Which of the following is the most common sexually

transmitted infection (STI) among young, sexually active

people?*

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Human papillomavirus (HPV)

Trichomoniasis

Gonorrhea

Chlamydia

The nurse is seeing a client for a follow up appointment in the

sexual health clinic. The nurse recognizes the client continues
to have a knowledge deficit regarding safe sexual practices
when the client makes which statement?*

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“Using oil to lubricate the condom has helped to increase comfort for me during
sexual intercourse.”

“My partner squeezes air out of the tip of the condom prior to unrolling it down over
the erect penis.”

“My partner and I use a new condom when transitioning from vaginal to anal sexual
intercourse.”

“Using a condom does not completely eliminate the risk of acquiring a sexually
transmitted infection.”

Correct answer

“Using oil to lubricate the condom has helped to increase comfort for me during
sexual intercourse.”

Feedback

The client should be reminded to never use skin lotions, oils, petroleum jelly, or cold cream
with condoms. The oil in these products will cause the condom to break. The client statement
in the correct option indicates the client continues to have this knowledge deficit. It is an
effective sexual health practice to squeeze the air out of the tip of the condom before
unrolling it over the penis, because this action can prevent the donned condom from tearing.
To more effectively prevent the transmission of infection, it is important to apply a new
condom when transitioning from vaginal to anal intercourse. The client is correct in stating
that using a condom does not completely eliminate the risk of acquiring a sexually
transmitted infection, though this practice does significantly reduce this risk.

The nurse is caring for a female client who has been

diagnosed with Neisseria gonorrhoeae. The nurse is aware
that if this client had not received treatment, what other
serious issues could have resulted from this disease? Select
all that apply.*

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Increased risk of HIV infection

Urethral stricture

Infection and scarring of the Fallopian tubes

Eye infection in an infant born to a woman with this disease

Infection of the epididymis

Correct answer

Increased risk of HIV infection

Infection and scarring of the Fallopian tubes

Eye infection in an infant born to a woman with this disease

Feedback

Complications of untreated Neisseria gonorrhea in a woman are infection of the cervix,

endometrium, and Fallopian tubes. It has been shown to facilitate the transmission of HIV and
it may transmitted to the eyes of a newborn. The development of infection of the epididymis
and urethral strictures can only be seen in men.
A nurse is participating in a vaccination clinic at the local
public health clinic. The nurse is describing the public health
benefits of vaccinations to participants. Vaccine programs
addressing which of the following diseases have been deemed
successful? Select all that apply.*

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Diphtheria

Mumps

Hepatitis

Chlamydia

Polio

Correct answer

Polio

Diphtheria

Mumps

Feedback

The most successful vaccine programs have been ones for the prevention of smallpox,
measles, mumps, rubella, polio, diphtheria, pertussis, and tetanus. There is no vaccine for
chlamydial infections. Hepatitis is not counted as one of the most successful vaccination
programs, because vaccination rates for hepatitis leave room for improvement.

A nurse is caring for a client with syphilis. Which nursing

interventions would be included on the plan of care? Select all
that apply.*

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 Inform the client that notification of the sexual partner by the department of public
health is important for the evaluation and treatment.

Inquire about the client's allergy history in anticipation of antibiotic treatment.

Collect health information and a sexual history.

Anticipate an antiviral medication to be ordered.

Place the client on contact precautions.

Correct answer

Inform the client that notification of the sexual partner by the department of public
health is important for the evaluation and treatment.

Inquire about the client's allergy history in anticipation of antibiotic treatment.

Collect health information and a sexual history.

Feedback

When caring for a client with syphilis, the nurse collects health information and a sexual
history, inquires about the client's allergy history in anticipation of antibiotic treatment, and
informs the client that notification of the sexual partner by the department of public health is
important for his or her evaluation and treatment. The nurse would not anticipate an antiviral
medication to be ordered because syphilis is a bacteria. Placing the client on contact
precautions is not necessary because syphilis is spread through sexual contact and childbirth.

A client is diagnosed with herpes simplex. Which statement

about herpes simplex infection is true?*

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Herpetic keratoconjunctivitis usually is bilateral and causes systemic symptoms.

 Genital herpes simplex lesions are painless, fluid-filled vesicles that ulcerate and
heal in 3 to 7 days.

