Chapter 74: Care of Patients with Sexually Transmitted Diseases Ignatavicius

Chapter 74: Care of Patients with Sexually Transmitted Diseases Ignatavicius

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse instructor is teaching a student nurse about the factors that have increased the number of people with sexually transmitted diseases (STDs) seen in practice. Which statement by the student indicates a lack of understanding?
   1. “There are improved techniques to diagnose an STD used in practice.”
   2. “There is increased incidence of sexual abuse and sexual trafficking.”
   3. “Females feel safe using oral agents rather than a condom as contraception.”
   4. “The organisms causing STDs are all becoming more virulent.”

ANS:   D

There is no evidence that the organisms that cause STDs are becoming more virulent, but a client may need to use another anti-infective if allergic or the protocol was not effective. Extensive histories are taken in the clinic of clients of all ages, as well as assessment of laboratory data such as cervical, urethral, oral, or rectal specimens and lesion samples for microbiology and virology. There are changes in sexual attitudes and practices, cultural factors, migration, and international travel. Women often think that the oral contraceptives protect them from an STD.

DIF:     Applying/Application                         REF: 1531                   KEY: Reproductive problems| evidence-based practice| teaching| secondary prevention MSC:       Integrated Process: Teaching/Learning                                                      NOT:              Client Needs Category: Health Promotion and Maintenance

2. A nurse is assessing a client who presents with a scaly rash over the palms and soles of the feet and the feeling of muscle aches and malaise. The nurse suspects syphilis. Which action by the nurse is appropriate?
   1. Reassure the client that this stage is not infectious unless she is pregnant.
   2. Assess the client for hearing loss and generalized weakness.
   3. Don gloves and further assess the client’s lesions.
   4. Take a history regarding any cardiovascular symptoms.

ANS:   C

The client is displaying symptoms similar to secondary syphilis, with flu-like symptoms and rash due to the spirochetes circulating throughout the bloodstream. Therefore, the nurse needs to further assess the client’s lesions with gloves since the client is highly contagious at this stage. Late latent syphilis is not infectious except to a fetus. Tertiary syphilis may display in the form of cardiovascular or central nervous system symptoms.

DIF:     Applying/Application                         REF: 1532                   KEY: Reproductive problems| secondary prevention| nursing assessment| Standard Precautions    MSC: Integrated Process: Nursing Process: Assessment NOT:                            Client Needs Category: Safe and Effective Care Environment: Management of Care

3. A male client is diagnosed with primary syphilis. Which question by the nurse is a priority at this time?
   1. “Have you been using latex condoms?”
   2. “Are you allergic to penicillin?”
   3. “When was your last sexual encounter?”
   4. “Do you have a history of sexually transmitted disease?”

ANS:           B

Benzathine penicillin G is the evidence-based treatment for primary syphilis. The client needs to be assessed for allergies before treatment. The other questions would be helpful in the client’s history of sexually transmitted diseases but not as important as knowing whether the client is allergic to penicillin.

DIF:            Applying/Application                         REF:    1533                 KEY: Reproductive problems| patient safety| secondary prevention                      MSC: Integrated Process: Nursing Process: Assessment                      NOT:                                                 Client Needs Category: Safe and Effective Care Environment: Safety and Infection Control

4. An African-American female with blisters on the vagina is being treated with acyclovir (Zovirax) for genital herpes. She is angry at her partner for transmitting the infection. Which action by the nurse is best?
   1. Encourage the client to engage in sexual activity since she is on medication.
   2. Be sensitive to the client’s feelings and refer her to a support group.
   3. Reinforce that the disease can no longer be spread to other partners.
   4. Reassure the client that sexual activity will not be painful while on acyclovir.

ANS:           B

The nurse needs to be sensitive and supportive of the client since infected clients may feel angry, lonely, and isolated. Allow the client to verbalize her feelings and refer her to a local support group, such as the National Herpes Resource Center. Sexual activity should not occur while the lesions are present because of discomfort and viral transmission. Genital herpes is an incurable viral disease, and the antiviral drugs minimize the infection but do not cure it. Condoms should be used to avoid the spread of the disease.

DIF:            Applying/Application                         REF:    1536

KEY:          Antiviral medication| reproductive problems| caring| infection control

MSC:          Integrated Process: Caring

NOT:          Client Needs Category: Psychosocial Integrity