Chapter 07: Sexually Transmitted and Other Infections My Nursing Test Banks

Lowdermilk: Maternity & Womens Health Care, 10th Edition

Chapter 07: Sexually Transmitted and Other Infections

Test Bank

MULTIPLE CHOICE

1. The two primary areas of risk for sexually transmitted infections (STIs) are:

a.

Sexual orientation and socioeconomic status

b.

Age and educational level

c.

Large number of sexual partners and race

d.

Risky sexual behaviors and inadequate preventive health behaviors

ANS: D

Risky sexual behaviors and inadequate preventive health behaviors put a person at risk for acquiring or transmitting an STI.

Although low socioeconomic status may be a factor in avoiding purchasing barrier protection, sexual orientation does not put one at higher risk.

Younger individuals with less education may not be aware of proper prevention techniques; however, these are not the primary areas for STIs.

Having a large number of sexual partners is certainly a risk-taking behavior, but race does not increase the risk for STIs.

DIF: Cognitive Level: Knowledge REF: 144

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

2. The most common perinatal complications associated with bacterial sexually transmitted infections (STIs) are:

a.

Preterm labor and preterm birth

b.

Newborn eye infections and low Apgar scores

c.

Nausea, vomiting, and frequent urinary tract infections

d.

Congenital anomalies and infertility

ANS: A

Risk factors associated with bacterial STIs include preterm labor and preterm birth, miscarriage, and intrauterine growth restriction (IUGR).

Perinatal complications of bacterial gonorrhea may lead to newborn eye infections but not necessarily to low Apgar scores.

Nausea, vomiting, and frequent urinary tract infections are not associated with bacterial STIs.

TORCH infections (which are not entirely sexually transmitted) are associated with congenital anomalies. Untreated STIs may progress to pelvic inflammatory disease (PID) and infertility.

DIF: Cognitive Level: Knowledge REF: 162

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

3. When evaluating a client for sexually transmitted infections (STIs), the nurse should be aware that the most common bacterial STI is:

a.

Gonorrhea

b.

Syphilis

c.

Chlamydia

d.

Candidiasis

ANS: C

Chlamydia is the most common and fastest spreading STI among American women, with an estimated 3 million new cases each year.

Gonorrhea is a bacterial STI; however, it is not the most common among American women.

Syphilis is a bacterial STI; however, it is not the most common among American women.

Candidiasis is caused by a fungus, not by bacteria.

DIF: Cognitive Level: Knowledge REF: 146

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

4. The Centers for Disease Control and Prevention (CDC) recommends that human papillomavirus (HPV) be treated with client-applied:

a.

Miconazole ointment

b.

Topical podofilox 0.5% solution or gel

c.

Penicillin given intramuscularly for two doses

d.

Metronidazole by mouth

ANS: B

Available treatments are imiquimod, podophyllin, and podofilox.

Miconazole ointment is used to treat athletes foot.

Penicillin IM is used to treat syphilis.

Metronidazole is used to treat bacterial vaginosis.

DIF: Cognitive Level: Knowledge REF: 148

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Implementation

5. A woman has a thick, white, lumpy, cottage cheeselike discharge, with patches on her labia and in her vagina. She complains of intense pruritus. The nurse practitioner orders which preparation for treatment?

a.

Fluconazole

b.

Tetracycline

c.

Clindamycin

d.

Acyclovir

ANS: A

Fluconazole, metronidazole, and clotrimazole are the drugs of choice to treat candidiasis.

Tetracycline is used to treat syphilis.

Clindamycin is used to treat bacterial vaginosis.

Acyclovir is used to treat genital herpes.

DIF: Cognitive Level: Comprehension REF: 161

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Implementation

6. To detect the human immunodeficiency virus (HIV), most laboratory tests focus on:

a.

HIV virus

b.

HIV antibodies

c.

CD4 counts

d.

CD8 counts

ANS: B

The screening tool used to detect HIV is the enzyme immunoassay, which tests for the presence of antibodies to the HIV.

In order to determine if the HIV is present, the test performed must be able to detect antibodies to the virus, not the virus itself.

CD4 counts are associated with the incidence of acquired immunodeficiency syndrome (AIDS) in HIV-infected individuals.

CD8 counts are not performed in order to detect HIV.

DIF: Cognitive Level: Knowledge REF: 156

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning

7. Which virus is most threatening to the fetus and neonate?

a.

Hepatitis A virus

b.

Herpes simplex virus (HSV)

c.

Hepatitis B virus (HBV)

d.

Cytomegalovirus (CMV)

ANS: C

HBV is the virus most threatening to the fetus and neonate.

Hepatitis A is not the most threatening to the fetus.

HSV is not the most threatening to the neonate.

Although serious, CMV is not the most threatening to the fetus.

DIF: Cognitive Level: Knowledge REF: 155

OBJ: Client Needs: Safe and Effective Care Environment

TOP: Nursing Process: Diagnosis

8. Care management of a woman diagnosed with acute pelvic inflammatory disease (PID) most likely includes:

a.

Oral antiviral therapy

b.

Bed rest in a semi-Fowler position

c.

Antibiotic regimen continued until symptoms subside

d.

Frequent pelvic examination to monitor the progress of healing

ANS: B

The woman with acute PID should be on bed rest in a semi-Fowler position.

Broad-spectrum antibiotics are used.

Antibiotics must be taken as prescribed, even if symptoms subside.

Few pelvic examinations should be conducted during the acute phase of the disease.

DIF: Cognitive Level: Comprehension REF: 151

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning

9. On vaginal examination of a 30-year-old woman, the nurse documents the following findings: profuse, thin, grayish-white vaginal discharge with a fishy odor; complains of pruritus. Based on these findings, the nurse suspects that this woman has:

a.

Bacterial vaginosis

b.

Candidiasis

c.

Trichomoniasis

d.

Gonorrhea

ANS: A

Most women with bacterial vaginosis (BV) complain of a characteristic fishy odor. The discharge usually is profuse, thin, and has a white, gray, or milky color. Some women also may have mild irritation or pruritus.

The discharge associated with candidiasis is thick, white, and lumpy and resembles cottage cheese.

Trichomoniasis may be asymptomatic, but women commonly have a characteristic yellowish to greenish, frothy, mucopurulent, copious, and malodorous discharge.

Women with gonorrhea are often asymptomatic. They may have a purulent endocervical discharge, but discharge usually is minimal or absent.

DIF: Cognitive Level: Comprehension REF: 159

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

10. Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes?

a.

Herpes simplex virus 2 (HSV-2)

b.

Human papillomavirus (HPV)

c.

Human immunodeficiency virus (HIV)

d.

Cytomegalovirus (CMV)

ANS: A

The initial HSV genital infection is characterized by multiple painful lesions, fever, chills, malaise, and severe dysuria; it may last 2 to 3 weeks. Recurrent episodes of HSV infection commonly have only local symptoms that usually are less severe than those of the initial infection.

With HPV infection, lesions are a chronic problem.

HIV is a retrovirus. Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered the body. Severe depression of the cellular immune system associated with HIV infection characterizes acquired immunodeficiency syndrome (AIDS). AIDS has no cure.

In most adults, the onset of CMV infection is uncertain and asymptomatic. However, the disease may become a chronic, persistent infection.

DIF: Cognitive Level: Comprehension REF: 153

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

11. The nurse should know that once the human immunodeficiency virus (HIV) enters the body, seroconversion to HIV positivity usually occurs within:

a.

6 to 10 days

b.

2 to 4 weeks

c.

6 to 12 weeks

d.

6 months

ANS: C

Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered the body.

Six to 10 days is too short a time period for seroconversion to HIV positivity to occur.

Two to 4 weeks is too short a time period for seroconversion to HIV positivity to occur.

Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered the body; 6 months is too long.

DIF: Cognitive Level: Knowledge REF: 156

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Assessment

12. A 25-year-old single female comes to the gynecologists office for a follow-up visit related to her abnormal Pap smear. The test revealed that the client has human papillomavirus (HPV). The client asks, What is that? Can you get rid of it? Your best response is:

a.

Its just a little lump on your cervix. We can just freeze it off.

b.

HPV stands for human papillomavirus. It is a sexually transmitted infection that may lead to cervical cancer.

c.

HPV is a type of early human immunodeficiency virus. You will die from this.

d.

You probably caught this from your current boyfriend. He should get tested for this.

ANS: B

It is important to inform the client about STIs and the risks involved with HPV.

The health care team has a duty to provide proper information to the client, including information related to sexually transmitted infections (STIs).

HPV and HIV are viruses that can be transmitted sexually, but they are not the same virus.

The onset of HPV can be insidious. Often STIs go unnoticed. Abnormal bleeding frequently is the initial symptom. The client may have had HPV before her current boyfriend. You cannot make any deductions from this limited information.

DIF: Cognitive Level: Analysis REF: 152

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

13. Which sexually transmitted infection is not bacterial and thus not treatable with antibiotics?

a.

Chlamydia

b.

Gonorrhea

c.

Genital herpes

d.

Syphilis

ANS: C

Genital herpes is a viral infection and therefore does not respond to antibiotics.

Chlamydia is a bacterial infection and is treated with doxycycline or azithromycin.

Gonorrhea is a bacterial infection and is treated with any of several antibiotics.

Syphilis is a bacterial infection and is treated with penicillin.

DIF: Cognitive Level: Comprehension REF: 154

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

14. Which statement about the various forms of hepatitis is accurate?

a.

A vaccine exists for hepatitis C but not for hepatitis B.

b.

Hepatitis A is acquired by eating contaminated food or drinking polluted water.

c.

Hepatitis B is less contagious than human immunodeficiency virus (HIV).

d.

The incidence of hepatitis C is decreasing.