During early pregnancy, herpes simplex infection may cause spontaneous abortion
or premature birth.

A client with genital herpes lesions may have sexual contact but must use a
condom.

Correct answer

During early pregnancy, herpes simplex infection may cause spontaneous abortion
or premature birth.

Feedback

Herpes simplex may be passed to the fetus transplacentally and, during early pregnancy, may
cause spontaneous abortion or premature birth. Genital herpes simplex lesions typically are
painful, fluid-filled vesicles that ulcerate and heal within 1 to 2 weeks. Herpetic
keratoconjunctivitis usually is unilateral and causes localized symptoms, such as
conjunctivitis. A client with genital herpes lesions should avoid all sexual contact to prevent
spreading the disease.

The public health nurse has been talking to a group of

community members about sexually transmitted infections.
Which statement by one of the participants demonstrates an
understanding of methods during sexual intercourse to
decrease the risk of a sexually transmitted infection?*

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“Using condoms will always prevent a sexually transmitted infection.”

“I will make sure and wash my genital area before and after having sexual
intercourse.”

“Sexually transmitted infections cannot be passed without having sexual

intercourse.”

“If I find out that I have a sexually transmitted infection, I should limit sexual contact
to the individual I believe gave me the infection.”

Correct answer

“I will make sure and wash my genital area before and after having sexual
intercourse.”

Feedback
It is important that an individual urinate and wash the genital and perineal area before and
after sexual intercourse. An individual who has a sexually transmitted infection (STI) should
not have sexual intercourse with anyone until treatment is completed. Condoms must be used
with spermicide to be effective against STIs. To ensure that an individual does not get a STI,
the individual should abstain from sexual intercourse. STIs can be passed by contact with an
infected individual without actually having sexual intercourse.

The nurse educator is discussing pathogens responsible for

various sexually transmitted infections. When teaching about
bacterial vaginosis (BV), the nurse educator is correct when
stating the overgrowth of which bacteria is responsible for this
infection?*

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Gardnerella vaginalis

Lactobacillus acidophilus

Chlamydia trachomatis

Trichomonas vaginalis

Feedback

BV is caused by an overgrowth of anaerobic bacteria and Gardnerella vaginalis, which is

normally found in the vagina, and an absence of lactobacilli. The vagina is protected against
infection by its normally low pH (3.5 to 4.5), which is maintained in part by Lactobacillus
acidophilus, the dominant bacteria in a healthy vaginal ecosystem. Trichomonas vaginalis is
the pathogen implicit in the trichomoniasis infection, a common sexually transmitted
vaginitis. In younger men, the major cause of epididymitis is Chlamydia trachomatis. This
pathogen is not responsible for BV and Chlamydia trachomatis infections frequently do not
cause symptoms in women.

A clinic nurse is caring for a male client diagnosed with

gonorrhea who has been prescribed ceftriaxone and
doxycycline. The client asks why he is receiving two
antibiotics. What is the nurse's best response?*

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“The combination of these two antibiotics reduces the later risk of reinfection.”

“There are many drug-resistant strains of gonorrhea, so more than one antibiotic
may be required for successful treatment.”
 “This combination of medications will eradicate the infection twice as fast than a
single antibiotic.”

"Many people infected with gonorrhea are infected with chlamydia as well.”

Correct answer

"Many people infected with gonorrhea are infected with chlamydia as well.”

Feedback

Because clients are often coinfected with both gonorrhea and chlamydia, the CDC
recommends dual therapy even if only gonorrhea has been laboratory proven. Although the
number of resistant strains of gonorrhea has increased, that is not the reason for use of
combination antibiotic therapy. Dual therapy is prescribed to treat both gonorrhea and
chlamydia, because many clients with gonorrhea have a coexisting chlamydial infection. This
combination of antibiotics does not reduce the risk of reinfection or provide a faster cure.

The nurse is seeing a client who has a pelvic infection. The

client is upset and states, "I have been in a monogamous
sexual relationship for 5 years, how is this possible?" Which
questions should the nurse ask to be able to rule out sexual
transmission of this infection? Select all that apply.*

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"Do you have an intrauterine device inserted?"

"Have you and your partner ever discussed your sexual health histories?"

