craven chapter 42

Which example best supports the diagnosis of Sexual Dysfunction: Dyspareunia? -A client with a colostomy believes she cannot have a sexual relationship with her husband because he will be repulsed by her stoma. - A 50-year-old woman with a history of stroke is afraid to have sex with her partner for fear it will elevate her blood pressure. - A 50-year-old woman in the process of menopause has pain and burning during intercourse. - A 39-year-old alcoholic woman is no longer interested in having sex with her partner.

A 50-year-old woman with a history of stroke is afraid to have sex with her partner for fear it will elevate her blood pressure.

Applying the American Psychiatric Association description of sexual response, place the phases in the order in which they would occur from first to last.

Appetitive Excitement Orgasm Resolution

A 28-year-old male comes to the clinic for an evaluation. The client complains of a penile discharge. After completing an assessment, the nurse suspects that the client has a chlamydia infection based on which finding? Select all that apply. - Painful lesion on the penis -Burning on urination -Swollen testes -Testicular pain - Painful vesicles around the genitals

Burning on urination Swollen testes Testicular pain

What term is used to describe painful intercourse? -Dysmenorrhea - Impotence - Dyspareunia - Vulvodynia

Dyspareunia

A nurse is explaining the use of an IUD to a female client interested in obtaining contraception. Which of the following statements regarding the IUD is correct? -The intrauterine device (IUD) is an object that is inserted by the client into her uterus. - IUDs are small devices made of flexible plastic that provide irreversible birth control. - IUDs do not prevent fertilization of the egg. - IUDs are a safe form of birth control that can be removed if the client wants to become pregnant.

IUDs are a safe form of birth control that can be removed if the client wants to become pregnant.

A gerontology nurse is discussing sexual dysfunction with an older adult male client. The nurse determines that the education has been effective when the client states: -"Antihypertensive medication will not affect sexual function." -"Malnutrition may cause impotence." -"I need to be able to walk a mile in order for sexual intercourse to not be dangerous." -"Erectile dysfunction, caused by diabetes, has no treatment."

Malnutrition may cause impotence

The nurse is advising an adolescent male about sexual myths that have him concerned. Which statements describe accurate client education regarding these concerns? Select all that apply. - A larger penis allows for a more satisfying sexual experience. -Nocturnal emissions indicate the existence of a sexual disorder. -Nocturnal emissions are signs of a sexually transmitted infection. -Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. - No male or female should feel pressured into sexual activity at any age. -Nocturnal emissions are normal in men of all ages.

Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. No male or female should feel pressured into sexual activity at any age. Nocturnal emissions are normal in men of all ages.

Which of the following statements should be incorporated into the teaching plan developed to present instruction about the female menstrual cycle to nursing students? A)Progesterone influences the growth of endometrial lining. B)The follicular phase is dominated by progesterone and testosterone. C)Menses ensues when the levels of estrogen and progesterone fall. D)Estrogen is the dominant hormone during the luteal phase.

Menses ensues when the levels of estrogen and progesterone fall.

Which statements describe sexual dysfunction in males or females? Select all that apply. -Premature ejaculation is a condition in which a man consistently reaches ejaculation or orgasm before or soon after entering the vagina. - Retarded ejaculation refers to the man's inability to ejaculate into the vagina or delayed intravaginal ejaculation. - Vaginismus is painful intercourse. -Dyspareunia is a condition in which the vaginal opening closes tightly and prevents penile penetration. - Vulvodynia is a chronic vulvar discomfort or pain characterized by burning, stinging, irritation, or rawness of the female genitalia that interferes with sexual activity. - Inhibited sexual desire refers to the inability of a woman to reach orgasm.

Premature ejaculation is a condition in which a man consistently reaches ejaculation or orgasm before or soon after entering the vagina. Retarded ejaculation refers to the man's inability to ejaculate into the vagina or delayed intravaginal ejaculation. Vaginismus is painful intercourse. Vulvodynia is a chronic vulvar discomfort or pain characterized by burning, stinging, irritation, or rawness of the female genitalia that interferes with sexual activity.

