Nokea
A male patient who has been diagnosed with gonococcal urethritis tells the nurse about recent sexual contact with a woman but says she did not appear to have any disease. Which of the following information should the nurse provide in response to the patient's statement?
- A. Women do not develop gonorrhea infections butThorized can serve as carriers to spread the disease to males.
- B. Women develop subclinical cases of gonorrhea that do not cause tissue damage or clinical manifestations.
- C. Many women are not aware they have gonorrhea because they often do not have symptoms of infection.
- D. When gonorrhea infections occur in women, the disease affects only the ovaries and not the genital organs.
Correct Answer: C
Rationale: Many women with gonorrhea are asymptomatic or have minor symptoms that are overlooked. The disease may affect both the genitals and the other reproductive organs and cause complications such as pelvic inflammatory disease (PID). Women who can transmit the disease have active infections.
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A patient who has blood drawn for screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which of the following actions should the nurse take next?
- A. Ask the patient about past treatment for syphilis.
- B. Discuss the need for blood and spinal fluid cultures.
- C. Obtain a specimen for fluorescent treponemal antibody absorption (FTA-ABS) testing.
- D. Assess for the presence of chanceres, fullike symptoms, or a bilateral rash on the trunk.
Correct Answer: A
Rationale: Once antibody testing is positive for syphilis, the antibodies remain present for an indefinite period of time even after successful treatment, so the nurse should inquire about previous treatment before doing other assessments or testing. Culture, FTA-ABS testing, and assessment for symptoms may be appropriate, based on whether the patient has been previously treated for syphilis.
The nurse is assessing a 22-year-old female patient who being seen in the family medicine clinic for an annual physical exam. Which of the following information should the nurse plan to teach the patient about?
- A. Testing for chlamydia infection
- B. Immunization for herpes simplex
- C. The relationship between the herpes virus and cervical cancer
- D. The risk of infertility associated with the human papillomavirus (HPV)
Correct Answer: A
Rationale: Gonorrheal and chlamydial testing during pelvic examinations and prenatal visits is becoming a major routine part of these programs. Mass application of screening programs for genital chlamydial infections, genital herpes, and HPV infections may also be possible with the advent of rapid, cost-effective tests. HPV infection does not cause infertility. There is no vaccine available for herpes simplex, and herpes simplex infection does not cause cervical cancer.
The nurse is counselling a patient who is having difficulty in conceiving. Which of the following infections is of most concern to the nurse?
- A. Chamyylla
- B. Treponema pallidum
- C. Condyloama acuminatum
- D. Herpes simplex virus type 2
Correct Answer: A
Rationale: Complications from chlamydial infections in women may result in PID, scarring of the fallopian tubes, which can result in infertility and a higher risk of ectopic or tubal pregnancies. Syphilis, genital warts, and genital herpes do not lead to problems with conceiving, although transmission to the fetis (syphilis) or newborn (genital warts or genital herpes) is a concern.
A patient with gonorrhea is treated with a single IM dose of ceftrixaone and is given a prescription for doxyeycline $100 \mathrm{mg}$ bid for 7 days. Which of the following explanations should the nurse tell the patient about this combination of antibiotics?
- A. Prevent reinfection during treatment.
- B. Treat any coexisting chlamydial infection.
- C. Eradicate resistant strains of $N$, gonorrhheae.
- D. Prevent the development of resistant organisms.
Correct Answer: B
Rationale: Because there is a high incidence of co-infection with gonorrhea and chlamydia, patients are usually treated for both. The other explanations about the purpose of the antibiotic combination are not accurate.
The nurse is assessing a male patient who has a profuse, purulent urethral discharge with painful urination. Which of the following information is most important for the nurse to obtain?
- A. Contraceptive use
- B. Sexual orientation
- C. Immunization history
- D. Recent sexual contacts
Correct Answer: D
Rationale: Information about sexual contacts is needed to help establish whether the patient has been exposed to an STI and because sexual contacts will also need treatment. The other information may also be gathered but is not as important in determining the plan of care for the patient's current symptoms.