Old's Maternal-Newborn Nursing and Women's Health, 11e (Davidson/London/Ladewig)

Chapter 5 Commonly Occurring Infections

1. A nonpregnant client is diagnosed with bacterial vaginosis (B V). What does the nurse expect to administer?
2. Penicillin G 2 million units I M one time
3. Zithromax 1 m g P O bid for 2 weeks
4. Doxycycline 100 m g P O bid for a week
5. Metronidazole 500 m g P O bid for a week

Page Ref: 78

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Planning.

Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is providing discharge instructions to a client with a diagnosis of vulvovaginal candidiasis (V V C), and knows the client understands when she makes which of the following statements?
2. "I need to apply the miconazole for 10 days."
3. "I need to douche daily."
4. "I need to add yogurt to my diet."
5. "I need to wear nylon panties."

Page Ref: 77

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅶ. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Evaluation.

Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse provides a couple with education about the consequences of not treating chlamydia, and knows they understand when they make which statement?
2. "She could become pregnant."
3. "She could have severe vaginal itching."
4. "He could get an infection in the tube that carries the urine out."
5. "It could cause us to develop a rash."

Page Ref: 77

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N Essentials Competencies: Ⅶ. 5. Use evidence-based practices to guide health teaching, health counseling, screening, outreach, disease and outbreak investigation, referral, and follow-up throughout the lifespan. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Evaluation.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is seeing clients in the women's clinic. Which client should be treated with ceftriaxone I M and doxycycline orally?
2. A pregnant client with gonorrhea and a yeast infection
3. A nonpregnant client with gonorrhea and chlamydia
4. A pregnant client with syphilis
5. A nonpregnant client with chlamydia and trichomoniasis

Page Ref: 77

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 3. Implement evidence-based nursing interventions as appropriate for managing the acute and chronic care of patients and promoting health across the lifespan. | N L N Competencies: Teamwork: Function completely within one's own scope of practice as leader and member of the healthcare team and manage delegation effectively. | Nursing/Integrated Concept: Nursing Process: Implementation.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is providing follow-up education to a client just diagnosed with vaginal herpes. What statement by the client verifies correct knowledge about vaginal herpes?
2. "I should douche daily to prevent infection."
3. "I could have another breakout during my period."
4. "I am more likely to develop cancer of the cervix."
5. "I should use sodium bicarbonate on the lesions to relieve discomfort."

Page Ref: 80

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Evaluation.

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman with an S T I.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse seeing a client just diagnosed with Chlamydia trachomatis knows that which client is at greatest risk for the infection?
2. 16-year-old sexually active girl, using no contraceptive
3. 22-year-old mother of two, developed dyspareunia
4. 35-year-old woman on oral contraceptives
5. 48-year-old woman with hot flashes and night sweats

Page Ref: 78

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology. | N L N Competencies: Context and Environment: Read and interpret data; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concept: Nursing Process: Assessment.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A client comes to the clinic complaining of difficulty urinating, flu-like symptoms, genital tingling, and blister-like vesicles on the upper thigh and vagina. She denies having ever had these symptoms before. The medication the physician is most likely to order would be:
2. Oral acyclovir
3. Ceftriaxone I M
4. Azithromycin P O
5. Penicillin G I M

Page Ref: 80

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Implementation.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is caring for a client hospitalized for pelvic inflammatory disease. Which nursing intervention would have priority?
2. Encourage oral fluids
3. Administer cefotetan Ⅳ
4. Enforce bed rest
5. Remove I U C, if present

Page Ref: 84

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 11. Provide nursing care based on evidence that contributes to safe and high-quality patient outcomes within healthcare microsystems. | N L N Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Planning.

Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (P I D) for future fertility to its pathologic origin, signs and symptoms, and treatment.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse obtains a health history from four clients. To which client should she give priority for teaching about cervical cancer prevention?
2. Age 30, treated for P I D
3. Age 25, monogamous
4. Age 20, pregnant
5. Age 27, uses a diaphragm

Page Ref: 84

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management. | A A C N 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 care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Planning.

