Chapter 40: Care of Patients with Sexually Transmitted Infections |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The nurse is caring for a homosexual man with a rectal tear and inflamed rectal tissue. The nurse understands that these findings increase the patient’s risk for which disorder? a. An abscess b. Human immunodeficiency virus (HIV) infection c. Hemorrhoids d. Rectal hemorrhage ANS: B Open lesions and inflamed tissue increase the risk of HIV infection. PTS:1 DIF: Cognitive Level: Comprehension REF: 941 OBJ:7 (theory) TOP: Exposure to HIV KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 2. The nurse instructs a sexually active teenager that frequent douching can cause which infection? a. Syphilis b. Bacterial vaginosis c. Pelvic inflammatory disease (PID) d. Purulent vaginitis ANS: B Bacterial vaginosis is caused when frequent douching changes the pH of the vaginal vault and creates an environment conducive to bacterial invasion. Sexually transmitted infections (STIs) like syphilis are not transferred by douching. PID is a condition that most often results from an untreated infection. Vaginitis is an inflammatory condition that does not result from douching. PTS:1 DIF: Cognitive Level: Comprehension REF: 942 OBJ:9 (theory) TOP: Vaginosis: Douching KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 3. Why are women at a greater risk for contracting sexually transmitted infections (STIs) than men? a. Male secretions are in contact with female mucous membranes for longer periods of time. b. Estrogens increase susceptibility of vaginal membranes. c. Penile friction to the vaginal wall encourages STIs. d. Changing hormonal levels create a vaginal environment conducive to bacterial growth. ANS: A Male secretions are in contact with female mucous membranes longer than female secretions are in contact with the penis. Estrogen provides for vaginal lubrication and therefore reduces friction and tissue tearing. PTS:1 DIF: Cognitive Level: Comprehension REF: 942 OBJ:1 (theory) TOP: Female Incidence of STIs KEY: Nursing Process Step: Planning MSC: NCLEX: Health Promotion and Maintenance 4. The nurse is educating a sexually active female patient about infection prevention. Which change during the premenstrual period increases the patient’s risk of infection? a. Cervical secretions become more alkaline. b. The cervical mucous plug becomes more permeable. c. Higher estrogen levels increase vaginal lubrication. d. Lower antibody levels increase risk for infection. ANS: B The mucous plug in the cervix of women provides protection to the upper genital tract. The hormonal changes make it become more permeable around the menstrual period. This change can result in an increased risk for infections in the upper genital tract, such as pelvic inflammatory disease (PID). Oral contraceptives alter cervical secretions and result in a more alkaline environment. Vaginal lubrication does not increase risk of infection, and antibody levels do not lower during the premenstrual period. PTS:1 DIF: Cognitive Level: Comprehension REF: 942 OBJ:3 (clinical) TOP: PID: Etiology KEY: Nursing Process Step: Implementation MSC: NCLEX: Health Promotion and Maintenance 5. Which statement indicates that a patient needs additional education about the vaccine for human papillomavirus(HPV)? a. “I know I must have three doses of the vaccine.” b. “Girls as young as 9 years of age may be vaccinated.” c. “I am relieved that the vaccine protects me from all HPV infections.” d. “I know I should continue having regular Pap smears.” ANS: C The vaccine protects against the most prevalent infections, genital warts and precancerous cervical lesions, but not against all HPV infections. The remaining statements are correct. PTS:1 DIF: Cognitive Level: Application REF:943 OBJ:3 (clinical) TOP: HPV: Vaccinations KEY: Nursing Process Step: Evaluation MSC: NCLEX: Health Promotion and Maintenance 6. During an assessment of an older adult patient, the nurse observes a red rash on the palms of the hands and the soles of the feet. What should the nurse do next? a. Notify the charge nurse. b. Float the patient’s heels on a pillow. c. Apply a prescribed emollient. d. Reposition the patient on the left side.