Which of the following should be included in teaching as increasing the risk for toxic shock syndrome?

• A. High-absorbency tampons
• B. Mosquito bites
• C. Travel to foreign countries
• D. Multiple sexual partners

Answer: (B)

Toxic shock syndrome risk rises when bacteria that make toxins—most commonly Staphylococcus aureus—have an opportunity to grow and release toxins. The key teaching point is that using high-absorbency tampons for long periods creates an ideal environment for bacteria to multiply and produce TSST-1, which can lead to rapid illness. That’s why the safest guidance is to use the lowest absorbency needed, change tampons every 4–8 hours, and avoid leaving a tampon in overnight; alternating with pads can also help reduce risk. Mosquito bites, travel, or having multiple sexual partners are not recognized risk factors for toxic shock syndrome, so they aren’t the focus of this particular teaching.