STD’s

A client who has localized herpes simplex virus (HSV) infection is admitted to the maternity unit. The nurse knows the client should ideally be placed in which of the following?
a. any available room
b. a single, unoccupied room
c. a double room with a client who underwent a c section 3 days prior
d. a double room with a curtain divider
b

the nurse cares for a client with genital herpes. After
the client is informed of the diagnosis, the client begins crying.
Which of the following responses by the nurse is the best
a. we have support groups that may help you talk about some of your feelings
b. i see that your upset. Share with me your thoughts
c. while herpes is a difficult disease, at least you dont have AIDS
d. i think the physician should explain more to you about genital herpes`
b. reflects feelings and allows the client to verbalize concerns

the current incidence of STD’s is related in part to
a. increased social acceptance of homosexuality
b increased virulence of organisms causing STD’s
c. the use of oral agents rather than condoms as contraceptives
d. development of resistance of microorganisms to common antibiotics
c

a female patient with a purulent vaginal discharge is seen at the outpatient clinic. The nurse would expect a diagnosis of gonorrhea to
a. be treated with benzathine penicillin G
b. be confirmed with a Gram stain smear of the exudate
c. indicate the presence of PID
d. be treated with cefixime (Suprax) and doxycycline (Vibramycin)
d

a 22 year old woman with multiple sex partners seeks care after several weeks of experiencing painful frequent urination and vaginal discharge. although the results of a culture of cervical secretions are not yet available, the nurse explains to the patient that she will be treated as if she has gonorrhea and chlamydia to prevent
a. obstruction of the fallopian tubes
b. endocarditis and aortic aneurysms
c. disseminated gonoccal infection
d. polyarthritis and generalized adenopathy
a

during evaluation and treatment of gonorrhea in a young man at the health clinic, it is most important that the nurse question the patient about
a. a prior history of STD
b. when the symptoms began
c. the date of his last sexual activity
d. the names of his recent sexual partners
d

a premarital blood test for syphilis reveals that a woman has a positive Venereal Disease Research Laboratory (VDRL) test. the nurse advises the patient that
a. a single dose of penicillin will cure the syphilis
b. she should question her fiancée about prior sexual contacts
c. a lumbar puncture to evaluate CSF is necessary to rule out active syphilis
d. additional testing to detect specific antitreponemal antibodies is necessary
d

the nurse encourages serologic testing for the HIV in the patient with syphilis primarily because
a. syphilis is more difficult to treat in patients with HIV infections
b. the presence of HIV infection increases the risk of contacting syphilis
c. CNS involvement is more common in patients with HIV infection and syphilis
d. the incidence of syphilis is highest in those with high rates of sexual promiscuity and drug abuse
d

in establishing screening programs for populations at high risk for chlamydial infections, the nurse recognizes that women in, C. trachomatis infection most often results in
a. cervicitis
b. no symptoms
c. acute urethritis
d. liver inflammation
b

a male patient returns to the clinic with a recurrent urethral discharge after being treated for a chlamydial infection 2 weeks ago. which statement by the patient indicates the most likely cause of the recurrence of his infection?
a. I took the vibramycin twice a day for a week
b. I haven’t told my girlfriend about my infection yet
c. I had a couple of beers while I was taking this medication
d. Ive only had sexual intercourse once since my medication was finished
b

a diagnosis of chlamydial infection can be
made in a male partner when
a. cultures for chlamydial organisms are positive
b. direct fluorescent antibody (DFA) tests are positive
c. Gram stain smears and cultures are negative for gonorrhea
d. signs and symptoms of epididymitis or proctitis are also present
c

during the physical assessment of a female patient with HPV infection, the nurse would expect to find
a. purulent vaginal discharge
b. a painless, indurated lesion on the vulva
c. painful perineal vesicles and ulcerations
d. multiple coalescing gray warts in the perineal area
d

it is most important for the nurse to teach the female patient with genital warts to
a. have an annual Pap smear
b. apply topical acyclovir faithfully as directed
c. have her sexual partner treated for the condition
d. use a contraceptive to prevent pregnancy, which might exacerbate the disease
a

based on the incidence of STD’s in the US, the nurse informs individuals who have unprotected sexual activity with multiple partners that they are at highest risk for contracting
a. syphilis
b. gonorrhea
c. chlamydia
d. genital warts
d

indicate what treatment or precautions should be taken during pregnancy or delivery when the patient has active
a. syphilis
b. gonorrhea
c. genital herpes
d. genital warts
a

although an 18 year old girl knows that abstinence is one way to prevent STD’s, she does not consider an alternative. She asks the nurse at the clinic if there are other measures for preventing STD’s. The nurse informs her that
a. abstinence is the only way to prevent STD’s
b. voiding immediately after intercourse will decrease the risk of infection
c. a vaccine can prevent genital warts and cervical cancer caused by some strains of HPV.
d. thorough hand washing after contact with genitals can prevent oral-genital spread of STD.
c

the patient who is most likely to have a nursing diagnosis of risk for noncompliance is the patient with
a. syphilis
b. gonorrhea
c. genital herpes
d. HPV infection
a

the individual with the lowest risk for sexually transmitted PID is a woman who
a. uses oral contraceptives
b. uses barrier methods of contraception
c. uses an intrauterine device for contraception
d. uses a Norplant implant or injectable Depo-Provera for contraception
b

the nurse is obtaining subjective data assessment from a woman reported as a sexual contact of a man with Chlamydia. The nurse understands that symptoms of chlamydial infection in women
a. are frequently absent
b. are similar to those of genial herpes
c. include a macular palmar rash in the later stages
d. may involve chancres inside the vagina that are not visible
a