"Do you have Pap smears on a regular basis?"

"Did you have the human papillomavirus vaccination before you were 26 years
old?"

"Have you ever had cesarean birth?"

Correct answer

"Do you have an intrauterine device inserted?"

 "Have you and your partner ever discussed your sexual health histories?"

"Do you have Pap smears on a regular basis?"

"Did you have the human papillomavirus vaccination before you were 26 years
old?"

Feedback

Pelvic infection is caused most commonly by sexual transmission but also can occur with
invasive procedures, such as endometrial biopsy, surgical abortion, hysteroscopy, or insertion
of an intrauterine device. Discussing the sexual health history with her partner would help the
client determine if the infection has resulted from sexual intercourse with previous partners.
Having regular Pap smears helps in the prevention of pelvic infections because pathogens can
be identified through screening. Having the human papillomavirus vaccination protects
against being infected with human papillomavirus, a pathogen associated with pelvic
inflammatory disease. Having had a cesarean birth experience would not predispose the client
to pelvic inflammatory disease.

A client with suspected primary syphilis is to undergo

diagnostic testing. Which of the following would the nurse
expect to be done to confirm this diagnosis?*

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Direct identification in a specimen from the chancre lesion

Venereal Disease Research Laboratory (VDRL) test

Rapid plasma reagin circle card test (RPR-CT)

Fluorescent treponemal antibody absorption tests (FTA-ABS)

Feedback

The conclusive diagnosis of syphilis can be made by direct identification of the spirochete
obtained from the chancre lesions of primary syphilis. Serologic tests such as VDRl, RPR-CT,
and FTA-ABS are used in the diagnosis of secondary and tertiary syphilis.

The nurse educator is discussing emerging diseases with a

group of nurses. The educator should cite what causes of
emerging diseases? Select all that apply.*

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 Progressive weakening of human immune systems

Use of extended-spectrum antibiotics

Population movements

Increased global travel

Globalization of food supplies

Correct answer

Use of extended-spectrum antibiotics

Population movements

Increased global travel

Globalization of food supplies

Feedback

Many factors contribute to newly emerging or re-emerging infectious diseases. These include
travel, globalization of food supply and central processing of food, population growth,
increased urban crowding, population movements (e.g., those that result from war, famine, or
man-made or natural disasters), ecologic changes, human behavior (e.g., risky sexual
behavior, IV/injection drug use), antimicrobial resistance, and breakdown in public health
measures. Not noted is an overall decline in human immunity.

The clinical manifestations of primary syphilis can be

diagnostic. Select all the symptoms consistent with this
diagnosis.*

0/1

a rash spreads to the extremities by week 4

It occurs 2 to 3 weeks after initial inoculation with the organism

 the lesion resolves in 2 months.

a painless lesion forms at the site of infection

Correct answer

It occurs 2 to 3 weeks after initial inoculation with the organism

a painless lesion forms at the site of infection

the lesion resolves in 2 months.

Feedback

The presence of a rash occurs with secondary syphilis. Primary syphilis has no rash.

A nurse is caring for a client diagnosed with a chlamydia

infection. The nurse teaches the client about disease
transmission and advises the client to inform sexual partners
of the infection. The client refuses, stating, "This is my
business and I'm not telling anyone. Beside, chlamydia doesn't
cause any harm like the other STIs." How should the nurse
proceed? Select all that apply.*

1/1

Educate the client about why it's important to inform sexual contacts so they can
receive treatment.

Do nothing because the client's sexual habits place him at risk for contracting other
sexually transmitted infections.

Inform the client's sexual contacts of their possible exposure to chlamydia.

Continue to pressure the client for the sexual partner's contact information.

Inform the health department that this client contracted a chlamydia infection.

Feedback

Gonorrhea and chlamydia are reportable communicable diseases. The nurse should educate
the client about the disease and how it impacts a person's health. Further education allows
the client to make an informed decision about notifying sexual contacts. The department of
health should contact the sexual contacts, not the nurse. Doing nothing for the client is
judgmental; everyone is entitled to healthcare regardless of health habits.

