Infectious Diseases Affecting The + Complete Test Bank Ch.21

Microbiology Fundamentals: A Clinical Approach, 3e (Cowan)

Chapter 21 Infectious Diseases Affecting the Genitourinary System

1) Which of the following is not a defense of the genitourinary tract?

A) Flushing action of urine

B) Lysozyme

C) IgA

D) IgG

E) Mucus secretions

2) Normal biota of the urethra include all of the following except ________.

A) nonhemolytic Streptococcus

B) Staphylococcus

C) Corynebacterium

D) Escherichia coli

E) Lactobacillus

3) Lactobacillus in the female reproductive tract ________.

A) is protective

B) is indicative of underlying infection

C) is the causative agent in common yeast infections

D) can lead to pelvic inflammatory disease

E) can contribute to STDs

4) The predominant microorganism in the female reproductive tract during childbearing years is ________.

A) Corynebacterium

B) Staphylococcus

C) Escherichia coli

D) Lactobacillus

E) Candida albicans

5) Which of the following is not a characteristic of the normal biota of the female reproductive tract during childbearing years?

A) Vaginal pH is neutral

B) Estrogen causes glycogen release

C) Lactobacilli convert sugars to acid

D) Candida albicans is present in small amounts

E) Secretory IgA provides protection

6) The most common causative agent of urinary tract infections is ________.

A) Escherichia coli O157:H7

B) Escherichia coli

C) Staphylococcus aureus

D) Streptococcus pyogenes

E) Pseudomonas aeruginosa

7) All of the following are signs and symptoms of urinary tract infections except ________.

A) red blood cells in urine

B) painful urination

C) white blood cells in urine

D) nausea

E) diarrhea

8) Which of the following organisms causes urinary tract infections?

A) Proteus mirabilis

B) Schistosoma haematobium

C) Treponema pallidum

D) Group B Streptococcus

E) Gardnerella

9) Infection of the urinary bladder is called ________.

A) urethritis

B) pyelonephritis

C) cystitis

D) vaginitis

E) PI

10) The most common mode of disease transmission in UTIs is ________.

A) fomites

B) indirect contact

C) opportunism

D) aerosol

E) endogenous transfer

11) The best prevention for UTIs is ________.

A) to avoid contact

B) hygiene

C) to flush tract with alcohol

D) to consume a high-carbohydrate diet

12) Infected animals shed Leptospira interrogans in their ________.

A) feces

B) blood

C) urine

D) respiratory secretions

E) saliva

13) Leptospirosis has all of the following characteristics except ________.

A) most common in cattle, horses, pigs, and dog

B) pathogen is a spirochete

C) infects kidneys, liver, brain, and eyes

D) humans acquire it by contact with abraded skin or mucous membranes

E) can be transmitted by animal bites

14) Leptospirosis ________.

A) has only humans as a reservoir

B) is communicable

C) can be contracted from the environment

D) is strictly transmitted by sexual contact

E) is contracted by the fecal-oral route

15) Trichomonas vaginalis ________.

A) does not produce cysts

B) in males causes urethritis

C) in females causes vaginitis with a foul-smelling discharge

D) has four flagella and an undulating membrane

E) All of the choices are correct.

16) The most common cause of vaginitis is ________.

A) Candida albicans

B) Escherichia coli

C) Staphylococcus aureus

D) Streptococcus pyogenes

E) Pseudomonas aeruginosa

17) Candida albicans is a ________.

A) fungus

B) bacteria

C) helminth

D) protozoa

E) None of the choices are correct.

18) Trichomonas vaginalis is a ________.

A) fungus

B) bacteria

C) helminth

D) protozoan

E) None of the choices are correct.

19) Which of the following is not true of prostatitis?

A) Caused by GI tract biota

B) Can be chronic or acute

C) The specific agent is easy to determine

D) Patients may be very ill with the acute form

E) Accompanied by pain and frequent, difficult urination

20) Neisseria gonorrhoeae is ________.

