Test Bank For Primary Care Art and Science of Advanced Practice Nursing- Inter-professional Approach

____ 31. A 24-year-old woman diagnosed with Chlamydia has been prescribed doxycycline. What should be included in the nurses teaching about the drug treatment? (Select all that apply.) a. Take this drug with a meal. b. Do not take with dairy products. c. Avoid unnecessary exposure to sunlight. d. Abstain from alcohol for at least 48 hours after treatment. e. Use birth control methods to ensure you do not become pregnant. ____ 32. The nurse is teaching a patient about the use of condoms to prevent sexually transmitted infections (STIs). Which information should the nurse include in this teaching? Select all that apply. a. Condoms can decrease the risk of transmitting STDs. b. Latex condoms are less likely to break than other types. c. Inflating the condom prior to use allows for effective inspection. d. Condoms should be used no more than twice and then discarded properly. e. Use of a water-soluble lubricant with a condom increases its effectiveness in preventing the spread of an STD. f. Use of a petroleum-based lubricant with a condom increases its effectiveness in preventing the spread of an STD. ____ 33. The nurse is providing care for a patient recently diagnosed with Chlamydia. Which information should the nurse recommend be included in patient teaching? (Select all that apply.) a. Women with Chlamydia may complain of a sore throat. b. Chlamydia is characterized by the development of chancres. c. Ophthalmia neonatorum is seen in infants born to women with Chlamydia. d. Chlamydia can be transmitted sexually and by blood and body fluid contact. e. The risk of ectopic pregnancy is increased in women with a history of Chlamydia. f. The Chlamydia virus can lie dormant in the nervous system tissues and reactivate when an individual is under stress or has a compromised immune system. ____ 34. The nurse notes that a patient is diagnosed with vulvovaginitis. What should the nurse expect when assessing this patient? (Select all that apply.) a. Vaginal edema b. Vaginal discharge c. Areas of ecchymosis d. Dark brown vaginal bleeding e. Complaints of vaginal itching and burning ____ 35. A patient in labor is diagnosed with mucopurulent cervicitis. For which health problems should the nurse anticipate providing care to the newborn? (Select all that apply.) a. Pneumonia b. Conjunctivitis c. Irregular heart rate d. Flaccid extremities e. Cyanotic extremities ____ 36. A patient diagnosed with syphilis reminds the HCP of having an allergy to penicillin. Which medications should the nurse expect to be prescribed for this patient? (Select all that apply.) a. Gentamicin b. Amoxicillin c. Tetracycline d. Doxycycline e. Erythromycin ____ 37. While providing a bath the nurse suspects that an older female patient has a Trichomonas infection. What type of discharge did the nurse observe to come to this conclusion? (Select all that apply.) a. Frothy discharge b. Foul-smelling discharge c. Yellow-green discharge d. Open sores on the labia majora e. Wart-like growths on the labia minora Chapter 44. Nursing Care of Patients With Sexually Transmitted Infections Answer Section MULTIPLE CHOICE 1. ANS: B The primary stage of syphilis begins with the entry of the Treponema pallidum spirochete through the skin or mucous membranes. Between 3 and 90 days later, a papule develops at the site of entry, then sloughs off, leaving a painless, red, ulcerated area called a chancre. A. Herpes is associated with vesicular skin lesions. C. D. Gonorrhea and Chlamydia are not associated with skin lesions. PTS: 1 DIF: Moderate KEY: Client Need: Safe and Effective Care EnvironmentSafety and Infection Control | Cognitive Level: Application 2. ANS: A Genital parasites are not a true sexually transmitted infection (STI), but they may be transmitted during close body contact. The two most commonly seen parasites are pubic lice (Phthirus pubis, commonly called crabs because of the shape of the lice) and scabies (Sarcoptes scabiei). B. C. D. Treponema pallidum, Neisseria gonorrhoeae, and Chlamydia trachomatis are not parasites. PTS: 1 DIF: Moderate KEY: Client Need: Safe and Effective Care EnvironmentSafety and Infection Control | Cognitive Level: Application 3. ANS: A In the tertiary stage of syphilis, the spirochete may form gummas, which are tumors of a rubbery consistency that can break down and ulcerate, leaving holes in body tissues. D. Herpes is associated with vesicular skin lesions. B. C. Gonorrhea and Chlamydia are not associated with skin lesions. PTS: 1 DIF: Moderate KEY: Client Need: Safe and Effective Care EnvironmentSafety and Infection Control | Cognitive Level: Application 4. ANS: C Condoms can greatly decrease the risk of STIs, but condoms can have tiny channels in the rubber (or other elastic material) that can allow microorganisms to pass through. Condoms can break, slip off, or be applied improperly. Petroleum-based lubricants may weaken latex condoms. A. Condoms do not provide a barrier for any area other than the penis and most of the vagina (or anus). B. Some STIs may still be transmitted by contact of surrounding uncovered tissues. D. Spermicide helps protect against pregnancy. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 5. ANS: C Vesicles are small blisters. A. B. D. Warts, rashes, and papules do not have the same characteristics. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 6. ANS: A Verrucous means wart-like. B. D. D. HPV causes wart-like growths, not rashes, blisters, or papules. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 7. ANS: D Fitz-HughCurtis syndrome, a surface inflammation of the liver, can also be caused by C. trachomatis. This inflammation may cause nausea, vomiting, and sharp pain at the base of the ribs that sometimes refers to the right shoulder and arm. A. B. C. Vaginal discharge, painful urination, and conjunctivitis are also concerns but are not as health-threatening as liver inflammation. PTS: 1 DIF: Moderate KEY: Client Need: Physiological Integrity Reduction of Risk Potential | Cognitive Level: Analysis | 8. ANS: C When wet-mount slides of Trichomonas discharge are viewed under a microscope, the organisms can be identified by their motility and whip-like flagella. A. B. D. Trichomonas is not diagnosed through a culture, blood test, or litmus paper. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 9. ANS: C Trichomonas may produce abnormal Pap smear readings, which require that more frequent Pap smears be done to provide adequate surveillance of cellular changes. A. Wet mount can identify the organism but not cellular changes. B. D. Serological testing and culture and sensitivity testing are not performed to detect cervical changes caused by Trichomonas. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 10. ANS: D Systemic interferon treatments attack warts all over the body at the same time, rather than individually as with topical treatments. This speeds the process of treatment. A. B. C. Interferons can produce side effects of flu-like symptoms, a drop in the number of white blood cells, and changes in liver function. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityPharmacological and Parenteral Therapies | Cognitive Level: Application 11. ANS: D It is recommended that all babies of HBV-positive mothers receive HBV immune globulin less than 12 hours after birth and then be immunized with HBV vaccine 1 week, 1 month, and 6 months after birth. A. Antibiotics are not effective against viruses. B. Eye medication may be necessary for gonorrhea or chlamydia. C. The infant needs to receive the HBV vaccination. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 12. ANS: C A nurses best protection against catching infections from blood and body fluids of infected patients is the strict practice of standard precautions and maintaining his or her own healthy, intact skin. A. Wearing gloves at all times is not appropriate. B. Washing hands is essential but is not sufficient. D. Touching patients cannot and should not be avoided. PTS: 1 DIF: Moderate KEY: Client Need: Safe and Effective Care Environment Safety and Infection Control | Cognitive Level: Application 13. ANS: B Newborns born to mothers who have gonorrhea can develop ophthalmia neonatorum, which involves inflammation of the conjunctiva and deeper parts of the eye and can, ultimately, result in blindness. A. C. D. Syphilis, genital warts, and genital herpes are not associated with infant eye problems. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 14. ANS: C Herpes, human papillomavirus (HPV), and hepatitis (not most sexually transmitted infections [STIs]) have been associated with cancers. A. Cancer has been associated with some STIs. B Most STIs do not cause cancer. D. Having a diagnosis of cancer does not increase the risk of contracting an STI. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 15. ANS: A Consumption of alcohol or other psychoactive drugs can reduce inhibitions and may result in unintended sexual encounters, which can transmit STIs. B. C. D. Alcohol does cause liver disease and may indirectly reduce resistance, but these are not the mechanisms by which immediate STI risk increases. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 16. ANS: C Condoms should never be inflated to test them, because this can weaken them. B. Lubrication decreases the chances of breakage during use, but only water-soluble lubricants should be used, because substances such as petroleum jelly (Vaseline) may weaken the condom. D. Either condoms with a reservoir tip or regular condoms that have been applied while holding approximately 1/2 inch of the closed end flat between the fingertips allow room for expansion by the ejaculate without creating excessive pressure, which might break the condom. A. Condoms should not be reused. PTS: 1 DIF: Moderate KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Evaluation 17. ANS: A Jaundice is a symptom of hepatitis. D. Headaches can be associated with many disorders and are not specific to hepatitis. B. C. Diabetes and bowel obstruction are not associated with hepatitis. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityPhysiological Adaptation| Cognitive Level: Analysis 18. ANS: C B. Men may be asymptomatic or may have urethritis with a yellow urethral discharge. C. Women who have gonorrhea may have either no noticeable symptoms or have a sore throat, mucopurulent cervicitis (MPC), urethritis, or abnormal menstrual symptoms such as bleeding between periods. A. Gonorrhea is treatable with antibiotics, which have side effects, but not such serious side effects that compliance is affected. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 19. ANS: D IV drug equipment can transmit some STIs. A. B. C. Sharing a cigarette or hairbrush or coughing and sneezing can spread various infections, but not generally STIs. PTS: 1 DIF: Moderate KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application 20. ANS: A Abstinence or lifelong monogamy of both sexual partners in a relationship are the only sure prevention against STIs. D. Antibiotics treat but do not prevent STIs. B. Oral contraceptives do not prevent STIs. C. Condoms may help prevent STIs, but they are not completely effective. PTS: 1 DIF: Moderate KEY: Client Need: Health Promotion and Maintenance | Cognitive Level: Application 21. ANS: C Condylomata acuminatum (genital warts) is a common sexually transmitted viral infection, and their incidence is increasing rapidly. Infection with human papillomavirus (HPV) produces the condylomata. A, B, and D do not cause warts. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 22. ANS: A Untreated syphilis can lead to neurosyphilis and neurological changes. B, C, and D do not cause neurological changes. PTS: 1 DIF: Moderate KEY: Client Need: Physiological IntegrityReduction of Risk Potential | Cognitive Level: Application 23. ANS: D There is presently no known cure for papillomavirus infection. The warts may be treated by freezing, burning, or chemically destroying them or by manipulating the patients immune system to attack the virus. Cryotherapy (freezing) of the warts may be done by touching each wart with a cryoprobe or a liquid nitrogen-soaked swab. Warts may also be burned or electro-coagulated with an electrocautery or a laser. Heat causes the proteins to coagulate, resulting in death of the wart tissue. A. B. Syphilis and Chlamydia are treated with antibiotics. C. Hepatitis B virus may be treated with immune globulins as well as supportive treatment.