ATI LPN
Lewis's Medical Surgical Nursing in Canada, 5th Edition
Chapter 55 Questions
Question 1 of 5
The nurse is assessing a patient at the community clinic who has a long history of IV drug use and reports difficulty walking because 'I don't know where my feet are.' Diagnostic screening reveals positive Venereal Disease Research Laboratory (VDRL) and fluorescent treponemal antibody absorption (FTA-ABS) tests. Which of the following assessments should the nurse implement based on the patient history?
Correct Answer: A,D,E
Rationale: The patient's clinical manifestations and laboratory tests are consistent with late (tertiary) syphilis; valvular insufficiency, gummas, and changes in mentation are other clinical manifestations of this stage therefore the nurse will assess heart sounds, mental state and the integument system.
Question 2 of 5
A patient is treated for chlamydia that was detected during a routine pelvic examination. Which of the following patient statements indicate that teaching regarding the management of the condition has been effective?
Correct Answer: B
Rationale: Sex partners should be treated simultaneously to prevent reinfection. Chlamydia is treated with oral antibiotics. Abstinence from sexual intercourse is recommended for 7 days after treatment, and condoms should be recommended during all sexual contacts to prevent infection. Persistent pelvic pain, as well as infertility, can result from untreated chlamydia.
Question 3 of 5
A patient with gonorrhea is treated with a single IM dose of ceftrixaone and is given a prescription for doxyeycline $100 \mathrm{mg}$ bid for 7 days. Which of the following explanations should the nurse tell the patient about this combination of antibiotics?
Correct Answer: B
Rationale: Because there is a high incidence of co-infection with gonorrhea and chlamydia, patients are usually treated for both. The other explanations about the purpose of the antibiotic combination are not accurate.
Question 4 of 5
The nurse is caring for a patient who is 6 weeks' pregnant and is diagnosed with primary syphilis. Which of the following information should the nurse plan to discuss with the patient?
Correct Answer: C
Rationale: In pregnant women with syphilis, penicillin G benzathine, 2.4 million Units by intramuscular route weekly for 1-3 doses is administered, depending on the stage of syphilis. Treatment administered in the second half of pregnancy may pose a risk of premature labour and fetal distress. Instillation of enythromycin into the eyes of the newborn is used to prevent gonorheal eye infections. C-section is used to prevent the transmission of herpes to the newborn. Although stillbirth can occur if the fetus is infected with syphilis, treatment before the tenth week of gestation will eliminate in utero transmission to the fetus.
Question 5 of 5
The nurse is assessing a male patient who has a profuse, purulent urethral discharge with painful urination. Which of the following information is most important for the nurse to obtain?
Correct Answer: D
Rationale: Information about sexual contacts is needed to help establish whether the patient has been exposed to an STI and because sexual contacts will also need treatment. The other information may also be gathered but is not as important in determining the plan of care for the patient's current symptoms.