A nurse is preparing a class for a group of middle-aged women about changes that may occur as a result of menopause. Which change would the nurse most likely include in the discussion? Select all that apply. -Thickening of the vaginal tissue -Reduced verbal fluency -Improved memory -Genitourinary atrophy -Increased fatigue

Reduced verbal fluency Genitourinary atrophy Increased fatigue

Which of the following statements best describes the relationship between biologic sex and gender identity? -Sex is chromosomally determined, while gender is a psychosocial construct. -Biologic sex and gender identity are both modifiable by surgery and medical interventions. - Biologic sex is genetically determined but gender identity is chosen during adolescence. - Biologic sex and gender identity are considered synonymous in nursing practice.

Sex is chromosomally determined, while gender is a psychosocial construct.

Which of the following is considered external male genitalia? Select all that apply. - Testes - Scrotum -Epididymis -Prostate gland -Penis

Testes Scrotum Penis

What hormones do the testes produce? A)Estrogen and testosterone B)Testosterone and spermatozoa C)Progesterone and ovum D)Thyroxin and cortisol

Testosterone and spermatozoa

The nurse determines that a female patient understands how to perform breast self-examination when the patient states A)"I should palpate the breast in a random manner with my thumb." B)"I should use my whole hand to feel for lumps and only at the nipple." C)"The best time to perform the exam is 1 week after my period." D)"Dimples around the nipple are normal and increase with age."

The best time to perform the exam is 1 week after my period

Traditionally, the male sexual response is thought to be broken up into three phases. Which occurrence is part of the plateau phase? - A rapid erection of the penis occurs. -The circumference of the penis thickens at the coronal ridge and a few drops of fluid appear at the urethral meatus. -A decrease in vasocongestion occurs. - The spermatic cords shorten, causing a partial elevation of both testes.

The circumference of the penis thickens at the coronal ridge and a few drops of fluid appear at the urethral meatus.

The nurse is talking with a young victim of sexual assault in the emergency department. The client states that she wants to take emergency contraception and asks the nurse what is recommended. What is the best response by the nurse? Select all that apply. -A vaginal sponge will be prescribed to be worn daily for 7 days. -The health care provider will prescribe increased doses of oral contraceptives. -The health care provider will order a copper IUD within 5 to 7 days of the unprotected sex. -An emergency dilation and curettage (D & C) will be performed within 24 hours of unprotected sex. -A vaginal ring will be inserted within 36 hours of unprotected sex. -Plan B One-Step may be obtained without a prescription at a drugstore or family planning clinic.

The health care provider will prescribe increased doses of oral contraceptives. The health care provider will order a copper IUD within 5 to 7 days of the unprotected sex. Plan B One-Step may be obtained without a prescription at a drugstore or family planning clinic.

The nurse caring for clients in a physician's office takes into consideration developmental stage when assessing sexuality. Which is an example of a developmentally appropriate intervention? -The nurse teaches parents of an 18-month old to discourage self-manipulation of genitals. - The nurse teaches parents of a 4-year-old that they may cause anxiety in the child by intolerance of inconsistency of sex-role behavior. - The nurse warns parents of 2-year-old that toilet training should be initiated immediately to prevent compulsive behaviors later on. - The nurse states that same-sex preference for relationships in the school-age child may be related to heterosexual or homosexual tendencies.

The nurse teaches parents of a 4-year-old that they may cause anxiety in the child by intolerance of inconsistency of sex-role behavior.

A client reports for a preoperative appointment in preparation for surgery that will change his body from a female to a male. The client has expressed to the nurse and physician that he should have been born a man. What identity is the client demonstrating? -Homosexual - Transvestite - Transsexual -Bisexual

Transsexual

A client visits a community clinic reporting a foul-smelling vaginal discharge that is thin, foamy, and green in color; itching of vulva and vagina; and burning on urination. Which STI would the nurse suspect? -Acquired immunodeficiency syndrome (AIDS) -Chlamydia trachomatis - Trichomonas vaginalis - Neisseria gonorrhoeae

Trichomonas vaginalis

A male client comes to the clinic because he thinks that he has syphilis. Which test would the nurse expect the client to have done? -HPV - Pap smear -Wet preparation -VDRL

VDRL

A nurse is assisting a clinician performing a complete pelvic examination for a client. Which of the following should be done when performing a speculum examination? Select all that apply. -Warm the speculum before insertion. - Withdraw the speculum and obtain smear for culture. -Expand the speculum after insertion into the vagina. -View the vaginal walls as the speculum is withdrawn. -Palpate the cervix, ovaries, and uterus with the speculum.

