NURS 317 Unit 4 Chapter 46 Path Point Questions Flashcards
What are the central nervous symptoms associated with tertiary stage syphilis? Select all that apply.
A) Deafness
B) Seizures
C) Ataxia
D) Blindness
E) Dementia
C) Ataxia
D) Blindness
E) Dementia
Rationale:Central nervous system lesions can produce dementia, blindness, or injury to the spinal cord, with ataxia and sensory loss. Neither deafness nor seizures are associated with this stage of progression.
When is syphilis highly contagious?
A) After the characteristic rash disappears
B) During its primary stage
C) When gummas lesions are observable
E) Years 3 to 5 of its latent stage
B) During its primary stage
Rationale:The infection is highly contagious during its primary stage, but because the symptoms are mild, it frequently goes unnoticed. The other options are not necessarily indicators of a highly contagious period.
When counseling a client who is 3 months’ pregnant and who recently went on a vacation to South America where she received several mosquito bites, the biggest complication the provider should prepare her for is delivering a child with which type(s) of defect? Select all that apply.
A) Eye concerns
B) Hearing problems
C) Spina bifida
D) Bilateral hip dysplasia
E) Microcephaly
A) Eye concerns
B) Hearing problems
E) Microcephaly
Rationale:Zika virus show few symptoms. If the woman is infected by Zika during prenancy, severe birth defects can occur, such as microcephaly, brain defects, hearing and eye defects, and impaired growth. Spina bifida is a birth defect that occurs when the spine and spinal cord do not form properly. It falls under the broader category of neural tube defects. The neural tube is the embryonic structure that eventually develops into the infant’s brain and spinal cord and the tissues that enclose them. A folic acid deficiency during pregnancy also plays a significant role. Hip dysplasia is the medical term for a hip socket that does not fully cover the ball portion of the upper thighbone. This allows the hip joint to become partially or completely dislocated. It is not known to be associated with Zika virus infection.
A nurse is caring for a client in whom genital herpes is being ruled out. Which information helps to confirm the diagnosis? Select all that apply.
A) Painful lesions
B) Pustules
C) Pain on urination
D) Positive urine culture
E) Itching
A) Painful lesions
B) Pustules
C) Pain on urination
E) Itching
Rationale:Symptoms of primary genital herpes infection include pain on urination, pustules, painful lesions, and itching. Tingling and pain in the genital area are also possible with urinary retention. Positive urine cultures do not help to diagnose this condition.
A nurse is interviewing a client about issues with infertility. Which condition contributes to the risk of infertility in both men and women?
A) Trichomoniasis
B) Herpes simplex
C) Genital warts
D) Chancroid
A) Trichomoniasis
Rationale:Trichomoniasis increases the risk of infertility in women because the trichomonads serve as vectors for the spread of pathogens into the fallopian tubes. In men it contributes to decreased mobility and viability of sperm. The others do not have the same risks for infertility.
A older female client has developed some central nervous system symptoms not usually common in her family history. After months of no improvement, the provider ordered blood panels that returned as positive for syphilis. Having been married for decades, the provider suspects tertiary syphilis based on which finding(s)? Select all that apply.
A) Lack of voluntary coordination resulting in gait abnormality
B) Slowly progressing dementia
C) Enlarged cervical lymph nodes
D) Gradual loss of sight
E) Kidney stone development
A) Lack of voluntary coordination resulting in gait abnormality
B) Slowly progressing dementia
D) Gradual loss of sight
Rationale:Symptoms of central nervous system lesions of teritary syphilis include dementia, blindness, or injury to the spinal cord with ataxia (lack of voluntary coordination of muscle movements that can include gait abnormality) and sensory loss. It is not associated with kidney stone development or cervical lymph node enlargement.
Which clients would the nurse determine are at increased risk of infection with gonorrhea? Select all that apply.
A) The client who married late in life
B) The client with multiple sexual partners
C) The client who is younger than 25 years of age
D) The client who does not use condoms
E) The client who has constant urinary tract pain
B) The client with multiple sexual partners
C) The client who is younger than 25 years of age
D) The client who does not use condoms
Rationale:Clients who are identified as being at increased risk of infection include those who are 25 and under, have multiple sexual partners, and do not use condoms. Clients who marry late in life or have constant urinary tract pain are not documented to be at increased risk.
