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STI/STD NCLEX Review Questions – COMPREHENSIVE

Test your knowledge of sexually transmitted infections (STIs) with this NCLEX-style quiz designed for nursing students and healthcare learners. These questions cover essential concepts such as screening guidelines, modes of transmission, hallmark signs and symptoms, staging of infections like syphilis, and first-line treatments for common STIs.

This quiz covers the following sexually transmitted infections (STIs):

  • Gonorrhea
  • Chlamydia
  • Syphilis
  • Trichomoniasis
  • Herpes Simplex Virus (HSV-1 and HSV-2)
  • Human Papillomavirus (HPV)
  • Hepatitis B (HBV)
  • Human Immunodeficiency Virus (HIV)

Sexually Transmitted Infections/Diseases (STI/STD) NCLEX Review Questions

1. You're providing education to a sexually active female patient who is 20 years old. According to the latest CDC guidelines, which statement by the patient indicates an understanding of when to undergo screening for gonorrhea?(Required)
2. Which signs and symptoms do NOT typically present with gonorrhea? Select all that apply:(Required)
3. A patient was diagnosed with syphilis approximately 3 weeks after engaging in sexual activity. They have a painless chancre on their genital region. What stage of syphilis is consistent with these findings?(Required)
4. As the nurse, you are providing education to a patient on how syphilis is transmitted. Which statement below is INCORRECT regarding the transmission of syphilis?(Required)
5. Which teaching point will the nurse PRIORITIZE regarding sexual partners of a patient who just received positive test results for chlamydia?(Required)
6. Select all the statements that accurately reflect the current CDC guidelines for screening patients for chlamydia?(Required)
7. Which sign/symptom would the nurse NOT expect to find in a female patient with trichomoniasis?(Required)
8. A patient is diagnosed with trichomoniasis. Which medication should the nurse anticipate as the first-line treatment?(Required)
9. A new mother has an active oral herpes (HSV-1) outbreak. Which steps should the patient take to prevent transmission to her newborn? Select all that apply.(Required)
10. Which of the following is not a typical way herpes simplex virus (HSV) is spread?(Required)
11. The nurse is educating a patient about genital warts. Which route of transmission should the nurse emphasize as a risk?(Required)
12. Which types of HPV is known to cause cervical cancer? Select all that apply:(Required)
13. The nurse is educating a parent about the HPV vaccine for their child. How many doses does the child need, and at what ages are they recommended?(Required)
14. Genital warts are caused by which of the following?(Required)
15. A 26-year-old patient has never been tested for hepatitis B. A triple panel is recommended. The nurse knows this panel includes which tests? (Select all that apply)(Required)
16. A patient who has never been infected with hepatitis B has been vaccinated. Which blood test would confirm immunity to the virus?(Required)
17. A patient receives a test result that is negative for total anti-HBc. How does the nurse interpret this result?(Required)
18. Fill in the blank: The childhood vaccine schedule recommends ____ doses of the hepatitis B vaccine given at _______________.(Required)
19. The Human Immunodeficiency Virus (HIV) mainly attacks what type of cells in the human body?(Required)
20. A patient with AIDS has dark purplish brown lesions on the mucus membranes of the mouth. As the nurse you know these lesions correlate with what type of opportunistic disease?(Required)
21. A 25-year-old patient reports that they engage in high risk activities that could lead to an HIV infection. The patient’s test results show the patient is HIV-negative. The nurse should provide the patient with education about?(Required)
22. The Human Immunodeficiency Virus (HIV) can NOT be spread in what type of fluid below? Select all that apply:(Required)

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Sexually Transmitted Infections/Diseases (STI/STD) NCLEX Review Questions

  1. You’re providing education to a sexually active female patient who is 20 years old. According to the latest CDC guidelines, which statement by the patient indicates an understanding of when to undergo screening for gonorrhea?

A. “I will get screened every 3 years.”
B. “I will get annual screening until I’m 25 and then depending on my risk factors I may not need to be screen annually.”
C. “I only need screening if I have signs and symptoms.”
D. “Screening is not recommended until I’m 25”.

The answer is B. The CDC recommends annual screening for sexually active patients under 25 years of age. For those older than 25, only high-risk patients should be screened regularly.

  1. Which signs and symptoms do NOT typically present with gonorrhea? Select all that apply:

A. chancre
B. tender testicles
C. thick, greenish/yellowish discharge
D. cauliflower-like warty growths
E. erythema and swelling of the affected area

The answers are A and D. Chancre (syphilis) and cauliflower-like warty growths (genital warts HPV) are associated with syphilis and genital warts (HPV), not gonorrhea. The typical signs and symptoms of gonorrhea include tender testicles, abnormal discharge, painful urination, pelvic inflammatory disease, lack of symptoms (especially in women) and erythema with swelling in the genital, throat, or anal areas.

  1. A patient was diagnosed with syphilis approximately 3 weeks after engaging in sexual activity. They have a painless chancre on their genital region. What stage of syphilis is consistent with these findings?