Warm the speculum before insertion. Expand the speculum after insertion into the vagina. View the vaginal walls as the speculum is withdrawn.

A female client experienced a pelvic fracture in a motor vehicle accident several months earlier and recovery has been slow. Among the challenges presented by this event is the fact that sexual activity causes a dull ache in her pelvis. Which nursing diagnosis is most appropriate for this client? -Alteration in Comfort: Pain - Altered Sexuality Patterns: Change in Sexual Expression - Impaired Social Interaction - Disturbed Body Image

alteration in comfort: pain

A woman complains of pain with intercourse. What patient medications should the nurse check for that contribute to dyspareunia? A)Calcium supplements B)Antihistamines C)Antibiotics D)Antihypertensives

antihistamines

The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following? -Antibiotics -Bronchodilators -Antihypertensive medication - Non-steroidal anti-inflammatory drugs (NSAIDs)

antihypertensive medication

A woman has been diagnosed with human papillomavirus (HPV) infection. When teaching the woman about this condition, the nurse would emphasize the need for screening for which type of cancer? -Colorectal -Breast -Lung -Cervical

cervical

The nurse recommends a barrier method of contraception for a client who is concerned about the side effects of hormonal contraception. Which method might the nurse suggest? -Abstinence -Cervical cap -Norplant system - Sterilization

cervical cap

What are the uterus and vagina connected by? -Cervix - Fallopian tubes -Ovaries -Clitoris

cervix

The term used to describe sexual changes that occur in the transition of a female from middle age to old age is A)Plateau B)Menopause C)Menarche D)Climacteric

climacteric

A nurse is teaching a female client about the sexual response cycle. The nurse determines that the education was successful when the client identifies which female structure as comparable to the male penis? - Skene glands -Mons pubis -Ovaries -Clitoris

clitoris

In the female reproductive system, what corresponds with the male penis? A)Skene's glands B)Mons pubis C)Clitoris D)Urethral meatus

clitoris

A nurse has been invited to be a guest speaker on sexuality for a freshmen level health class at a local high school. The nurse plans to discuss sexual health and function and sexual intercourse. When describing the role of the various glands with sexual intercourse, which glands would the nurse include as important in producing fluids necessary to lubricate the urethra for the passage of spermatozoa? -Skene glands -Mammary glands -Bartholin glands -Cowper glands

cowper glands

The nurse is to fill in at a clinic for sexually transmitted infections (STI) and is aware of the need to perform focused sexuality assessments. The nurse spends some time reviewing questions to include for sexuality assessments and finds which question to be pertinent? -"Has your appetite changed recently?" -"Are you gay or straight?" -"Do you have concerns about infections?" - "Do you have problems sleeping?"

do you have concerns about your infections

A woman age 49 years has sought care from her primary care provider because of "intimacy problems." Upon questioning, the woman reveals that she is experiencing sexual desire, but that intercourse causes her significant pain. In the absence of sexual activity, the woman states that she does not have any significant vaginal discomfort. What would the clinician recognize that this client is most likely experiencing? -Dyspareunia - Vaginismus - Vulvodynia -A sexually transmitted infection (STI)

dyspareunia

What do most nursing interventions pertaining to sexuality involve? -examinations to identify sexually transmitted infections - advocacy for those with sexual dysfunctions -maintaining confidentiality and privacy - educating to promote sexual health

educating to promote sexual health

. When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is the A)Refractory phase B)Obligatory phase C)Excitement phase D)Orgasmic phase

excitement phase

A nurse is preparing an education plan about sexual response for a male client who is experiencing changes in this area. The nurse plans to review the phases of the male sexual response. Which topic would the nurse expect to integrate into the discussion as occurring during the orgasm phase? - rapid loss of vasocongestion -expulsive contractions of the urethra -thickening of the scrotal skin - thickening of the penis at the coronal ridge

expulsive contractions of the urethra

A nursing instructor is teaching a class of nursing students about female reproductive structure and function. As part of the class, the instructor discusses menstruation. The instructor determines that the education was successful when the students identify which statement as true about the hormonal interplay related to menstruation? -Hypothalamus secretes luteinizing hormone. -Follicle-stimulating hormone stimulates the ovary. - Pituitary gland secretes the hormone progesterone. -Gonadotropin-releasing hormone stimulates the hypothalamus.

