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The nurse is assessing an older adult client with a sexually transmitted infection (STI). Which of the following should inform the nurse's assessment?
- A. Older adults can be sexually active, and it is important to abandon biases suggesting otherwise.
- B. Older adults, because of their maturity, are rarely embarrassed to talk about this.
- C. Older adults know the ways to prevent STIs.
- D. Older adults who are sexually active have less risk for STIs than other age groups.
Correct Answer: A
Rationale: Nurses should abandon biases that older adults are sexually inactive. Therefore, when taking a health history, nurses should include questions about sexuality and behaviors that put them at risk for STIs. Older clients who are sexually active have the same risks of acquiring an STI as other age groups. Older adults who are not in monogamous relationships may not understand ways that are appropriate for preventing STIs. Some older adults with an STI are embarrassed and may not seek medical attention. Careful assessment is necessary to help the older adult receive medical treatment as quickly as possible.
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A client with primary syphilis is allergic to penicillin. The nurse would expect the physician to order which agent?
- A. Acyclovir
- B. Ceftriaxone
- C. Podophyllum resin
- D. Tetracycline
Correct Answer: D
Rationale: Clients who are allergic to penicillin are given a 14-day regimen of tetracycline or doxycycline. Acyclovir is used to treat genital herpes. Ceftriaxone may be used for gonorrhea. Podophyllum resin is used to treat genital warts.
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.
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 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.
The nurse is caring for a female client diagnosed with a sexually transmitted infection (STI). The client states that her sister also has an STI. Which instruction, by the nurse, provides the rationale for women obtaining infections more frequently than men?
- A. The vagina is more conducive to microbial growth.
- B. Menstrual flow provides the medium for growth.
- C. Women have a more difficult time with hygiene.
- D. Hormones alter the pH of the vagina.
Correct Answer: A
Rationale: The vagina's warm, moist environment is more conducive to microbial growth compared to male anatomy, increasing the likelihood of infections in women. Menstrual flow may facilitate bacterial growth but is not the primary reason. Hygiene practices vary individually and are not a primary cause. Hormonal changes can alter vaginal pH, but the vaginal environment itself is the key factor.