Nokea
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.
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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.
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.
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.
Which of the following patients should the nurse plan on teaching about the Gardasil vaccine?
- A. A 50-year-old man who has multiple sexual partners
- B. A 23-year-old woman who is pregnant for the first time
- C. An 11-year-old female who has never been sexually active
- D. A 28-year-old male who is in a monogamous relationship
Correct Answer: C
Rationale: HPV vaccines include Gardasil (HPV4) and Cervarrix (HPV2) HPV2 or HPV4 vaccine is recommended for women 9-26 years of age and HPV4 vaccine is recommended for men aged 9-26 years. It is not recommended for women during pregnancy, or for older women.
A patient is treated for chlamydia that was detected during a routine pelvic examination. Which of the following patient statements indicate that teaching regarding the management of the condition has been effective?
- A. Go ahead and give me the antibiotic injection so I will be cured.
- B. My boyfriend will need to take antibiotics at the same time I do.
- C. I will use condoms during sex until I finish taking all the antibiotics.
- D. Since I do not plan on having any children, treatment is not as important.
Correct Answer: B
Rationale: Sex partners should be treated simultaneously to prevent reinfection. Chlamydia is treated with oral antibiotics. Abstinence from sexual intercourse is recommended for 7 days after treatment, and condoms should be recommended during all sexual contacts to prevent infection. Persistent pelvic pain, as well as infertility, can result from untreated chlamydia.