LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)

Chapter 50 Nursing Care of Patients with Sexually Transmitted Infections

1) A patient recently diagnosed with herpes simplex II asks how to best manage the lesions. What information should the nurse provide for this patient?

1. The use of soap should be restricted.

2. It is safe to use a solution of 50% rubbing alcohol and 50% water to clean the lesions.

3. Wearing nylon panties will reduce discomfort.

4. Gentle soap and water can be used to clean the lesions.

Page Ref: 1838

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

2) A patient recently treated for pelvic inflammatory disease asks how to prevent a recurrence of the disease. What information should the nurse provide for the patient?

1. The physician will prescribe prophylactic antibiotic therapy.

2. The use of condoms will be beneficial.

3. Annual gynecological examinations should be scheduled.

4. Douching after intercourse will assist in removing potential pathogens from the genital area.

Page Ref: 1851

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

3) The nurse instructs a patient diagnosed with pelvic inflammatory disease regarding the use of tampons. Which patient statements indicate that teaching has been effective? Select all that apply.

1. "I will be able to wear tampons."

2. "The use of tampons is forever prohibited."

3. "Tampons must be changed at least every four hours."

4. "I should not wear tampons at night, but pads instead."

5. "I should immediately report any malodorous discharge, fever, or pelvic pain."

Page Ref: 1851

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.9. Monitor client outcomes to evaluate the effectiveness of psychobiological interventions | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

4) A patient diagnosed with latent syphilis asks about transmitting the disease to others. What information should be provided to the patient?

1. "You will need to abstain from sexual relations until treatment is completed."

2. "You will need to wear a condom."

3. "At this late stage, the disease is contained to only you."

4. "At this stage of the disease, transmission is by contact with blood."

Page Ref: 1847

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

5) A female patient diagnosed with a chlamydial infection denies any symptoms of the disease and asks when the disease was contracted. What information should the nurse provide to the patient?

1. The patient has most likely had the infection for about 1-3 weeks.

2. The infection has been in her body for less than one month, since no symptoms are present.

3. The infection might have been in her body for an indefinite period of time.

4. Symptoms typically begin a few months after the infection enters the body.

Page Ref: 1843

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

6) The nurse is planning to teach a group of adolescents about sexually transmitted infections. What information concerning genital warts should be included?

1. Hand washing will aid in reducing the spread of genital warts.

2. Genital warts will result in cervical cancer for the majority of women who get them.

3. Women who have certain types of genital warts should be vaccinated against other types.

4. The risk for the development of penile cancer is high in men diagnosed with genital warts.

Page Ref: 1840

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

7) A patient asks which method of contraception will provide the greatest protection against sexually transmitted infections. What method should the nurse recommend?

1. Oral contraceptives

2. Male condoms

3. Sponges

4. Spermicides

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

8) A female patient is experiencing a painless, ulcerated area on the labia. What should the nurse suspect is occurring with this patient?

1. Herpes simplex II

2. Syphilis

3. Condylomata acuminata

4. Gonorrhea

Page Ref: 1847

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

9) A patient diagnosed with herpes simplex II is concerned about sexual relations. What information should be provided to the patient?

1. The infection can be transmitted only when lesions are present.

2. The infection can be prevented with condom use.

3. Sexual relations must be avoided during the prodromal period and for at least 10 days after the lesions are healed.

4. Sexual activity is permissible once the lesions have dried out.

Page Ref: 1837-1838

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

10) During a physical examination, a young patient asks for information about birth control. What information in the patient's history should the nurse use to guide teaching? Select all that apply.

1. Multiple sex partners

2. No use of condoms

3. Lives with grandmother

4. Aged 15

5. Allergic to penicillin

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

11) The nurse is providing community education to a large group of high school students about the characteristics of sexually transmitted infections (STIs). Which characteristic would be beneficial for the students to understand? Select all that apply.

