Exam 1 - Chapter 7 Flashcards
Syphilis is a complex disease that can lead to serious systemic illness and even death if
left untreated. Which manifestation differentiates primary syphilis from secondary syphilis?
a. Fever, headache, and malaise
b. Widespread rash
c. Identified by serologic testing
d. Appearance of a chancre 2 months after infection
D - Primary syphilis is characterized by a primary lesion (the chancre), which appears 5 to 90 days
after infection. The chancre begins as a painless papule at the site of inoculation and erodes to
form a nontender, shallow, and clean ulcer several millimeters to centimeters in size. Secondary
syphilis occurs 6 weeks to 6 months after the appearance of the chancre and is characterized by a
widespread maculopapular rash. The individual may also experience fever, headache, and
malaise. Latent syphilis are those infections that lack clinical manifestations; however, they are
detected by serologic testing.
The human papillomavirus (HPV), also known as genital warts, affects 79 million
Americans, with an estimated number of 14 million new infections each year. The highest rate of
infection occurs in young women, ages 20 to 24 years. Prophylactic vaccination to prevent the
HPV is now available. Which statement regarding this vaccine is inaccurate?
a. Only one vaccine for the HPV is available.
b. The vaccine is given in three doses over a 6-month period.
c. The vaccine is recommended for both boys and girls.
d. Ideally, the vaccine is administered before the first sexual contact.
A - Two vaccines for HPV are availableCervarix and Gardasiland other vaccines continue to be
investigated. These vaccines protect against HPV types 6, 11, 16, and 18. They are most
effective if administered before the first sexual contact. Recommendations are that vaccines be
administered to 11- and 12-year-old girls and boys. The vaccine can be given to girls as young as
9 years of age and young women ages 13 to 26 years in three doses over a 6-month period.`
Which sexually transmitted infection (STI) is the most commonly reported in American women? a. Gonorrhea b. Syphilis c. Chlamydia d. Candidiasis
C - Chlamydia is the most common and fastest spreading STI among American women, with an
estimated 3 million new cases each year. Infection rates are two and a half times that of men.
Gonorrhea is probably the oldest communicable disease in the United States and second to
Chlamydia in reported conditions. Syphilis is the earliest described STI. Candidiasis is a
relatively common fungal infection
The Centers for Disease Control and Prevention (CDC) recommends which therapy for
the treatment of the HPV?
a. Miconazole ointment
b. Topical podofilox 0.5% solution or gel
c. Two doses of penicillin administered intramuscularly (IM)
d. Metronidazole by mouth
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.
A client exhibits a thick, white, lumpy, cottage cheeselike discharge, along with white
patches on her labia and in her vagina. She complains of intense pruritus. Which medication
should the nurse practitioner order to treat this condition?
a. Fluconazole
b. Tetracycline
c. Clindamycin
d. Acyclovir
A - The client is experiencing a candidiasis infection. Fluconazole, metronidazole, and clotrimazole
are the drugs of choice to treat this condition. Tetracycline is used to treat syphilis. Clindamycin
is used to treat bacterial vaginosis. Acyclovir is used to treat genital herpes.
Which laboratory testing is used to detect the human immunodeficiency virus (HIV)?
a. HIV screening
b. HIV antibody testing
c. Cluster of differentiation 4 (CD4) counts
d. Cluster of differentiation 8 (CD8) counts
B - The screening tool used to detect HIV is the enzyme immunoassay, which tests for the presence
of antibodies to the HIV. HIV-1 and HIV-2 antibody tests are used to confirm the diagnosis. To
determine whether 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
to detect HIV.
Which condition is the most life-threatening virus to the fetus and neonate?
a. Hepatitis A virus (HAV)
b. Herpes simplex virus (HSV)
c. Hepatitis B virus (HBV)
d. Cytomegalovirus (CMV)
C - HBV is the most life-threatening viral condition to the fetus and neonate. HAV is not the most
threatening to the fetus nor is HSV the most threatening to the neonate. Although serious, CMV
is not the most life-threatening viral condition to the fetus.
