A 46-year-old man who has had blood drawn for an insurance ...

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A 46-year-old man who has had blood drawn for an insurance screening has a positive Venereal Disease Research Laboratory (VDRL) test. Which action should the nurse take next?
 
  a. Ask the patient about past treatment for syphilis.
  b. Explain the need for blood and spinal fluid cultures.
  c. Obtain a specimen for fluorescent treponemal antibody absorption (FAT-Abs) testing.
  d. Assess for the presence of chancres, flulike symptoms, or a bilateral rash on the trunk.

Question 2

A 32-year-old man who has a profuse, purulent urethral discharge with painful urination is seen at the clinic. Which information will be most important for the nurse to obtain?
 
  a. Contraceptive use
  b. Sexual orientation
  c. Immunization history
  d. Recent sexual contacts

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Answer to Question 1

ANS: A
Once antibody testing is positive for syphilis, the antibodies remain present for an indefinite period of time even after successful treatment, so the nurse should inquire about previous treatment before doing other assessments or testing. Culture, FAT-Abs testing, and assessment for symptoms may be appropriate, based on whether the patient has been previously treated for syphilis.

Answer to Question 2

ANS: D
Information about sexual contacts is needed to help establish whether the patient has been exposed to a sexually transmitted infection (STI) and because sexual contacts also will need treatment. The other information also may be gathered but is not as important in determining the plan of care for the patient's current symptoms.