Nokea
The nurse is giving a presentation about chlamydia to a group of adult women. Which female client should the nurse use as an example of an individual for whom annual screening is recommended?
- A. 43-year-old client who practices consistent condom use
- B. 32-year old client with one long-term, exclusive sex partner
- C. 23-year-old client who is not sexually active
- D. 18-year old client who is pregnant
Correct Answer: D
Rationale: The US Preventive Services Task Force (2021) recommends annual screening for chlamydia for all pregnant and nonpregnant sexually active women younger than 24 years. It is not recommended to conduct screening for the client who practices condom use and the client with one long-term, exclusive sex partner, as they are both over 24 years old. The 23-year-old client is not sexually active and therefore does not require an annual screening.
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A client requesting a chlamydia test asks why it is necessary to receive a test for gonorrhea and syphilis at the same time. Which response from the nurse is the correct explanation?
- A. The symptoms of these diseases are the same, and culture tests alone can determine the disease that has infected the client.
- B. The infecting bacterium in all cases is the same, and therefore, clients have concurrent infections.
- C. The infections spread through the same medium, and therefore, clients have concurrent infections.
- D. It is not unusual for clients to have concurrent infections with more than one sexually transmitted infection (STI).
Correct Answer: D
Rationale: It is common practice to test clients for chlamydia, gonorrhea, syphilis, and HIV because it is not unusual for clients to have concurrent infections with more than one STI. For chlamydia, the causative microorganism is a bacterium named Chlamydia trachomatis. For gonorrhea, the infection is caused by a bacterium named Neisseria gonorrhoeae. The spirochete Treponema pallidum is the causative microorganism of syphilis. The symptoms of these conditions are not identical. The causative microorganisms do not spread through the same medium.
Which type of sexually transmitted disease is the nurse most accurate to highlight in the client's history as it remains dormant in the body and can reoccur at any time?
- A. Chlamydia
- B. Herpes infection
- C. Gonorrhea
- D. Syphilis
Correct Answer: B
Rationale: The nurse is most accurate to highlight the herpes infection as the virus can remain dormant in the ganglia of the nerves. Symptoms are usually more severe with the initial outbreak. Subsequent episodes are usually shorter and less intense. The other infections are important to note in the history.
A client with syphilis did not receive treatment and has now progressed into the tertiary stage of the disorder. Which symptoms would the nurse expect the client to exhibit?
- A. Ulcated chancre, aortic valve insufficiency, lymphadenopathy
- B. Fever, malaise, sore throat
- C. Papular lesions, rash, headache
- D. Tabes dorsalis, ataxia, and Charcot's joints
Correct Answer: D
Rationale: The client with late or tertiary syphilis is noninfectious because the microorganism has invaded the central nervous system (CNS) as well as other organs of the body. Symptoms of tertiary syphilis include tabes dorsalis (a degenerative condition of the CNS that results in loss of peripheral reflexes and of vibratory and position senses), ataxia, and neuropathic joint disease, also called Charcot's joints. Symptoms of secondary syphilis include fever, malaise, rash, headache, sore throat, and lymph node enlargement. Ulcerated chancre occurs in the primary stage.
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.
A client with genital warts is receiving treatment with a local application of trichloroacetic acid. Which client statement indicates adequate understanding of the procedure?
- A. One or two treatments should get rid of the warts.
- B. I'm temporarily not contagious once the warts are destroyed.
- C. Once the warts are gone, then I know I'm cured.
- D. My partner doesn't need to be treated.
Correct Answer: B
Rationale: Genital warts when treated chemically will most likely be eradicated after three to six cycles of treatment. Eradication does not mean the condition is cured; the person is temporarily noncontagious once the warts are destroyed. All sexual contacts of the client need to be examined and treated.