A primary HSV infection differs from a recurrent HSV episodes in that
Select all that apply
a. only primary infections are sexually transmitted
b. symptoms are less severe during recurrent episodes
c. transmission of the virus to a fetus is less likely during primary infection
d. systemic manifestations such as fever and myalgia are more common in primary infection
e. lesions from recurrent HSV are more likely to transmit the virus than lesions from primary HSV.
b, d

explain to the patient with gonorrhea that treatment will include both ceftriaxone and doxycycline because
a. most patients need both drugs to eradicate the organism
b. coverage with more than one antibiotic will prevent reinfection
c. no single agent successfully eradicate both primary and recurrent infections
d. the high rate of coexisting chlamydial infection and gonorrhea indicates coverage with both drugs
d

a patient with an STD who is most likely to have a nursing diagnosis of disturbed image that hinders future sexual relationships is the patient with
a. syphilis
b. gonorrhea
c. chlamydial infection
d. genital warts
d

to prevent the infection and transmission of STD’s, the nurse’s teaching plan would include an explanation of
a. the appropriate use of oral contraceptives
b. sexual positions that can be used to avoid infection
c. the necessity of annual Pap tests for patients with HPV
d. sexual practices that are considered high risk behaviors
d

provide emotional support to a patient with an STD by
a. offering information on how safe sexual practices can prevent STD’s.
b. showing concern when listening to the patient who expresses negative feelings
c. reassuring the patient that the disease is highly curable with appropriate treatment
d. helping the patient who received an STD from his or her sexual partner in forgiving the partner
b

A patient comes to the clinic after being informed by a sexual partner of possible recent exposure to syphilis. The nurse will examine the patient for which of the following characteristic findings of syphilis in the primary clinical stage?
a. Chancre
b. Alopecia
c. Condylomata lata
d. Regional adenopathy
a. Chancres appear in the primary stage of the bacterial invasion of Treponema pallidum, the causative organism of syphilis. The other findings do not appear until the secondary stage of syphilis, occurring a few weeks after the chancres appear.

Teaching for patients with a sexually transmitted disease (STD) would include (select all that apply)
a. Treatment of sexual partner is important.
b. Douching may help provide relief of itching.
c. Cotton undergarments are preferred over synthetic materials.
d. Sexual abstinence is indicated during the communicable phase of the disease.
e. Condoms should be used during as well as after treatment during sexual activity.
a,c,d,e Douching may spread the infection or alter the local immune responses and is therefore contraindicated in patients with STDs. All other choices are appropriate patient teaching.

A 22-year-old male is being treated at a college health care clinic for gonorrhea. Which of the following teaching points should the nurse include in patient teaching?
a. “While being treated for the infection, you will not be able to pass this infection on to your sexual partner.”
b. “While you’re taking your antibiotics, you will need to abstain from participating in sexual activity or drinking alcohol.”
c. “It’s important to complete your full course of antibiotics in order to ensure that you become resistant to reinfection.”
d. “The symptoms of gonorrhea will resolve on their own, but it is important for you to abstain from sexual activity while this is occurring.”
b. Treatment for gonorrhea necessitates abstinence from sexual activity (to prevent infection of partners) and alcohol (to avoid urethral irritation). The disease is not self limiting nor does successful treatment confer future resistance.

Screening for chlamydia is recommended for young women because
a. Chlamydia is frequently comorbid with HIV.
b. Chlamydial infections may progress to sepsis.
c. Untreated chlamydial infections can lead to infertility.
d.Chlamydial infections are treatable only in the early stages of infection.
c. Because of the potential for infertility, screening for chlamydia is recommended for women under 25. Sepsis is not a primary risk of chlamydia and is not noted to be strongly correlated with HIV infection. The disease is treatable at all stages of infection.

A 30-year-old female patient has sought care because of the recent appearance of itchy lesions on her vulva, some of which have recently burst. The patient’s description of her problem would lead you to first suspect
a. HIV.
b. Gonorrhea.
c. Chlamydia.
d. Genital herpes.
d. A primary episode of genital herpes is often marked by multiple small, vesicular lesions on the genitals. This symptomatology is not commonly associated with gonorrhea, chlamydia, or HIV.