follicle stimulating hormone stimulates the ovary

During the orgasmic phase of the sexual response, the woman may experience A)Vaginal relaxation B)Bradycardia C)Hypoventilation D)Hypertension

hypertension

The nurse is providing education about barrier contraceptives. Which statement by the patient indicates a need for further education? A)"I have to wash my cervical caps after each use." B)"I can leave my diaphragm in for up to 48 hours." C)"I can insert my female condoms up to 8 hours before intercourse." D)"Male latex condoms when used correctly are an effective means of contraceptive and very effective at preventing transmission of STDs."

i can leave my diaphragm in for up to 48 hours

After discussing the various methods of contraception with a female client and her partner, the couple decides to use depot injections of medroxyprogesterone. After teaching the couple about this type of contraception, which statement by the client indicates effective education? -"The injection lasts for 7 days; then I need to get another one." - "I have to get an injection once every 3 months." - "This injection is good for at least 3 years." -"I need to inject myself every 2 weeks."

i have to get an injection once every 3 months

Which question or statement would be most useful in beginning to elicit information about a client's sexual history? - "I know this might be hard to talk about, but it is important." - "Why did you have unprotected sex?" - "I'm going to have a talk with you about sex." - "I need to know some information about each of your sex partners."

i know this might be hard to talk about but it is important

A client that is 90 days postpartum states to the nurse, "I have not had a period since I had the baby. Do you think something may be wrong?" What is the best response by the nurse? -"Did you have a problem with your periods before you got pregnant?" -"If you are breastfeeding, it is common for there to be a delay before resuming menstruation." - "There could be something serious, so we will need to run some tests." - "Have you started having sex again since the baby was born?"

if you are breastfeeding it is common for there to be a delay before resuming menstruation

The nurse is using the PLISSIT model when discussing sexual health with a patient. Which of the following would be an appropriate comment for the SS portion? A)"Some people practice birth control, while others choose not to. It is an individual choice." B)"The typical signs and symptoms include nausea and vomiting." C)"Keeping sexual secrets can hurt a healthy relationship." D)"If you were to use the pill, the cost of the pill will be $5.00 per month."

if you were to use the pill, the cost of the pill will be $5.00 per month

The nurse is preparing a presentation on contraceptive methods. Which methods are designated highly effective? Select all that apply. A)Vaginal ring B)Injectable depoprovera C)Subdermal implants D)IUDs E)Transdermal patch

injectable depoprovera subdermal implants IUDs

A nurse is teaching a sex education class to a group of teenage girls. They ask the nurse about the sexual response cycle in females. Which physiologic response does the nurse tell them is only seen in females? -increase in heart rate -nipples become hard and erect - refractory period after orgasm - loss of muscular control during orgasm causing spastic contractions

loss of muscular control during orgasm causing spastic contractions

The school nurse is educating a group of 5th and 6th grade girls on menstruation. One girl asks if there is a name for having her first menstrual period. The nurse replies with which of the following terms? -Menses - Menopause -Menarche - Follicular phase

menarche

The nurse determines that the patient needs further instruction regarding Kegel exercises when the patient tells the nurse that one of the benefits of the exercises is A)Relief of constipation. B)Rapid postpartum recovery C)Increased vaginal lubrication D)More frequent orgasms

more frequent orgasms

During the plateau phase of the sexual response, the man may experience A)Bradycardia B)Nipple erection C)Hypoventilation D)Hypotension

nipple erection

A male client age 15 years is experiencing nocturnal emissions. What nursing intervention would be appropriate for this client? - Ask the parents to consult with a specialist. - Tell the client to limit physical activity in the evening. - Ask the primary care provider to perform a physical examination. -No intervention is necessary as this is a normal phenomenon.

