NUR 300 WI Maternity & Women’s Health Care 12th Edition (2019/2020) - Chapter 7 – Central Michigan University | Sexually Transmitted and Other Infections

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NUR 300 WI Maternity & Women’s Health Care 12th Edition - Chapter 7 – Central Michigan University Chapter 7: Sexually Transmitted and Other Infections MULTIPLE CHOICE 1. Syphilis is a c... omplex disease that can lead to serious systemic illness and even death if left untreated. Which manifestation differentiates primary syphilis from secondary syphilis? a. Fever, headache, and malaise b. Widespread rash c. Identified by serologic testing d. Appearance of a chancre 2 months after infection Primary syphilis is characterized by a primary lesion (the chancre), which appears 5 to 90 days after infection. The chancre begins as a painless papule at the site of inoculation and erodes to form a nontender, shallow, and clean ulcer several millimeters to centimeters in size. Secondary syphilis occurs 6 weeks to 6 months after the appearance of the chancre and is characterized by a widespread maculopapular rash. The individual may also experience fever, headache, and malaise. Latent syphilis are those infections that lack clinical manifestations; however, they are detected by serologic testing. DIF: Cognitive Level: Understand REF: IMS: 151 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. The human papillomavirus (HPV), also known as genital warts, affects 79 million Americans, with an estimated number of 14 million new infections each year. The highest rate of infection occurs in young women, ages 20 to 24 years. Prophylactic vaccination to prevent the HPV is now available. Which statement regarding this vaccine is inaccurate? a. Only one vaccine for the HPV is available. b. The vaccine is given in three doses over a 6-month period. c. The vaccine is recommended for both boys and girls. d. Ideally, the vaccine is administered before the first sexual contact. Two vaccines for HPV are availableCervarix and Gardasiland other vaccines continue to be investigated. These vaccines protect against HPV types 6, 11, 16, and 18. They are most effective if administered before the first sexual contact. Recommendations are that vaccines be administered to 11- and 12-year-old girls and boys. The vaccine can be given to girls as young as 9 years of age and young women ages 13 to 26 years in three doses over a 6-month period. DIF: Cognitive Level: Remember REF: IMS: 154 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 3. Which sexually transmitted infection (STI) is the most commonly reported in American women? a. Gonorrhea b. Syphilis c. Chlamydia d. Candidiasis Chlamydia is the most common and fastest spreading STI among American women, with an estimated 3 million new cases each year. Infection rates are two and a half times that of men. Gonorrhea is probably the oldest communicable disease in the United States and second to Chlamydia in reported conditions. Syphilis is the earliest described STI. Candidiasis is a relatively common fungal infection. DIF: Cognitive Level: Remember REF: IMS: 149 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 4. The Centers for Disease Control and Prevention (CDC) recommends which therapy for the treatment of the HPV? a. Miconazole ointment b. Topical podofilox 0.5% solution or gel c. Two doses of penicillin administered intramuscularly (IM) d. Metronidazole by mouth Available treatments are imiquimod, podophyllin, and podofilox. Miconazole ointment is used to treat athletes foot. Penicillin IM is used to treat syphilis. Metronidazole is used to treat bacterial vaginosis. DIF: Cognitive Level: Remember REF: IMS: 148 TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity 5. A client exhibits a thick, white, lumpy, cottage cheeselike discharge, along with white patches on her labia and in her vagina. She complains of intense pruritus. Which medication should the nurse practitioner order to treat this condition? a. Fluconazole b. Tetracycline c. Clindamycin d. Acyclovir The client is experiencing a candidiasis infection. Fluconazole, metronidazole, and clotrimazole are the drugs of choice to treat this condition. Tetracycline is used to treat syphilis. Clindamycin is used to treat bacterial vaginosis. Acyclovir is used to treat genital herpes. DIF: Cognitive Level: Apply REF: IMS: 163 TOP: Nursing Process: Implementation MSC: Client Needs: Physiologic Integrity 6. Which laboratory testing is used to detect the