The nurse is caring for a client who tests positive for the sexually transmitted infection (STI) gonorrhea. The client reports having sex with someone who has many partners. Which response should the nurse provide?
Emphasize that using safe sex practices removes the risk of STIs.
Clarify that all STIs are transmitted through sexual intercourse.
Discuss that partners without similar symptoms may not be infected.
Teach the importance of medication regimen and follow-up protocol.
The Correct Answer is D
A. While safe sex practices can reduce the risk of STIs, they do not eliminate the risk entirely, especially in cases where partners have multiple sexual partners.
B. Not all STIs are transmitted solely through sexual intercourse; some can be transmitted through other means, making this statement overly simplistic.
C. It's important to note that asymptomatic individuals can still be carriers of STIs, so this statement may give a false sense of security.
D. Teaching the importance of adhering to the medication regimen and ensuring follow-up appointments is critical in managing gonorrhea effectively and preventing complications or reinfection. This approach emphasizes the importance of treatment compliance and ongoing health management.
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Correct Answer is C
Explanation
A. A nursing care plan in the medical record before assessing the patient so that the nurse can identify priorities. The nurse should assess the patient first to determine their needs and priorities rather than create a care plan without assessment.
B. At least three times during the shift: at the beginning, in the middle, at the end, and as needed. Regular documentation is good practice, but the initial assessment must be documented at the beginning of the shift to establish a baseline.
C. An initial assessment of the patient and a plan based on the needs of the patient as assessed at the beginning of the shift. Documenting an initial assessment is crucial for identifying immediate needs and planning care, especially after surgery.
D. At the end of the shift so that the nurse can give full attention to the patient's needs during the shift. Waiting until the end of the shift risks missing critical changes and does not provide a clear baseline assessment.
Correct Answer is D
Explanation
A. Joint pain is a common symptom of systemic lupus erythematosus (SLE) and, while it may indicate an exacerbation of the disease, it is not the most critical finding to report.
B. A low-grade fever can signify an infection or increased disease activity but is generally not as urgent as changes in renal function or systemic involvement.
C. Muscle atrophy is a concern over time but does not pose an immediate threat to the client’s health compared to acute changes in kidney function.
D. Hematuria is significant in SLE as it can indicate renal involvement, such as lupus nephritis, which can lead to severe complications. This finding requires prompt reporting and assessment to prevent further renal damage and manage potential complications effectively.