Nurs 534 Exam Questions And Correct
Solutions New Update (Verified Pass)
what are risk factors for gonorrhea? - Answers -multiple partners, hx STIs, early age at
first coitus, gay/bisexual/MSM, unprotected intercourse
-majority <30
who should get screened for gonorrhea? - Answers -pregnant women, sex workers,
high risk males and females
what are signs and symptoms of gonorrhea? - Answers -§ Usually asymptomatic
§ Purulent yellow/green discharge
§ May have Skene's and bartholin's glands inflammation
§ Dysuria
§ Menstrual irregularities
§ Pelvic pain
§ Fever
§ Necrotic skin lesions
-abd pain with intercourse
-infected kidneys
What are the male symptoms of gonorrhea? - Answers --"drip"
- urethritis
- epididymitis
-inflammation of penis
How is gonorrhea diagnosed? - Answers -NAAT (for chlamydia as well)
can be urine, endocervical swab or vaginal swab
What is the treatment for gonorrhea? - Answers -ceftriaxone 250 mg IM once +
azithromycin 1 g PO once
Preggos get the same treatment
what are complications of gonorrhea? - Answers ---PID
-Ectopic pregnancy
-Infertility
-Conjunctivitis
-Tubo-ovarian abscess
-Epididymitis
-Associated with other STIs
-Pregnancy complications: ----premature rupture of membrane,
-chorioamnionitis
Neonatal complications: opthalmia neonatorum, pneumonia, sepsis
,what education is needed for gonorrhea? - Answers -Need for partner notification and
treatment. Notification for any partner
with whom the patient had sexual contact as soon as possible but within
30 days of the onset of symptoms or 60 days if asymptomatic
Avoid sexual intercourse after single-dose therapy or until treatment
completion and for 7 more days following the last days of antibiotic tx
and resolution of symptoms (if present)
Repeat infections place women at high risk for PID
Men and women who have been treated should be retested 3 months
after treatment
If retesting at 3 months is not possible, should retest whenever
they present for medical care within 12 months following initial
treatment
What are risk factors for chlamydia? - Answers -History of STIs, multiple sex partners,
early age of first coitus, unprotected intercourse
What are the signs and symptoms of chlamydia? - Answers -Ø 80 % asymptomatic
Ø Mucopurulent cervical, vaginal, or urethral discharge
Ø Dyuria
Ø Urinary frequency and urgency
Ø Pelvic pain
Ø Cervical friability
Ø Cervical motion tenderness
Ø Inspect males for anal/urethral discharge
Ø Inspect females for anal/vaginal/cervical discharge
-bleeding with intercourse
How is chlamydia diagnosed? - Answers -endocervical/vaginal swab for urine for NAAT
Q-tip test: yellow-green discharge from cervix
-antigen detection
what is the treatment for chlamydia? - Answers -Ø Azithro 1G x1
Ø Azithro 500 mg 3x/day for 7 days
0 Doxy 100 mg PO 2x/7days
Preggos-
no doxy or levo
retest in 3 weeks
retest at 3rd trimester
what is the follow-up for chalmydia? - Answers -follow-up for repeat cultures in 3 months
**ALWAYS TREAT FOR CHLAMYDIA AND GONORRHEA TOGETHER** (Ceftriazone
250
,mg IM x1 dose, and azithromycin 1000mg po x1 OR Doxycline 100 mg PO BID x 7
(allergy
or intolerance of azirthromycin) - Answers -
What is Trichomoniasis vaginalis? - Answers --sexually transmitted infections
- most common non viral sti
what are signs and symptoms of Trichomoniasis? - Answers -Ø Copious, yellow-green,
or watery gray vaginal discharge
-frothy
Ø Vaginal odor
Ø Dysuria
Ø Dyspareunia
Ø Postcoital spotting or bleeding
Ø Abd discomfort
Ø Pruritus
Ø Perineal infection
strawberry cervic
How is Trichomonas vaginalis diagnosed? - Answers -Ø Wet prep- look for motile,
flagellated trichomonads
Ø NAAT
Ø PAP smear- low sensitivity
Ø Vaginal pH >4.5
What is the treatment for Trichomoniasis? - Answers -Ø Metrondizaole 2 G PO or
tinidazole 2 G PO
§ Avoid alcohol for 24-48 hours
Ø Metronidazole 500 mg 2x/7days
§ If fails, retry
No flagyl in 1st trimester for preggos
discontinue if breastfeeding
What are genital warts? - Answers -Soft, pointed, moist, fleshly, painless papules in a
cauliflower-like patch
caused by HPV
What are signs and symptoms of genital warts? - Answers -Painless genital bumps or
warts
Pruritis
Bleeding during or after coitus
Malodorous vaginal discharge
Dysuria
Wart like growth on genital area that are elevated and rough or flat and smooth
Occur singly or in clusters
, Papillomas that are pale pink in color
How are genital warts diagnosed? - Answers -Observation, serologic and cytologic
testing to differentiate from condylomata lata, cancer and benign neoplasms, HPV DNA
test
colposcopy
What is the treatment for genital warts? - Answers --Trichloroacetic acid 80-90% weekly
-Podophyllum resin 10-25% applied weekly
- cryotherapy and liquid nitrogen
What is a sign of oral HPV cancer? - Answers -An ulcer or sore that does not heal within
2-3 weeks
A red, white, or black discoloration on the soft tissues in the mouth
Difficult or painful swallowing. A sensation that things are sticking in the throat when
swallowing
A swollen but painless tonsil. When looking in the mouth, tonsils on both sides should
be symmetrical in size
Pain when chewing
A persistent sore throat or hoarse voice
A swelling or lump in the mouth
A painless lump felt on the outside of the neck, which has been there for at least two
weeks.
A numb feeling in the mouth or lips
Constant coughing
An ear ache on one side (unilateral) which persists for more than a few days.
what are the recommendations for HPV vaccine? - Answers -11-12 year old get 2 doses
-second dose given 6-12 months after first dose
Three doses for those 15 and older as well as high risk
What is herpes? - Answers -virus causing sores
Life long viral disease
HSV-1- oral lesions
HSV-2- genital lesion
what are the signs and symptoms of herpes? - Answers -Dysuria, pruritus, burning,
swelling sensation
Painful, itchy, vesicular, ulcerated, or crusted oral or genital lesions,
Singly or in clusters
Flu-like syndrome- fever, chills, headache, malaise, myalgia
how is herpes diagnosed? - Answers -Viral culture- unroof or uncrust for sample
Cell culture or PCR
NAAT
PAP smear is not sensitive for HSV-2
