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.
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.
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