A) the cause of ophthalmia neonatorum

B) the cause of gonorrhea

C) called the gonococcus

D) virulent due to fimbriae and a protease that inactivates IgA

E) All of the choices are correct.

21) All of the following pertain to gonorrhea except ________.

A) a chancre-type lesion develops at the portal of entry

B) is a sexually transmitted disease

C) pelvic inflammatory disease (PID), epididymitis, and infertility are complications

D) females can have asymptomatic infection

E) symptoms include painful urination and discharge

22) The primary virulence factor of Neisseria gonorrhoeae is ________.

A) endotoxin

B) exotoxin

C) kinase

D) fimbriae

E) All of the choices are correct.

23) Pelvic inflammatory disease results from infection of the ________.

A) vagina

B) fallopian tubes

C) ovaries

D) Both vagina and fallopian tubes are correct.

E) Both fallopian tubes and ovaries are correct.

24) The leading cause of pelvic inflammatory disease is ________.

A) gonorrhea

B) chlamydia

C) genital herpes

D) syphilis

E) HIV

25) Pelvic inflammatory disease often leads to ________.

A) ovarian cancer

B) uterine cancer

C) cervical cancer

D) infertility

E) kidney cancer

26) The following are characteristics of chlamydias except ________.

A) they are gram-negative

B) they are obligate parasites that need host cells for growth

C) their elementary bodies are the infectious form

D) the formation of elementary bodies is not part of the life cycle

E) their reticulate bodies differentiate into elementary bodies

27) Chlamydia trachomatis causes ________.

A) nongonococcal urethritis in males

B) cervicitis in females

C) congenital conjunctivitis

D) pelvic inflammatory disease in females

E) All of the choices are correct.

28) The most common reported STD in the United States is ________.

A) gonorrhea

B) chlamydia

C) genital herpes

D) syphilis

E) HIV

29) Lymphogranuloma venereum is a complication of ________.

A) gonorrhea

B) chlamydia

C) genital herpes

D) syphilis

E) HIV

30) The best way to directly observe spirochetes is ________ microscopy.

A) bright-field

B) dark-field

C) fluorescent

D) phase-contrast

E) electron scanning

31) Treponema pallidum ________.

A) has humans as the reservoir

B) can cross the placenta

C) has a hooked tip to attach to epithelium

D) is transmitted by direct sexual contact

E) All of the choices are correct.

32) The chancre of syphilis ________.

A) occurs due to small hemorrhaging of capillaries

B) is very painful

C) occurs during the tertiary stage

D) develops into a lesion with firm margins and an ulcerated, central crater

E) All of the choices are correct.

33) The secondary stage of syphilis ________.

A) is when the patient is no longer infectious to others

B) occurs within 10 days of the primary stage

C) is a time when the pathogen enters and multiplies in the blood

D) has no symptoms

E) is when gummas develop in tissues

34) During which stage of syphilis does fever, lymphadenopathy, and a red to brown rash occur?

A) Primary

B) Secondary

C) Tertiary

D) Latent

E) All of the choices are correct.

35) Permanent cardiovascular and neurological damage is seen in which stage of syphilis?

A) Primary

B) Secondary

C) Tertiary

D) Latent

E) All of the choices are correct.

36) Syphilitic lesions called ________ develop in the liver, skin, bone, and cartilage during the tertiary stage of syphilis.

A) chancres

B) gummas

C) ulcers

D) nodules

E) None of the choices are correct.

37) The rash of secondary syphilis ________.

A) causes severe itching

B) is intensely painful

C) only lasts a few days

D) usually disappears spontaneously after a few weeks

E) appears within 1 to 2 days of infection

38) The latency period of syphilis can last up to ________.

A) 3 to 6 months

B) 1 year

C) 10 years

D) 20 years or more

E) Syphilis is never a latent infection.

39) Which of the following is the current effective treatment for syphilis?

A) Mercury

B) Arsenic

C) Malaria

D) Penicillin G

E) Ampicillin

40) Which of the following antivirals is not used for treatment of HSV-1 and HSV-2?