The physical assessment and history of a 29-year-old female patient are indicative of human papillomavirus (HPV) infection. You would perform patient teaching related to
a. Gardasil.
b. Antibiotic therapy.
c. Wart removal options.
d. Treatment with antiviral drugs.
c. The HPV vaccine (Gardasil) is ineffective in cases of existing HPV, whereas neither antiviral nor antibiotic drugs are effective treatments. Patient teaching should focus on the various options for physically removing the warts.

A female patient with a purulent vaginal discharge is seen at an outpatient clinic. the nurse would expect a dx of gonorrhea to:
a. be treated with benathine penicillin G
b. indicate PID
c. be confirmed with a Gram’s stain
d. be treated wit hceftriaxone (Rocephine) and doxycycline (Vibramycin)
d. be treated with ceftriaxone (Rocephine) and doxycycline (Vibramycin

The nurse encourages serologic testing for HIV in the patient with syphilis primarily because
a. syphilis is more difficult to treat in patients with HIV
b. CNS involvement is more common in patients wit HIV
c. the incidence of syphilis is highest in those with high rates of sexual promiscuity and drug abuse
c. the incidence of syphilis is highest in those with high rates of sexual promiscuity and drug abuse

In establishing screening programs for populations at high risk for chlamydia infections, the nurse recognizes that in women, C trachomatis infection most often results in
a. cervicitis
b. No symptoms
c. acute arethritis
b. No symptoms

A diagnosis of chlamydia infection is made in a male patient with a purulent urethral discharge when
a. cultures for chlamydia organisms are positive
b. Gram’s stains and cultures are negative for gonorrhea
c. signs and symptoms of epididymitis or procititis are also present
b. Gram’s stains and cultures are negative for gonorrhea

During the physical assessment of a female patient with HPV, the nurse would expect to find
a. purulent discharge
b. painless, indurated lesion on the vulva
c.multiple coalescing gray warts in the perineal area
c.multiple coalescing gray warts in the perineal area

It is most important for the nurse to teach the female patient with warts to
a. have annual pap smears
b. apply topical acyclovir faithfully as directed
c. have her sexual partner treated for the condition
a. have annual pap smears

Based on incidence of STDs in the US, the nurse informs individuals who have unprotected sex that they are at high risk for contracting:
a. syphilis
b. gonorrhea
c. chlamydia
d. genital warts
c. chlamydia

When caring for a patient with an STD, it is most important that the nurse teach the patient to:
a. use a barrier contraceptive during sex
b. advise all sexual partners of the need for treatment
c. take the full course of antibiotics
d. return to clinic for retesting
b. advise all sexual partners of the need for treatment

The nurse teaches the patient with genital herpes about the use of:
a. oral acylovir (Zovirax)
b. acyclovir ointment
c. podofilox topical gel
d. HPV vaccine
a. oral acylovir (Zovirax)

Which STD is considered a “silent disease” due to being asymptomatic, & superficial that becomes invasive
a. gonorrhea
b. chlamydia
c. HPV
d. syphilis
b. chlamydia

While obtaining subjective assessment data from a woman reported as a sexual contact of a man with chlamydia, the nurse understands that symptoms of chlamydia infections in women
A. are frequently absent.
B. mimic those of genital herpes.
C. include a macular palmar rash in later stages.
D. may involve chancres hidden inside the vagina.
A. are frequently absent

A primary HSV infection differs from recurrent episodes in that
A. it is of shorter duration than recurrent episodes.
B. only primary infections are sexually transmissible.
C. systemic manifestations such as fever and myalgia are more common.
D. transmission of the virus to a fetus is less likely during primary infection.
C. systemic manifestations such as fever and myalgia are more common.

The nurse explains to a patient with gonorrhea that treatment will include both ceftriaxone and doxycycline because
A. most patients do not respond to ceftriaxone alone.
B. coverage with more than one antibiotic prevents reinfection.
C. no single agent successfully eradicates all strains of gonorrhea.
D. the high rate of coexisting chlamydia and gonorrhea indicates dual coverage.
D. the high rate of coexisting chlamydia and gonorrhea indicates dual coverage.

A patient with an STD who is most likely to have a nursing diagnosis of disturbed body image that hinders future sexual relationships is the patient with
A. syphilis.
B. gonorrhea.
C. genital warts.
D. chlamydia infection.
C. genital warts.

An appropriate nursing intervention to provide emotional support to a patient with an STD is to
A. use concerned listening when the patient expresses negative feelings.
B. reassure the patient that the disease is curable with appropriate treatment.
C. offer many alternatives that the patient can use to change sexual relationships.
D. help the patient who is an innocent sexual partner forgive the infecting partner.
A. use concerned listening when the patient expresses negative feelings.

A nurse is teaching a client with genital herpes. Education for this client should include an explanation of: a) why the disease is transmittable only when visible lesions are present. b) the need for the use of petroleum products. c) …

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The nurse is participating at a health fair at the local mall giving influenza vaccines to senior citizens. What level of prevention is the nurse practicing? A) Primary prevention B) Secondary prevention C) Tertiary prevention D) Quaternary prevention Primary prevention …

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