoms provide any protection against STIs.
c. Condoms can decrease the risk of STIs, but they are not foolproof.
d. Condoms must be used with a spermicide to guarantee protection against STIs.
____ 5. The nurse is providing care for a patient with genital herpes who has vesicular lesions. What term should the nurse use to describe these lesions to the patient?
a. Warts
b. Rashes
c. Blisters
d. Papules
____ 6. Human papillomavirus (HPV) produces verrucous growths. What term should the nurse use to describe these lesions to the patient?
a. Warts
b. Rashes
c. Blisters
d. Papules
____ 7. The nurse is collecting data on a patient with Chlamydia. Which assessment finding should be reported immediately to the RN or physician?
a. Painful urination
b. Red conjunctivae
c. Vaginal discharge
d. Sharp pain at the base of the ribs
____ 8. Because Trichomonas is relatively large, unusually shaped, and diagnosed quickly, the nurse is asked to assist the physician obtain which type of specimen?
a. Culture
b. Blood test
c. Wet mount
d. Litmus paper
____ 9. A patient diagnosed with Trichomonas asks the nurse how the diagnosis will affect her risk for cervical cancer. Which response by the nurse is best?
a. “Wet-mount slides should be done yearly to help detect cervical cancer.”
b. “Serological testing will be done to detect tumor proteins and screen for cervical cancer.”
c. “Papanicolaou smears should be done more frequently because results may be altered by Trichomonas.”
d. “Culture and sensitivity testing is done with Papanicolaou (Pap) smears every other year to determine if you have cervical cancer.”
____ 10. A patient asks why the physician has recommended systemic interferon treatment for genital warts. Which explanation should the nurse provide to the patient?
a. “Interferon can improve liver function.”
b. “Interferons can increase your red blood cell count.”
c. “Interferon treatment does not have any side effects.”
d. “Interferon therapy can attack warts all over the body at the same time.”
____ 11. A patient with hepatitis B virus (HBV) delivers a 6-pound 2-ounce baby boy. Which action should the nurse anticipate will be needed for the infant?
a. Intravenous antibiotics for 12 hours
b. Antiviral eye medication less than 2 hours after birth
c. There is no treatment that is safe and effective for infants.
d. HBV-immune globulin less than 12 hours after birth and then HBV vaccine series
____ 12. The nurse must bathe a patient with herpes. What is the nurse’s best protection against contracting sexually transmitted infections (STIs) from patients while providing perineal hygiene?
a. Wearing gloves at all times
b. Washing hands following care
c. Practicing standard precautions
d. Avoiding touching patients who have STIs
____ 13. The nurse is caring for a pregnant woman who is fearful that her unborn child will be born blind because of having a sexually transmitted infection (STI). For which STI should the nurse plan care to prevent ophthalmia neonatorum in the newborn?
a. Syphilis
b. Gonorrhea
c. Genital warts
d. Genital herpes
____ 14. The nurse is caring for a young woman who is newly diagnosed with genital warts. She states, “I heard you can get cancer from STIs. Is that true?” Which response by the nurse is correct?
a. “No, you cannot get cancer from STIs.”
b. “Yes, most STIs can lead to cancerous changes if not treated promptly.”
c. “Yes, some STIs have been linked to cancer, so adequate treatment is very important.”
d. “No, that is not true, but a diagnosis of cancer does increase the risk of contracting an STI.”
____ 15. The nurse is identifying ways for a young adult to reduce the risk of contracting a sexually transmitted infection (STI). What should the nurse teach about the relationship between consumption of alcohol and immediate risk of contracting an STI?
a. Alcohol may reduce inhibitions.
b. Alcohol increases risk for liver disease.
c. Alcohol lowers the body’s resistance to infection.
d. Alcohol impairs the integrity of the mucous membranes, providing a portal of entry for infection.
____ 16. The nurse reviews the ways to prevent condom breakage with a patient. Which patient statement indicates that more teaching is necessary?
a. “Condoms should never be reused.”
b. “I should use a water-soluble lubricant.”
c. “Before I use a condom, I should inflate it and check it for holes and leaks.”
d. “I should make sure to leave a half inch extra space at the end of the condom.”