Which treatment regime would be most appropriate for a client who has been recently
diagnosed with acute pelvic inflammatory disease (PID)?
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 healing progress
B - The woman with acute PID should be on bed rest in a semi-Fowler position. Broad-spectrum
antibiotics are used; antiviral therapy is ineffective. Antibiotics must be taken as prescribed, even
if symptoms subside. Few pelvic examinations should be conducted during the acute phase of the
disease.
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 and complaints of
pruritus. Based upon these findings, which condition would the nurse suspect?
a. Bacterial vaginosis
b. Candidiasis
c. Trichomoniasis
d. Gonorrhea
A - Most women with bacterial vaginosis complain of a characteristic fishy odor. The discharge is
usually profuse, thin, and has a white, gray, or milky color. Some women may also experience
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 yellow-to-green, frothy, mucopurulent, copious, and malodorous discharge.
Women with gonorrhea are often asymptomatic. Although they may have a purulent
endocervical discharge, the discharge is usually minimal or absent.
Which viral sexually transmitted infection is characterized by a primary infection followed by recurrent episodes? a. Herpes simplex virus 2 (HSV-2) b. HPV c. HIV d. CMV
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 the 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.
The nurse should understand the process by which the HIV infection occurs. Once the
virus has entered the body, what is the time frame for seroconversion to HIV positivity?
a. 6 to 10 days
b. 2 to 4 weeks
c. 6 to 12 weeks
d. 6 months
C - Seroconversion to HIV positivity usually occurs within 6 to 12 weeks after the virus has entered
the body. Both 6 to 10 days and 2 to 4 weeks are too short for seroconversion to HIV positivity
to occur, and 6 months is too long
A 25-year-old single woman comes to the gynecologists office for a follow-up visit
related to her abnormal Papanicolaou (Pap) smear. The test revealed that the client has the HPV.
The woman asks, What is that? Can you get rid of it? Which is the best response for the nurse to
provide?
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.
B - Informing the client about STIs and the risks involved with the HPV is important. The health
care team has a duty to provide proper information to the client, including information related to
STIs and the fact that although the HPV and HIV are both viruses that can be sexually
transmitted, they are not the same virus. The onset of the HPV can be insidious. Often STIs go
unnoticed. Abnormal bleeding is frequently the initial symptom. The client may have had the
HPV before her current boyfriend. The nurse should make no deductions from this limited
information.
Which STI does not respond well to antibiotic therapy?
a. Chlamydia
b. Gonorrhea
c. Genital herpes
d. Syphilis
C- Genital herpes is a chronic and recurring disease for which no known cure is available; therefore,
it does not respond to antibiotics. Chlamydia is a bacterial infection that is treated with
doxycycline or azithromycin. Gonorrhea is a bacterial infection that is treated with any of several
antibiotics. Syphilis is a bacterial infection that is treated with penicillin.
Five different viruses (A, B, C, D, and E) account for almost all cases of hepatitis
infections. Which statement regarding the various forms of hepatitis is most accurate?
a. Vaccine exists for hepatitis C virus (HCV) but not for HBV.
b. HAV is acquired by eating contaminated food or drinking polluted water.
c. HBV is less contagious than HIV.
d. Incidence of HCV is decreasing.
B - Contaminated milk and shellfish are common sources of infection for HAV. A vaccine exists for
HBV but not for HCV. HBV is more contagious than HIV. The incidence of HCV is on the rise
A 21-year-old client exhibits a greenish, copious, and malodorous discharge with vulvar
irritation. A speculum examination and wet smear are performed. Which condition is this client
most likely experiencing?
a. Bacterial vaginosis
b. Candidiasis
c. Yeast infection
d. Trichomoniasis
D - Although uncomfortable, a speculum examination is always performed and a wet smear obtained
if the client exhibits symptoms of trichomoniasis. 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.
