A 55-year-old woman in the sexually transmitted infection (STI) clinic tells the nurse that she is concerned she may have been exposed to gonorrhea by her partner. To determine whether the patient has gonorrhea, the nurse will plan to
a. interview the patient about symptoms of gonorrhea.
b. take a sample of cervical discharge for Gram staining.
c. draw a blood specimen or rapid plasma reagin (RPR) testing.
d. obtain secretions for a nucleic acid amplification test (NAAT).
ANS: D
NAAT has a high sensitivity (similar to a culture) for gonorrhea. Because women have few symptoms of gonorrhea, asking the patient about symptoms may not be helpful in making a diagnosis. Smears and Gram staining are not useful because the female genitourinary tract has many normal flora that resemble N. gonorrhoeae. RPR testing is used to detect syphilis.
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The nurse reviews the health record of a client with melasma. The nurse would anticipate that this client will exhibit:
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