The Client with Sexually Transmitted Disease

The nurse determines that a woman with genital herpes (HSV-2) understands her self-care related to this infection when she states:
1. "When I have a baby, I don't want a cesarean."
2. "I can have sex when all the herpes sores have healed."
3. "When I finish the acyclovir prescription, I will be cured."
4. "I must be careful when I have sex because herpes is a lifelong problem."
A 16-year-old adolescent has a steady boyfriend and is having sexual relations with him. She is seeking advice as to how she can protect herself from contracting HIV. The nurse advises her to:
1. Have her partner withdraw before ejaculating
2. Make certain their relationship is monogamous
3. Seek counseling about various contraceptive methods
4. Be sure that her partner uses a condom when having sex
When assessing a female client who is suspected of having primary syphilis, the nurse should expect the client to exhibit the early sign of:
1. Flat wartlike plaques around the vagina and anus
2. An indurated painless nodule on the vulva that begins to drain
3. Glistening patches in the mouth covered with a yellow exudate
4. A maculopapular rash on the palms of the hands and soles of the feet
A client who has been diagnosed as having syphilis tells the nurse that it must have been contracted from a toilet seat. The nurse knows that this cannot be true because the causative agent of syphilis is:
1. Immobilized by body contact
2. Chelated by wood and plastic
3. Destroyed by warmth and moisture
4. Inactivated when exposed to a dry environment
A 35-year-old woman arrives at the women's health care center complaining of frequency and burning pain when urinating. The diagnosis is a urinary tract infection. When instructing this client it is important to:
1. Encourage her to void every two hours
2. Have her record her fluid intake and output
3. Pour warm water over her vulva whenever she voids
4. Teach her to wash her hands before and after voiding
The nurse in the women's health clinic recognizes that a client who complains of swelling of the labia and throbbing pain in the labial area after sexual intercourse should be treated for:
1. Urethritis
2. Bartholinitis
3. Vaginal hematoma
4. Inflamed Skene's glands
Four days after a vaginal hysterectomy a client calls the telephone follow-up service and tells the nurse that she has a yellowish green vaginal discharge. The nurse advises the client to return to the clinic because the nurse knows that there is a need to assess:
1. The blood pressure and pulse
2. The specific gravity of her urine
3. For the symptoms of a urinary tract infection
4. For the presence of abdominal pain and a rising temperature
The LVN discusses herpes genitalis as part of a sex education program. The nurse should instruct the patients that herpes genitalis is:
1. Painless in both men and women.
2. Curable with antibiotics.
3. Transmitted via toilet seats.
4. Responsible for systemic and local reactions.
The nurse understands that gonorrhea is difficult to control because:
1. The blood test is expensive and time consuming
2. The causative organism has become resistant to treatment
3. There is no specific diagnostic test for the causative organism
4. The symptoms are vague and the incubation period is relatively short
When a student in a high school sex education class asks whether recurrent infection is possible with herpes genitalis, the nurse should reply that:
1. A healthy lifestyle will prevent recurrences
2. Once herpes genitalis has been effectively treated, recurrence is rare
3. Although attacks do recur they are not as severe as the initial infection
4. The surest way to prevent recurrent attacks is to abstain from sexual activity
The nurse evaluates that a young female client who is being treated for a sexually transmitted infection understands instructions regarding future sexual contacts when she states:
1. "If I have sex, nothing I do will really prevent me from getting another sexually transmitted infection."
2. "If I get a sexually transmitted infection I can take whatever you give me because I'm not allergic to any drugs."
3. "I will not have unprotected sex again and I will tell my partners to be tested for sexually transmitted infections."
4. "I must ask my partners if they have a sexually transmitted infection and if they say no, then I'll know that I can have sex."
A client at 16 weeks' gestation is being treated for Trichomonas vaginalis. The statement that best indicates to the nurse that the client has learned measures to prevent recurrence is, "I will:
1. "Void immediately after intercourse."
2. "Persuade my sexual partner to be treated."
3. "Insert a vaginal suppository after intercourse."
4. "Douche immediately after having sexual intercourse."