The nurse should assess a client with a history of untreated chlamydia for which potential disease process?
A) Cervical cancer
B) Reiter syndrome
C) Early-onset dementia
D) HIV encephalopathy
B) Reiter syndrome
Rationale:Reiter syndrome, a reactive arthritis that includes the triad of urethritis, conjunctivitis, and painless mucocutaneous lesions, is a complication of an untreated chlamydial infection. The remaining options are not related to chlamydial infection.
For a woman, what is the most serious long-term outcome of an infection resulting from exposure to the N. gonorrhoeae bacteria?
A) Dysuria
B) Postcoital bleeding
C) Sterility
D) Bartholin gland abscesses
C) Sterility
Rationale:There may be infections of the uterus and development of acute or chronic infection of the fallopian tubes (i.e., salpingitis), with ultimate scarring and sterility. The other options are less serious in nature.
Laboratory analysis of vaginal discharge identifies hyphae on microscopic exam and pH of 4.2. The client most likely has:
A) N. gonorrhoeae
B) C. trachomatis
C) C. albicans
D) T. vaginalis
C) C. albicans
Rationale:Candida albicans has a definitive morphology under the microscope of budding yeast filaments (hyphae) and a low pH.
What is the primary reason that the nurse urges clients to be seen by their health care provider when they have genital warts?
A) To have an MRI to screen for other conditions
B) To be informed of the risk of premalignant and malignant changes
C) To receive intravenous antibiotics
D) To be informed of the chance of transmitting to others
B) To be informed of the risk of premalignant and malignant changes
Rationale:The association with premalignant and malignant changes has increased concern regarding the diagnosis and treatment of this viral infection. Intravenous antibiotics are not used to treat viruses. The client does not have to see the health care provider to be told that they have a risk of transmitting this condition to others. There are several pharmacologic treatments for symptomatic removal of visible genital warts, and cryotherapy is one of them.
Which condition is associated with domelike lesions on both the inner thighs and vaginal area that produce a curdlike exudate?
A) Chancroid
B) Molluscum contagiosum
C) Genital herpes
D) Genital warts
B) Molluscum contagiosum
Rationale:The lesions described with the curdlike exudate fits the description of molluscum contagiosum lesions. None of the remaining options present with a curdlike exudate.
Select the treatment of choice for syphilis.
A) UV radiation to the genital area
B) Long-acting penicillin in a single injection
C) Oral amoxicillin for 10 days
D) Topical clotrimazole cream
B) Long-acting penicillin in a single injection
Rationale:The treatment of choice for syphilis is penicillin. Because of the spirochetes’ long generation time, effective tissue levels of penicillin must be maintained for several weeks. Long-acting injectable forms of penicillin are used.
The public health nurse is presenting a program on the prevalence of STIs. Which information should be included in the presentation? Select all that apply.
A) STIs may be asymptomatic.
B) Partners of infected persons are easy to find and treat.
C) Condoms do not prevent the spread of STIs.
D) Drugs can manage infections but do not control the spread.
E) STIs are only bacterial.
A) STIs may be asymptomatic
D) Drugs can manage infections but do not control the spread.
Rationale:Many factors contribute to the increased prevalence and the continued spread of STIs. STIs are frequently asymptomati. Partners of infected persons are often difficult to notify and treat. Condoms could prevent the spread of many STIs, but they often are not used or are used improperly. In addition, there currently are no cures for viral STIs; although there are drugs available that may help to manage the infections, they do not entirely control the spread. Also, drug-resistant microorganisms are rapidly emerging, making treatment of many STIs more difficult.
A client has been diagnosed with a chlamydial infection. Select the pharmacologic treatment of choice.
A) Ceclor
B) Azithromycin
C) Bactrim
D) Acyclovir
B) Azithromycin
Rationale:The CDC recommends the use of azithromycin or doxycycline in the treatment of chlamydial infection; penicillin is ineffective. Azithromycin or amoxicillin is the preferred choice in pregnancy.