A. Primary stage syphilis
B. Secondary stage syphilis
C. Latent state syphilis
D. Tertiary state syphilis

The answer is A: primary stage syphilis. This stage typically begins around 3 weeks after initial exposure to an infected chancre of a person with syphilis. It can last up to 6 weeks and is highly contagious during this stage. The secondary stage occurs 6-12 weeks after the primary stage. The latent state can last for years with no symptoms, and the tertiary stage usually occurs 10-30 years after the initial infection.

  1. As the nurse, you are providing education to a patient on how syphilis is transmitted. Which statement below is INCORRECT regarding the transmission of syphilis?

A. Syphilis is transmitted sexually via direct contact with chancres (sores), which appear on the genitals, mouth, anus, or mucous membranes.
B. Syphilis is transmitted from mother to baby during pregnancy if there is direct contact with chancres.
C. The patient should inform any sexual partners so they can be tested and treated (if necessary).
D. It is safe to resume sexual activity as soon as treatment begins.

The answer is D. This is the incorrect statement about the transmission of syphilis. Sexual activity should cease until treatment is complete, the infection has completely cleared, and there are no more signs and symptoms.

  1. Which teach point will the nurse PRIORITIZE regarding sexual partners of patient who just received positive test results for chlamydia?

A. “Partners only need to wear a condom during intercourse while you are taking the treatment.”
B. “Partners need to immediately be tested and treated.”
C. “Partners should be immediately tested if they have symptoms.”
D. “Avoid sexual activity when symptoms are present.”

The answer is B: The priority teaching point for a patient with chlamydia is that all recent sexual partners should be tested and treated as soon as possible, regardless of whether they have symptoms. This prevents reinfection and further spread of the disease. Most people with chlamydia are asymptomatic, so waiting for symptoms (option C) puts others at risk. Option A is incorrect because condom use during treatment does not prevent reinfection if a partner is already infected. Option D is misleading, as chlamydia can be transmitted even in the absence of symptoms. Prompt testing and treatment of partners is critical for effective infection control.

  1. Select all the statements that accurately reflect the current CDC guidelines for screening patients for chlamydia?

A. “Only high risk sexually active patients should be screened.”
B. “All sexually active women 35 or older and high risk should be screened annually.”
C. “All sexually active women 25 or under should be screened yearly.”
D. “All pregnant women should be screened at first prenatal visit.”
E. “Pregnant women 25 or under and high risk should be screened at first prenatal visit and rescreened in 3rd trimester.”

The answers are C and E. According to current CDC guidelines, all sexually active women under age 25 should be screened for chlamydia annually due to higher prevalence in this age group (option C). Women aged 25 and older should be screened only if they are at increased risk, such as having new or multiple partners (option B). For pregnant patients, those under 25 or with risk factors should be screened at the first prenatal visit and rescreened during the third trimester to prevent complications such as neonatal conjunctivitis or pneumonia (option E).

  1. Which sign/symptom would the nurse NOT expect to find in a female patient with trichomoniasis?

A. thick, foamy discharge
B. “strawberry” appearance to cervix
C. pruritus in the affected area
D. chancres

The answer is D: chancres. Options A, B, and C can all appear with this STI. However, it’s important to note some patients can be asymptomatic. Chancres appears with the STI known as syphilis. These are painless lesions that is highly contagious during the primary stage of syphilis.

  1. A patient is diagnosed with trichomoniasis. Which medication should the nurse anticipate as the first-line treatment?

A. Penicillin G
B. Metronidazole
C. Acyclovir
D. Doxycycline

The answer is B: Metronidazole. This is the first-line treatment for this STI. Penicillin G is used for syphilis; acyclovir is used for herpes simplex virus; and doxycycline is used for chlamydia.

  1. A new mother has an active oral herpes (HSV-1) outbreak. Which steps should the patient take to prevent transmission to her newborn? Select all that apply.

A. Only kiss the newborn when lesions are covered
B. Wash hands thoroughly before and after caring for the baby
C. Keep oral lesions covered whenever near the baby
D. Avoid sharing blankets, bottles, or utensils with the newborn

The answers are B, C, and D. The mother should completely avoid kissing the newborn (even if lesions are covered) because the virus can still spread through the saliva. The other options help prevent transmission to the baby.

  1. Which of the following is not a typical way herpes simplex virus (HSV) is spread?

A. Sharing razors
B. Oral sexual contact
C. Kissing
D. Coughing or sneezing

The answer is D: coughing or sneezing. Herpes spreads through direct contact with infected skin, or mucous membranes, such as kissing or oral sexual contact, where the virus is present in saliva or genital secretions. It’s possible it can be transmitted through shared items like razors (rare but possible) if they have contact with infected fluid. Airborne droplets from coughing or sneezing do not transmit HSV because the virus cannot survive well in the air.

  1. The nurse is educating a patient about genital warts. Which route of transmission should the nurse emphasize as a risk?

A. Respiratory droplets
B. Fecal-oral route
C. Sexual contact
D. Blood transfusion

The answer is C: Sexual contact. Genital warts are spread through skin-to-skin contact during sexual activity, including vaginal, anal, or oral sex with an infected person. The virus enters through tiny breaks in the skin or mucous membranes. It is not spread through coughing or sneezing (respiratory droplets), eating or drinking (fecal-oral route), or blood transfusions.