The nurse is caring for a client with dysuria. Urinary tract infection is the presumed diagnosis and a urine analysis is completed. The nurse is aware that the results exclusively indicating the development of infection would include the presence of:
1. Nitrate
2. Protein
3. Bilirubin
4. Erythrocytes
A client comes to the infectious disease clinic because a sexual partner was recently diagnosed as having gonorrhea. The health history reveals that the client has engaged in receptive anal intercourse. The nurse should assess the client for:
1. Melena
2. Anal itching
3. Constipation
4. Ribbon-shaped stools
The nurse should ask the client with secondary syphilis about sexual contacts during the past:
1. 21 days
2. 30 days
3. 3 months
4. 6 months
A client is suspected of having late-stage (tertiary) syphilis. When obtaining a health history, the nurse recognizes that the statement by the client that most supports this diagnosis would be:
1. "I noticed a wart on my penis."
2. "I have sores all over my mouth."
3. "I've been losing a lot of hair lately."
4. "I'm having trouble keeping my balance."
A young sexually active client at the family planning clinic is advised to have a Pap smear. She has never had a Pap smear before. The nurse's explanation of the procedure should include that:
1. Pap smears can detect cancer of the cervix
2. Vaginal bleeding is expected after a Pap smear
3. Colposcopy will be used to magnify the cervix
4. Scraping the cervix is the most uncomfortable part
Immediately after a sexual assault, appropriate nursing care should include:
1. Obtaining a history of the assault from the client
2. Informing the police before the client is examined
3. Asking the client to collect a clean-catch urine specimen
4. Testing the client's urine for seminal alkaline phosphatase
The school nurse discusses herpes genitalis as part of a high school sex education program. The nurse should instruct the students that herpes genitalis is:
1. Painless in women
2. Curable with penicillin
3. Transmitted via fomites such as toilet seats
4. Responsible for local as well as systemic reactions
The nurse understands that gonorrhea is difficult to control because:
1. Blood cultures are time consuming
2. The causative organism is a virus
3. diagnostic test is very painful
4. The incubation period is relatively short and there might be no symtpoms at all
A 20-year-old client is being treated for epididymitis. Teaching for this client should include the fact that epididymitis is often a result of a
1. Virus
2. Parasite
3. Sexually Transmitted Infection
4. Protozoa
Women who have had an STD are at increased risk for:
1. infertility
2. HIV/AIDS
3. getting another STD
4. Cancer
The nurse explains to a sexually active woman with a history of a mucopurulent discharge and bleeding associated with cervical dysplasia, dysuria, and dyspareunia that she will receive erythromycin or amoxicillin for the treatment of:
1. Herpes simplex 2
2. Treponema pallidum
3. Neisseria gonorrhoeae
4. Chlamydia trachomatis
A home care nurse begins caring for a 25-year-old female client who has just been diagnosed with human immunodeficiency virus (HIV) infection. The client asks the nurse, "How could this have happened?" The nurse responds to the question based on the most frequent mode of HIV transmission, which is
1. hugging an HIV-positive sexual partner without using barrier precautions.
2. inhaling cocaine.
3. sharing food utensils with an HIV-positive person without proper cleaning of the utensils.
4. having sexual intercourse with an HIV-positive person without using a condom.
A client with HIV is taking zidovudine (AZT). AZT is a drug that acts to
1. destroy the virus.
2. enhance the body's antibody production.
3. slow replication of the virus.
4. neutralize toxins produced by the virus
Women who have human papillomavirus (HPV) are at risk for development of
1. sterility.
2. cervical cancer.
3. uterine fibroid tumors.
4. irregular menses.
Which of the following nursing diagnoses would most likely be a priority for a client with herpes genitalis?
1. Disturbed Sleep Pattern
2. Imbalanced Nutrition: Less Than Body Requirements
3. Pain.
4. Ineffective Breathing Pattern.
The primary reason that a herpes simplex virus (HSV) infection is a serious concern to a client with HIV infection is that it
1. is an acquired immunodeficiency virus (AIDS)–defining illness.
2. is curable only after 1 year of antiviral therapy.
3. leads to cervical cancer.
4. causes severe electrolyte imbalances.
In educating a client about HIV, the nurse should take into account the fact that the most effective method known to control the spread of HIV infection is
1. premarital serologic screening.
2. prophylactic treatment of exposed people.
3. laboratory screening of pregnant women.
4. ongoing sex education about preventive behaviors.
A male client with HIV infection becomes depressed and tells the nurse "I have nothing worth living for now." Which of the following statements would be the best response by the nurse?