A) Interferon

B) Valacyclovir

C) Acyclovir

D) Famciclovir

E) All of the choices are correct.

41) Chancroid ________.

A) is caused by Treponema pallidum

B) is caused by a spirochete

C) presents with a hard chancre

D) is caused by Haemophilus ducreyi

E) is very painful in both sexes

42) Herpes simplex 1 ________.

A) is exclusive to oral mucosa

B) is exclusive to genitourinary tract

C) confers immunity to herpes simplex 2

D) is cleared by acyclovir

E) None of the choices are correct.

43) Herpes simplex 2 (HSV-2) causes ________.

A) genital lesions

B) intensely sensitive vesicles on or near the genitals

C) symptoms that include urethritis, cervicitis, and itching

D) infection in neonates that have contact with lesions in the birth canal

E) All of the choices are correct.

44) An occasional serious complication of herpes simplex 1 is ________.

A) shingles

B) paralysis

C) encephalitis

D) myocarditis

E) kidney failure

45) All of the following are true for HSV-2 except ________.

A) becomes latent in sacral ganglion

B) virus is only shed from active lesions

C) is reactivated by bacterial infections

D) can infect oral mucosa

E) All of the choices are correct.

46) All of the following pertain to genital warts except ________.

A) are not common in the United States

B) are sexually transmitted

C) often occur on the penis, vagina, and cervix

D) includes large cauliflower-like masses called condylomata acuminata

E) certain strains strongly predispose a person to cancer of the cervix or penis

47) Warts are caused by ________.

A) bacteria

B) enveloped DNA viruses

C) nonenveloped DNA viruses

D) enveloped RNA viruses

E) nonenveloped RNA viruses

48) Which group is at greatest risk for group B Streptococcus infection?

A) Pregnant women

B) Neonates

C) 21-year-old females

D) 21-year-old males

E) Older adults (age 65 years and older)

49) Even after a positive test for a microbial cause, prostatitis is unresponsive to antibiotic therapy. Why?

A) It is a viral infection

B) Drug-induced side effects are too great

C) Mixed biofilms are hard to kill

D) The infection is sporadic

E) Prostatitis is never caused by bacteria

50) Which of the following are characteristics that can be utilized to distinguish between vaginitis and vaginosis?

A) Causative agent

B) Presence of vaginal inflammation

C) Presence of discharge

D) All of the choices are correct.

51) Chlamydia trachomatis is commonly transmitted by direct sexual activity.

52) Chlamydias can cross the placenta and cause intrauterine infection.

53) Chlamydiosis can lead to cervicitis, salpingitis, and pelvic inflammatory disease.

54) The antivirals used for herpes simplex infections have the ability to completely destroy the virus and permanently cure the latent infection.

55) Group B streptococcal infections can cause serious infections in infants through vertical transmission.

56) The HPV vaccine prevents infection by a single pathogenic strain of HPV.

57) The male urinary tract differs from the female tract in that ________.

A) in males the urethra acts as the terminal organ for both the urinary and reproductive systems, whereas in females, the urethra is separate from the vagina

B) in males the kidneys attach to the bladder via the ureter, whereas in females it attaches via the urethra

C) in females the bladder is significantly smaller than the male bladder to provide room for the uterus

D) in males the kidneys are significantly larger than in females due to testosterone production

58) Which of the following is not a component of the female reproductive tract?

A) Vas deferens

B) Fallopian tubes

C) Ovary

D) Cervix

E) Uterus

59) The male reproductive system comprises all of the following except ________.

A) the Fallopian tubes

B) vas deferens

C) epididymides

D) the scrotum

E) seminal vesicles

60) The urinary tract defenses in both males and females consists of mechanical factors such as ________, and chemicals like ________, to prevent the growth of pathogens in the system.

A) the flushing action of urine; lysozyme

B) phagocytosis; interleukins

C) lysis of foreign cells; interferons

D) the inflammatory response; leukotrienes

61) Which of the following statements is incorrect regarding the defense mechanisms of the female reproductive tract?

