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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.
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The nurse is instructing an adolescent on ways to prevent sexually transmitted infections (STIs). When evaluating the options, which is best when the client states being sexually active?
- A. Having one sexual partner
- B. Abstinence
- C. Use a latex condom with a spermicide.
- D. Urinating after sexual intercourse
Correct Answer: C
Rationale: The nurse is most correct to instruct the sexually active client on the proper use of a latex condom. A latex condom with nonoxynol-9 is best to be used when having oral, vaginal, or anal intercourse. Having one sexual partner does not mean that the partner does not have a sexually transmitted infection. The client states being sexually active, thus, abstinence is not an option. Urinating after intercourse reduces the risk of an STI, however, providing a barrier between the partners is a better option.
The nurse is addressing a multidisciplinary panel stating the need for continued education on sexually transmitted infections (STI). One of the points is the fact that the statistics of infection are underreported. Which is the main reason that statistics are underreported?
- A. Clients do not often seek treatment for STIs.
- B. Only certain STIs are reported to the Centers for Disease Control and Prevention.
- C. Poor communication is suffered between their physician offices and reporting agency.
- D. Reporting physicians are afraid of being sued for a breach in confidentiality.
Correct Answer: B
Rationale: The nurse is most correct to state that only certain sexually transmitted infections are mandated to be reported to the Centers for Disease Control and Prevention, thus providing incomplete data. Most clients with an infection report for treatment to a physician's office, clinic, or emergency department. Although communication between government agencies and local offices can always be improved, mandated reporting is specific to the information needed. There is no breach in confidentiality.
A female client with an anal gonorrhea infection experiences painful bowel elimination and a purulent rectal discharge. The nurse would predict which symptom as most likely to develop as the microorganism disseminates throughout the body?
- A. Painful joints
- B. Sore throat
- C. Intermenstrual bleeding
- D. Painful urination
Correct Answer: A
Rationale: The client with an anal gonorrhea infection experiences symptoms of gonorrhea where the microorganism has invaded the rectum. After the microorganism disseminates throughout the body, the client may manifest a skin rash, fever, and painful joints. Other symptoms such as infections of the urinary tract or vagina, sore throat, intermenstrual bleeding due to cervicitis, and painful urination are associated with the organism's invasion of those structures, depending on the nature of the sexual contact.
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 discussing information regarding the human papilloma viral (HPV) infection. Which statement, made by the client, requires clarification?
- A. HPV transmission may occur when the client is asymptomatic.
- B. HPV is spread during sexual intercourse.
- C. HPV may be spread to a newborn at the time of delivery.
- D. HPV can be spread by autoinoculation.
Correct Answer: B
Rationale: The nurse is correct to clarify that sexual penetration is not necessary to transmit HPV; the warts can also be spread by autoinoculation. The other options are correct statements that need no clarification.