Chapter 57: Sexually Transmitted Infections

A woman is diagnosed with bacterial vaginosis and will begin taking metronidazole

(Flagyl).What will the nurse teach the patient about this medication?

a. "Abstain from sexual intercourse while taking this medication."

b. "Do not consume alcohol while taking this drug and for 48 hours after

finishingthe prescription."

c. "Take this medication on an empty stomach to increase absorption."

d. "Topical preparations are ineffective for treating bacterial vaginosis."

ANS: B

Metronidazole can cause a disulfiram-like reaction when taken with alcohol, so

patients shouldbe cautioned against using foods or drug products that contain

alcohol. There is no need to abstain from sexual intercourse. Metronidazole should be

taken with food. The topical preparation is effective against bacterial vaginosis

The nurse is speaking with the parent of an 11-year-old girl that is considering

vaccination forhuman papillomavirus (HPV). Which of the following statements is

NOT correct?

a. "HPV infections cause most cervical, vaginal and oropharyngeal cancers."

b. "Pap tests can detect cervical dysplasia, which can be a precursor to

cervicalcancer if left untreated."

c. "There are several HPV vaccines available in the US."

d. "HPV infection is uncommon."

ANS: D

HPV infection is common, with most sexually active persons becoming infected at some

point intheir lifetime

A patient is taking azithromycin to treat a chancroid infection. Which of the following

would beimportant counseling to the patient?

a. Apply a bacteriostatic ointment to the lesions twice daily.

b. Avoid washing the lesions to prevent spread of the infection.

c. Cover the lesions with gauze at all times to minimize discomfort.

d. Any sexual partners within the 10 days preceding the onset of symptoms

should beexamined and treated

ANS: D

Sex partners of patients who have chancroid should be examined and treated if they

had sexualcontact with the patient during the 10 days preceding the patient's onset of

symptoms. It is not necessary to apply bacteriostatic ointment or to cover the lesions

with gauze. Washing the lesions is recommended.

A nursing student encounters a patient newly diagnosed with uncomplicated

gonorrhea. Thestudents' preceptor asks what the recommended treatment would

be for this patient. Which statement by the nursing student is correct?

a. "Ceftriaxone IM as a single dose is prescribed."

b. "Erythromycin ointment is prescribed."

c. "IM ceftriaxone and oral azithromycin are prescribed."

d. "Oral doxycycline is prescribed.

ANS: A

Due to developing resistance to azithromycin, in uncomplicated N. gonorrhea in

adolescents andadults, two-drug therapy is no longer recommended. Treatment of

uncomplicated N. gonorrhea should be with ceftriaxone 500 mg IM as a single dose.

Treatment of co-infection with Chlamydia trachomatis, or when Chlamydia is not

excluded, should be with oral doxycycline 100 mg twice a day for seven days.

Which of the following is considered the most common STI in young adults in the United

States?

a. HIV

b. Gonorrhea

c. Chlamydia

d. Genital herpes

ANS: C

Chlamydia trachomatis is the most common STI in the United States in young

adults. Thisinfection is most often asymptomatic

A woman is diagnosed with herpes simplex virus (genital herpes). Which

statement by thepatient indicates understanding of the medication regimen?

a. "Antiviral drugs can help with my outbreaks and symptoms, but will not

cure mygenital herpes."

b. "I take my medication as prescribed I will not have any more outbreaks."

c. "If I stay on my medication after my current outbreak resolves I won't

have anymore episodes."

d. "I can use the medications once a month to treat symptoms."

ANS: A

Suppressive therapy reduces the frequency of genital herpes recurrences by 70% to

80% in thosewho have frequent recurrences. Systemic antiviral drugs can control some

of the signs and symptoms of genital herpes, but these do not cure herpes. Outbreaks

occur even while on antiviral medication, and transmission can occur when patients are

asymptomatic. Episodic treatment, to be effective, should begin within 1 day of lesion

onset or during the prodrome period, not a given week each month

A woman with complaints of abnormal vaginal discharge, vaginal soreness, pruritus,

and dysuriais diagnosed with vulvovaginal candidiasis (VVC). Which statement will the

nurse include in teaching?

a. "Treatment with prescription medication is lifelong."

b. "Alcohol should be avoided during treatment."

c. "Candida albicans can be readily passed between sex partners."

d. "Over the counter cream can be used to treat the condition."

ANS: D

Over the counter or prescribed medications can be used to treat the condition;

treatment is episodic. The medications do not interact with alcohol.

Uncomplicated VVC is not usually acquired through sexual intercourse, thus

treatment of sexual partners is not necessary.