Nokea
A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit?
- A. Ulcated chancre, aortic valve insufficiency, lymphadenopathy
- B. Fever, malaise, sore throat
- C. Papular lesions, rash, headache
- D. Tabes dorsalis, ataxia, and Charcot's joints
Correct Answer: D
Rationale: The client with late or tertiary syphilis is noninfectious because the microorganism has invaded the central nervous system (CNS) as well as other organs of the body. Symptoms of tertiary syphilis include tabes dorsalis (a degenerative condition of the CNS that results in loss of peripheral reflexes and of vibratory and position senses), ataxia, and neuropathic joint disease, also called Charcot's joints. Symptoms of secondary syphilis include fever, malaise, rash, headache, sore throat, and lymph node enlargement. Ulcerated chancre occurs in the primary stage.
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The experienced nurse is assisting the novice nurse in caring for a client with a newly acquired sexually transmitted infection. Which infection(s) does the experienced nurse stress to report to the Centers for Disease Control (CDC)? Select all that apply.
- A. Venereal warts
- B. Chlamydia
- C. Hepatitis B
- D. Syphilis
- E. HIV
- F. Gonorrhea
Correct Answer: B,C,D,E,F
Rationale: Reporting new sexually transmitted infections (STIs) to the CDC is the responsibility of either the healthcare provider or the testing laboratory. Chlamydia, syphilis, HIV, hepatitis B, and gonorrhea are all reportable infections. Venereal warts are not reportable.
The nurse is providing teaching for a client newly diagnosed with a sexually transmitted infection. Which instruction is most helpful to prevent autoinoculation of the STI?
- A. Pat lesions instead of scratching.
- B. Use different sections of a towel to dry areas with lesions.
- C. Perform thorough handwashing.
- D. Do not share personal items with others.
Correct Answer: C
Rationale: Autoinoculation means to 'self-infect.' The nurse is most helpful to stress that handwashing helps prevent the spread of infection to others and to other parts of one's own body. Patting lesions can still spread the infection. The client should use a different towel to clean non-infected parts of the body. Sharing personal items spreads the infection to others.
The nurse is completing a community education via a pamphlet on sexually transmitted diseases. Which key point is most important for the nurse to emphasize?
- A. Common age-groups for clients with sexually transmitted diseases are in their late teens and 20s.
- B. Many people are asymptomatic and show no symptoms contributing to the spread of the disease.
- C. Some sexually transmitted diseases can cause infertility caused by scarring of reproductive organs.
- D. Some sexually transmitted diseases can be transmitted to newborns through the birth canal.
Correct Answer: B
Rationale: The nurse is most correct to emphasize information regarding prevention of sexually transmitted diseases. The information that many people are asymptomatic and show no symptoms is an important point to stress. Common age-groups are an interesting fact. Repercussions of the disease are also important to highlight; however, prevention is most important.
The nurse is counseling a client who has been diagnosed with two sexually transmitted infections. The client is shocked and states not knowing how this has happened. Which of the following statements is most appropriate by the nurse?
- A. Your partner could have been asymptomatic at that time.
- B. You should have asked your partner if they have any infections.
- C. Sexually transmitted infections have obvious signs of their presence.
- D. Your partner should have told you of a previous infection.
Correct Answer: A
Rationale: The nurse is most correct to support the client and provide information on how the infection could have been spread. It is true that the client's partner could have been asymptomatic during their sexual contact. The nurse should not be judgmental or accusing in nature as in the other responses.
The nurse is instructing a client on proper procedures to protect herself from sexually transmitted infections (STIs). Which statement, made by the client, requires correction from the nurse?
- A. If I use barrier protection, it will reduce my risk of exposure to STIs.
- B. You cannot always know everything about a person.
- C. I consider myself protected because I am on birth control pills.
- D. I refrain from sexual contact or use protection to keep myself safe.
Correct Answer: C
Rationale: The nurse is most correct to clarify that although birth control pills are effective at preventing pregnancy, they do not prevent against exposure to STIs. The other statements have no inaccurate content as can be determined at this time.