Nokea
A patient has herpes simplex 2 viral infection (HSV2). The nurse recognizes that which of the following should be included in teaching the patient?
- A. The virus causes cold sores of the lips.
- B. The virus may be cured with antibiotics.
- C. The virus, when active, may not be contracted during intercourse.
- D. Treatment is aimed at relieving symptoms.
Correct Answer: D
Rationale: HSV-2 causes genital herpes, not cold sores (which are caused by HSV-1). It is not curable with antibiotics, as it is a viral infection. The virus is transmissible during active outbreaks. Treatment focuses on symptom relief.
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While taking a health history on a 20-year-old female patient, the nurse ascertains that this patient is taking miconazole (Monistat). The nurse is justified in presuming that this patient has what medical condition?
- A. Bacterial vaginosis
- B. Human papillomavirus (HPV)
- C. Candidiasis
- D. Toxic shock syndrome (TSS)
Correct Answer: C
Rationale: Candidiasis is a fungal or yeast infection caused by strains of Candida. Miconazole (Monistat) is an antifungal medication used in the treatment of candidiasis. This agent is inserted into the vagina with an applicator at bedtime and may be applied to the vulvar area for pruritus. HPV, bacterial vaginosis, and TSS are not treated by Monistat.
When teaching patients about the risk factors of cervical cancer, what would the nurse identify as the most important risk factor?
- A. Late childbearing
- B. Human papillomavirus (HPV)
- C. Postmenopausal bleeding
- D. Tobacco use
Correct Answer: B
Rationale: HPV is the most salient risk factor for cervical cancer, exceeding the risks posed by smoking, late childbearing, and postmenopausal bleeding.
A nurse is caring for a pregnant patient with active herpes. The teaching plan for this patient should include which of the following?
- A. Babies delivered vaginally may become infected with the virus.
- B. Recommended treatment is excision of the herpes lesions.
- C. Pain generally does not occur with a herpes outbreak during pregnancy.
- D. Pregnancy may exacerbate the mothers symptoms, but poses no risk to the infant.
Correct Answer: A
Rationale: In pregnant women with active herpes, babies delivered vaginally may become infected with the virus, posing a risk for fetal morbidity and mortality. Lesions are not controlled with excision. Itching and pain often accompany outbreaks. Pregnancy can exacerbate symptoms and poses risks to the infant if the virus is active during delivery.
A student nurse is caring for a patient who has undergone a wide excision of the vulva. The student should know that what action is contraindicated in the immediate postoperative period?
- A. Placing patient in low Fowlers position
- B. Application of compression stockings
- C. Ambulation to a chair
- D. Provision of a low-residue diet
Correct Answer: C
Rationale: Sitting in a chair would place too much tension on the incision site and is contraindicated immediately post-surgery. Low Fowlers position reduces tension on the incision. Compression stockings prevent deep vein thrombosis, and a low-residue diet prevents straining during defecation.
A female patient with HIV has just been diagnosed with condylomata acuminata (genital warts). What information is most appropriate for the nurse to tell this patient?
- A. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) test annually.
- B. The most common treatment is metronidazole (Flagylastin), which should eradicate the problem within 7 to 10 days.
- C. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse.
- D. The human papillomavirus (HPV), which causes condylomata acuminata, cannot be transmitted during oral sex.
Correct Answer: A
Rationale: HIV-positive women have a higher rate of HPV. Infections with HPV and HIV together increase the risk of malignant transformation and cervical cancer. Thus, women with HIV infection should have frequent Pap smears. Because condylomata acuminata is a virus, there is no permanent cure. Condoms reduce but do not eliminate transmission risk. HPV can be transmitted to other parts of the body, including during oral sex.