The nurse is instructing a health class on the proper use of a

male condom. Place the steps of using a condom in the proper
order. Use all options. (a) Check the expiration date of the
condom. (b) Obtain an erection. (c) Unroll the condom over the
penis leaving a ½-inch space at the top. (d) Roll the condom up
to the tip of the penis pinching the top. (e) Dispose of the used
condom.*

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1b, 2a, 3c, 4d, 5e

1a, 2b, 3d, 4c, 5e

1a, 2c, 3b, 4d, 5e

1b, 2a, 3d, 4c, 5e

1a, 2b, 3c, 4d, 5e

Feedback

The correct method to use a male a condom is to begin by making sure that the condom is not
passed the expiration date. After the male obtains an erection, the user unrolls the condom
over the penis, leaving a ½-inch space at the top of the condom for the semen. After orgasm,
the user rolls the condom up to the tip of the penis, pinching the top where the semen is
contained. Then, the user disposes of the used condom.

The nurse educator is planning a health promotion class with a

focus on sexually transmitted infections. What points
regarding risk factors for chlamydia and gonorrhea should the
nurse educator include? Select all that apply.*

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“Young adults and teenagers are a high risk age group for both these infections.”
 “If you have been notified that you have these infections, you are obligated to
inform any past sexual partners.”

“Once treatment has been completed, reinfection with either of these infections is
not possible.”

“Women between 28 to 35 years of age are in a unique high risk category for both
these infections.”

“Your chances of contracting these infections are higher the more sexual partners
you have.”

Correct answer

“Your chances of contracting these infections are higher the more sexual partners
you have.”

“Young adults and teenagers are a high risk age group for both these infections.”

Feedback

Any sexually active person can be infected with chlamydia or gonorrhea, and the risk
increases with the number of sexual partners. The target group for preventive client teaching
about gonorrhea and chlamydia is the adolescent and young adult population. The group with
the greatest risk for chlamydia infection is young women 24 years of age and younger and
may be associated with a cervix that has not matured fully; therefore, it is incorrect that
women between the ages of 28 to 35 years are at higher risk. Retesting of woman 3 months’
posttreatment is recommended due to the possibility of reinfection. Although education for
men includes that they must inform their female partners of infection, informing sexual
contacts is not a risk factor for the infection.

The nurse is discussing information regarding the human

papilloma viral (HPV) infection. Which statement, made by the
client, requires clarification?*

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“HPV may be spread to a newborn at the time of delivery.”

“HPV transmission may occur when the client is asymptomatic.”

“HPV is spread during sexual intercourse.”

“HPV can be spread by autoinoculation.”

Correct answer

“HPV is spread during sexual intercourse.”

Feedback

The nurse would correctly clarify that sexual penetration is not necessary to transmit HPV;
the warts can also be spread by nonpenetrative sexual contact or autoinoculation. The other
options are correct statements.

When preparing a teaching presentation regarding

reproductive health in women, which points should the nurse
include when discussing the prevention of bacterial vaginosis?
Select all that apply.*

0/1

Choose clothing options that are loose around the genital area

Use douche after your monthly menses is complete

If you smoke, try to quit

Keep the frequency of your sexual activity balanced

Prevent unprotected sexual encounters

Correct answer

Choose clothing options that are loose around the genital area

If you smoke, try to quit

Keep the frequency of your sexual activity balanced

Prevent unprotected sexual encounters

Feedback

When providing information about the prevention of bacterial vaginosis, the nurse should tell
women to avoid wearing pants that are tight around the external genitalia. Wearing tight,
nonabsorbent, and heat- and moisture-retaining clothing promotes an environment that is
conducive to the overgrowth of the bacteria responsible for bacterial vaginosis. The nurse
should advise clients not to use douche, after the completion of menses or otherwise. Douche
interferes with the normally acidic pH of the vagina and increases the risk of bacterial
vaginosis. Additional risk factors for bacterial vaginosis include smoking, multiple sex
partners, other sexually transmitted infections, and increased sexual activity. Using condoms
reduces the risk of developing bacterial vaginosis. By teaching clients to keep sexual activity
balanced, the nurse is aiming to prevent the development of illness related to high frequency
of sexual activity. By teaching clients to prevent or avoid unprotected sexual encounters, the
nurse is emphasizing the need for protected sex including using condoms.