____ 17. The nurse is assisting with the admission of a known intravenous drug abuser to a medical unit. In addition to drug abuse, which disorder in the patient’s history is most consistent with a diagnosis of hepatitis?
a. Jaundice
b. Diabetes mellitus
c. Bowel obstruction
d. Chronic headaches
____ 18. The nurse is teaching a patient the importance of completing treatment for gonorrhea. On which information is the nurse basing this teaching?
a. Gonorrhea is not treatable.
b. Only men experience symptoms; women are usually asymptomatic.
c. Men and women may be asymptomatic and still transmit the infection.
d. Treatment is associated with many serious side effects, so compliance is low.
____ 19. The nurse is assisting in the preparation of a teaching seminar for adolescents to prevent the development of a sexually transmitted infection (STI). Which nonsexual activity should the nurse teach that may transmit a sexually transmitted infection (STI)?
a. Sharing a cigarette
b. Borrowing a hairbrush
c. Coughing and sneezing
d. Sharing intravenous drug equipment
____ 20. A patient asks for the best way to prevent contracting a sexually transmitted infection (STI). What response should the nurse make to this patient’s question?
a. Abstinence
b. Oral contraceptives
c. Condom with spermicide
d. Prophylactic oral antibiotics
____ 21. A patient diagnosed with genital warts asks how they developed. Which pathogen should the nurse explain as causing genital warts?
a. Sarcoptes scabiei
b. Hepatitis A and B
c. Human papillomavirus
d. Chlamydia trachomatis
____ 22. The nurse is caring for a 76-year-old retired man who is undergoing evaluation for dementia. What would be an important part of the man’s history to report to the physician?
a. The patient has a history of syphilis.
b. The patient was exposed to Chlamydia.
c. The patient has a history of hepatitis B.
d. The patient has a history of genital warts.
____ 23. A patient is undergoing treatment that involves the burning of lesions with heat or chemical agents. The nurse recognizes that this patient most likely has which condition?
a. Syphilis
b. Chlamydia
c. Hepatitis B
d. Genital warts
____ 24. The nurse is providing care for a newborn. Which intervention should the nurse make to prevent development of ophthalmia neonatorum?
a. Interferon injection
b. Antibiotic eyedrops
c. Vitamin K injection
d. Hepatitis B virus (HBV)-immune globulin
____ 25. While reviewing a medical record the nurse notes that patient has a “strawberry” cervix. For which sexually transmitted infection (STI) would the nurse plan care?
a. Gonorrhea
b. Herpes simplex
c. Trichomoniasis
d. Human papillomavirus infection
____ 26. The nurse is preparing a poster presentation identifying the frequency of sexually transmitted infections (STIs) in the United States. Which STI should the nurse highlight as being the most commonly diagnosed?
a. Gonorrhea
b. Chlamydia
c. Trichomoniasis
d. Human papillomavirus
____ 27. While assisting a health care provider (HCP) conduct a pelvic examination, the patient complains of severe pain during the bimanual examination. For which health problem should the nurse suspect this patient is going to need care?
a. Syphilis
b. Gonorrhea
c. Pelvic inflammatory disease
d. Human papillomavirus infection
____ 28. While assisting with care, the nurse counsels the patient diagnosed with a sexually transmitted infection (STI) about notification of sexual partners. Which patient statement indicates the need for further teaching? (Select all that apply.)
a. “I can contact my sexual partners myself.”
b. “Reporting regulations are the same throughout the country.”
c. “A report form will be completed in my chart that includes a list of my sexual contacts.”
d. “The public health authority can notify a list of sexual contacts without including my identity.”
Multiple Response
Identify one or more choices that best complete the statement or answer the question.
