Question 1

A 47-year-old patient with a long history of IV drug use is seen at a community clinic, where the patient reports difficulty walking because "I don't know where my feet are." Diagnostic screening reveals positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-ABS) tests. Based on the patient history, the nurse will assess which of the following (select all that apply)?

Accepted Answer

A)   Heart sounds
B)   Genitalia for lesions
C)   Joints for swelling and inflammation
D)   Mental state for judgment and orientation
E)   Skin and mucous membranes for gummas A, D, E

Question 2

A patient with positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FAT-ABS) tests has a rash on the palms and the soles of the feet and moist papules in the anal and vulvar area. Which action will the nurse include in the plan of care?

Accepted Answer

A)   Assess for arterial aneurysms.
B)   Place the patient in a private room.
C)   Wear gloves when touching the patient.
D)   Apply antibiotic ointments to the perineum. C

Question 3

A woman who is 6 weeks' pregnant is diagnosed with primary syphilis. The nurse will plan to teach the patient about

Accepted Answer

A)   the likelihood of a stillbirth.
B)   the need for cesarean section.
C)   intramuscular injection of penicillin.
D)   use of antibiotic eye drops for the newborn. C

Question 4

A patient who has labs drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which action should the nurse take next?

Accepted Answer

A)   Ask the patient about past treatment for syphilis.
B)   Discuss the need for blood and spinal fluid cultures.
C)   Obtain a specimen for fluorescent treponemal antibody absorption (FAT-ABS)  testing.
D)   Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

Question 5

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 of antibiotics is prescribed to

Accepted Answer

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.

Question 6

A 21-year-old woman is being seen in the family medicine clinic for an annual physical exam. The nurse will plan to teach the patient about

Accepted Answer

A)   testing for chlamydia infection.
B)   immunization for herpes simplex.
C)   the relationship between the herpes virus and cervical cancer.
D)   the risk of infertility associated with the human papillomavirus (HPV) .

Question 7

When a patient returns to the clinic for follow-up after treatment for gonococcal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection, which question is most appropriate for the nurse to ask the patient?

Accepted Answer

A)   "Did you take the prescribed antibiotic for a week?"
B)   "Did you drink at least 2 quarts of fluids every day?"
C)   "Were your sexual partners treated with antibiotics?"
D)   "Do you wash your hands after using the bathroom?"

Question 8

When counseling a woman who is having difficulty conceiving, the nurse will be most concerned about a history of infection with

Accepted Answer

A)   N. gonorrhoeae.
B)   Treponema pallidum.
C)   condyloma acuminatum.
D)   herpes simplex virus type 2.

Question 9

A patient is treated for chlamydia that was detected during a routine pelvic examination. The nurse knows that teaching regarding the management of the condition has been effective when the patient says,

Accepted Answer

A)   "Go ahead and give me the antibiotic injection so I will be cured."
B)   "My boyfriend will need to take antibiotics at the same time I do."
C)   "I will use condoms during sex until I finish taking all the antibiotics."
D)   "Since I do not plan on having any children, treatment is not as important."

Question 10

A woman in the sexually transmitted disease ( STD ) clinic tells the nurse that she is concerned she may have been exposed to gonorrhea by her partner. To determine whether the patient has gonorrhea, the nurse will plan to

Accepted Answer

A)   interview the patient about symptoms of gonorrhea.
B)   take a sample of cervical discharge for Gram staining.
C)   draw a blood specimen or rapid plasma reagin ( RPR )  testing.
D)   obtain vaginal secretions for a nucleic acid amplification test ( NAAT ) .

Question 11

After the nurse teaches the patient who has primary genital herpes about management of the disease, which statement by the patient indicates that the teaching has been effective?

Accepted Answer

A)   "I will use the acyclovir ointment on the area to relieve the pain."
B)   "I will use condoms for intercourse until the medication is all gone."
C)   "I will take the acyclovir (Zovirax)  every 8 hours for the next week."
D)   "I will need to take all of the medication to be sure the infection is cured."

Question 12

A 23-year-old patient has genital warts around her external genitalia and perianal area. She tells the nurse that she has not had treatment until now because "the warts are so disgusting." Which nursing diagnosis is most appropriate?

Accepted Answer

A)   Disturbed body image related to feelings about the genital warts
B)   Ineffective coping related to denial of increased risk for infection
C)   Risk for infection related to lack of knowledge about transmission
D)   Anxiety related to impact of condition on interpersonal relationships

Question 13

A woman who is diagnosed with chlamydia tells the nurse that she is very angry because her husband is her only sexual partner. Which response should the nurse make first?

Accepted Answer

A)   "You may need professional counseling to help resolve your anger."
B)   "It is understandable that you are angry with your husband right now."
C)   "Your feelings are justified and you should share them with your husband."
D)   "It is important that both you and your husband be treated for the infection."

Question 14

A man who has a profuse, purulent urethral discharge with painful urination is seen at the sexually transmitted disease ( STD ) clinic. Which information will be most important for the nurse to obtain?

Accepted Answer

A)   Contraceptive use
B)   Sexual orientation
C)   Immunization history
D)   Recent sexual contacts

Question 15

A male patient who has been diagnosed with gonococcal urethritis tells the nurse about 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

Accepted Answer

A)   women do not develop gonorrhea infections but can serve as carriers to spread the disease to males.
B)   women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations.
C)   many women are not aware they have gonorrhea because they often do not have symptoms of infection.
D)   when gonorrhea infections occur in women, the disease affects only the ovaries and not the genital organs.

Question 16

Which of these patients will the nurse plan on teaching about the Gardasil vaccine?

Accepted Answer

A)   A 50-year-old woman who has multiple sexual partners
B)   A 23-year-old woman who is pregnant for the first time
C)   An 18-year-old female who has never been sexually active
D)   A 28-year-old woman who is in a monogamous relationship

Exam 53: Nursing Management: Sexually Transmitted Diseases