Exam 3: STI and Breast Content

Question 1

Genital herpes pathophysiology review

what is it?

what are the types?

incubation time?

is it curable?

Answer 1

acute, recurring, common viral disease

HSV-1 or 2

Incubation is 2 to 20 days

Primary outbreak may be asymptomatic, but the patient is still infectious

not curable

Question 2

How do we confirm GH

Answer 2

lab testing –> viral culture, PCR

Question 3

GH lesions resolve

Answer 3

2 to 6 weeks

Question 4

Drug therapy for GH

Answer 4

antivirals –> episodic vs suppressive

Question 5

Episodic vs suppressive antivirals for GH

Answer 5

Episodic antivirals
Taken when the first signs of an outbreak appear, the goal is to shorten the duration of the outbreak, reduce pain, and speed healing.

Suppressive antivirals
Taken daily, the goal is to prevent the herpesvirus from reactivating and causing new outbreaks. Suppressive therapy is often recommended for people who have multiple outbreaks per year

Question 6

Syphilis early and late categories

primary
secondary
early latent
tertiary/late

Answer 6

primary: chancre is the first sign

secondary: systemic develops in 25% of untreated individuals w/in a few months –> flu like symptoms

early latent: seropositive but asymptomatic

tertiary/late: uncommon, can develop 4 to 20 years after infection, usually untreated cases –> organ affected

Question 7

Drug therapy for syphilis

Answer 7

benzathine penicillin G

Question 8

what is the test for syphilis

Answer 8

VDRL, RPR, treponemal tests

Question 9

Condylomata acuminata (genital warts): caused by

Answer 9

certain types of HPV

Question 10

GW non surgical managment

Answer 10

Cryodestruction

Immune-mediated therapies

Topical treatment

Question 11

GW surgical managment

Answer 11

• Excision

*Cryoablationorlaserablation

• Electrocautery
• Ultrasonicaspiration

Question 12

Chlamydia infection patho review

Answer 12

Chlamydia trachomatis—intracellular
bacterium, causative agent of cervicitis,
urethritis, proctitis

*Report able to local health departments in
all states

• Often asymptomatic
• High prevalence of rectal and pharyngeal
  infection in MSM

Question 13

Drug therapy –> interventions

Answer 13

*Doxycycline

*Expedited Partner Therapy (EPT)

Question 14

Gonorrhea pathoreview

Answer 14

Neisseria gonorrheoeae

can be asymptomatic

First symptoms occur within a week after sexual contact with infected person

can cause PID and other complications in females

can cause epididymitis (which can lead to infertility) and other complications in males

Question 15

Area involvement with gonorrhea

Answer 15

pharyngitis in both M/W

proctitis, epididymitis, purulent penile discharge, prostatis, and urethritis in men

endometritis, salpingitis, cervictitis, proctitis, and urethritis in women

Question 16

Gonorrhea intervention

Answer 16

All patients with gonorrhea should be tested for syphilis, chlamydia, hepatitis B, hepatitis C, and HIV; HSV and HPV if possible

Question 17

Drug therapy for Gonorrhea

Answer 17

Uncomplicated gonorrhea treated with IM ceftriaxone single dose
* Co-infection with Chlamydia treated with doxycycline.

Question 18

PID pathophysiology review

Answer 18

Organisms move from endocervix upward through uterine cavity into fallopian tube

multiple pathogens

Question 19

PID infection can spread to… (3)

Answer 19

uterus

fallopian tubes (most common)

adjacent pelvic structures

Question 20

What is a potential complication of PID

Answer 20

sepsis and death if treatment is delayed or inadequate

Question 21

The priority collaborative problems for a patient with PID are:

Answer 21

Infection due to invasion of pelvic organs by sexually transmitted pathogens

Pain due to infectious process

Question 22

What does the nurse identify as an expected outcome when planning care for a client with genital herpes being treated with antiviral drugs?

A. Eradication of the infection
B. Inability to transmit the virus to a partner
C. Decrease in severity and frequency of
recurrent outbreaks
D. Prevention of viral shedding even when
asymptomatic

Answer 22

C. Decrease in severity and frequency of
recurrent outbreaks

Question 23

The nurse is assessing a client with genital warts. Which assessment finding does the nurse anticipate?

A. Chancre
B. No symptoms
C. Abdominal pain
D. Small flesh-colored growths

Answer 23

D. Small flesh-colored growths

Question 24

A 24-year-old sexually active male reports a low- grade fever and headache, and a rash on his hands. What condition does the nurse anticipate?
A. HIV
B. HPV
C. Syphilis
D. Gonorrhea

Answer 24

ANS: C

Symptoms of secondary syphilis usually develop 6 weeks to 6 months after the onset of primary syphilis. During this stage, syphilis is a systemic disease because the spirochetes circulate throughout the bloodstream. Common signs and symptoms include malaise, low-grade fever, headache, muscular aches and pains, sore throat, and generalized rash (usually on the hands and feet).

Question 25

Breast abscess

Answer 25

Non-lactational breast abscess are often related to diabetes, clogged sweat glands, acne, or trauma

Question 26

Risk factors of breast abcess

Answer 26

smoking, obesity, nipple piercings

Question 27

Treatment of breast abscess

Answer 27

broad-spectrum antibiotics, ultrasound-guided
aspiration, and/or incision and drainage

Question 28

Mastitis

Answer 28

Inflammation, infection, pain

Can occur in women whether they are lactating/breastfeeding or not

Question 29

What is mastitis more common in

Answer 29

women who smoke or have nipple piercings

Question 30

Treatment of mastitis

Answer 30

Treatment = antibiotic therapy, steroid therapy, watchful waiting

Question 31

invasive breast cancer includes

Answer 31

• Inflammatory breast cancer (IBC)
• Invasive ductal carcinoma

Question 32

non invasive breast cancers

Answer 32

• Ductal carcinoma in situ (DCIS)
• Lobular carcinoma in situ (LCIS)

Question 33

Invasive ductal carcinoma

Answer 33

• Originates in mammary ducts and break
  through wall of ducts into surrounding tissue
• Fibrosis develops around the cancer
• Peau d’orange

Question 34

Paget’s disease

Answer 34

• Rare form of breast cancer.
• Occurs in or around the nipple, extends to areola
• Scaly, red, irritated, looks like eczema
• May have other types of breast cancer
• Ductal Carcinoma Insitu or Invasive Breast Cancer

Question 35

Incidence and prevalence of breast cancer

Answer 35

• One of every eight women in the U.S. will develop breast cancer in her lifetime
• Second leading cause of cancer death in women

Question 36

etiology and genetic risk

Answer 36

Mutations in BRCA1 and BRCA2

Question 37

2. What information will the nurse include when teaching this client about breast cancer? (Select all that apply.)

A. Annual MRI of the breasts is recommended
B. Mammograms are ordered only if necessary.
C. The provider can perform a clinical breast examination (CBE) at visits.
D. Notify the provider if you notice any changes in your breasts.
E. Breast self-examination(BSE) is the best way to detect breast cancer
early.

Answer 37

C
D

Question 38

The nurse is caring for a client who just had a bilateral mastectomy. When the client states, “my partner is going to hate how I look”, which nursing response is appropriate?

A. “I’m sure your partner will be accepting.”
B. “Why haven’t you asked your partner about their
feelings?”
C. “We can work on that after you are feeling stronger.”
D. “It sounds like you are concerned about how your body
looks after surgery.”

Answer 38

D