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman with an S T I.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is discharging a client after hospitalization for pelvic inflammatory disease (P I D). Which statements indicate that teaching was effective?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. "I might have infertility because of this infection."
2. "It is important for me to finish my antibiotics."
3. "Tubal pregnancy could occur after P I D."
4. "My P I D was caused by a yeast infection."
5. "I am going to have an I U D placed for contraception."

Page Ref: 84

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being and self-care management. | A A C N 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 care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Evaluation.

Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (P I D) for future fertility to its pathologic origin, signs and symptoms, and treatment.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. Which of the following diagnostic tests would the nurse question when ordered for a client diagnosed with pelvic inflammatory disease (P I D)?
2. C B C (complete blood count) with differential
3. Venereal Disease Research Laboratory (V D R L)
4. Throat culture for Streptococcus A
5. R P R (Rapid Plasma Reagin)

Page Ref: 84

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Physiological Adaptation

Standards: Q S E N Competencies: Ⅰ. B. 1. Elicit patient values, preferences, and expressed needs as part of clinical interview, implementation of care plan and evaluation of care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply ethical decision making models. | Nursing/Integrated Concept: Nursing Process: Implementation.

Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (P I D) for future fertility to its pathologic origin, signs and symptoms, and treatment.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. Women with pyelonephritis during pregnancy are at significantly increased risk for which condition?
2. Foul-smelling discharge
3. Ectopic pregnancy
4. Preterm labor
5. A colicky large intestine

Page Ref: 85

Cognitive Level: Understanding

Client Need/Sub: Physiological Integrity: Basic Care and Comfort

Standards: Q S E N Competencies: Ⅰ. B. 3. Provide patient-centered care with sensitivity and respect for the diversity of human experience. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management, and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Apply professional standards; show accountability for nursing judgment and actions; develop advocacy skills; apply health promotion/disease prevention strategies; apply health policy; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concept: Nursing Process: Implementation.

Learning Outcome: 5 Contrast cystitis and pyelonephritis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is preparing an education session for women on the prevention of urinary tract infections (U T Is). Which statement should be included?
2. Lower urinary tract infections rarely occur in women.
3. The most common causative organism of cystitis is E. coli.
4. Wiping from back to front after a B M will help prevent a U T I.
5. Back pain often develops with a lower urinary tract infection.

Page Ref: 85

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. B. 10. Engage patients or designated surrogates in active partnerships that promote health, safety and well-being, and self-care management. | A A C N 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 care. | N L N Competencies: Relationship-Centered Care: Communicate information effectively; listen openly and cooperatively. | Nursing/Integrated Concept: Nursing Process: Planning.

Learning Outcome: 5 Contrast cystitis and pyelonephritis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse in the community clinic is preparing educational materials to be used for teaching patients with sexually transmitted infections. What information should the nurse include regarding the medications metronidazole or tinidazole?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Take this medication until symptoms disappear
2. Abstain from all alcohol while taking these medications
3. Stop taking oral contraceptives while taking these medications
4. Abstain from all alcohol for 72 hours after completing tinidazole
5. Abstain from all alcohol for 24 hours after completing metronidazole

Page Ref: 74

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient is concerned about contracting herpes genitalis from a sexual partner and asks the nurse what to expect if the infection is present. In which order should the nurse explain the infection to the patient?
2. Emotional trigger occurs
3. Lesions spontaneously appear
4. Take oral acyclovir as prescribed
5. Virus enters a dormant phase with no lesions
6. Development of single or multiple blister-like vesicles

Page Ref: 80

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A female patient comes into the clinic because of concerns about a sore that was present on her labia but spontaneously healed. During the interview the patient asks what could occur if the infection is syphilis. In what order should the nurse explain the course of this sexually transmitted infection?
2. Latent period with no lesions
3. Development of a chancre sore
4. Skin eruptions and sore throat occur
5. Tertiary stage with various symptoms
6. Development of a fever, weight loss, and malaise

Page Ref: 80

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. While assisting a female client into the lithotomy position for a pelvic examination the nurse observes the following on the patient's perineum. For which health problem should the nurse expect orders to be written by the healthcare provider?

