Question 1

The nurse caring for clients with STDs knows that which diseases are reportable in all states? (Select all that are correct.)

Accepted Answer

A)   Chlamydia
B)   Gonorrhea
C)   Herpes simplex virus (genital) 
D)   Human papilloma virus
E)   Syphilis A, B, E

Question 2

The nurse conducting health education about gonorrhea would teach a client that

Accepted Answer

A)   gonorrhea is difficult to treat effectively.
B)   gram-negative organisms multiply rapidly.
C)   the organisms can survive for a long period outside the body.
D)   there is a large carrier population because it can be asymptomatic in women. D

Question 3

A client with genital herpes asks the nurse what effect the herpes will have on her becoming pregnant and having a child. The nurse's response is based on the fact that active genital herpes lesions can cause

Accepted Answer

A)   birth defects.
B)   infection of the fetus in utero.
C)   infection of the newborn during vaginal delivery.
D)   sterility. C

Question 4

The statement made by a client being treated for gonorrhea that would indicate that teaching has been effective is "I

Accepted Answer

A)   can get some antibiotics to take home, in case I get infected again."
B)   don't want to get this again because treatment is lengthy and expensive."
C)   will come back after I finish all my medicine."
D)   won't have sex until I have completed my medications."

Question 5

An adolescent female states that she cannot use condoms because her "boyfriend won't let her." Which action by the nurse would best fill the role of the advocate for this client?

Accepted Answer

A)   Give the adolescent pamphlets to share with the boyfriend.
B)   Help the teen practice negotiation techniques.
C)   Reinforce teaching on the consequences of STDs.
D)   Teach the client the proper way to apply a condom.

Question 6

The nurse would assess a female client with second-stage syphilis for

Accepted Answer

A)   local lymphadenopathy.
B)   maculopapular, nonpruritic rash on the palms and soles of the feet.
C)   presence of a chancre.
D)   yellow, mucopurulent vaginal discharge.

Question 7

As part of health teaching for a female client with genital warts, the nurse would explain that

Accepted Answer

A)   condom use is recommended.
B)   genital warts are cured after medication therapy.
C)   testing for warts eliminates the need for Pap smears.
D)   this disorder is unrelated to development of genital cancers.

Question 8

The nurse is counseling a client with herpes simplex virus (HSV) infection. Which of the following would best meet most clients' needs in coping with this diagnosis?

Accepted Answer

A)   Contact information for a support group
B)   Information about promising drug trials
C)   Websites containing STD information
D)   Written information about the disease and treatment

Question 9

A client with uncomplicated gonorrhea who is treated with ceftriaxone and doxycycline asks if a follow-up examination and culture will be necessary. The most appropriate response by the nurse is

Accepted Answer

A)   "No, because the disease cannot recur."
B)   "No, because treatment failure with these medications is rare."
C)   "Yes, because monthly cultures are now recommended."
D)   "Yes, because reinfection is very probable."

Question 10

A female caller to an STD hotline is crying, saying that her husband is accusing her of cheating on him after she was diagnosed with chlamydia. The best response by the nurse would be

Accepted Answer

A)   "I can refer you to a marriage counselor if you think your husband would go."
B)   "There is a lot of information about chlamydia on the CDC website. I can give you that address."
C)   "There is no way to tell when you got infected because chlamydia often does not cause symptoms in women."
D)   "You need to tell your husband to see his doctor so he can be evaluated and treated if needed."

Question 11

A nurse is teaching a community group about STDs, including proper use of condoms. The nurse informs the group that condom failure is generally due to

Accepted Answer

A)   environmental concerns.
B)   improper or inconsistent use.
C)   latex versus non-latex construction.
D)   manufacturer's defect.

Question 12

In teaching a client receiving doxycycline for the treatment of chlamydial infection, the nurse should include

Accepted Answer

A)   avoidance of alcoholic beverages while taking doxycycline.
B)   increasing fluid intake while taking doxycycline.
C)   protecting the medication from sunlight.
D)   using a condom as a birth control method.

Question 13

When caring for clients with STDs, the nurse is aware that the best method of infection control is

Accepted Answer

A)   good hand-washing.
B)   disease-based isolation techniques.
C)   no extra infection control measures.
D)   universal precautions.

Question 14

A female client with genital warts who was treated with topical podophyllin and tincture of benzoin would indicate to the nurse the need for further teaching when the client says

Accepted Answer

A)   "I need to come for frequent treatment until all the warts disappear."
B)   "I'll be glad when these warts are cured."
C)   "I'll make sure my boyfriend is treated."
D)   "These warts are usually spread by having sex."

Question 15

A client is receiving metronidazole (Flagyl) orally for treatment of trichomoniasis. The nurse should explain to the client that

Accepted Answer

A)   alcoholic beverages and products containing alcohol should be avoided.
B)   douching is necessary after sexual contact.
C)   recurrence generally is rare.
D)   the medication must be taken for 14 days.

Question 16

A client whose VDRL test was positive asks the nurse if he has syphilis. The nurse's best response is

Accepted Answer

A)   "A blood culture is necessary to make the diagnosis."
B)   "A positive VDRL indicates syphilis."
C)   "The FTA-ABS test will need to be done."
D)   "This study is specific for gonorrhea."

Question 17

The nurse working in an ambulatory clinic explains that the most common bacterial STD in the United States is

Accepted Answer

A)   chlamydia.
B)   genital herpes.
C)   gonorrhea.
D)   syphilis.

Question 18

The physician has prescribed ceftriaxone (Rocephin) administered intramuscularly, followed by doxycycline (Vibramycin) orally for 7 days, to treat a client with gonorrhea. The nurse would explain that the rationale for the second medication is

Accepted Answer

A)   because some strains of Neisseria gonorrhoeae are resistant to antibiotics.
B)   that two drugs are better tolerated than one large dose.
C)   to prevent reinfection.
D)   to treat a chlamydial co-infection.

Question 19

To make a definite diagnosis in a client with suspected chlamydial infection, the nurse should prepare the client for

Accepted Answer

A)   biopsy.
B)   blood study.
C)   culture.
D)   Papanicolaou (Pap)  smear.

Question 20

The nurse determines that the woman who least needs screening for chlamydial infection is a

Accepted Answer

A)   22-year-old with multiple partners.
B)   35-year-old with a single partner
C)   high-risk pregnant woman.
D)   sexually active 17-year-old.

Exam 41: Management of Clients with Sexually Transmitted Infections