human immunodeficiency virus (HIV)? a. HIV screening b. HIV antibody testing c. Cluster of differentiation 4 (CD4) counts d. Cluster of differentiation 8 (CD8) counts The screening tool used to detect HIV is the enzyme immunoassay, which tests for the presence of antibodies to the HIV. HIV-1 and HIV-2 antibody tests are used to confirm the diagnosis. To determine whether the HIV is present, the test performed must be able to detect antibodies to the virus, not the virus itself. CD4 counts are associated with the incidence of acquired immunodeficiency syndrome (AIDS) in HIV-infected individuals. CD8 counts are not performed to detect HIV. DIF: Cognitive Level: Understand REF: IMS: 160 TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity 7. Which condition is the most life-threatening virus to the fetus and neonate? a. Hepatitis A virus (HAV) b. Herpes simplex virus (HSV) c. Hepatitis B virus (HBV) d. Cytomegalovirus (CMV) HBV is the most life-threatening viral condition to the fetus and neonate. HAV is not the most threatening to the fetus nor is HSV the most threatening to the neonate. Although serious, CMV is not the most life-threatening viral condition to the fetus. DIF: Cognitive Level: Remember REF: IMS: 158 TOP: Nursing Process: Diagnosis MSC: Client Needs: Safe and Effective Care Environment - - - - - - - - - - - - - - - - - - - - - 18. Clients treated for syphilis with penicillin may experience a Jarisch-Herxheimer reaction. Which clinical presentation would be unlikely if a client is experiencing this reaction? a. Vomiting and diarrhea b. Headache, myalgias, and arthralgia c. Preterm labor d. Jarisch-Herxheimer in the first 24 hours after treatment The Jarisch-Herxheimer reaction is an acute febrile reaction that occurs within the first 24 hours of treatment and is accompanied by headache, myalgias, and arthralgia. Vomiting and diarrhea are not anticipated. If the client is pregnant, then she is at risk for preterm labor and birth. DIF: Cognitive Level: Remember REF: IMS: 152 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 19. The health history and physical examination cannot reliably identify all persons infected with HIV or other blood-borne pathogens. Which infection control practice should the nurse use when providing eye prophylaxis to a term newborn? a. Wear gloves. b. Wear mouth, nose, and eye protection. c. Wear a mask. d. Wash the hands after medication administration. Standard Precautions should be consistently used in the care of all persons. Personal protective equipment in the form of gloves should be worn during infant eye prophylaxis, care of the umbilical cord, circumcision site care, diaper changes, handling of colostrum, and parenteral procedures. Masks are worn during respiratory isolation or if the health care practitioner has a cough. Mouth, eye, and nose protection are used to protect the mucous membranes if client-care activities are likely to generate splashes or sprays of body fluids. The hands should be washed both before having contact with the client and after administering medications. DIF: Cognitive Level: Apply REF: IMS: 168 TOP: Nursing Process: Planning MSC: Client Needs: Safe and Effective Care Environment 20. The nurse providing care in a womens health care setting must be knowledgeable about STIs. Which STIs can be successfully treated? a. HSV b. AIDS c. Venereal warts d. Chlamydia The usual treatment for Chlamydia bacterial infection is doxycycline or azithromycin. Concurrent treatment of all sexual partners is needed to prevent recurrence. No known cure is available for HSV; therefore, the treatment focuses on pain relief and preventing secondary infections. Because no cure is known for AIDS, prevention and early detection are the primary focus of care management. HPV causes condylomata acuminata (venereal warts); no available treatment eradicates the virus. DIF: Cognitive Level: Remember REF: IMS: 150 TOP: Nursing Process: Assessment MSC: Client Needs: Physiologic Integrity 21. What is the drug of choice for the treatment of gonorrhea? a. Penicillin G b. Tetracycline c. Ceftriaxone d. Acyclovir Ceftriaxone is effective for the treatment of all gonococcal infections. Penicillin is used to treat syphilis. Tetracycline is prescribed for chlamydial infections. Acyclovir is used to treat herpes genitalis. DIF: Cognitive Level: Remember REF: IMS: 151 TOP: Nursing Process: Planning MSC: Client Needs: Physiologic Integrity [Show More]

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