1. Most STIs can be prevented by the use of latex condoms.

2. STIs cannot occur from the first sexual experience.

3. For treatment to be effective, both partners must be treated for STIs.

4. There are few complications resulting from delayed treatment of STIs.

5. A person with multiple sexual partners is at a greater risk for STIs.

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

12) The nurse is reviewing a list of patients seen in the community clinic. Which patient should the nurse identify as having a reportable sexually transmitted disease? Select all that apply.

1. Aged 26 with bacterial vaginosis

2. Aged 32 with syphilis

3. Aged 16 with gonorrhea

4. Aged 17 with trichomonas

5. Aged 22 with vaginal candidiasis

Page Ref: 1835

Cognitive Level: Analyzing

Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

13) A female patient develops small painful blisters on the labia that occurred after having sex with a new partner about six days ago. Which STI should the nurse suspect this patient is experiencing?

1. Syphilis

2. Gonorrhea

3. Chlamydia

4. Genital herpes

Page Ref: 1837

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

14) A female patient is experiencing intense vaginal itching with a cheesy discharge after using an over-the-counter vaginal cleanser daily for three weeks. Which disorder should the nurse suspect this patient is experiencing?

1. Candidiasis

2. Syphilis

3. Gonorrhea

4. Genital herpes

Page Ref: 1841

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

15) A male patient experiencing a small, painless lesion on the side of the penis is sexually active with multiple partners and does not use a condom. Which STI should the nurse suspect this patient is experiencing?

1. Condyloma acuminatum

2. Syphilis

3. Gonorrhea

4. Chlamydia

Page Ref: 1846-1847

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

16) A patient who contracted syphilis from a sexual partner infected the spouse. What intervention should the nurse plan for this couple? Select all that apply.

1. Explain the need for follow-up testing in three months and six months.

2. Refer to a marriage counselor.

3. Administer intramuscular injection of penicillin G as prescribed.

4. Discuss abstaining from sexual activity until cured.

5. Review handwashing techniques.

Page Ref: 1848-1849

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

17) An adolescent female patient reports being sexually active for two months. For which sexually transmitted infection should this patient be assessed?

1. Genital herpes

2. Human papillomavirus

3. Condyloma acuminatum

4. Chlamydia

Page Ref: 1843

Cognitive Level: Analyzing

Client Need & Sub: Health Promotion and Maintenance: High Risk Behaviors

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

18) The nurse is preparing to teach a patient newly diagnosed with chlamydia trachomatis on the pathophysiology of the disease process. In which order should the nurse explain this process to the patient? Place in order the steps of the process.

Choice 1. Organism enters a cell and changes into a reticulate body.

Choice 2. Reticulate body divides within the cell.

Choice 3. The cell bursts.

Choice 4. Organism enters the body as an elementary body.

Choice 5. The reticulate body infects the adjoining cells.

Page Ref: 1843

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

19) A patient diagnosed with gonorrhea has not been adhering to the prescribed medication regime. What finding indicates the patient is experiencing complications of the disease? Select all that apply.

1. WBC 22,000

2. Ambulating slowly with legs apart

3. Abdominal pain

4. Vaginal bleeding unrelated to menstruation

5. Serum potassium of 3.8 mEq/L

Page Ref: 1851

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with sexually transmitted infections.

20) The healthcare provider prescribes doxycycline 100 mg by mouth every 12 hours for 7 days. The pharmacy fills the prescription with 0.1 g doxycycline capsules. The nurse should instruct the patient to take how many capsules per day? Record your answer rounding to the nearest whole number.

Page Ref: 1843

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with sexually transmitted infections.

21) A patient positive for syphilis is allergic to penicillin and is being treated with tetracycline for 28 days. The healthcare provider prescribes tetracycline 500 mg to be taken every six hours. The prescription is filled with 250 mg tablets. How many tablets should the patient take every day to achieve the prescribed dose?

Page Ref: 1847

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with sexually transmitted infections.