A) Vaginal pH is continually around 5 throughout the lifespan of the female to prevent the growth of pathogenic organisms.

B) After puberty, glycogen is secreted into the vaginal mucus, which is fermented into acid by the normal biota thus lowering the pH.

C) Before puberty and after menopause, vaginal mucus remains around pH 7.

D) The microbiota of the female vaginal tract varies throughout her lifetime in response to vaginal pH; lower pH encourages the growth of organisms that prevent invasion by pathogens that could harm a developing fetus.

62) Prostatitis is usually caused by bacteria that are transmitted by ________.

A) endogenous transfer from the gastrointestinal tract

B) direct contact from a sexual partner

C) poor hygiene during urination

D) opportunism by the microbiota following an antibiotic regime

63) Evaluate the following statements and determine which is incorrect regarding the development of genital warts.

A) Warts caused by human papillomavirus can be inconspicuous, whereas warts caused by the poxvirus are large and unsightly, a condition called condyloma acuminata.

B) Two types of virus, HPV and a poxvirus can cause genital warts although HPV infection has more serious consequences.

C) Genital warts caused by the human papillomavirus range from being inconspicuous or extensive, whereas those from the poxvirus do not vary.

D) Regardless of the viral cause of genital warts, the condition is not treatable, although the warts can be removed.

64) Evaluate the statements below and determine which one is incorrect regarding the HPV vaccine.

A) Only females have a cervix so it is not necessary to vaccinate males against HPV since they cannot develop cervical cancer.

B) Even if a female retains her virginity until she marries, it is important she is vaccinated before having sex because the virus is transmitted from male to female regardless of marital status.

C) Males can develop cancer from HPV, most often in the penis, anus, mouth and throat, so it important that males as well as females are vaccinated during adolescence.

D) HPV is so pervasive in our society that the CDC states that nearly all sexually active adults will be exposed to HPV at some stage of their lives.

E) Since HPV is incurable and some strains house oncogenes, vaccination before first exposure is the best cancer prevention.

65) The HPV vaccine is recommended for all adolescents because ________.

A) it causes a variety of cancers in both males and females

B) the vaccine prevents infection by up to nine strains of the virus that cause both cancers and genital warts

C) the virus can be transmitted from male to female, female to male, male to male, and female to female, so everyone, regardless of sexual preference, should receive the vaccine

D) the virus is so common that most sexually active individuals will be exposed to the virus at some point in their lives

E) All of the choices are correct.

66) Colonization of pregnant females by Group B Streptococcus puts the neonate at risk because ________.

A) the organism produces hemolysins that can break down red blood cells

B) colonization during pregnancy can result in preterm labor

C) the neonate can develop meningitis or pneumonia through exposure to the organism in the birth canal

D) permanent damage such as hearing or vision loss can result following recovery from an acute condition after delivery

E) All of the choices are correct.

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A nurse in the emergency department is caring for a 23-year-old female who is on vacation for her honeymoon. Two days ago, she began experiencing burning while voiding and a tactile fever. The patient reports she has been treating the symptoms with cranberry tablets and increased fluid intake. Her symptoms have not improved and now she is experiencing a frequent urge to void and lower abdominal pain. Upon assessment, the nurse finds the patient has a low-grade fever.

67) Based on the patient's clinical presentation, which of the following diagnoses is most likely? 

A) Urethritis

B) Cystitis

C) Pyelonephritis

D) General urinary tract infection

68) What findings on urinalysis would be consistent with cystitis? 

A) Increased glucose

B) Depleted protein

C) Presence of WBCs

D) Decreased specific gravity

69) The nurse provides education for the patient prior to discharge. She is instructed to seek care for which of the following symptoms?

A) High fever and low back pain

B) Lack of fever and RLQ tenderness

C) Nausea and vomiting

D) Lack of pain and pink urine

70) The medical provider prescribes an antibiotic regimen. The patient asks the nurse if antibiotics are necessary if she increases her intake of cranberry tablets. What is the most appropriate response by the nurse?  

