Chapter 51: Sexually Transmitted Infections
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A nurse in the outpatient clinic notes that a patient has been treated for syphilis three separate
times in the past 2 years. What should the antibiotic treatment for this patient consist of this
time?
a.
Penicillin G
b.
Penicillin G today and a follow-up with another injection in 1 month
c.
Penicillin G today and 3 months of oral tetracycline antibiotic medications
d.
Penicillin G today and a 2-month protocol of oral antiviral agents
2. A nurse is completing a history of illnesses for a young woman who suspects she may have a
sexually transmitted infection (STI). What specific symptom(s) should the nurse ask this
patient if she experienced?
a.
Lethargy and fatigue
b.
Genital discharge
c.
Abdominal cramps
d.
Heavy menses
3. A patient has been diagnosed with herpes simplex virus, type 2 (HSV type 2). What
instruction should the nurse provide?
a.
Avoid telling anyone about the condition.
b.
Wear close-fitting undergarments.
c.
Wash towels and personal items daily.
d.
Soak the sores with peroxide every day.
4. A nurse is caring for a patient taking acyclovir (Zovirax). Which side effects of this drug
should the nurse be alert for?
a.
Fever and bone marrow suppression
b.
Vaginal burning and skin irritation
c.
Dizziness, headache, and nausea
d.
Leukopenia and peripheral neuropathy
5. A woman diagnosed with gonorrhea is astounded and states that she had no idea that she had
an STI. What should the nurse explain about gonorrhea?
a.
It produces no symptoms in half of those in the early stages of the infection.
b.
It always produces a foul vaginal discharge.
c.
It causes a vaginal chancre that is not easily detected.
d.
It may appear to be an upper respiratory infection in the early stages of the
infection.
6. A nurse giving instruction to a patient with an STI says, “I am supposed to tell you about
STIs, but you probably know more about them than I do.” What is this nurse doing?
a.
Admitting her own ignorance about STIs
b.
Trying to get the patient’s attention
c.
Referencing current statistics
d.
Making a judgmental statement
7. A patient at the outpatient clinic is reluctant to identify her sexual contacts. Why is the
reporting of contacts essential?
a.
Slows transmission and spread of infections
b.
Increases public awareness
c.
Increases state funding for treatment
d.
Collects data for research
8. A patient with gonorrhea is taking a protocol of tetracycline antibiotics. Which statement by
the nurse is most likely to help overcome patient noncompliance?
a.
“You should take all of this medicine.”
b.
“Failing to take the entire medicine amount will make your disease resistant to it.”
c.
“You will become sterile if you do not complete the supply of medicines.”
d.
“The doctor wants you to take all of this medication.”
9. A patient with syphilis is seen at the clinic and complains of body aches, pustules, fever, and
sore throat. Which stage of syphilis should the nurse recognize these symptoms identify?
a.
Primary
b.
Secondary
c.
Latent
d.
Late
10. Doxycycline (Vibramycin) has been prescribed for a patient who has gonorrhea. What
instruction should the nurse provide to the patient before beginning the medication?
a.
Take the medication with food or crackers.
b.
Refrain from sexual relations for 4 weeks.
c.
Follow up to determine if the treatment was effective.
d.
Keep the medication in the refrigerator.
11. A couple comes to the emergency department for the treatment of an STI. The man’s
presenting symptoms include a creamy penile discharge and frequent urination. The woman
has lower abdominal pain and a vaginal discharge. What should the nurse recognize these
symptoms to characterize?
a.
Chlamydial infection
b.
Gonorrhea infection
c.
HSV type B
d.
Trichomoniasis
12. A pregnant patient with HSV type 2 has a Herp-Test performed in the physician’s office 1 day
before she is due to deliver by cesarean section. The test result is negative. What should the
nurse know this means?
a.
The delivery must be by cesarean section.
b.
The patient must start on an antiviral protocol today.
c.
The baby will have to have antiviral medication 24 hours after birth.
d.
The delivery may be accomplished vaginally.
13. Which method is used to identify organisms of gonorrhea?
a.
Smears and cultures
b.
Serologic tests
c.
Antibody screening
d.