no intervention is necessary as this is a normal phenomenon

During the menstrual cycle, when does ovulation typically take place? -On day 14 -On day 1 of a new cycle -When sperm is present - From days 15 to 28

on day 14

During assessment of a female client, the client tells the nurse that she uses oral contraceptives. Based on the nurse's knowledge about the action of these drugs, which phase of the menstrual cycle would most likely be affected? -Proliferative phase -Follicular phase -Ovulatory phase -Luteal phase

ovulatory phase

The nurse is caring for a patient diagnosed with vaginismus. When reviewing the patient's history, what would the nurse expect to find? A)Past history of an STD B)Past history of a rape C)Multiple vaginal deliveries D)The patient is in the first trimester of pregnancy

past history of rape

When a 19-year-old male patient tells the nurse that he has never been able to achieve an erection, the nurse recognizes that the patient is experiencing A)Sexual identity problems B)Primary impotence C)Psychological impotence D)Ejaculatory dysfunction

primary impotence

In the male reproductive system, the glands that produce and store most of the seminal fluid include the seminal vesicle and the A)Scrotum B)Glans penis C)Gonads D)Prostate

prostate

The nurse is assisting during a physical exam of a patient. In regards to the genital exam, what steps does the nurse need to complete? Select all that apply. A)Provide privacy. B)Instruments should be kept cold. C)Use careful draping of the patient. D)Use gloves during the exam. E)Observe breasts for deviations from normal.

provide privacy use careful draping of the patient use gloves during the exam

The combination of seminal fluid and spermatozoa forms A)Ovum B)Orgasm C)Blood D)Semen

semen

The nurse has provided information to a patient about oral contraceptives. Which statement by the patient would indicate a need for further education? A)"Some oral contraceptives protect against STDs." B)"Hormonal oral contraceptives reduce the risk of ovarian cancer." C)"Oral contraceptives need to be taken on a daily basis." D)"Some hormonal contraceptives do not contain estrogen and rely instead on a progestin only."

some oral contraceptives protect against STDs

A female client comes to the clinic for a routine physical examination. As part of the physical, the client is to undergo testing for sexually transmitted infections. When preparing the client for testing, which sexually transmitted infection would the nurse explain as requiring a blood specimen? -Gonorrhea -Chlamydia - Human Papilloma virus - Syphilis

syphilis

As part of a class project, a nursing student is to discuss the anatomic and physiologic changes that occur in a woman's breast during pregnancy and lactation. What would the student be most likely to include? -The nipples become lighter in color. -Areolar sebaceous glands remain the same size. - The alveolar cells begin to secrete colostrum. -Colostrum is produced during the first half of pregnancy.

the alveolar cells begin to secrete colostrum

A pregnant teenager did not understand the process of fertilization. The school nurse's best explanation of fertilization is that A)Fertilization is a process that occurs in the lower portion of the cervix. B)the fertilization process occurs in the outer third of the fallopian tube C)An ovum can be fertilized during a period of 1 week after intercourse. D)The first 2 months after fertilization is critical for the embryo.

the fertilization process occurs in the outer third of the fallopian tube

The school nurse is presenting a class on female reproductive health. While discussing prevention the nurse teaches what about a Pap smear? -The test may be performed at any time during the client's menstrual cycle. -The smear should be done every 2 years. -The Pap smear detects cervical cancer. - False-negative Pap smear results occur mostly from not douching before the examination.

the pap smear detects cervical cancer

A female client tells the nurse that vaginal intercourse with her partner is not as exciting as it used to be. Which of the following could the nurse teach her? - Use of the BETTER model - Voyeurism -Masturbation -Use of Kegel exercises

use of kegel exercises

A couple who has come to the clinic is seeking information about natural family planning. What would the nurse be least likely to include when explaining this method of fertility control to this couple? -requires some period of abstinence -uses calculations of menstrual cycles - uses estrogen and progestin in various combinations -determines ovulation from basal body temperature

uses estrogen and progestin in various combinations

The nurse is assessing the sexual health of a female client age 20 years. During the interview, the client says, "I feel that my vaginal opening constricts whenever I am about to have intercourse. I seem to have no control over it." What would the nurse use when documenting the client's report? -Vaginismus - Dyspareunia - Orgasmic dysfunction -Celibacy

vaginismus

A female patient presents with a complaint of pain and burning in the area of the vulva during intercourse. The nurse documents this complaint as: A)vulvodynia B)vaginismus C)dyspareunia D)orgasmic dysfunction

vulvodynia