A) Cranberry tablets should acidify your bladder and urinary tract, effectively killing bacteria. Antibiotics shouldn't be necessary if you increase your dose.

B) Your genitourinary tract defenses should be able to fight this infection without the use of antibiotics or additional therapies. If your symptoms worsen, you should take the antibiotics.

C) It is important to complete a course of antibiotics to prevent this infection from becoming more serious.

D) You must take the antibiotics to prevent this infection from spreading to others.

NCLEX Prep - Test Bank Question: Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A 20-year-old male college student presents to the campus health clinic. The patient reports no significant past medical history. He has been experiencing painful urination for several days and yellow discharge from his urethra. The nurse asks the student about his sexual activity. He reports engaging in unprotected sex, and is concerned that he may have contracted a sexually transmitted infection. The nurse sends a sample of the urethral discharge to the microbiology laboratory.  The laboratory reports gram-negative diplococci and many neutrophils on the smear, suggestive of gonorrhea.

71) Based on the patient's clinical presentation and history alone, how could the nurse have distinguished gonorrhea from chlamydia?  

A) Chlamydia rarely presents with a yellow discharge.

B) Painful urination is the hallmark of gonorrhea.

C) Chlamydia additionally presents with lower abdominal pain.

D) Gonorrhea and chlamydia mimic each other in presentation.

72) Which antibiotic(s) does the nurse anticipate will be ordered to treat the patient? 

A) Amoxicillin

B) Bactrim

C) Gonorrhea is not treated with antibiotics

D) Ceftriaxone and azithromycin

73) The nurse provides education about prevention of future gonorrheal infection. Which of the following topics would be included in the teaching?

A) Always use a condom for sexual contact

B) Vaccination with Gardisil

C) Strict abstinence

D) Gonorrhea will always be latent in the patient's genitourinary system.

74) The patient asks the nurse to keep his diagnosis confidential. What is the nurse's best response? 

A) I'm bound by HIPAA laws to maintain patient confidentiality, including your diagnosis.

B) I am required by law to contact the health department, and you should notify any recent sexual partners.

C) Once a sexually transmitted infection is detected, HIPAA laws no longer apply. I am obligated to share this with the school to track occurrences of gonorrhea on campus.

D) I am required, by law, to contact the health department, unless you sign a ‘Waiver of Liability' form.

NCLEX Prep - Test Bank Question:  Please read the clinical scenario, and then answer the questions that follow to become familiar with the traditional NCLEX question format.

A 21-year-old college student presents to the university campus clinic. The nurse collects the patient's medical history and performs an initial assessment. The patient states, "I'm having a herpes flair, and I need a prescription for acyclovir." The nurse examines the lesion on the shaft of his penis. The ulcer is 2 cm in size and seems painless and hard upon palpation.

75) Based upon the assessment of the lesion, what is the most likely diagnosis?  

A) Herpes

B) Primary syphilis

C) Chancroid

D) Human papillomavirus infection

76) How would the diagnosis of syphilis be confirmed?  

A) Dark-field microscopy

B) Blood antibody test

C) PCR

D) All of these tests can be used in diagnosis.

77) The physician in the clinic wrote a prescription for acyclovir when the student called him on the phone that morning. What is the most appropriate action by the nurse?  

A) Give the student the prescription for acyclovir

B) Give the student the prescription for acyclovir and instruct him to use it in the future

C) Call the physician, report the assessment findings, and suggest a prescription for penicillin G

D) Ask the physician to write a prescription for a broad-spectrum antibiotic

78) The student states, "My friend had syphilis, but the lesion healed without antibiotics. Do I really need to take medications?" What is the best response by the nurse?  

A) The lesion will probably heal independently, but antibiotics will make it heal faster.

B) The lesion will heal on its own, but latent syphilis will cause serious disease later on and must be treated.

C) Syphilis is primarily viral in nature so an antibiotic is used to prevent bacterial infection of the healing lesion.

D) Antibiotics will protect you from contracting other sexually transmitted infections while the lesion is healing.