Introduction to Sexually Transmitted Infections and Drugs to Treat Them

Every question here, with the answer

1. A client is prescribed doxycycline for chlamydia. Which instruction should the nurse include?

   1. You can stop once the discharge clears up.
   2. Take it with a glass of milk to protect your stomach.
   3. Take it together with your daily iron tablet.
   4. Avoid prolonged sun exposure and use sunscreen or protective clothing.

   Answer: Avoid prolonged sun exposure and use sunscreen or protective clothing.

   Doxycycline can cause sunburn, so clients should avoid prolonged sun and use sun protection. Calcium- and iron-containing products such as milk and iron tablets block its absorption, and all doses over 7 days must be taken to prevent treatment failure and resistance.

2. A client with genital herpes on daily suppressive valacyclovir says, 'Since I have no sores, I can't pass it to my partner.' What is the nurse's best response?

   1. The virus can still be shed without active lesions, so use condoms.
   2. Your partner should take your medication too.
   3. You only need condoms during the first week of treatment.
   4. That is correct, the medication cures the infection.

   Answer: The virus can still be shed without active lesions, so use condoms.

   Antivirals do not cure HSV, and viral shedding can occur even without active lesions, so barrier methods such as condoms are still needed. The medication is not curative, protection is not limited to the first week, and sharing the client's medication is not the teaching.

3. A client asks which condoms best protect against STIs. Which answer is correct?

   1. Latex or polyisoprene condoms.
   2. Condoms do not reduce STI risk.
   3. Lambskin condoms, because they are natural.
   4. Any type works the same.

   Answer: Latex or polyisoprene condoms.

   Clients should use latex or polyisoprene condoms because lambskin condoms are too porous to stop many organisms that cause STIs. Correct and consistent condom use does reduce the risk of transmission.

4. A nurse is preparing an intramuscular injection of ceftriaxone for a client with uncomplicated gonorrhea. Which action does the nurse take, as ordered, to reduce the main expected adverse effect?

   1. Give it as a continuous IV infusion.
   2. Split it into several daily injections.
   3. Mix the ceftriaxone with lidocaine.
   4. Give it with food.

   Answer: Mix the ceftriaxone with lidocaine.

   The main adverse effect of ceftriaxone for gonorrhea is pain at the injection site, which can be offset by mixing it with a local anesthetic such as lidocaine. It is given as a single intramuscular injection, so food, split doses or an infusion do not address the injection pain.

5. A client is being treated with metronidazole for trichomoniasis. Which teaching points should the nurse include? Select all that apply.

   1. Refrain from sexual activity while taking the medication.
   2. Stop the drug once symptoms improve.
   3. Your sexual partners should also be tested and treated.
   4. Avoid alcohol during treatment.
   5. A lambskin condom will protect your partner.

   Answer: Refrain from sexual activity while taking the medication., Your sexual partners should also be tested and treated., Avoid alcohol during treatment.

   Alcohol should be avoided with metronidazole, sexual activity should stop during treatment, and partners should be tested and treated to prevent reinfection. The whole course must be taken, and lambskin condoms are too porous to prevent many STIs.

6. A client is prescribed ciprofloxacin as an alternative treatment. Which products should the client avoid taking at the same time? Select all that apply.

   1. Multivitamins
   2. Water
   3. Milk
   4. Iron supplements
   5. Yogurt

   Answer: Multivitamins, Milk, Iron supplements, Yogurt

   Iron and calcium bind to ciprofloxacin and make it ineffective, so multivitamins, dairy products and iron-containing products should be avoided with the dose. Water does not interfere, and adequate hydration is encouraged.