Final Exam Public Health Nursing with
513 complete solutions.
Final Exam Public Health Nursing with
513 complete solutions.
1. A school nurse is teaching a class of sophomores about the relationship between the risk of sexually
transmitted disease (STD) and risk-taking behaviors. A key point to include is:
a. all STDs are easily preventable with consistent condom use.
b. once a young woman is pregnant, she is no longer at risk for most STDs.
c. STDs are most likely to be transmitted during a student's initial sexual encounter.
d. use of alcohol and drugs makes a student more likely to make decisions that result in exposure to and
infection with STDs. - ANSWER ANS: D
Drug use is linked to STD transmission because drugs such as alcohol lower inhibitions and impair
judgment about engaging in risky behaviors. Addictions to drugs may cause individuals to acquire the
drug or money to purchase the drug by performing sexual favors. This increases both the frequency of
sexual contacts and the chances of contracting STDs. Adolescents are particularly at risk. Not all STDs are
preventable through condom use. The challenge of preventing human papillomavirus (HPV) infection
(genital warts) is that condoms do not necessarily prevent infection because warts may grow in areas
that barriers such as condoms do not cover and skin-to-skin contact may occur
2. A client newly diagnosed with HPV infection, herpes simplex virus 2 (HSV-2) infection, and syphilis
asks, "Okay, so how do I get rid of all this stuff?" In developing a plan of care, the nurse recognizes that it
is essential to address:
a. correct use of condoms to prevent transmission of all STDs.
b. cures for each of the STDs identified.
c. risk of skin-to-skin contact in transmitting the identified STDs.
d. safety of sexual contact in the absence of lesions. - ANSWER ANS: C
The client needs to understand which STDs are transmitted by skin-to-skin contact and which are
transmitted by body fluids. The client also needs to understand which infections are curable with
antibiotics (syphilis) and which are virus infections that are treatable but not curable (HPV, HSV-2
infections). In HSV-2 infection, although the ability to pass the infection is higher when active lesions are
present, some individuals can spread the infection even when they are asymptomatic. HPV transmission
,Final Exam Public Health Nursing with
513 complete solutions.
occurs through direct contact with the warts that result from HPV, but the virus has also been detected
in semen, and exposure to the virus through body fluids is also possible. In addition, the challenge of
HPV prevention is that condoms do not necessarily prevent infection because warts can grow in areas
that are not covered by barriers such as condoms and skin-to-skin contact may occur.
3. A nurse is assigned to teach clients STD prevention information. The nurse updates her teaching plan
to incorporate new guidelines from the Centers for Disease Control and Prevention. She includes which
of the following as updated information during her next teaching session?
a. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea.
b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but
are not always effective in preventing infections transmitted by skin-to-skin contact.
c. Condoms should not be used during oral sex, because they are not effective in preventing
transmission of infection.
d. When genital ulcers are present, condoms should be used to prevent the spread of infection. -
ANSWER ANS: B
The lesions of HSV-2 and HPV infection as well as other lesions capable of transmitting STDs can occur
on all parts of the male and female genitalia and rectum. Condoms are effective in reducing
transmission via body fluids from the penis and vagina. However, lesions not covered by a male or
female condom can still transmit infection even with proper condom use
4. A woman comes to the community health center complaining of increasing lower abdominal pain,
fever, and abnormal menses for several months. During the assessment, the client indicates that she is
aware that her husband has had multiple sex partners in the past 2 years. Appropriate intervention by
the nurse would be to:
a. arrange to have the client referred for medical evaluation for pelvic inflammatory disease (PID) and
appropriate intervention and treatment.
b. contact the health department to confirm the spouse's diagnosis of Chlamydia infection to determine
the client's exposure, give the client antibiotics, and have her return to the clinic if symptoms worsen.
c. provide STD prevention and treatment education and refer the client to the health department for
STD screening for gonorrhea and/or Chlamydia infection.
d. supply the client with nonsteroidal anti-inflammatory drugs and caution her to call the after- -
ANSWER ANS: A
,Final Exam Public Health Nursing with
513 complete solutions.
Nursing assessment should always include taking a comprehensive sexual history to determine an
individual's potential risk for STDs. Each sexual partner is potentially exposed to all the STDs of all the
persons with whom their partner has been sexually active. PID is a serious infection involving the
fallopian tubes and is the most common complication of gonorrhea, but it may also result from
chlamydial infections. Symptoms include fever, abnormal menses, and lower abdominal pain. Symptoms
can vary among women. PID can cause ectopic pregnancy, and this should be ruled out in all cases.
Stillbirth, premature labor, and infertility are also possible complications.
5. The clients most at risk of reactivation of latent infections of tuberculosis (TB) are:
a. immunocompromised persons, substance abusers, and those with diabetes.
b. individuals previously treated for TB.
c. long-term cigarette smokers.
d. persons with new-onset asthma or emphysema - ANSWER ANS: A
Reactivation of latent TB infections later in life is common, and the incidence rises in
immunocompromised persons, substance abusers, underweight and undernourished individuals, and
those with diabetes, silicosis, or gastrectomy.