Sensitivity testing
14. A gynecologist caring for a pregnant patient who has gonorrhea prescribed cefixime (Suprax)
instead of the more common tetracycline hydrochloride (Achromycin). What is the rationale
for this decision?
a.
Gonorrhea is less likely to be resistant to Suprax.
b.
Achromycin requires a longer treatment protocol than Suprax.
c.
Suprax is a more potent drug that Achromycin.
d.
Achromycin is contraindicated in a patient who is pregnant.
15. What instruction should be included by a health educator giving a presentation on how to use
condoms correctly?
a.
Condoms are 100% effective when used correctly.
b.
The effectiveness of condoms deteriorates in heat.
c.
Any style and material of condom is safe to use.
d.
Use of petroleum jelly will ease application.
16. A nurse asks a patient to repeat the instructions to evaluate her knowledge about safe sex
practices. Which statement indicates an understanding?
a.
“Body massage would be considered safe.”
b.
“Mutual open–mouth kissing is safe.”
c.
“Vaginal intercourse with a properly used condom is safe.”
d.
“Anal sex with a condom made of latex is a safe sex practice.”
17. A female patient, newly diagnosed with gonorrhea, screams, “I am going to kill my husband. I
mean it.” What is the nurse’s best response?
a.
“Are you sure it is your husband who gave you gonorrhea?”
b.
“Yikes! Killing your spouse seems extreme.”
c.
“Shall I report your spouse as a sexual contact?”
d.
“I can understand your anger. How best can you deal with it?”
18. What is characteristic of the primary stage syphilis?
a.
Chancre
b.
Alopecia
c.
Pruritus
d.
Dry skin
19. What does diagnosis with the human papilloma virus (HPV) increase a person’s risk for?
a.
Uterine fibroids
b.
Chronic vaginitis
c.
Premature menopause
d.
Cervical cancer
20. Which antiviral drug is commonly used to relieve symptoms of herpes simplex virus (HSV)?
a.
Tetracycline (Achromycin)
b.
Acyclovir (Zovirax)
c.
Erythromycin (E-Mycin)
d.
Metronidazole (Flagyl)
21. What does chlamydial infection place a person at greater risk for?
a.
HIV if exposed to it
b.
Urinary infections
c.
Hepatitis B if exposed to it
d.
Opportunistic bacterial infections
22. A patient at the outpatient clinic who has received an intramuscular dose of ceftriaxone
sodium (Rocephin) calls and complains of pain and induration at the injection site. What
should the nurse advise the patient to do?
a.
Undergo 30 minutes of active exercise to speed absorption of the drug.
b.
Make an appointment at the clinic for evaluation to initiate another drug.
c.
Immediately come to the clinic for treatment of the allergic reaction.
d.
Place a warm compress on the area.
23. What should a nurse caution a patient taking Flagyl for Trichomonas to do?
a.
Double the dose if any doses are missed.
b.
Report dark urine.
c.
Take the drug on an empty stomach.
d.
Abstain from alcohol while taking the drug.
24. A patient with a chlamydial infection is taking a 7-day course of doxycycline (Vibramycin).
What information should the nurse provide?
a.
Return in 1 month for a follow-up culture.
b.
Take the drug on an empty stomach with a minimum of fluid.
c.
Delay sexual activity until cured.
d.
Expect genital or anal itching or burning.
MULTIPLE RESPONSE
25. A nurse explains that STIs must be reported to the local public health department. Which are
considered reportable diseases? (Select all that apply.)
a.
HIV
b.
Acquired immunodeficiency syndrome (AIDS)
c.
Gonorrhea
d.
Chlamydia
e.
Viral hepatitis
26. What body areas might systemic (disseminated) gonorrhea involve? (Select all that apply.)
a.
Heart
b.
Eyes
c.
Meninges
d.
Skin
e.
Joints
27. A nurse recognizes that a patient with an STI may not cooperate in reporting sexual contacts.
What fears might prevent reporting? (Select all that apply.)
a.
Judgment by health care workers
b.
Identifying self as infected
c.
Rejection by contacts
d.
Infecting others
e.
Reprisal from identified contacts
COMPLETION
28. A patient who is using imiquimod (Aldara) for genital warts asks the outpatient clinic nurse
how long she must use the medication. The nurse replies that she must apply the medication
for _____ weeks.