The nurse is caring for a client who tests positive for gonorrhea. The client reports having had prior sexually transmitted infections (STIs). Which response should the nurse provide?

Urge the client to have regular STI screening every two years.

Answer questions directly and correct any misinformation.

Clarify that all STIs are transmitted through sexual intercourse.

Provide counseling that most contraceptives protect against infection.

Answer and Explanation

The Correct Answer is B

A. Urge the client to have regular STI screening every two years: Screening every two years is insufficient for individuals with recurrent STIs. More frequent testing is recommended to prevent reinfection and detect new infections early.

B. Answer questions directly and correct any misinformation: Providing accurate, evidence-based information helps the client understand STI transmission, prevention, and treatment. Direct responses foster trust, support informed decision-making, and address misconceptions effectively.

C. Clarify that all STIs are transmitted through sexual intercourse: Not all STIs are transmitted solely through intercourse; some, like herpes or HPV, can be transmitted via skin-to-skin contact. This statement could be misleading and does not fully educate the client.

D. Provide counseling that most contraceptives protect against infection: Most contraceptives, such as oral contraceptives or IUDs, do not protect against STIs. Only barrier methods, like condoms, reduce the risk of STI transmission.

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Correct Answer is A

Explanation

A. Provide a bedside commode for toileting: Minimizing physical exertion helps reduce cardiac workload in a client with heart failure. Providing a bedside commode decreases the need for frequent trips to the bathroom, conserving energy and reducing strain on the heart.

B. Assist with ambulation in the hallway: While ambulation promotes circulation and prevents complications of immobility, it increases oxygen demand and cardiac workload, which may not be safe for a client with acute heart failure.

C. Teach to sleep in a side-lying position: Side-lying may improve comfort but does not significantly impact cardiac workload or oxygen consumption compared with upright or semi-Fowler positions that promote easier breathing.

D. Encourage active range of motion exercises: Active exercises increase metabolic demand and cardiac workload. Although beneficial long-term, they should be limited during acute illness to prevent overexertion and exacerbation of heart failure.

Correct Answer is []

Explanation

Rationale for Correct Choices:

• Extrapyramidal reaction: The client exhibits muscle stiffness, constant leg shaking, forward-backward rocking, and abnormal head positioning, all of which are hallmark signs of extrapyramidal symptoms (EPS) often caused by antipsychotic medications like haloperidol and chlorpromazine. Recognizing EPS early prevents further complications such as severe dystonia or Parkinsonism.

• Initiate one-on-one observation: Continuous observation is essential to ensure client safety, particularly due to agitation, abnormal movements, and risk of injury from dystonia or uncontrolled motor activity, which can be exacerbated in psychiatric patients on antipsychotics.

• Education on administration and side effects of haloperidol: Teaching the client and caregivers about haloperidol’s potential side effects, including EPS, akathisia, and tardive dyskinesia, enhances adherence, promotes early reporting of adverse effects, and supports safe medication management.

• Gait and muscle strength: Monitoring gait and muscle strength allows the nurse to track the severity and progression of extrapyramidal symptoms, assess mobility limitations, and evaluate the effectiveness of interventions like anticholinergic medications or dosage adjustments.

• Improvement in symptoms: Observing improvement in EPS or agitation provides measurable evidence that interventions are effective, guiding ongoing care and any necessary modifications to therapy or dosing.

Rationale for Incorrect Choices:

• Mucositis: Mucositis involves inflammation and ulceration of the mucous membranes, typically related to chemotherapy or radiation therapy, and is not consistent with this client’s current presentation of abnormal motor activity and psychiatric symptoms.

•Hypertensive crisis: The client’s blood pressure is within a normal to mildly elevated range, and there are no signs of acute end-organ damage, so hypertensive crisis is unlikely in this scenario.

• Parkinson’s Disease: Parkinsonism is a chronic neurodegenerative disorder characterized by resting tremor, bradykinesia, and rigidity, not acute onset EPS triggered by antipsychotic use in a young adult with schizophrenia.

• Institute oral hygiene to prevent candidiasis: Oral hygiene is generally important but does not address the acute neurological side effects of antipsychotic medications, making it nonessential for EPS management.

• Immediate dietician consult: While nutrition is important, it is not immediately relevant for extrapyramidal symptoms and does not address the urgent motor complications caused by antipsychotics.

• Administer antihypertensive: The client’s blood pressure is not critically elevated, and there are no indications of hypertensive emergency, so antihypertensive therapy is unnecessary.

• Blood pressure: Monitoring blood pressure is routine but not directly related to tracking extrapyramidal symptoms or response to antipsychotic therapy in this case.

• Swallowing: While dysphagia can occur in severe EPS, this client does not currently present with swallowing difficulties, making it less critical to monitor compared to gait and muscle strength.

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The nurse is caring for a client who tests positive for gonorrhea. The client reports having had prior sexually transmitted infections (STIs). Which response should the nurse provide?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is A

Explanation

Correct Answer is []

Explanation

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