____ 29. The nurse is assisting with teaching a patient who has been exposed to hepatitis B. Which symptoms should the nurse explain may occur before jaundice appears? (Select all that apply.)
a. Rash
b. Nausea
c. Confusion
d. Dark-colored urine
e. Muscle or joint pain
f. Elevated blood glucose
____ 30. The nurse is reviewing prescribed laboratory tests for a patient demonstrating manifestations of syphilis. What diagnostic tests should the nurse expect to be prescribed for this patient? (Select all that apply.)
a. RPR
b. NAT
c. VDRL
d. ELISA
e. Culture
f. CD4 counts
____ 31. A 24-year-old woman diagnosed with Chlamydia has been prescribed doxycycline. What should be included in the nurse’s teaching about the drug treatment? (Select all that apply.)
a. “Take this drug with a meal.”
b. “Do not take with dairy products.”
c. “Avoid unnecessary exposure to sunlight.”
d. “Abstain from alcohol for at least 48 hours after treatment.”
e. “Use birth control methods to ensure you do not become pregnant.”
____ 32. The nurse is teaching a patient about the use of condoms to prevent sexually transmitted infections (STIs). Which information should the nurse include in this teaching? Select all that apply.
a. Condoms can decrease the risk of transmitting STDs.
b. Latex condoms are less likely to break than other types.
c. Inflating the condom prior to use allows for effective inspection.
d. Condoms should be used no more than twice and then discarded properly.
e. Use of a water-soluble lubricant with a condom increases its effectiveness in preventing the spread of an STD.
f. Use of a petroleum-based lubricant with a condom increases its effectiveness in preventing the spread of an STD.
____ 33. The nurse is providing care for a patient recently diagnosed with Chlamydia. Which information should the nurse recommend be included in patient teaching? (Select all that apply.)
a. “Women with Chlamydia may complain of a sore throat.”
b. “Chlamydia is characterized by the development of chancres.”
c. “Ophthalmia neonatorum is seen in infants born to women with Chlamydia.”
d. “Chlamydia can be transmitted sexually and by blood and body fluid contact.”
e. “The risk of ectopic pregnancy is increased in women with a history of Chlamydia.”
f. “The Chlamydia virus can lie dormant in the nervous system tissues and reactivate when an individual is under stress or has a compromised immune system.”
____ 34. The nurse notes that a patient is diagnosed with vulvovaginitis. What should the nurse expect when assessing this patient? (Select all that apply.)
a. Vaginal edema
b. Vaginal discharge
c. Areas of ecchymosis
d. Dark brown vaginal bleeding
e. Complaints of vaginal itching and burning
____ 35. A patient in labor is diagnosed with mucopurulent cervicitis. For which health problems should the nurse anticipate providing care to the newborn? (Select all that apply.)
a. Pneumonia
b. Conjunctivitis
c. Irregular heart rate
d. Flaccid extremities
e. Cyanotic extremities
____ 36. A patient diagnosed with syphilis reminds the HCP of having an allergy to penicillin. Which medications should the nurse expect to be prescribed for this patient? (Select all that apply.)
a. Gentamicin
b. Amoxicillin
c. Tetracycline
d. Doxycycline
e. Erythromycin
____ 37. While providing a bath the nurse suspects that an older female patient has a Trichomonas infection. What type of discharge did the nurse observe to come to this conclusion? (Select all that apply.)
