Chapter 07: Sexually Transmitted and Other Infections
MULTIPLE CHOICE
1. Which manifestation differentiates primary syphilis from secondary syphilis?
a. Fever, headache, and malaise
b. Widespread rash
c. Identified by serologic testing
d. Appearance of a chancre 2 months after infection
ANS: D
Primary syphilis is characterized by a primary lesion (the chancre), which appears 5 to 90
days after infection. The chancre begins as a painless papule at the site of inoculation and
erodes to form a nontender, shallow, and clean ulcer several millimeters to centimeters in
size. Secondary syphilis occurs 6 weeks to 6 months after the appearance of the chancre and
is characterized by a widespread maculopapular rash. The individual may also experience
fever, headache, and malaise. Latent syphilis are those infections that lack clinical
manifestations; however, they are detected by serologic testing.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
2. Which statement made by a nurse regarding the prophylactic vaccination to prevent human
papillomavirus (HPV) demN onUsR
traSteIsN
aGneTeB
d.foC
r fOuM
rther education?
a. “Currently there is only one vaccine for the HPV available.”
b. “The vaccine is given in three doses over a 6-month period.”
c. “The vaccine is recommended for both boys and girls.”
d. “Ideally, the vaccine is administered before the first sexual contact.”
ANS: A
Three vaccines for HPV are available—Cervarix, Gardasil and Gardasil 9—and other
vaccines continue to be investigated. They are most effective if administered before the first
sexual contact. Recommendations are that vaccines be administered to 11- and 12-year-old
girls and boys. The vaccine can be given to girls as young as 9 years of age and young
women ages 13 to 26 years in three doses over a 6-month period.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. Which sexually transmitted infection (STI) is the most commonly reported in American
women?
a. Gonorrhea
b. Syphilis
c. Chlamydia
d. Candidiasis
, ANS: C
Chlamydia is the most common STI in women in the United States and one of the most
common causes of pelvic inflammatory disease (PID). Gonorrhea is probably the oldest
communicable disease in the United States and second to Chlamydia in reported conditions.
Syphilis has reemerged as a common STI, affecting black women more than any other
ethnic or racial group. Candidiasis is a relatively common fungal infection.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
4. The Centers for Disease Control and Prevention (CDC) recommends which therapy for the
treatment of the HPV?
a. Miconazole ointment
b. Topical podofilox 0.5% solution or gel
c. Two doses of penicillin administered intramuscularly (IM)
d. Metronidazole by mouth
ANS: B
Available treatments are imiquimod, podophyllin, and podofilox. Miconazole ointment is
used to treat athlete’s foot. Penicillin IM is used to treat syphilis. Metronidazole is used to
treat bacterial vaginosis.
PTS: 1 DIF: Cognitive Level: Applying
TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
5. Which condition is the mosNt U
lifR thI
e-S atG
reN enTinBg.vC
irusMto the fetus and neonate?
a. Hepatitis A virus (HAV)
b. Herpes simplex virus (HSV)
c. Hepatitis B virus (HBV)
d. Cytomegalovirus (CMV)
ANS: C
HBV is the most life-threatening viral condition to the fetus and neonate. HAV is not the
most threatening to the fetus nor is HSV the most threatening to the neonate. Although
serious, CMV is not the most life-threatening viral condition to the fetus.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Diagnosis
MSC: Client Needs: Safe and Effective Care Environment
6. Which treatment regime would be most appropriate for a client who has been recently
diagnosed with acute pelvic inflammatory disease (PID)?
a. Oral antiviral therapy
b. Bed rest in a semi-Fowler position
c. Antibiotic regimen continued until symptoms subside
d. Frequent pelvic examination to monitor the healing progress
ANS: B
, The woman with acute PID should be on bed rest in a semi-Fowler position.
