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MULTIPLE CHOICE
1. 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
ANS: 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.
8. 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
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
ANS: 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.
11. 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
ANS: 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.
14. 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.
ANS: 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.
DIF: Cognitive Level: Analyze REF: pp. 147-148 TOP: Nursing Process:
Planning
MSC: Client Needs: Health Promotion and Maintenance
17. Group B Streptococcus (GBS) is part of the normal vaginal flora in 20% to
30% of healthy pregnant women. GBS has been associated with poor pregnancy
outcomes and is an important factor in neonatal morbidity and mortality. Which finding is
not a risk factor for neonatal GBS infection?
a. Positive prenatal culture
b. Preterm birth at 37 weeks or less of
gestation
c. Maternal temperature of 38 C or higher
d. Premature rupture of membranes (PROM)
24 hours or longer before the birth
ANS: D
PROM 18 hours or longer before the birth increases the risk for neonatal GBS infection.
Positive prenatal culture is a risk factor for neonatal GBS infection. Preterm birth at 37
weeks or less of gestation remains a risk factor for neonatal GBS infection. Maternal
temperature of 38 C or higher is also a risk factor for neonatal GBS infection.
18. Clients treated for syphilis with penicillin may experience a Jarisch-
Herxheimer reaction. Which clinical presentation would be unlikely if a client is
experiencing this reaction?
a. Vomiting and diarrhea
b. Headache, myalgias, and arthralgia
c. Preterm labor
d. Jarisch-Herxheimer in the first 24 hours
after treatment
ANS: A
The Jarisch-Herxheimer reaction is an acute febrile reaction that occurs within the first 24
hours of treatment and is accompanied by headache, myalgias, and arthralgia. Vomiting
and diarrhea are not anticipated. If the client is pregnant, then she is at risk for preterm
labor and birth.
19. The health history and physical examination cannot reliably identify all
persons infected with HIV or other blood-borne pathogens. Which infection control
practice should the nurse use when providing eye prophylaxis to a term newborn?
a. Wear gloves.
b. Wear mouth, nose, and eye protection.
c. Wear a mask.
d. Wash the hands after medication
administration.
ANS: A
Standard Precautions should be consistently used in the care of all persons. Personal
protective equipment in the form of gloves should be worn during infant eye prophylaxis,
care of the umbilical cord, circumcision site care, diaper changes, handling of colostrum,
and parenteral procedures. Masks are worn during respiratory isolation or if the health
care practitioner has a cough. Mouth, eye, and nose protection are used to protect the
mucous membranes if client-care activities are likely to generate splashes or sprays of
body fluids. The hands should be washed both before having contact with the client and
after administering medications.
20. The nurse providing care in a womens health care setting must be
knowledgeable about STIs. Which STIs can be successfully treated?
a. HSV
b. AIDS
c. Venereal warts
d. Chlamydia
ANS: D
The usual treatment for Chlamydia bacterial infection is doxycycline or azithromycin.
Concurrent treatment of all sexual partners is needed to prevent recurrence. No known
cure is available for HSV; therefore, the treatment focuses on pain relief and preventing
secondary infections. Because no cure is known for AIDS, prevention and early detection
are the primary focus of care management. HPV causes condylomata acuminata (venereal
warts); no available treatment eradicates the virus.
MULTIPLE RESPONSE
2. Which statements regarding the HPV are accurate? (Select all that apply.)
HPV infections:
a. are thought to be less common in pregnant
women than in women who are not
pregnant.
b. are thought to be more common in
pregnant women than in women who are
not pregnant.
c. were previously called genital warts.
d. were previously called herpes.
e. may cause cancer.
ANS: B, C, E
HPV infections are thought to be more common in pregnant women than in women who
are not pregnant, with an increase in incidence from the first trimester to the third
trimester. HPV, formerly called venereal or genital warts, is an STI with more than 30
known serotypes, several of which are associated with cervical cancer.
5. The nurse should be familiar with the use of the five Ps as a tool for
evaluating risk behaviors for STIs and the HIV. Which components would the nurse
include in her use of the five Ps as an assessment tool? (Select all that apply.)
a. Number of partners
b. Level of physical activity
c. Prevention of pregnancy
d. Protection from STIs
e. Past history
ANS: A, C, D, E
Level of physical activity is not a component of this assessment. The five Ps include
partners, prevention of pregnancy, protection from STIs, understanding of sexual
practices, and past history.