1. "You are a young person and have a great deal to live for."
2. "You should not be too depressed; we are close to finding a cure for AIDS."
3. "You are right; it is very depressing to have HIV."
4. "Tell me more about how you are feeling about being HIV positive."
The organism responsible for causing syphilis is classified as a
1. virus.
2. fungus.
3. rickettsia.
4. spirochete.
The typical chancre of syphilis appears as
1. a grouping of small, tender pimples.
2. an elevated wart.
3. a painless, moist ulcer.
4. an itching, crusted area.
When interviewing a client with newly diagnosed syphilis, the public health nurse should be aware that the spread of the disease can be controlled by
1. motivating the client to undergo treatment.
2. obtaining a list of the client's sexual contacts.
3. increasing the client's knowledge of the disease.
4. reassuring the client that records are confidential.
Benzathine penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The intramuscular injection is administered in
1. the deltoid.
2. the upper outer quadrant of the buttock.
3. the quadriceps lateralis of the thigh.
4. the midlateral aspect of the thigh.
A priority nursing diagnosis for a client with primary syphilis is
1. Deficient Knowledge related to lack of exposure to information about mode of transmission.
2. Pain related to cutaneous skin lesions on palms and soles.
3. Ineffective Tissue Perfusion related to a bleeding chancre.
4. Disturbed Body Image related to alopecia.
An 18-year-old female college student is seen at the university health center. She undergoes a pelvic examination and is diagnosed with gonorrhea. Which of the following responses by the nurse would be best when the client says that she is nervous about the upcoming pelvic examination?
1. "Can you tell me more about how you're feeling?"
2. "You're not alone. Most women feel uncomfortable about this examination."
3. "Do not worry about Dr. Smith. He's a specialist in female problems."
4. "We'll do everything we can to avoid embarrassing you."
When educating a female client with gonorrhea, the nurse should emphasize that for women gonorrhea
1. is often marked by symptoms of dysuria or vaginal bleeding.
2. does not lead to serious complications.
3. can be treated but not cured.
4. may not cause symptoms until serious complications occur.
Which of the following groups has experienced the greatest rise in the incidence of STDs over the past two decades?
1. Teenagers.
2. Divorced people.
3. Young married couples.
4. Older adults.
A 16-year-old sexually active male client presents to the clinic with a complaint of burning on urination and a milky discharge from the urethral meatus. Documentation on the client's chart should include which of the following information? Select all that apply.
1. History of unprotected sex (sex without a condom).
2. Length of time since symptoms presented.
3. History of fever or chills.
4. Presence of any enlarged lymph nodes on examination.
A 19-year-old male client is diagnosed with Chlamydia. Azithromycin (Zithromax) 1 gram is ordered. The supply of azithromycin is in 250-milligram tablets. The number of tablets to be administered is
1. 1
2. 0
3. 2
4. 4
A female client with gonorrhea informs the nurse that she has had sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men the symptoms of gonorrhea include
1. impotence.
2. scrotal swelling.
3. urinary retention.
4. dysuria
The nurse assesses the mouth and oral cavity of a client with HIV because the most common opportunistic infection initially presents as
1. HSV lesions on the lips.
2. oral candidiasis.
3. cytomegalovirus (CMV) infection.
4. aphthae on the gingiva.
A 28-year-old male client is diagnosed with acute epididymitis. The nurse would expect to find that the symptoms that caused the client to seek medical care are
1. burning and pain on urination
2. severe tenderness and swelling in the scrotum.
3. foul-smelling ejaculate.
4. foul-smelling urine.
Which of the following bacterial STDs is the most common?
1. Scabies
2. Syphilis
3. Chlamydia
4. HIV
Which STD besides HIV/AIDS can be detected by a blood test?
1. gonorrhea
2. syphilis
3. chlamydia
4. trichomoniasis
Mrs Hawk is being treated with penicillin for syphilis. Twelve hours after the first injection of penicillin, the client develops fever, musculoskeletal pain, and tachycardia. The nurse recognizes these manifestations as being suggestive of:
1. anaphylaxis to penicillin.
2. complications of the syphilis infection.
3. resulting from the release of toxins from the spirochetes into the bloodstream.
4. resulting from the client's anxiety regarding the diagnosis of syphilis.

The Client with Sexually Transmitted Disease

Quiz