1. Syphilis
2. Gonorrhea
3. Chlamydia
4. Human papillomavirus

Page Ref: 81

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning: Nursing Process.

Learning Outcome: 2 Summarize modes of transmission, treatments, and descriptions of the most commonly occurring sexually transmitted infections (S T Is).

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A pregnant patient is concerned about the development of several urinary tract infections (U T Is) over the last few months of her pregnancy. What should the nurse explain as reasons for the development of these infections in this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Decrease in bladder tone
2. Hyperemic bladder mucosa
3. Urethral stricture and loss of micturition reflex
4. Ureters elongate and are displaced by the uterus
5. Distal ureters hypertrophy leading to ureteral stenosis

Page Ref: 84—85

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment; Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Nursing Process.

Learning Outcome: 5 Contrast cystitis and pyelonephritis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse suspects that a patient is experiencing bacterial vaginosis. What finding caused the nurse to make this clinical determination?
2. Dysuria
3. Vaginal itching
4. Thick white vaginal discharge
5. Fishy odor to vaginal discharge

Page Ref: 74

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient in the 2nd trimester of pregnancy is diagnosed with bacterial vaginosis. Which medication regimen should the nurse expect to be prescribed for this patient?
2. Metronidazole 500 m g orally one dose
3. Metronidazole 250 m g orally once a day for 7 days
4. Metronidazole 500 m g orally twice a day for 7 days
5. Metronidazole 250 m g orally twice a day for 14 days

Page Ref: 74

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N Essentials Competencies: Ⅸ. 3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across the lifespan, and in all healthcare settings. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning.

Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is concerned that a patient is at risk for developing vulvovaginal candidiasis (V V C). What assessment information caused the nurse to have this concern? Select all that apply.
2. 16 weeks pregnant
3. +3 glucose in the urine
4. Elevated blood pressure
5. Type 2 diabetes mellitus
6. Edematous lower extremities

Page Ref: 76

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient is being assessed for recurrent vulvovaginal candidiasis (V V C) infections. What should the nurse instruct this patient to do to help reduce the incidence of infection?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Avoid douching
2. Use vaginal sprays
3. Wear cotton underwear
4. Avoid tight-fitting clothing
5. Apply cornstarch to the vulva

Page Ref: 76—77

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 1 Compare vulvovaginal candidiasis and bacterial vaginosis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient and her partner are being treated for trichomoniasis. What should the nurse emphasize when teaching the couple about this infection?
2. Avoid intercourse until symptom free
3. Ensure a repeat test is completed in 3 months
4. Limit alcohol intake while taking metronidazole
5. Have annual screening for recurrence of the infection

Page Ref: 78

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman with an S T I.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient is being instructed on adverse effects of gonorrhea. For which reason should the nurse instruct the patient to contact the healthcare provider?
2. Dysuria
3. Urinary frequency
4. Sharp abdominal pain
5. Purulent, greenish-yellow vaginal discharge

Page Ref: 79—80

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman with an S T I.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is preparing instructions for a patient newly diagnosed with genital herpes. What should the nurse encourage to promote healing of the lesions?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Take sitz baths
2. Use vaginal sprays
3. Wear cotton underwear
4. Douche after intercourse
5. Wear loose fitting clothing

Page Ref: 80

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman with an S T I.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A college student is distraught after being diagnosed with pediculosis pubis. What should the nurse instruct this student to do to help prevent future infections?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Both partners need to be treated
2. Take the prescribed medication for 10 days
3. Avoid all sexual contact until treated and cured
4. Wash bed linens in hot water and dry in a dryer for 20 minutes
5. Testing for other sexually transmitted infections is recommended