Broad-spectrum antibiotics are used; antiviral therapy is ineffective. Antibiotics must be
taken as prescribed, even if symptoms subside. Few pelvic examinations should be
conducted during the acute phase of the disease.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
7. On vaginal examination of a 30-year-old woman, the nurse documents the following
findings: profuse, thin, grayish-white vaginal discharge with a “fishy” odor and reports of
pruritus. Based upon these findings, which condition would the nurse suspect?
a. Bacterial vaginosis
b. Candidiasis
c. Trichomoniasis
d. Gonorrhea
ANS: A
Most women with bacterial vaginosis complain of a characteristic “fishy” odor. The
discharge is usually profuse, thin, and has a white, gray, or milky color. Some women may
also experience mild irritation or pruritus. The discharge associated with candidiasis is thick,
white, and lumpy and resembles cottage cheese. Trichomoniasis may be asymptomatic, but
women commonly have a characteristic yellow-to-green, frothy, mucopurulent, copious, and
malodorous discharge. Women with gonorrhea are often asymptomatic. Although they may
have a purulent endocervical discharge, the discharge is usually minimal or absent.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: ANs sesR
smeInt G B.C M
U S N and
MSC: Client Needs: Health Promotion T Maintenance
O
8. Which viral sexually transmitted infection is characterized by a primary infection followed
by recurrent episodes?
a. Herpes simplex virus 2 (HSV-2)
b. Human papillomavirus (HPV)
c. Human immunodeficiency virus (HIV)
d. Cytomegalovirus (CMV)
ANS: A
The initial HSV genital infection is characterized by multiple painful lesions, fever, chills,
malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of the HSV
infection commonly have only local symptoms that usually are less severe than those of the
initial infection. With HPV infection, lesions are a chronic problem. The HIV is a retrovirus.
Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has
entered the body. Severe depression of the cellular immune system associated with the HIV
infection characterizes AIDS, which has no cure. In most adults, the onset of CMV infection
is uncertain and asymptomatic. However, the disease may become a chronic, persistent
infection.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
MULTIPLE CHOICE
1. Which manifestation differentiates primary syphilis from secondary syphilis?
a. Fever, headache, and malaise
b. Widespread rash
c. Identified by serologic testing
d. Appearance of a chancre 2 months after infection
ANS: D
Primary syphilis is characterized by a primary lesion (the chancre), which appears 5 to 90
days after infection. The chancre begins as a painless papule at the site of inoculation and
erodes to form a nontender, shallow, and clean ulcer several millimeters to centimeters in
size. Secondary syphilis occurs 6 weeks to 6 months after the appearance of the chancre and
is characterized by a widespread maculopapular rash. The individual may also experience
fever, headache, and malaise. Latent syphilis are those infections that lack clinical
manifestations; however, they are detected by serologic testing.
PTS: 1 DIF: Cognitive Level: Understand
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
2. Which statement made by a nurse regarding the prophylactic vaccination to prevent human
papillomavirus (HPV) demN onUsR
traSteIsN
aGneTeB
d.foC
r fOuM
rther education?
a. “Currently there is only one vaccine for the HPV available.”
b. “The vaccine is given in three doses over a 6-month period.”
c. “The vaccine is recommended for both boys and girls.”
d. “Ideally, the vaccine is administered before the first sexual contact.”
ANS: A
Three vaccines for HPV are available—Cervarix, Gardasil and Gardasil 9—and other
vaccines continue to be investigated. They are most effective if administered before the first
sexual contact. Recommendations are that vaccines be administered to 11- and 12-year-old
girls and boys. The vaccine can be given to girls as young as 9 years of age and young
women ages 13 to 26 years in three doses over a 6-month period.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
3. Which sexually transmitted infection (STI) is the most commonly reported in American
women?
a. Gonorrhea
b. Syphilis
c. Chlamydia
d. Candidiasis
, ANS: C
Chlamydia is the most common STI in women in the United States and one of the most
common causes of pelvic inflammatory disease (PID). Gonorrhea is probably the oldest
communicable disease in the United States and second to Chlamydia in reported conditions.