22) The nurse is caring for a patient with syphilis. In which order should the nurse explain the disease process to the patient? Place in order the steps of the process.

Choice 1. Appearance of a chancre and regional enlargement of lymph nodes

Choice 2. Localized development of gummas

Choice 3. Asymptomatic period

Choice 4. Skin rash on palms and feet

Page Ref: 1846-1847

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

23) A female patient has just been diagnosed with a trichomonas infection. What symptom should the nurse expect to assess in this patient? Select all that apply.

1. Frothy yellow drainage

2. Smooth lesions on labia majora

3. Itching and irritation of the genitalia

4. Dysuria

5. Fever

Page Ref: 1841

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

24) The nurse is planning a teaching session about STIs for a group of college students. What should the nurse keep in mind when teaching? Select all that apply.

1. One in two sexually active persons will contract an STI by age 25.

2. Many STIs are more easily transmitted from a man to a woman than from a woman to a man.

3. Oral contraceptives do not protect against STIs.

4. Research supports that there is a relationship between domestic violence and STI infections.

5. Sexual activity with multiple partners is associated with increased incidence of STIs.

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

25) A male patient who has been diagnosed with gonorrhea twice over the last year states, "It's no big deal. I just come here and get antibiotics when it gets bad." What should the nurse identify as a priority problem for this patient?

1. Noncompliance related to disease treatment

2. Pain related to appearance of chancres

3. Impaired social interactions because of low self-esteem

4. Potential for harm to the patient and partners related to the disease process

Page Ref: 1845

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with sexually transmitted infections.

26) A female patient is having difficulty accepting the diagnosis of a sexually transmitted disease because of being "on the pill" for years. Which information should the nurse provide to aid this patient?

1. Skipping doses could have caused the disease.

2. Type of birth control pill being used needs to be changed.

3. Some diseases are virulent, and the pill will not provide protection.

4. Oral contraceptives do not protect against sexually transmitted diseases.

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

27) A male patient is "relieved" to learn that a sexually transmitted disease is not HIV. What would be an appropriate response for the nurse to make to this patient?

1. "Having a sexually transmitted infection does predispose the body to be infected with HIV if exposed to the virus."

2. "You are lucky. Not all patients have a disease that can be cured."

3. "I told you not to be concerned."

4. "You would know if you had HIV from the symptoms, which are not like those you have."

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.4. Communicate effectively with all members of the healthcare team, including the patient and the patient's support network | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

28) A female patient who was just diagnosed with a sexually transmitted infection is beginning treatment. What should the nurse remind the patient to do?

1. Avoid all sexual activity in the future.

2. Begin birth control pills to prevent future disease transmission.

3. Be pleased that she was not diagnosed with HIV.

4. Inform all sexual partners about the diagnosis so they can also be treated.

Page Ref: 1834

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation/Communication and Documentation

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with sexually transmitted infections.

29) A female patient is seen for a new onset of blisters on the labia majora. Which health problem should the nurse suspect the patient is experiencing?

1. A drug reaction

2. First episode of a herpes virus infection

3. Prodromal symptoms of the herpes virus

4. Latency period of the herpes virus infection

Page Ref: 1837

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

30) A patient with genital herpes is experiencing increased pain with urination. What should the nurse suggest to the patient to manage this symptom?

1. Drink more water.

2. Drink more cranberry juice.

3. Drink more orange juice.

4. Restrict fluids.

Page Ref: 1838

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

31) A male patient is concerned about a "smooth growth" that appeared on the penis. Which type of genital wart should the nurse suspect this patient is experiencing?

1. Condyloma acuminatum

2. Keratotic wart

3. Papular wart

4. Flat wart

Page Ref: 1839

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

32) After the removal of genital warts, the male patient says, "Now I can have sex again." What information should the nurse provide to this patient?

