NURSING 338-Chapter 52: Sexually Transmitted Infections Lewis: Medical-Surgical Nursing, 10th Edition

NURSING 338-Chapter 52: Sexually Transmitted Infections Lewis: Medical-Surgical Nursing, 10th Edition MULTIPLE CHOICE 1. A male patient who has a profuse, purulent urethral discharge with painful urination is seen at the clinic. Which information will be most important for the nurse to obtain? a. Sexual orientation c. Recent sexual contacts b. Immunization history d. Contraceptive preference ANS: C Information about sexual contacts is needed to help establish whether the patient has been exposed to a sexually transmitted infection and because sexual contacts also will need treatment. The other information also may be gathered but is not as important in determining the plan of care for the patient’s current symptoms. DIF: Cognitive Level: Apply (application) REF: 1237 TOP: Nursing Process: Assessment MSC: NCLEX: Physiological Integrity 2. A 20-yr-old female patient who is being seen in the family medicine clinic for an annual physical examination reports being sexually active. The nurse will plan to teach the patient about a. testing for Chlamydia infection. b. immunization for herpes simplex. c. infertility associated with the human papillomavirus (HPV). d. the relationship between the herpes virus and cervical cancer. ANS: A Testing for Chlamydia is recommended by the Centers for Disease Control and Prevention for all sexually active women younger than age 25 years. HPV infection does not cause infertility. There is no vaccine available for herpes simplex, and herpes simplex infection does not cause cervical cancer. DIF: Cognitive Level: Apply (application) REF: 1230 TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance 3. A patient with gonorrhea is treated with a single IM dose of ceftriaxone (Rocephin) and is given a prescription for doxycycline (Vibramycin) 100 mg bid for 7 days. The nurse explains to the patient that this combination is prescribed to a. prevent reinfection during treatment. b. treat any coexisting chlamydial infection. c. eradicate resistant strains of N. gonorrhoeae. d. prevent the development of resistant organisms. ANS: B Because there is a high incidence of co-infection with gonorrhea and Chlamydia, patients are usually treated for both. The other explanations about the purpose of the antibiotic combination are not accurate. DIF: Cognitive Level: Apply (application) REF: 1229 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 4. A 46-yr-old patient who has had blood drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which action should the nurse take next? a. Ask the patient about past treatment for syphilis. b. Explain the need for blood and spinal fluid cultures. c. Schedule fluorescent treponemal antibody absorption (FAT-Abs) testing. d. Assess for the presence of chancres, flulike symptoms, or a rash on the trunk. ANS: A When antibody testing is positive for syphilis, the antibodies remain present for an indefinite period of time even after successful treatment, so the nurse should inquire about previous treatment before doing other assessments or testing. Culture, FAT-Abs testing, and assessment for symptoms may be appropriate based on whether the patient has been previously treated for syphilis. DIF: Cognitive Level: Apply (application) REF: 1236 TOP: Nursing Process: Implementation MSC: NCLEX: Physiological Integrity 5. A 48-yr-old male patient who has been diagnosed with gonococcal urethritis tells the nurse he had recent sexual contact with a woman but says she did not appear to have any disease. In responding to the patient, the nurse explains that a. women do not develop gonorrhea infections but can serve as carriers to spread the disease to men. b. women may not be aware they have gonorrhea because they often do not have symptoms of infection. c. women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations.