Chapter 43 My Nursing Test Banks

Osborn, Medical-Surgical Nursing, 2e
Chapter 43

Question 1

Type: MCSA

A patient recently diagnosed with herpes simplex 2 asks how to best manage the lesions. What information should be given to the patient?

1. The use of soap should be restricted.

2. A solution of 50% rubbing alcohol and 50% water can be used to clean the lesions.

3. Wearing nylon panties will reduce discomfort.

4. Warm soaks may be used to cleanse the area.

Correct Answer: 4

Rationale 1: The lesions need to be kept clean and dry. It is safe to use mild soap and water.

Rationale 2: Rubbing alcohol would cause burning of the lesions and should not be used.

Rationale 3: Nylon panties promote moisture and reduce ventilation to the perineal area.

Rationale 4: Warm soaks can cleanse the area, increase circulation, and enhance healing.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-3

Question 2

Type: MCSA

A patient recently treated for pelvic inflammatory disease asks how she can best prevent a recurrence of the disease. What information should the nurse provide?

1. The physician will prescribe prophylactic antibiotic therapy.

2. The use of condoms will be beneficial.

3. Annual gynecological examinations should be scheduled.

4. Douching after intercourse will assist in removing potential pathogens from the genital area.

Correct Answer: 2

Rationale 1: Prophylactic antibiotics are not used to manage pelvic inflammatory disease.

Rationale 2: Condoms provide a barrier against the introduction of pathogens to the womans body.

Rationale 3: Annual gynecological examinations are recommended but will not prevent the spread of the disease.

Rationale 4: Douching can actually increase the incidence of pelvic inflammatory disease. Douching forces fluids higher into the womans vagina and cervical area.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 3

Type: MCSA

The nurse is determining diagnoses appropriate for a pregnant patient newly diagnosed with herpes simplex. Which nursing diagnosis has the highest priority?

1. Risk for Injury related to the disease process

2. Deficient Knowledge related to the diagnosis

3. Anxiety related the diagnosis

4. Interrupted Family Processes related to the effects of the diagnosis on her relationship with her partner

Correct Answer: 1

Rationale 1: The patients and neonates greatest risk is related to the potential for complications from the herpes simplex.

Rationale 2: The knowledge deficit can be addressed after a higher-priority diagnosis is addressed.

Rationale 3: Anxiety can be managed after the highest-priority diagnosis is addressed.

Rationale 4: Interrupted Family Processes can be managed after the highest-priority diagnosis is addressed.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 43-2

Question 4

Type: MCSA

A female patient diagnosed with a chlamydial infection denies any symptoms and asks when she contracted the disease. What information should be provided to the patient?

1. The patient has most likely had the infection for about 1 to 3 weeks.

2. The infection has been in her body for less than 1 month, as no symptoms are present.

3. The infection might have been in her body for an indefinite period of time.

4. Symptoms typically begin a few months after infection.

Correct Answer: 3

Rationale 1: The infection can be asymptomatic in the womans body for months or years before symptoms are produced.

Rationale 2: The infection can be asymptomatic in the womans body for months or years before symptoms are produced.

Rationale 3: The infection can be asymptomatic in the womans body for months or years before symptoms are produced. The incubation period for the disease is 1 to 3 weeks.

Rationale 4: Symptoms may not appear for years after infection.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-1

Question 5

Type: MCSA

The nurse is planning to teach a group of adolescents about sexually transmitted infections. What information concerning genital warts should the nurse discuss?

1. Hand washing will aid in reducing the spread of genital warts.

2. Genital warts lead to cervical cancer in the majority of women who get them.

3. Women who have certain types of genital warts should be vaccinated against other types.

4. Wearing a condom eliminates the risk of contracting genital warts.

Correct Answer: 1

Rationale 1: Hand hygiene is the first line of defense against disease.

Rationale 2: Genital warts are implicated in many cases, but not the majority of cases, of cervical cancer.

Rationale 3: The vaccine does not eliminate the disease once it is established.

Rationale 4: The use of condoms significantly lowers, but does not eliminate, the risk of contracting genital warts.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 6

Type: MCSA

A patient asks which method of contraception will provide the greatest protection against gonorrhea. What method can the nurse recommend?

1. Oral contraceptives

2. Male condoms

3. Sponges

4. Spermicides

Correct Answer: 2

Rationale 1: Oral contraceptives contain hormones and do not affect resistance to sexually transmitted infections.

Rationale 2: The condom provides a barrier against pathogens.

Rationale 3: Sponges contain chemicals to kill sperm. These chemicals alone do not provide protection from disease.

Rationale 4: Spermicides contain chemicals to kill sperm. These chemicals alone do not provide protection from disease.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 7

Type: MCSA

A patient is experiencing a painless, ulcerated area on her labia. The nurse would conduct additional assessment for which disease?

1. Herpes simplex 2

2. Syphilis

3. Condylomata acuminata

4. Gonorrhea

Correct Answer: 2

Rationale 1: Herpes simplex 2 infection presents with a painful ulceration.

Rationale 2: The chancre associated with syphilis is a painless, firm ulcer. This is the disease most likely affecting the patient.

Rationale 3: Condylomata acuminata appear as fleshy growths in which the skin is intact.

Rationale 4: Gonorrhea infection manifests with dysuria or discharge and is often asymptomatic in women.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 8

Type: MCSA

A patient diagnosed with herpes simplex II is concerned about sexual relations. What information should the nurse discuss with the patient?

1. The infection can be transmitted only when the lesions are present.

2. The infection can be prevented with condom use.

3. Sexual relations must be avoided at the first sign of recurrence.

4. Sexual activity is permissible once the lesions have dried out.

Correct Answer: 3

Rationale 1: The herpes simplex virus can be transmitted during the prodromal period and for approximately 10 days after the lesions have healed.

Rationale 2: Condom use is beneficial in protecting against the disease, but it is not 100% effective.

Rationale 3: At the first sign of recurrence, the patient must practice sexual abstinence. Prodromal signs include tingling or itching in the affected areas.

Rationale 4: The lesions crust in 4 to 5 days, but complete healing takes approximately 10 days.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 9

Type: MCMA

A 15-year-old patient is seeking information on birth control and sexually transmitted infections (STIs). What teaching should the nurse provide?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Multiple sex partners increase the risk for STIs.

2. Condom use is 100% effective in preventing pregnancy and STIs.

3. Abstinence is the only sure way to prevent pregnancy.

4. Abstinence prevents transmission of STIs.

5. Young girls having unprotected sex are more likely to become pregnant than to contract an STI.

Correct Answer: 1,3

Rationale 1: The patient should be educated on the risks of having multiple sex partners.

Rationale 2: Condoms are effective only if used correctly and consistently, and even then they do not offer 100% protection.

Rationale 3: The only sure way to prevent pregnancy is to remain abstinent.

Rationale 4: Some STIs such as scabies can be transmitted by any close physical contact. Infections such as hepatitis and HIV/AIDS can be transmitted by exposure to blood or body fluids other than through sexual contact.

Rationale 5: Unprotected sexual contact is a risk for both pregnancy and STIs.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 10

Type: MCMA

The nurse is providing community education to a large group of high school students about the treatment of sexually transmitted infections (STIs). Which information would be beneficial for the students to understand?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Prevention of STIs is the best approach.

2. It is easier to treat a second STI than the first STI.

3. For treatment to be effective, both partners must be treated.

4. Few complications result from delaying treatment.

5. Treatment of STIs is usually quick and effective.

Correct Answer: 1,3,4

Rationale 1: It is more desirable to prevent STIs than it is to have to treat them.

Rationale 2: Treatment does not get easier with repeated infection.

Rationale 3: For treatment to be effective, both partners must be treated to prevent reinfection.

Rationale 4: Many complications may result from delaying treatment, such as pelvic inflammatory disease, ectopic pregnancy, infertility, chronic pelvic pain, neonatal illness, genital cancer, and death.

Rationale 5: Treatment depends on the infection. Some infections require extensive treatment, and some infections cannot be effectively treated.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 11

Type: MCMA

The nurse would determine that which patient has a reportable sexually transmitted infection according to Centers for Disease Control and Prevention (CDC) regulations?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Patient with bacterial vaginosis

2. Patient with syphilis

3. Patient with gonorrhea

4. Patient with trichomonas

5. Patient with chlamydia.

Correct Answer: 2,3,5

Rationale 1: Bacterial vaginosis is not a reportable infection.

Rationale 2: Syphilis is a reportable infection.

Rationale 3: Gonorrhea is a reportable infection.

Rationale 4: Trichomonas is not a reportable infection.

Rationale 5: Chlamydia is a reportable infection.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 12

Type: MCSA

A 20-year-old patient has small painful blisters on her labia that developed about 6 days after having sex with her new boyfriend. The nurse would conduct additional assessment for which most likely STI?

1. Syphilis

2. Gonorrhea

3. Chlamydia

4. Genital herpes

Correct Answer: 4

Rationale 1: Syphilis is characterized in the early stage by a painless chancre at the site of inoculation.

Rationale 2: Women who have gonorrhea may be asymptomatic until the disease is advanced but may experience dysuria, abnormal menses, increased vaginal discharge, and dyspareunia.

Rationale 3: Chlamydia manifests with dysuria and discharge, not blisters.

Rationale 4: Two to 10 days after exposure to the genital herpes virus, painful red papules appear in the genital area. Soon afterward, they form small painful blisters filled with clear fluid containing virus particles.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 13

Type: FIB

A patient is prescribed ceftriaxone (Rocephin) 350 mg IM. The nurse reconstitutes a 500 mg vial of ceftriaxone powder with 1.8 mL of diluent to achieve a concentration of 250 mg/mL. The nurse will administer _______ mL for the total dose.

Standard Text:

Correct Answer: 1.4

Rationale : 250 mg/1 mL = 350 mg/x mL; x= 1.4

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-3

Question 14

Type: MCSA

A male patient who is sexually active with multiple partners and does not use a condom has a small, painless lesion on the side of his penis. The history is an indication of what STI?

1. Condylomata acuminata

2. Syphilis

3. Gonorrhea

4. Chlamydia

Correct Answer: 2

Rationale 1: Condylomata acuminata are cauliflower-shaped lesions that appear on moist skin surfaces such as the vagina, perineum, penis, urethra, and anus.

Rationale 2: The primary stage of syphilis is characterized by the appearance of a chancre and by regional enlargement of the lymph nodes. The chancre appears at the site of inoculation 3 to 4 weeks after the infectious contact. There is little or no pain.

Rationale 3: The male patient who presents with gonorrhea does not have lesions on the penis.

Rationale 4: The male patient who presents with chlamydia does not have lesions on the penis.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 15

Type: MCSA

A teenaged female patient tells the nurse that she has been sexually active with her boyfriend for 2 months. She has no symptoms of a sexually transmitted infection (STI). Screening for which infection is the nurses priority?

1. Genital herpes

2. Human papillomavirus (HPV)

3. Condylomata acuminata

4. Chlamydia

Correct Answer: 4

Rationale 1: If the patient had contracted genital herpes, she would likely be showing symptoms.

Rationale 2: HPV screening would be considered but is not the most likely infection to be present. The incubation period is 2 to 3 months.

Rationale 3: Condylomata acuminata or genital warts are a manifestation of HPV, which is not the most likely infection to be present. The incubation period is 2 to 3 months.

Rationale 4: Chlamydia is the most prevalent STI in the United States and number one in infections of the female population under the age of 25. Screening is strongly recommended for all sexually active females age 25 or younger.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-4

Question 16

Type: MCMA

A patient diagnosed with gonorrhea has not been adhering to the prescribed medication regimen. Which findings could indicate the patient is experiencing complications of the disease?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. WBC 22,000

2. Complaints of severe abdominal pain

3. Ambulating slowly with legs apart

4. Tenderness upon palpation of the abdomen

5. Serum potassium of 3.4

Correct Answer: 1,2,3,4

Rationale 1: The elevation in white blood count is an indicator of an infectious process somewhere in the body.

Rationale 2: Complaints of severe abdominal pain may indicate pelvic inflammatory disease (PID). PID in women can lead to internal abscesses, chronic pain, ectopic pregnancy, and infertility.

Rationale 3: Ambulating slowly with legs apart may indicate pelvic inflammatory disease, prostatitis, or epididymitis.

Rationale 4: Complaints of tenderness upon palpation of the abdomen may indicate pelvic inflammatory disease (PID).

Rationale 5: Changes in serum potassium level are not associated with inadequately treated gonorrhea.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 17

Type: FIB

The health care provider orders doxycyline 100 mg PO every 12 hours for 7 days. The pharmacy fills the prescription with 0.1 g doxycyline capsules. The nurse should instruct the patient to take ____ capsules per day.

Standard Text:

Correct Answer: 2

Rationale : To achieve the ordered dose, it is necessary to change the milligrams to grams.
1000 mg = 1gram
100 mg = 0.1grams
One capsule is 100 mg. The patient would take one capsule twice a day or two capsules per day.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-3

Question 18

Type: FIB

A patient who is positive for syphilis is allergic to penicillin and is being treated with tetracycline for 28 days. The health care provider orders tetracycline 500 mg to be taken every 6 hours. The prescription is filled with 250 mg tablets. How many tablets will the patient need to take every day to achieve the ordered dosing?

Standard Text:

Correct Answer: 12

Rationale : 500. mg / 250 mg = 2
2 tablets every 6 hours
= 2 6
= 12 tablets every day

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-3

Question 19

Type: SEQ

When implementing nursing care for a patient with a diagnosis of syphilis, the nurse must take into consideration the disease process. Rank in correct sequence the stages of the disease process.

Standard Text: Click and drag the options below to move them up or down.

Choice 1. Appearance of a chancre and regional enlargement of lymph nodes

Choice 2. Localized development of gummas

Choice 3. Asymptomatic period

Choice 4. Skin rash on palms and feet

Correct Answer: 1,4,3,2

Rationale 1: The primary stage of syphilis is characterized by the appearance of a chancre at the site of inoculation.

Rationale 2: The tertiary stage is characterized by localized development of infiltrating tumors (gummas) in skin, bones, and liver. The disease can be treated at this stage, but much of the cardiovascular and central nervous system damage is irreversible.

Rationale 3: The symptoms of the second stage disappear in 2 to 6 weeks and a latency period begins. During this period, the patient may be asymptomatic and the disease is not transmissible by sexual contact.

Rationale 4: Secondary syphilis may occur anytime from 2 weeks to 6 months after the first chancre disappears. Symptoms may include a skin rash on the palms of the hands or soles of the feet, generalized lymphadenopathy, and flulike symptoms.

Global Rationale:

Cognitive Level: Understanding

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 43-1

Question 20

Type: MCMA

A young female patient has just been diagnosed with a trichomoniasis infection. The nurse would expect which assessment findings?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Greenish-yellow vaginal discharge

2. Smooth lesions on labia majora

3. Itching and irritation of the genitalia

4. Dysuria

5. fever

Correct Answer: 1,3,4

Rationale 1: Trichomoniasis is caused by Trichomonas vaginalis, a protozoan parasite. Symptoms usually appear in 5 to 28 days of exposure. Women have a frothy, green-yellow vaginal discharge with a strong fishy odor, often accompanied by itching and irritation of the genitalia.

Rationale 2: Lesions are usually not associated with a trichomoniasis infection.

Rationale 3: Itching and irritation of the genitalia are characteristic of trichomoniasis.

Rationale 4: The symptoms of trichomoniasis can include dysuria.

Rationale 5: Fever is usually not associated with a trichomoniasis infection.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 21

Type: MCMA

The nurse is educating a young female college student about STIs. The nurse would evaluate that teaching goals have been met when the student makes which statements?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Women between 14 and 25 have a particularly high risk of contracting an STI.

2. STIs can be transmitted from me to my unborn baby.

3. Oral contraceptives do not protect against STIs.

4. STIs are easy to diagnose.

5. Sexual activity with multiple partners is associated with an increased incidence of STIs.

Correct Answer: 1,2,3,5

Rationale 1: Women ages 14 to 25 are particularly vulnerable because the transformational zone and columnar cells of the cervical os are vulnerable to any organisms that may enter the vagina.

Rationale 2: Many STIs can be passed from mother to fetus.

Rationale 3: Oral contraceptives do not protect against STIs.

Rationale 4: Diagnosis is difficult with many STIs.

Rationale 5: Drug abuse, unprotected sexual activity, and sexual activity with multiple partners are associated with an increased incidence of STIs.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 43-5

Question 22

Type: MCMA

A 17-year-old sexually active female comes to the clinic requesting a pelvic exam. She has complaints of pelvic pain and a heavy vaginal discharge. She states she has had a sore throat for about a week. In reviewing her chief complaints and lab work, the nurse suspects an STI diagnosis. Which additional assessment information should the nurse collect?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Risk factors, including unprotected sex

2. List of names of all sexual partners

3. Estimated time frame of presenting symptoms

4. Attempts at self-treatment of symptoms

Correct Answer: 1,3,4

Rationale 1: For a patient suspected of having an STI, sexual and gynecological history need to be obtained.

Rationale 2: The nurse does not need to collect this history.

Rationale 3: Inquiring about the duration of symptoms is appropriate with this patient.

Rationale 4: The nurse should inquire about attempts at self-treatment.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-3

Question 23

Type: MCMA

A patient is being treated for secondary syphilis. The nurse would assess for a rash in which areas?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Palms of the hands

2. Soles of the feet

3. Across the genitals

4. In the axilla

5. On the lower legs

Correct Answer: 1,2

Rationale 1: Rash on the palms of the hands is an assessment finding associated with secondary syphilis.

Rationale 2: Rash on the soles of the feet is an assessment finding associated with secondary syphilis.

Rationale 3: Genital rash is not associated with secondary syphilis.

Rationale 4: Axillary rash is not associated with secondary syphilis.

Rationale 5: Rash across the lower legs is not associated with secondary syphilis.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 24

Type: MCMA

A patient who is febrile and has vaginal drainage has been admitted for treatment of pelvic inflammatory disease (PID). Which interventions would the nurse include in the plan of care for this patient?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Encourage the patient to assume a side-lying position with knees drawn up.

2. Encourage the patient to ambulate to mobilize trapped intestinal gas.

3. Maintain strict universal precautions.

4. Provide intravenous antibiotics as prescribed.

5. Teach the patient how to use a pain scale.

Correct Answer: 3,4,5

Rationale 1: The patient should be encouraged to remain in high-Fowlers position.

Rationale 2: The patient should be encouraged to maintain bed rest. Trapped intestinal gas is not a prominent issue with PID.

Rationale 3: The patient has a serious infection, so the nurse should comply with all universal precautions.

Rationale 4: Until the patient is afebrile, antibiotics are administered intravenously.

Rationale 5: The patient will likely be in pain, so education about using the pain scale will be necessary.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 43-1

Question 25

Type: MCSA

A female patient is having difficulty accepting the diagnosis of a sexually transmitted infection (STI) because she has been on the pill for years. What information can the nurse provide to aid this patient?

1. Skipping doses could have caused the disease.

2. She may need to change the type of birth control pill she is using.

3. The pill offers some protection against STIs.

4. Latex condoms are better protection against bacterial STIs.

Correct Answer: 4

Rationale 1: Inconsistent compliance does not increase the risk of STIs.

Rationale 2: The type of oral contraceptive used does not increase the risk of STIs.

Rationale 3: The pill does not offer a barrier against transmission of STIs.

Rationale 4: Latex condoms, if used correctly, offer some protection against bacterial STIs.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 26

Type: MCSA

A male patient is relieved to learn that he has a sexually transmitted infection (STI) and is not HIV positive. Which response by the nurse would be most appropriate?

1. Having a sexually transmitted infection does predispose the body to infection with HIV if exposed to the virus.

2. You are lucky.

3. I told you not to be concerned.

4. You would know if you had HIV.

Correct Answer: 1

Rationale 1: STIs that cause sores, ulcers, or breaks in the skin or mucous membranes disrupt barriers that provide protection against infections such as HIV.

Rationale 2: This is an inappropriate response and does not provide the patient with needed information.

Rationale 3: The nurse should not discount the patients concern about having HIV but should provide additional information.

Rationale 4: The patient would not necessarily recognize HIV infection.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 27

Type: MCSA

A female patient who was just diagnosed with a sexually transmitted infection (STI) is beginning treatment. The nurse would evaluate that education goals have been met if this patient makes which statement?

1. I will avoid all sexual activity in the future.

2. I need to begin birth control pills to prevent future disease transmission.

3. I am so glad it was just an STI and not something dangerous.

4. I need to tell my sexual partners about the diagnosis so they can also be treated.

Correct Answer: 4

Rationale 1: Implementation of safe sex practices, rather than avoidance of all sexual activity, is a more appropriate action.

Rationale 2: Birth control pills do not prevent disease transmission.

Rationale 3: STIs can be dangerous. This statement indicates the patient does not understand the seriousness of the diagnosis.

Rationale 4: For treatment to be effective, sexual partners of the infected person must also be treated.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 43-5

Question 28

Type: MCSA

After the removal of genital warts, a male patient says, Now I can have sex again. The nurse should provide the patient with which information?

1. How to prevent reinfection now that he is cured of the warts

2. The need to always have female partners douche after having sex

3. The need to wash the genitals well before every sexual encounter

4. The need to always use a condom for sexual activity

Correct Answer: 4

Rationale 1: There is no known cure for human papillomavirus.

Rationale 2: Douching does not protect against disease transmission.

Rationale 3: Washing the genitals does not protect against disease transmission.

Rationale 4: Condoms help to protect others against contracting this disease, although they are not 100% effective.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-4

Question 29

Type: MCMA

A female patient has recurring bacterial vaginal infections. Which information should the nurse provide?

Note: Credit will be given only if all correct choices and no incorrect choices are selected.

Standard Text: Select all that apply.

1. Wear only thong-type underwear.

2. Be sure to wash the perineal region daily and as necessary throughout the day.

3. Some women find that taking probiotics helps reduce infections.

4. Avoid sexual intercourse.

5. Use condoms when engaging in sexual activity.

Correct Answer: 2,3,5

Rationale 1: Wearing thong underwear promotes the development of bacterial vaginal infections.

Rationale 2: Washing the perineum daily and as necessary may help reduce the frequency of vaginal infections.

Rationale 3: The use of probiotics to reduce bacterial infection of the vagina is being researched.

Rationale 4: There is no indication that this woman should avoid sexual intercourse.

Rationale 5: Preventive measures against vaginal infections include safer sex.

Global Rationale:

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 43-4

Question 30

Type: MCSA

A female patient is complaining of a watery vaginal discharge with a really strong fishy odor. The nurse asks additional assessment questions related to which disorder?

1. Bacterial vaginosis

2. Yeast infection

3. Trichomoniasis infection

4. Genital warts

Correct Answer: 1

Rationale 1: Bacterial vaginosis is the most common cause of vaginal infection in women of reproductive age. The primary manifestation is a vaginal discharge that is thin and grayish-white and has a foul, fishy odor.

Rationale 2: Yeast infections present with a thick, cheesy discharge.

Rationale 3: Trichomoniasis presents with a frothy, yellow-green discharge with a strong odor.

Rationale 4: Genital warts are growths, not discharge.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 43-1

Question 31

Type: MCSA

A patient has been diagnosed with pelvic inflammatory disease (PID). She becomes tearful and asks if this disease will make her unable to have children later. What response by the nurse is indicated?

1. You have nothing to worry about because you are getting treatment now.

2. The underlying cause of the disease will be the greatest determinant of your potential infertility.

3. This disease is associated with infertility, but it is too early to know.

4. Yes, this disease will likely cause you to be infertile.

Correct Answer: 3

Rationale 1: Telling the woman not to worry is inappropriate and may be incorrect.

Rationale 2: The possibility of infertility will be based on the degree of damage, not the root cause of the disorder.

Rationale 3: PID is associated with infertility.

Rationale 4: Infertility is not an absolute result of PID.

Global Rationale:

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Client Need Sub:

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-3

Question 32

Type: MCSA

A patient is seen in the STI clinic with his third case of gonorrhea in the last 18 months. The patient says, Just give me my medicine so I will quit burning. Which nursing diagnosis would the nurse prioritize as most important for this patient?

1. Impaired Tissue Integrity

2. Anxiety

3. Deficient Knowledge

4. Self-Neglect

Correct Answer: 4

Rationale 1: Impaired Tissue Integrity may occur, but this is not the current priority.

Rationale 2: There is no evidence that this patient is anxious about his diagnosis.

Rationale 3: As this is at least the patients third contact with the STI clinic, it is unlikely that information has not been provided. This is not the priority diagnosis.

Rationale 4: The patient who has recurrent gonorrhea is not using the information provided to prevent infection from recurring.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Diagnosis

Learning Outcome: 43-2

Question 33

Type: MCSA

A patient has been diagnosed with chlamydia. Which statement by the patient would the nurse evaluate as indicating that the goal of expedited partner therapy (EPT) has been met?

1. My boyfriend has made an appointment to get his medication.

2. I talked to my boyfriend about what we need to do to prevent reinfection.

3. I cannot convince my boyfriend to come to the clinic to learn about chlamydia.

4. Once I have completed treatment, my boyfriend will start taking the medication.

Correct Answer: 2

Rationale 1: EPT does not require that the partner make an appointment.

Rationale 2: EPT allows the patient to bring medication and health advice to the sexual partner.

Rationale 3: If EPT is successful, the boyfriend would not need to come to the clinic.

Rationale 4: The goal of EPT is to treat both partners at the same time.

Global Rationale:

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Evaluation

Learning Outcome: 43-5

Question 34

Type: MCSA

What information should the nurse include when teaching a patient about taking metronidazole (Flagyl)?

1. Taking this drug will not require changing any sexual practices.

2. This drug will protect the patient against human papillomavirus.

3. The patient should not drink alcohol while taking this medication.

4. This drug is administered in a transdermal patch.

Correct Answer: 3

Rationale 1: The patient should refrain from sex during therapy.

Rationale 2: Metronidazole is used to treat trichomoniasis and bacterial vaginosis.

Rationale 3: The patient should not drink alcohol while taking metronidazole.

Rationale 4: Metronidazole is given orally or as vaginal gel or ovules.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Pharmacological and Parenteral Therapies

Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 43-3

Question 35

Type: MCSA

Laboratory results indicate that a patients Rapid Plasma Reagin (RPR) test is positive. What intervention does the nurse anticipate?

1. Surgery to evacuate an ectopic pregnancy

2. Pap smear

3. Venereal Disease Research Laboratory (VDRL) test

4. Abdominal CT

Correct Answer: 3

Rationale 1: RPR is not associated with ectopic pregnancy.

Rationale 2: A positive RPR can occur in either gender. It does not indicate the need for a Pap smear.

Rationale 3: RPR is a screening test for syphilis. If the RPR is positive, a VDRL is run to confirm or disprove the presence of syphilis.

Rationale 4: There is no immediate indication for an abdominal CT.

Global Rationale:

Cognitive Level: Applying

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 43-3

 

Leave a Reply