A patient has developed chickenpox and asks the nurse what

the incubation period would be. What should the nurse inform
the patient?*

1/1

It is 24 to 48 hours.

It is 2 to 3 days.

It is 7 to 10 days.

It is 10 to 21 days.

Feedback

The incubation period for varicella zoster, the virus that causes chickenpox, is about 2 weeks
(range, 10 to 21 days).

A client who has developed a painless penile ulcer is

diagnosed with syphilis. What treatment would physician
prescribe?*

1/1

IV penicillin G; single dose

IV penicillin G; multiple dosing

oral penicillin G; single dose

IV tetracycline

Feedback
This client has primary syphilis. A single dose of parenterally administered penicillin G is used
to treat primary and secondary syphilis.

The nurse is assessing a client who states having had

"unusual aches" in the muscles and joints. On physical
examination, the nurse notes the client has rough, reddish-
brown spots on the palms and the soles of the feet. The client
reports being infected with a "cold sore" from her partner 1
month ago. What should the nurse anticipate will be the next
step in this client's care?*

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A prescription for a nontreponemal test (NTT)

Administration of pain medication

A prescription for a topical antibiotic

Obtaining a culture from the rash covered areas

Feedback

The client' symptoms are consistent with syphilis. The rash of secondary syphilis occurs
about 2 to 8 weeks after the chancre and involves the trunk and the extremities, including the
palms of the hands and the soles of the feet. Transmission of the organism can occur through
contact with these lesions. Serological tests called nontreponemal or reagin tests, such as
the Venereal Disease Research Laboratory (VDRL) or the rapid plasma reagin used in the
diagnosis of secondary and tertiary syphilis require clinical correlation in interpretation. The
nurse should anticipate this diagnostic evaluation prior to planning further treatment and care
for this client. If the client is confirmed positive for infection with syphilis, the client will
require an injection of antibiotics, not topical. Obtaining a culture of the rash covered areas
will not help rule out syphilis. This is the gold standard for diagnosis for herpes simplex virus.
Although the client may benefit from pain medication, the nurse should anticipate diagnosis is
the priority for this client. Thus, a prescription for a diagnostic test would be paramount in the
client's care.

A nurse is assessing a client with vaginal discharge. The nurse

suspects bacterial vaginosis when the client states which of
the following?*

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"I noticed a strange fishy odor during my period."

 "I've been experiencing some really intense itching."

"The discharge looks almost like cottage cheese."

"The discharge is yellowish but thin."

Feedback

Bacterial vaginosis is characterized by a fishlike odor that is particularly noticeable after

sexual intercourse or during menstruation. Most clients do not experience local discomfort or
pain; more than one half of clients do not notice any symptoms. Intense itching is often
associated with candidiasis or trichomoniasis. A cottage-cheese like discharge is associated
with candidiasis. A thin, yellow discharge is most commonly noted with trichomoniasis.

A nurse practitioner was preparing a health education program

for freshmen college students. During orientation week, the
nurse mentioned that C. trachomatis and N. gonorrhoeae are
the two most common infections in sexually active young
women under the age of 25. The nurse told the students that
the most common finding for these infections is:*

0/1

Pelvic inflammatory disease.

Urinary tract infections.

Mucopurulent cervicitis.

Vaginitis.

Correct answer

Mucopurulent cervicitis.

Feedback

Although symptoms are usually “silent,” mucopurulent cervicitis with exudates in the
endocervical canal are diagnostic.
The nurse is instructing a client with herpes simplex virus type
2 (HSV-2) about self-care and precautions. Which instruction
would not be included in this client education session?*

0/1

Inform all potential sexual partners of the HSV infection even if it is in an inactive
state.

Keep lesions dry using alcohol, peroxide, witch hazel, and warm air from a hair
dryer.

Wear loose clothing that promotes air circulation about the genitals.

A condom does not need to be used during sexual activity if the disease is dormant.

Correct answer

A condom does not need to be used during sexual activity if the disease is dormant.

Feedback

A condom does need to be used during sexual activity even if the disease is dormant. Keep
lesions dry using alcohol, peroxide, witch hazel, and warm air from a hair dryer. Inform all
potential sexual partners of the HSV infection even if it is in an inactive state. Wear loose
clothing that promotes air circulation about the genitals.