a. Frothy discharge
b. Foul-smelling discharge
c. Yellow-green discharge
d. Open sores on the labia majora
e. Wart-like growths on the labia minora
Chapter 44. Nursing Care of Patients With Sexually Transmitted Infections
Answer Section
MULTIPLE CHOICE
1. ANS: B
The primary stage of syphilis begins with the entry of the Treponema pallidum spirochete through the skin or mucous membranes. Between 3 and 90 days later, a papule develops at the site of entry, then sloughs off, leaving a painless, red, ulcerated area called a chancre. A. Herpes is associated with vesicular skin lesions. C. D. Gonorrhea and Chlamydia are not associated with skin lesions.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
2. ANS: A
Genital parasites are not a true sexually transmitted infection (STI), but they may be transmitted during close body contact. The two most commonly seen parasites are pubic lice (Phthirus pubis, commonly called “crabs” because of the shape of the lice) and scabies (Sarcoptes scabiei). B. C. D. Treponema pallidum, Neisseria gonorrhoeae, and Chlamydia trachomatis are not parasites.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
3. ANS: A
In the tertiary stage of syphilis, the spirochete may form gummas, which are tumors of a rubbery consistency that can break down and ulcerate, leaving holes in body tissues. D. Herpes is associated with vesicular skin lesions. B. C. Gonorrhea and Chlamydia are not associated with skin lesions.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
4. ANS: C
Condoms can greatly decrease the risk of STIs, but condoms can have tiny channels in the rubber (or other elastic material) that can allow microorganisms to pass through. Condoms can break, slip off, or be applied improperly. Petroleum-based lubricants may weaken latex condoms. A. Condoms do not provide a barrier for any area other than the penis and most of the vagina (or anus). B. Some STIs may still be transmitted by contact of surrounding uncovered tissues. D. Spermicide helps protect against pregnancy.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
5. ANS: C
Vesicles are small blisters. A. B. D. Warts, rashes, and papules do not have the same characteristics.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
6. ANS: A
Verrucous means “wart-like.” B. D. D. HPV causes wart-like growths, not rashes, blisters, or papules.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
7. ANS: D
Fitz-Hugh–Curtis syndrome, a surface inflammation of the liver, can also be caused by C. trachomatis. This inflammation may cause nausea, vomiting, and sharp pain at the base of the ribs that sometimes refers to the right shoulder and arm. A. B. C. Vaginal discharge, painful urination, and conjunctivitis are also concerns but are not as health-threatening as liver inflammation.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Analysis |
8. ANS: C
When wet-mount slides of Trichomonas discharge are viewed under a microscope, the organisms can be identified by their motility and whip-like flagella. A. B. D. Trichomonas is not diagnosed through a culture, blood test, or litmus paper.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
9. ANS: C
Trichomonas may produce abnormal Pap smear readings, which require that more frequent Pap smears be done to provide adequate surveillance of cellular changes. A. Wet mount can identify the organism but not cellular changes. B. D. Serological testing and culture and sensitivity testing are not performed to detect cervical changes caused by Trichomonas.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
10. ANS: D
Systemic interferon treatments attack warts all over the body at the same time, rather than individually as with topical treatments. This speeds the process of treatment. A. B. C. Interferons can produce side effects of flu-like symptoms, a drop in the number of white blood cells, and changes in liver function.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application
11. ANS: D
It is recommended that all babies of HBV-positive mothers receive HBV immune globulin less than 12 hours after birth and then be immunized with HBV vaccine 1 week, 1 month, and 6 months after birth. A. Antibiotics are not effective against viruses. B. Eye medication may be necessary for gonorrhea or chlamydia. C. The infant needs to receive the HBV vaccination.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
12. ANS: C
A nurse’s best protection against catching infections from blood and body fluids of infected patients is the strict practice of standard precautions and maintaining his or her own healthy, intact skin. A. Wearing gloves at all times is not appropriate. B. Washing hands is essential but is not sufficient. D. Touching patients cannot and should not be avoided.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
13. ANS: B
Newborns born to mothers who have gonorrhea can develop ophthalmia neonatorum, which involves inflammation of the conjunctiva and deeper parts of the eye and can, ultimately, result in blindness. A. C. D. Syphilis, genital warts, and genital herpes are not associated with infant eye problems.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
14. ANS: C
Herpes, human papillomavirus (HPV), and hepatitis (not most sexually transmitted infections [STIs]) have been associated with cancers. A. Cancer has been associated with some STIs. B Most STIs do not cause cancer. D. Having a diagnosis of cancer does not increase the risk of contracting an STI.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
15. ANS: A
Consumption of alcohol or other psychoactive drugs can reduce inhibitions and may result in unintended sexual encounters, which can transmit STIs. B. C. D. Alcohol does cause liver disease and may indirectly reduce resistance, but these are not the mechanisms by which immediate STI risk increases.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
16. ANS: C
Condoms should never be inflated to test them, because this can weaken them. B. Lubrication decreases the chances of breakage during use, but only water-soluble lubricants should be used, because substances such as petroleum jelly (Vaseline) may weaken the condom. D. Either condoms with a reservoir tip or regular condoms that have been applied while holding approximately 1/2 inch of the closed end flat between the fingertips allow room for expansion by the ejaculate without creating excessive pressure, which might break the condom. A. Condoms should not be reused.
PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation
17. ANS: A
Jaundice is a symptom of hepatitis. D. Headaches can be associated with many disorders and are not specific to hepatitis. B. C. Diabetes and bowel obstruction are not associated with hepatitis.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation| Cognitive Level: Analysis
18. ANS: C
B. Men may be asymptomatic or may have urethritis with a yellow urethral discharge. C. Women who have gonorrhea may have either no noticeable symptoms or have a sore throat, mucopurulent cervicitis (MPC), urethritis, or abnormal menstrual symptoms such as bleeding between periods. A. Gonorrhea is treatable with antibiotics, which have side effects, but not such serious side effects that compliance is affected.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
19. ANS: D
IV drug equipment can transmit some STIs. A. B. C. Sharing a cigarette or hairbrush or coughing and sneezing can spread various infections, but not generally STIs.
PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application
20. ANS: A
Abstinence or lifelong monogamy of both sexual partners in a relationship are the only sure prevention against STIs. D. Antibiotics treat but do not prevent STIs. B. Oral contraceptives do not prevent STIs. C. Condoms may help prevent STIs, but they are not completely effective.
PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application
21. ANS: C
Condylomata acuminatum (genital warts) is a common sexually transmitted viral infection, and their incidence is increasing rapidly. Infection with human papillomavirus (HPV) produces the condylomata. A, B, and D do not cause warts.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
22. ANS: A
Untreated syphilis can lead to neurosyphilis and neurological changes. B, C, and D do not cause neurological changes.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
23. ANS: D
There is presently no known cure for papillomavirus infection. The warts may be treated by freezing, burning, or chemically destroying them or by manipulating the patient’s immune system to attack the virus. Cryotherapy (freezing) of the warts may be done by touching each wart with a cryoprobe or a liquid nitrogen–soaked swab. Warts may also be burned or electro-coagulated with an electrocautery or a laser. Heat causes the proteins to coagulate, resulting in death of the wart tissue. A. B. Syphilis and Chlamydia are treated with antibiotics. C. Hepatitis B virus may be treated with immune globulins as well as supportive treatment.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Analysis
24. ANS: B
Ophthalmia neonatorum may be prevented by use of antibiotic eye preparations, which contain silver nitrate, erythromycin, or tetracycline. D. HBV immune globulin is given to prevent HPV. C. Vitamin K prevents bleeding. A. Interferon is not used.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
25. ANS: C
Visualization of the cervix during pelvic examination shows a characteristic “strawberry cervix” with Trichomonas infection. A, B, and D are not associated with a strawberry cervix.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
26. ANS: B
Chlamydia is the most commonly diagnosed STI in the United States. A. C. D. Gonorrhea, Trichomoniasis, and HPV are not the most commonly diagnosed STIs in the United States.
PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application
27. ANS: C
With pelvic inflammatory disease, findings during physical examination include adnexal tenderness upon palpation, and pain in the uterus and cervix when moved during a bimanual examination. A. B. D. Pain during a bimanual examination is not associated with syphilis, gonorrhea, or human papillomavirus infection.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Analysis
28. ANS: B
The requirements for reporting STDs may vary for different states, provinces, and countries. C. The report form has spaces for listing sexual contacts who should be notified of possible STD exposure. A. Depending on the laws of the state, province, or country, HCPs may notify identified sexual contacts or patients may do so themselves. D. Contacts may also be notified by a public health authority that they have been listed as a sexual contact by an anonymous person who has tested positive for a particular STD.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Analysis
MULTIPLE RESPONSE
29. ANS: A, B, E
Early signs of hepatitis are loss of appetite, rashes, malaise, muscle and joint pain, headaches, nausea, and vomiting. D. As the virus affects the liver, the urine may darken and the stool color lightens, liver enzymes may rise, and jaundice may appear. C. Confusion is a late sign of liver disease. F. Glucose abnormalities occur with pancreatic disease.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Physiological Adaptation | Cognitive Level: Application
30. ANS: A, C, D, E
Several tests for syphilis exist, and a combination may be used for accurate diagnosis. Cultures may be done but are difficult to grow. Serological (blood) tests include the Venereal Disease Research Laboratory (VDRL) test, the rapid plasma reagin (RPR) test, and the automated reagin test (ART). Treponemal enzyme-linked immunosorbent assay (ELISA), fluorescent treponemal antibody absorption (FTA-ABS), and polymerase chain reaction (PCR) tests for treponemal DNA are some newer methods that reduce the risk of false results. B. F. NAT is done for Chlamydia. CD4 and CD8 are used to evaluate HIV/AIDS.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Reduction of Risk Potential | Cognitive Level: Application
31. ANS: B, C, E
Do not administer doxycycline during pregnancy due to bone/teeth effects. Do not take with antacids or dairy products. Avoid unnecessary exposure to sunlight. A. Administer on an empty stomach. D. Alcohol should be avoided with metronidazole.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application
32. ANS: A, B, E
Condoms can reduce (but not eradicate) the risk of STDs. Latex condoms are less likely to break during intercourse than other types. Lubrication decreases the chances of breakage during use, but only water-soluble lubricants should be used. F. Substances such as petroleum jelly (Vaseline) may weaken the condom. C. Condoms should never be inflated to test them, because this can weaken them. D/ Condoms should never be reused and should be discarded properly after use so that others will not come in contact with the contents.
PTS: 1 DIF: Moderate
KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application
33. ANS: D, E
Chlamydia is the most commonly diagnosed sexually transmitted infection (STI) in the United States. It can be transmitted sexually and by blood and body fluid contact. Chlamydia is a frequent cause of pelvic inflammatory infection (PID) and infertility, and it increases the risk of ectopic pregnancy. A. Women who have gonorrhea may have either no noticeable symptoms or have a sore throat. C. Newborns born to mothers who have gonorrhea can develop ophthalmia neonatorum. F. Herpes viruses have an affinity for tissues of the skin and nervous system and can lie dormant in nervous system tissues and then reactivate periodically when the body undergoes stress, fever, or immune system compromise/ B. Chancres can develop with syphilis.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
34. ANS: A, B, E
Vulvovaginitis is an inflammation of the vulva and vagina and can be asymptomatic or involve redness, itching, burning, excoriation, pain, swelling of the vagina and labia, and discharge. C. D. Ecchymosis and dark brown vaginal bleeding are not manifestations of this disorder.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
35. ANS: A, B
Mucopurulent cervicitis (MPC) is an inflammation of the cervix that may produce a mucopurulent yellow exudate on the cervix or may have no noticeable symptoms. MPC during pregnancy can result in conjunctivitis and pneumonia in newborn infants. C. D. E. MPC does not cause irregular heart rate, or flaccid or cyanotic extremities in the newborn.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Application
36. ANS: C, D
Penicillin G is the treatment of choice for patients diagnosed with syphilis. For those who are allergic to penicillin, doxycycline and tetracycline are treatment options. A. E Gentamicin and erythromycin are not antibiotics identified to treat syphilis. B. Amoxicillin is a later generation of penicillin and should not be given.
PTS: 1 DIF: Moderate
KEY: Client Need: Physiological Integrity—Pharmacological and Parenteral Therapies | Cognitive Level: Application
37. ANS: A, B, C
Trichomoniasis is a sexually transmitted infection caused by a protozoan parasite. It can be also be transmitted through nonsexual contact with infected articles because it can survive for a long time outside the body. Carriers of Trichomonas vaginalis can be asymptomatic for several years until changes in vaginal or urethral conditions encourage an outbreak of the infection. Symptoms include redness, swelling, itching, and burning of the genital area; pain with intercourse and voiding; and a frothy, foul-smelling discharge that can be clear, white, yellowish, or greenish. D. Trichomoniasis is not associated with open sores or wart-like growths.
PTS: 1 DIF: Moderate
KEY: Client Need: Safe and Effective Care Environment—Safety and Infection Control | Cognitive Level: Analysis
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