6. Community health nurses conducting health education among populations vulnerable to HIV infection
should explain the natural history of the infection, including the fact that HIV infection may go
undetected during the primary infection stage because:
a. antibody test results are typically negative.
b. antibody production by the immune system increases.
c. incubation period is prolonged.
d. symptoms include myalgias, sore throats, and rash. - ANSWER ANS: A
Individuals may experience flu-like symptoms such as lymphadenopathy, myalgias, sore throat, lethargy,
rash, and fever during the primary stage of HIV infection. Results of an antibody test during this phase
are usually negative, so the illness often is not recognized as HIV infection. After a variable period of
time, commonly 6 weeks to 3 months, HIV antibodies appear in the blood and can be used to confirm
the presence of HIV infection
, Final Exam Public Health Nursing with
513 complete solutions.
7. A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and
abdominal discomfort. During the course of the assessment, the nurse determines that the client is a
health care aide working at a daycare center. These facts are important because:
a. acute hepatitis B is self-limiting.
b. hepatitis A outbreaks commonly occur in facilities where staff change diapers.
c. hepatitis C is a "silent stalker."
d. individuals with chronic liver disease are at greater risk for hepatitis A. - ANSWER ANS: B
Hepatitis A virus is most often transmitted through the fecal-oral route. It remains the most frequently
reported vaccine-preventable disease. Outbreaks are common in daycare centers where staff must
change diapers, among household and sexual contacts of infected individuals, and among travelers to
countries were hepatitis A is endemic.
8. Many behaviors place any individual—regardless of age, gender, ethnicity, or other characteristics—at
greater risk for STDs. The nurse should include primary prevention interventions in all client encounters
through the discussion of:
a. partner notification.
b. safer sex.
c. standard precautions.
d. STD testing - ANSWER ANS: B
Sexual abstinence is the best way to prevent STDs; however, for many people it is not realistic.
Therefore, education about how to make sexual behavior safer is critical. Safer sexual behavior includes
masturbation, dry kissing, touching, fantasy, and vaginal or oral sex with a condom. Nurses should not
base assessments on considerations of age, gender, ethnicity, or any other factor, but should discuss
safe sex in all client encounters.
9. A population-level tertiary prevention intervention typically carried out by nurses caring for those
with communicable disease in the community is:
a. HIV test results counseling.
b. needle exchange.
c. partner notification.
513 complete solutions.
Final Exam Public Health Nursing with
513 complete solutions.
1. A school nurse is teaching a class of sophomores about the relationship between the risk of sexually
transmitted disease (STD) and risk-taking behaviors. A key point to include is:
a. all STDs are easily preventable with consistent condom use.
b. once a young woman is pregnant, she is no longer at risk for most STDs.
c. STDs are most likely to be transmitted during a student's initial sexual encounter.
d. use of alcohol and drugs makes a student more likely to make decisions that result in exposure to and
infection with STDs. - ANSWER ANS: D
Drug use is linked to STD transmission because drugs such as alcohol lower inhibitions and impair
judgment about engaging in risky behaviors. Addictions to drugs may cause individuals to acquire the
drug or money to purchase the drug by performing sexual favors. This increases both the frequency of
sexual contacts and the chances of contracting STDs. Adolescents are particularly at risk. Not all STDs are
preventable through condom use. The challenge of preventing human papillomavirus (HPV) infection
(genital warts) is that condoms do not necessarily prevent infection because warts may grow in areas
that barriers such as condoms do not cover and skin-to-skin contact may occur
2. A client newly diagnosed with HPV infection, herpes simplex virus 2 (HSV-2) infection, and syphilis
asks, "Okay, so how do I get rid of all this stuff?" In developing a plan of care, the nurse recognizes that it
is essential to address:
a. correct use of condoms to prevent transmission of all STDs.
b. cures for each of the STDs identified.
c. risk of skin-to-skin contact in transmitting the identified STDs.
d. safety of sexual contact in the absence of lesions. - ANSWER ANS: C
The client needs to understand which STDs are transmitted by skin-to-skin contact and which are
transmitted by body fluids. The client also needs to understand which infections are curable with
antibiotics (syphilis) and which are virus infections that are treatable but not curable (HPV, HSV-2
infections). In HSV-2 infection, although the ability to pass the infection is higher when active lesions are
present, some individuals can spread the infection even when they are asymptomatic. HPV transmission
,Final Exam Public Health Nursing with
513 complete solutions.
occurs through direct contact with the warts that result from HPV, but the virus has also been detected
in semen, and exposure to the virus through body fluids is also possible. In addition, the challenge of
HPV prevention is that condoms do not necessarily prevent infection because warts can grow in areas
that are not covered by barriers such as condoms and skin-to-skin contact may occur.