ANS: B

Contaminated milk and shellfish are common sources of infection with hepatitis A.

A vaccine exists for hepatitis B but not for hepatitis C.

Hepatitis B is more contagious than HIV.

The incidence of hepatitis C is increasing.

DIF: Cognitive Level: Knowledge REF: 155

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Assessment

15. A saline wet smear (vaginal secretions mixed with normal saline on a glass slide) is the test for:

a.

Bacterial vaginosis

b.

Candidiasis

c.

Yeast infection

d.

Trichomoniasis

ANS: D

The presence of many white blood cell protozoa is a positive finding for trichomoniasis.

A normal saline test is used to test for bacterial vaginosis.

A potassium hydroxide preparation is used to test for candidiasis.

Yeast infection is the common name for candidiasis, for which the test is a potassium hydroxide preparation.

DIF: Cognitive Level: Knowledge REF: 160

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Diagnosis

MULTIPLE RESPONSE

1. Examples of sexual risk behaviors associated with exposure to a sexually transmitted infection (STI) include (choose all that apply):

a.

Fellatio

b.

Unprotected anal intercourse

c.

Multiple sex partners

d.

Dry kissing

e.

Abstinence

ANS: A, B, C

Engaging in fellatio, unprotected anal intercourse, or having multiple sex partners increases the exposure risk and the possibility of acquiring an STI.

Dry kissing and abstinence are considered safe sexual practices.

DIF: Cognitive Level: Comprehension REF: 145

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

2. Which statements are true? Choose all that apply.

a.

Human papillomavirus (HPV) infections are thought to be less common in pregnant women than in women who are not pregnant.

b.

HPV infections are thought to be more common in pregnant women than in women who are not pregnant.

c.

HPV infection previously was called genital warts.

d.

HPV infection previously was called herpes.

e.

HPV may cause cancer.

ANS: B, C, E

HPV infections are thought to be more common in pregnant women, with an increase in incidence from the first trimester to the third trimester. HPV, formerly called venereal or genital warts, is a sexually transmitted infection with more than 30 known serotypes, several of which are associated with cervical cancer.

HPV infections are thought to be more common in pregnant women than in women who are not pregnant. HPV formerly was called genital warts.

DIF: Cognitive Level: Comprehension REF: 152

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Diagnosis

3. A 23-year-old primiparous client with inconsistent prenatal care is admitted to the hospitals maternity unit in labor. The client states that she has tested positive for human immunodeficiency virus (HIV) but has not undergone any treatment during her pregnancy. As her primary nurse you understand that the risk of perinatal transmission can be significantly decreased by a number of prophylactic interventions. Select the appropriate interventions that should be included in this clients plan of care:

a.

Intrapartum treatment with antiviral medications

b.

Cesarean birth

c.

Postpartum treatment with antiviral medications

d.

Avoidance of breastfeeding

e.

Pneumococcal, hepatitis B, and Haemophilus influenzae vaccine

ANS: A, B, D

The prophylactic measures of prenatal antiviral use, elective cesarean birth, and formula feeding reduce transmission as low as 1% to 2%. The client who refuses a cesarean birth should be given antiviral therapy intravenously during labor.

Ideally, medications should be given prenatally. Administration of antiviral drugs in the postpartum period will not reduce transmission to the infant. All women who are HIV positive should be encouraged to receive these immunizations. They will not reduce the risk of perinatal transmission.

DIF: Cognitive Level: Application REF: 157

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Planning

COMPLETION

1. TORCH stands for:

T __________________

ANS: Toxoplasmosis

DIF: Cognitive Level: Comprehension REF: 163

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

2. TORCH stands for:

O _______________________

ANS: Other infections

DIF: Cognitive Level: Comprehension REF: 163

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

3. TORCH stands for:

R __________________

ANS: Rubella

DIF: Cognitive Level: Comprehension REF: 163

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

4. TORCH stands for:

C __________________

ANS:

Cytomegalovirus

CMV

DIF: Cognitive Level: Comprehension REF: 163

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

5. TORCH stands for:

H ___________________________

ANS: Herpes simplex virus

DIF: Cognitive Level: Comprehension REF: 163

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Planning

6. The Jarisch-Herxheimer reaction is an acute febrile reaction associated with treatment for __________________.

ANS: Syphilis

DIF: Cognitive Level: Knowledge REF: 150

OBJ: Client Needs: Physiologic Integrity

TOP: Nursing Process: Implementation

TRUE/FALSE

1. Rates of syphilis in the United States among women, especially African-Americans, have continued to rise since 2004. Is this statement true or false?

ANS: T

African-American women have the highest rate of syphilis among all ethnic groups in the United States. In 2008 the rate was 36% higher than in 2007.

DIF: Cognitive Level: Knowledge REF: 149

OBJ: Client Needs: Health Promotion and Maintenance

TOP: Nursing Process: Assessment

Mosby items and derived items 2012, 2007, 2006 by Mosby, Inc., an affiliate of Elsevier Inc.

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