Syphilis has reemerged as a common STI, affecting black women more than any other
ethnic or racial group. Candidiasis is a relatively common fungal infection.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
4. The Centers for Disease Control and Prevention (CDC) recommends which therapy for the
treatment of the HPV?
a. Miconazole ointment
b. Topical podofilox 0.5% solution or gel
c. Two doses of penicillin administered intramuscularly (IM)
d. Metronidazole by mouth
ANS: B
Available treatments are imiquimod, podophyllin, and podofilox. Miconazole ointment is
used to treat athlete’s foot. Penicillin IM is used to treat syphilis. Metronidazole is used to
treat bacterial vaginosis.
PTS: 1 DIF: Cognitive Level: Applying
TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity
5. Which condition is the mosNt U
lifR thI
e-S atG
reN enTinBg.vC
irusMto the fetus and neonate?
a. Hepatitis A virus (HAV)
b. Herpes simplex virus (HSV)
c. Hepatitis B virus (HBV)
d. Cytomegalovirus (CMV)
ANS: C
HBV is the most life-threatening viral condition to the fetus and neonate. HAV is not the
most threatening to the fetus nor is HSV the most threatening to the neonate. Although
serious, CMV is not the most life-threatening viral condition to the fetus.
PTS: 1 DIF: Cognitive Level: Remember
TOP: Nursing Process: Diagnosis
MSC: Client Needs: Safe and Effective Care Environment
6. Which treatment regime would be most appropriate for a client who has been recently
diagnosed with acute pelvic inflammatory disease (PID)?
a. Oral antiviral therapy
b. Bed rest in a semi-Fowler position
c. Antibiotic regimen continued until symptoms subside
d. Frequent pelvic examination to monitor the healing progress
ANS: B
, The woman with acute PID should be on bed rest in a semi-Fowler position.
Broad-spectrum antibiotics are used; antiviral therapy is ineffective. Antibiotics must be
taken as prescribed, even if symptoms subside. Few pelvic examinations should be
conducted during the acute phase of the disease.
PTS: 1 DIF: Cognitive Level: Apply
TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity
7. On vaginal examination of a 30-year-old woman, the nurse documents the following
findings: profuse, thin, grayish-white vaginal discharge with a “fishy” odor and reports of
pruritus. Based upon these findings, which condition would the nurse suspect?
a. Bacterial vaginosis
b. Candidiasis
c. Trichomoniasis
d. Gonorrhea
ANS: A
Most women with bacterial vaginosis complain of a characteristic “fishy” odor. The
discharge is usually profuse, thin, and has a white, gray, or milky color. Some women may
also experience mild irritation or pruritus. The discharge associated with candidiasis is thick,
white, and lumpy and resembles cottage cheese. Trichomoniasis may be asymptomatic, but
women commonly have a characteristic yellow-to-green, frothy, mucopurulent, copious, and
malodorous discharge. Women with gonorrhea are often asymptomatic. Although they may
have a purulent endocervical discharge, the discharge is usually minimal or absent.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: ANs sesR
smeInt G B.C M
U S N and
MSC: Client Needs: Health Promotion T Maintenance
O
8. Which viral sexually transmitted infection is characterized by a primary infection followed
by recurrent episodes?
a. Herpes simplex virus 2 (HSV-2)
b. Human papillomavirus (HPV)
c. Human immunodeficiency virus (HIV)
d. Cytomegalovirus (CMV)
ANS: A
The initial HSV genital infection is characterized by multiple painful lesions, fever, chills,
malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of the HSV
infection commonly have only local symptoms that usually are less severe than those of the
initial infection. With HPV infection, lesions are a chronic problem. The HIV is a retrovirus.
Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has
entered the body. Severe depression of the cellular immune system associated with the HIV
infection characterizes AIDS, which has no cure. In most adults, the onset of CMV infection
is uncertain and asymptomatic. However, the disease may become a chronic, persistent
infection.
PTS: 1 DIF: Cognitive Level: Analyzing
TOP: Nursing Process: Assessment
MSC: Client Needs: Health Promotion and Maintenance