  1. Which types of HPV is known to cause cervical cancer? Select all that apply:

A. 16
B. 18
C. 6
D. 11

The answers are A: 16 and B: 18. HPV types 16 and 18 are considered high-risk strains because they can lead to cervical cancer over time. In contrast, types 6 and 11 are low-risk and usually only cause genital warts, not cancer.

  1. The nurse is educating a parent about the HPV vaccine for their child. How many doses does the child need, and at what ages are they recommended?

A. 3 doses: 11–12 years, 16 years, and 18 years
B. 2 doses: 11–12 years and 16 years
C. 2 doses: 11–12 years and 18 years
D. 2 doses: 11–12 years and 6-12 months later

The answer is D: 2 doses: 11–12 years and 6-12 months later. The HPV vaccine is recommended in two doses for children starting at ages 11–12, with the second dose given around 6-12 months later.

  1. Genital warts are caused by which of the following?

A. Treponema pallidum
B. Human papillomavirus
C. HSV-2
D. Trichomonas vaginalis

The answer is B: Human papillomavirus (HPV). Genital warts are caused by certain strains of the human papillomavirus, most commonly types 6 and 11. These strains lead to the growth of soft, flesh-colored bumps in the genital area. Treponema pallidum causes syphilis (a bacterial infection), HSV-2 causes genital herpes (characterized by painful blisters or ulcers), and Trichomonas vaginalis is a parasite that causes trichomoniasis (a frothy, foul-smelling vaginal discharge).

  1. A 26-year-old patient has never been tested for hepatitis B. A triple panel is recommended. The nurse knows this panel includes which tests? (Select all that apply)

A. AST/ALT
B. Bilirubin
C. Anti-HBs
D. HBsAg
E. Total anti-HBc

The answer is C, D, and E. The panel includes anti-HBs (immunity), HBsAg (current infection), and total anti-HBc (past or current exposure).

  1. A patient who has never been infected with hepatitis B has been vaccinated. Which blood test would confirm immunity to the virus?

A. HBsAg
B. Anti-HBc
C. AST/ALT
D. Anti-HBs

The answer is D: Anti-HBs. This confirms immunity from vaccination. HBsAg and anti-HBc should be negative because there was no infection.

  1. A patient receives a test result that is negative for total anti-HBc. How does the nurse interpret this result?

A. The patient has had a past infection of hepatitis B.
B. The patient is not immune to hepatitis B.
C. The patient is currently infected with hepatitis B virus.
D. The patient has never been infected with the hepatitis B virus.

The answer is D: The patient has never been infected with hepatitis B virus. A negative total anti-HBc means no past or current exposure.

  1. Fill in the blank: The childhood vaccine schedule recommends _________ doses of the hepatitis B vaccine given at ______.

A. 3 doses; birth, 2 months, and 6–18 months
B. 2 doses; 2 months and 6–18 months
C. 3 doses; birth, 2 months, and 24 months
D. 2 doses; birth and 2 months

The answer is A: 3 doses; birth, 2 months, and 6–18 months. This schedule ensures early protection and long-term immunity. Note: In 2025, the CDC updated these guidelines so that infants born to hepatitis B–negative mothers may have the first vaccine dose delayed until 2 months of age.

  1. The Human Immunodeficiency Virus (HIV) mainly attacks what type of cells in the human body?

A. Red Blood Cells
B. CD4 positive cells
C. Stem Cells
D. Platelets

The answer is B. The HIV virus attacks the human body’s immune system, specifically the CD4 positive cells…mainly the helper t cells. These cells are white blood cells that help the immune system fight infection.

  1. A patient with AIDS has dark purplish brown lesions on the mucus membranes of the mouth. As the nurse you know these lesions correlate with what type of opportunistic disease?

A. Epstein-Barr Virus
B. Herpes Simplex Virus
C. Cytomegalovirus
D. Kaposi’s Sarcoma

The answer is D: Kaposi’s Sarcoma

  1. A 25-year-old patient reports that they engage in high risk activities that could lead to an HIV infection. The patient’s test results show the patient is HIV-negative. The nurse should provide the patient with education about?

A. PEP
B. PrEP
C. Opportunistic Infections
D. Nucleic Acid Test (NAT)

The answer is B. The nurse should provide the patient with education about PrEP (Pre-Exposure Prophylaxis). These medications are taken BEFORE a possible encounter with HIV, which helps prevent a possible HIV infection. The patient must be HIV-negative before taking these medications.

  1. The Human Immunodeficiency Virus (HIV) can NOT be spread in what type of fluid below? Select all that apply:

A. Breastmilk
B. Blood
C. Tears
D. Semen
E. Vaginal Fluid
F. Sweat

The answers are C and F. HIV can NOT be spread in tears or sweat (unless blood is present which rarely occurs). HIV is spread in the following fluids: breast milk, blood, semen, and vaginal fluid.

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