3. A nurse is assigned to teach clients STD prevention information. The nurse updates her teaching plan
to incorporate new guidelines from the Centers for Disease Control and Prevention. She includes which
of the following as updated information during her next teaching session?
a. Always use spermicides with condoms to reduce the risk of contracting chlamydia or gonorrhea.
b. Condoms can be effective in preventing infections transmitted by fluids from mucosal surfaces but
are not always effective in preventing infections transmitted by skin-to-skin contact.
c. Condoms should not be used during oral sex, because they are not effective in preventing
transmission of infection.
d. When genital ulcers are present, condoms should be used to prevent the spread of infection. -
ANSWER ANS: B
The lesions of HSV-2 and HPV infection as well as other lesions capable of transmitting STDs can occur
on all parts of the male and female genitalia and rectum. Condoms are effective in reducing
transmission via body fluids from the penis and vagina. However, lesions not covered by a male or
female condom can still transmit infection even with proper condom use
4. A woman comes to the community health center complaining of increasing lower abdominal pain,
fever, and abnormal menses for several months. During the assessment, the client indicates that she is
aware that her husband has had multiple sex partners in the past 2 years. Appropriate intervention by
the nurse would be to:
a. arrange to have the client referred for medical evaluation for pelvic inflammatory disease (PID) and
appropriate intervention and treatment.
b. contact the health department to confirm the spouse's diagnosis of Chlamydia infection to determine
the client's exposure, give the client antibiotics, and have her return to the clinic if symptoms worsen.
c. provide STD prevention and treatment education and refer the client to the health department for
STD screening for gonorrhea and/or Chlamydia infection.
d. supply the client with nonsteroidal anti-inflammatory drugs and caution her to call the after- -
ANSWER ANS: A
,Final Exam Public Health Nursing with
513 complete solutions.
Nursing assessment should always include taking a comprehensive sexual history to determine an
individual's potential risk for STDs. Each sexual partner is potentially exposed to all the STDs of all the
persons with whom their partner has been sexually active. PID is a serious infection involving the
fallopian tubes and is the most common complication of gonorrhea, but it may also result from
chlamydial infections. Symptoms include fever, abnormal menses, and lower abdominal pain. Symptoms
can vary among women. PID can cause ectopic pregnancy, and this should be ruled out in all cases.
Stillbirth, premature labor, and infertility are also possible complications.
5. The clients most at risk of reactivation of latent infections of tuberculosis (TB) are:
a. immunocompromised persons, substance abusers, and those with diabetes.
b. individuals previously treated for TB.
c. long-term cigarette smokers.
d. persons with new-onset asthma or emphysema - ANSWER ANS: A
Reactivation of latent TB infections later in life is common, and the incidence rises in
immunocompromised persons, substance abusers, underweight and undernourished individuals, and
those with diabetes, silicosis, or gastrectomy.
6. Community health nurses conducting health education among populations vulnerable to HIV infection
should explain the natural history of the infection, including the fact that HIV infection may go
undetected during the primary infection stage because:
a. antibody test results are typically negative.
b. antibody production by the immune system increases.
c. incubation period is prolonged.
d. symptoms include myalgias, sore throats, and rash. - ANSWER ANS: A
Individuals may experience flu-like symptoms such as lymphadenopathy, myalgias, sore throat, lethargy,
rash, and fever during the primary stage of HIV infection. Results of an antibody test during this phase
are usually negative, so the illness often is not recognized as HIV infection. After a variable period of
time, commonly 6 weeks to 3 months, HIV antibodies appear in the blood and can be used to confirm
the presence of HIV infection
, Final Exam Public Health Nursing with
513 complete solutions.
7. A client comes to the local clinic with acute symptoms of fever, nausea, lack of appetite, malaise, and
abdominal discomfort. During the course of the assessment, the nurse determines that the client is a
health care aide working at a daycare center. These facts are important because:
a. acute hepatitis B is self-limiting.
b. hepatitis A outbreaks commonly occur in facilities where staff change diapers.
c. hepatitis C is a "silent stalker."
d. individuals with chronic liver disease are at greater risk for hepatitis A. - ANSWER ANS: B
Hepatitis A virus is most often transmitted through the fecal-oral route. It remains the most frequently
reported vaccine-preventable disease. Outbreaks are common in daycare centers where staff must
change diapers, among household and sexual contacts of infected individuals, and among travelers to
countries were hepatitis A is endemic.
8. Many behaviors place any individual—regardless of age, gender, ethnicity, or other characteristics—at
greater risk for STDs. The nurse should include primary prevention interventions in all client encounters
through the discussion of:
a. partner notification.
b. safer sex.
c. standard precautions.
d. STD testing - ANSWER ANS: B
Sexual abstinence is the best way to prevent STDs; however, for many people it is not realistic.
Therefore, education about how to make sexual behavior safer is critical. Safer sexual behavior includes
masturbation, dry kissing, touching, fantasy, and vaginal or oral sex with a condom. Nurses should not
base assessments on considerations of age, gender, ethnicity, or any other factor, but should discuss
safe sex in all client encounters.
9. A population-level tertiary prevention intervention typically carried out by nurses caring for those
with communicable disease in the community is:
a. HIV test results counseling.
b. needle exchange.
c. partner notification.
