Nokea
A patient in the sexually transmitted infection (STI) clinic expresses concern about possible exposure to gonorrhea by her partner. Which of the following actions should the nurse take to determine if the patient has gonorrhea?
- A. Interview the patient about symptoms of gonorrhea.
- B. Take a sample of cervical discharge for Gram staining.
- C. Draw a blood specimen or rapid plasma reagin (RPCR) testing.
- D. Obtain vaginal secretions for a nucleic acid amplification test (NAAT).
Correct Answer: D
Rationale: NAAT has a high sensitivity (similar to a culture) for gonorrhea. Because women have few symptoms of gonorrhea, asking the patient about symptoms is not helpful in making a diagnosis. Smears and Gram staining are not useful because the female genitourinary tract has many normal flora that resemble $N$. gonorthoeae. RPR testing is used to detect syphilis.
You may also like to solve these questions
The nurse is caring for a patient who is diagnosed with chlamydia and tells the nurse that she is very angry because her husband is her only sexual partner. Which of the following responses should the nurse make first?
- A. You may need professional counselling to help resolve your anger.
- B. It is understandable that you are angry with your husband right now.
- C. Your feelings are justified and you should share them with your husband.
- D. It is important that both you and your husband be treated for the infection.
Correct Answer: B
Rationale: This response expresses the nurse's acceptance of the patient's feelings and encourages further discussion and problem-solving. The patient may need professional counselling, but more assessment of the patient is needed before making this judgment. The nurse should also assess further before suggesting that the patient share her feelings with the husband because problems such as abuse might be present in the relationship. Although it is important that both partners be treated, the patient's current anger suggests that this is not the appropriate time to bring this up.
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.
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.
When a patient returns to the clinic for follow-up after treatment for gonoccocal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection, which of the following questions is best for the nurse to ask the patient?
- A. Did you take the prescribed antibiotic for a week?
- B. Did you drink at least 2 quarts of fluids every day?
- C. Were your sexual partners treated with antibiotics?
- D. Do you wash your hands after using the bathroom?
Correct Answer: C
Rationale: All sexual contacts of patients with gonorrhea must be examined and treated to prevent reinfection after resumption of sexual relations. The 'ping-pong' effect of re-exposure, treatment, and reinfection can cease only when infected partners are treated simultaneously. Because gonorrhea is treated with one dose of antibiotic, antibiotic therapy, for a week is not needed. An adequate fluid intake is important, but a low fluid intake is not a likely cause for failed treatment. Poor hygiene may cause complications such as ocular trachoma but will not cause a failure of treatment.