1. Preventing reinfection now that he is cured of the warts

2. Using a chemical barrier to avoid impregnating his partner

3. Asking every partner if she has a diagnosed sexually transmitted disease

4. Using a condom with all sexual activity

Page Ref: 1840

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.2 Describe the pathophysiology and manifestations of viral sexually transmitted diseases, including genital herpes and human papillomavirus, and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

33) A female patient continues to develop vaginal infections. What teaching should the nurse provide to assist this patient? Select all that apply.

1. "Wear only nylon underwear."

2. "Be sure to wash the perineal region daily and as necessary throughout the day."

3. "Avoid wearing tight jeans or pants."

4. "Douche daily."

5. "Use condoms when engaging in sexual activity."

Page Ref: 1841

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

34) A female patient is complaining of a "watery" vaginal discharge with a "really strong fishy" odor. Which health problem should the nurse suspect this patient is experiencing?

1. Bacterial vaginosis

2. Yeast infection

3. Trichomoniasis infection

4. Genital warts

Page Ref: 1841

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with sexually transmitted infections.

35) A female patient reports using "the medication for a yeast infection" but it is not "getting any better." What should the nurse consider is occurring with this patient?

1. Has not used the medication long enough

2. Might be using a treatment that is not appropriate for the cause

3. Is not using the medication correctly

4. Is not washing her hands before applying the medication

Page Ref: 1842

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with sexually transmitted infections.

36) A female patient is seen for a recurrence of a vaginal infection. What teaching should the nurse realize this patient needs? Select all that apply.

1. Implementing personal hygiene

2. Avoiding tight underwear

3. Saving some of the prescribed medication for use when symptoms return

4. Avoiding sexual contact until the infection heals

5. Avoiding feminine hygiene products

Page Ref: 1843

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Planning/Teaching/Learning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

37) A patient prefers to use the diaphragm as a method of birth control. Which sexually transmitted infection (STI) should the nurse review as being prevented by the use of this barrier? Select all that apply.

1. HIV

2. HPV

3. Gonorrhea

4. Chlamydia

5. Trichomoniasis

Page Ref: 1836

Cognitive Level: Applying

Client Need & Sub: Health Promotion and Maintenance: Health Promotion/Disease Prevention

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.7. Provide appropriate patient teaching that reflects developmental stage, age, culture, spirituality, patient preferences, and health literacy considerations to foster patient engagement in their care | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Implementation/Teaching/Learning

Learning Outcome: 50.1 Describe the characteristics of sexually transmitted infections, as well as key factors in their prevention and control.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with sexually transmitted infections.

38) The nurse is reviewing medication prescribed for a patient with uncomplicated gonorrhea. Which medication should the nurse expect to be prescribed for this patient? Select all that apply.

1. Cefoxitin

2. Ceftriaxone

3. Doxycycline

4. Clindamycin

5. Azithromycin

Page Ref: 1845

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with sexually transmitted infections.

39) The nurse suspects that patient who received intramuscular penicillin for treatment of secondary syphilis is developing the Jarisch-Herxheimer reaction. What information did the nurse use to make this clinical determination? Select all that apply.

1. New onset of fever

2. Heart rate 112 beats per minute

3. Sudden severe abdominal cramping

4. Complaints of musculoskeletal pain

5. Administration of medication 16 hours ago

Page Ref: 1847-1848

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with sexually transmitted infections.

40) A patient with pelvic inflammatory disease (PID) wants to avoid long-term effects. Which intervention should the nurse select to help achieve this patient's goal? Select all that apply.

1. Instruct on perineal care.

2. Ensure thorough hand hygiene.

3. Disinfect bedpan and toilet seat.

4. Administer antibiotic therapy as prescribed.

5. Monitor for adverse effects of antibiotic therapy.

Page Ref: 1851

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.8. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 50.3 Describe the pathophysiology and manifestations of bacterial sexually transmitted diseases, including vaginal infection, chlamydia, gonorrhea, syphilis, and pelvic inflammatory disease,

and outline the interprofessional care and nursing care of patients with these disorders.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with sexually transmitted infections.