Page Ref: 81—82

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 3 Describe the health teaching that a nurse needs to provide to a woman with an S T I.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. While reviewing data, the nurse determines that a patient is at risk for pelvic inflammatory disease. Which information did the nurse use to make this clinical determination?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Age 23
2. Douches weekly
3. Smokes cigarettes 1 ppd
4. I U D inserted 2 months ago
5. Received H P V vaccination

Page Ref: 84

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (P I D) for future fertility to its pathologic origin, signs and symptoms, and treatment.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. After a pelvic examination, a patient is scheduled for tests to diagnose pelvic inflammatory disease. Which finding from the physical examination suggested to the nurse practitioner that further testing is required?
2. Cervical tenderness
3. Greenish vaginal discharge
4. Open sores along the vagina
5. Condylomata acuminata on the vulva

Page Ref: 84

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (P I D) for future fertility to its pathologic origin, signs and symptoms, and treatment.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is reviewing laboratory testing completed for a patient with suspected pelvic inflammatory disease. Which test result should the nurse identify as supporting this diagnosis?
2. Decreased hematocrit level
3. Elevated sedimentation rate
4. Decreased hemoglobin level
5. Elevated white blood cell count

Page Ref: 84

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 4 Relate the implications of pelvic inflammatory disease (P I D) for future fertility to its pathologic origin, signs and symptoms, and treatment.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient schedules an appointment to be seen in the community clinic for dysuria, urgency, frequency, blood in the urine, and low back pain. For which health problem should the nurse provide care for this patient?
2. Cystitis
3. Pyelonephritis
4. Glomerulonephritis
5. Asymptomatic bacteriuria

Page Ref: 85

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning.

Learning Outcome: 5 Contrast cystitis and pyelonephritis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is caring for a client diagnosed with cystitis. When teaching the client about self-care techniques, which foods or beverages will the nurse advise the client to avoid?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Caffeine
2. Dairy products
3. Alcohol
4. Carbonated beverages
5. Acidic fruit juices

Page Ref: 86

Cognitive Level: Understanding

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation; Teaching/Learning.

Learning Outcome: 5 Contrast cystitis and pyelonephritis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient treated for a urinary tract infection a month ago is experiencing symptoms of the same infection. What should the nurse suspect is the reason for the reoccurrence of the infection?
2. Using oral contraceptives
3. Wearing cotton underwear
4. Cleansing from front to back
5. Stopped antibiotics after 3 days

Page Ref: 86

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 5 Contrast cystitis and pyelonephritis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. A patient seeks medical attention after being exposed to blood during a gang fight several weeks ago. For which types of hepatitis should the nurse anticipate that this patient will be tested?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. A
2. B
3. C
4. D
5. E

Page Ref: 82

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Planning.

Learning Outcome: 6 Compare the different types of viral hepatitis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse is planning teaching for a patient diagnosed with hepatitis A. What should the nurse emphasize when instructing the patient about this disease process?
2. It is a chronic illness
3. It is not a chronic illness
4. A vaccination is not available
5. It occurs in East and South Asia

Page Ref: 82

Cognitive Level: Applying

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Implementation: Teaching/Learning.

Learning Outcome: 6 Compare the different types of viral hepatitis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.

1. The nurse suspects that a newly admitted patient is experiencing manifestations of hepatitis A. What assessment findings did the nurse use to make this clinical determination?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Select all that apply.

1. Rash
2. Fever
3. Jaundice
4. Joint pain
5. Gray-colored stool

Page Ref: 82

Cognitive Level: Analyzing

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

Standards: Q S E N Competencies: Ⅰ. A. 1. Integrate understanding of multiple dimensions of patient-centered care. | A A C N 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. | N L N Competencies: Context and Environment: Practice; conduct population-based transcultural health assessments and interventions. | Nursing/Integrated Concepts: Assessment.

Learning Outcome: 6 Compare the different types of viral hepatitis.

M N L L O: Demonstrate use of the nursing process in the care of women with genital or urinary infections.