A nurse instructor is teaching a student nurse about the factors that have increased the number of ...

The answer to question 1

ANS: D
There is no evidence that the organisms that cause STDs are becoming more virulent, but a client may need to use another anti-infective if allergic or the protocol was not effective. Extensive histories are taken in the clinic of clients of all ages, as well as assessment of laboratory data such as cervical, urethral, oral, or rectal specimens and lesion samples for microbiology and virology. There are changes in sexual attitudes and practices, cultural factors, migration, and international travel. Women often think that the oral contraceptives protect them from an STD.

The answer to question 2

ANS: B
Benzathine penicillin G is the evidence-based treatment for primary syphilis. The client needs to be assessed for allergies before treatment. The other questions would be helpful in the client's history of sexually transmitted diseases but not as important as knowing whether the client is allergic to penicillin.

The answer to question 3

ANS: A, B, C, D
Common routine monitoring for this population includes lipid and liver panels, mammograms if any breast tissue is present, and PSA for natal males as the prostate is not removed during a vaginoplasty/penectomy. Renal profiles are not required based on treatment options for this population.

The answer to question 4

ANS: A, B, D
Complications from phalloplasty include infection or scarring of the donor site, necrosis, and stenosis of the urinary tract. Rectal perforation can occur with vaginoplasty, as can infections.

The answer to question 5

ANS: D
Self-care management for this client includes instructions to dilate the new vagina several times a day for months after the procedure, using water-based lubricant. The client also needs to douche regularly, especially after intercourse, to avoid infections. Sexual intercourse is another way to keep the vagina dilated.

The answer to question 6

ANS: A, B, C
Gender dysphoria is emotional distress caused by the incongruence between natal sex (sex assigned at birth) and gender identity. Gender queer is a label sometimes used by people whose gender identity does not fit the established categories of male or female. Natal sex describes the gender a person is born with or is assigned to at birth. Transgender is an adjective to describe a person who crosses or transcends culturally defined categories of gender. Transition is the period of time when transgender individuals change from the gender role associated with their sex to a different gender role.

All are right