Funds Exam 3 Ch 35 EAQs and practice questions

The nurse is providing education about condom use at a community clinic for older adults. Which statements demonstrate that the adults understand correct use of condoms? Select all that apply. "I can use any kind of lubricant such as lotions or baby oil." "Before using the condom, I should check the package for damage or expiration." "I need to use a condom to help reduce the risk of sexually transmitted infections." "A good place to store condoms is in the bathroom so they don't dry out." "I should not use a condom because I have a latex allergy."

"Before using the condom, I should check the package for damage or expiration." "I need to use a condom to help reduce the risk of sexually transmitted infections." Older adults sometimes are not familiar with condom use and storage. Teach them to use water-based lubricants because oil-based products contribute to breakage of latex condoms. Condoms should be stored in a cool, dry location away from sunlight. Condoms are available in non-latex varieties.

Which question represents a nonjudgmental approach when gathering a sexual health history? "How do you and your wife/husband feel about intimacy?" "Do you have sex with men, women, or both?" "Are you heterosexual or homosexual?" "What is your sexual orientation?"

"Do you have sex with men, women, or both?" A nonjudgmental attitude facilitates trust and open communication between the nurse and patient. Using terms such as partner versus wife or husband allows patients to identify their sexual preference. The terms gay, lesbian, bisexual, or transgender are preferred over the terms heterosexual or homosexual and are more specific in reference to sexual practices.

The nurse at a community health center is teaching a group of menopausal women about normal changes in the female sexual response that occur with aging. Which statement by one of the women indicates that the information is understood? "It's normal for me to take longer to reach an orgasm." "I might experience chest pain or shortness of breath during intercourse." "It's normal for me to lose interest in sexual relationships." "I won't need to be concerned about contraception or sexually transmitted infections because of my age."

"It's normal for me to take longer to reach an orgasm."

When conducting a comprehensive sexual history assessment, which questions should the nurse include? Select all that apply. "To how many babies have you given birth?" "Do you know about contraception?" "Have you had a urinary tract infection?" "How many sexual partners have you ever had?" "Have you undergone a surgical removal of a kidney?"

"To how many babies have you given birth?" "Do you know about contraception?" "How many sexual partners have you ever had?" While assessing a patient's sexual history, the nurse should ask about the number of children and the means of contraception. A comprehensive sexual assessment also gathers information about the number of sexual partners the patient has had in the past. Questions regarding urinary tract infection or surgical removal of a kidney do not provide information about the sexual history and hence are not included in the assessment.

The nurse is assessing a couple who have been unable to conceive a child for some time. Which questions should the nurse ask the couple to determine whether they should be diagnosed as infertile? Select all that apply. "What is the duration of having unprotected sex?" "Do you experience a sense of failure?" "Do you feel that your body is defective?" "Do you enjoy having sexual intercourse?" "Do you live in a city or suburban area?"

"What is the duration of having unprotected sex?" "Do you experience a sense of failure?" "Do you feel that your body is defective?" Patients are diagnosed as infertile if they are unable to conceive after having 1 year of unprotected sexual intercourse. The patients may experience a feeling of failure and may even think that their bodies are defective. Infertility does not depend on seeking pleasure from sexual intercourse and enjoying the activity. The location of a residence does not affect fertility.

The nurse is caring for a patient with sexual dysfunction. The nurse uses the PLISSIT model when implementing nursing interventions. Arrange the interventions of the PLISSIT model in the correct order. Gather information about sexual health problems. Give suggestions about sexual health and related disorders. Refer to a professional with advanced training. Give the patient permission to discuss sexual concerns.

1. Give the patient permission to discuss sexual concerns. 2. Gather information about sexual health problems. 3. Give suggestions about sexual health and related disorders. Correct 4. Refer to a professional with advanced training. The nurse should first give permission to the patient to discuss sexual issues. Not everybody may feel comfortable discussing sexuality. Obtaining information related to sexual health problems helps in planning interventions. Specific suggestions should be given to help the patient manage a sexual problem. The patient may then be directed to a professional with advanced training if required.

A nurse is providing spiritual care to a group of patients. Match the group to their belief. a. Nature controls life and health. b. Organ transplantation or donation is not considered. c. Observance of the Sabbath is important. d. Past sins cause illness. e. Nonhuman spirits invading the body cause illness.

1. Hinduism 2. Buddhism 3. Islam 4. Judaism 5. Appalachians

The nurse is a part of a campaign on cervical cancer. The campaign involves administering the human papillomavirus (HPV) vaccine. For which age group is the HPV vaccine most effective? 20 to 50 years of age 9 to 26 years of age 20 to 30 years of age 25 to 35 years of age

9 to 26 years of age The human papillomavirus (HPV) vaccine is most effective when given before first sexual exposure in the age group of 9 to 26 years. Individuals in the age group of 20 to 50 years, 20 to 30 years, and 25 to 35 years are usually already sexually active and may already be infected with the HPV virus. Therefore, the vaccine may not be as effective in these age groups as in the younger age group.

17. The nurse is caring for a group of patients. Which patient will the nurse see first? a. A patient saying that God has left and there is no reason for living. b. A patient refusing treatment on the Sabbath. c. A patient having a folk healer in the room. d. A patient praying to Allah.

ANS: A A patient saying that God has left and there is no reason for living must be seen first for safety reasons. It must be determined by the nurse if the patient is planning suicide or is just angry and frustrated. A patient refusing treatment on the Sabbath is within that patient's right and doesn't need to be seen first. A patient with a folk healer is within the patient's right and does not need to be seen first. A patient praying to Allah is within the patient's right and does not need to be seen first.

15. The nurse is caring for a patient who has been diagnosed with a terminal illness. The patient states, "I just don't feel like going to work. I have no energy, and I can't eat or sleep." The patient shows no interest in taking part in the care by saying, "What's the use?" Which response by the nurse is best? a. It sounds like you have lost hope. b. It sounds like you have lost energy. c. It sounds like you have lost your appetite. d. It sounds like you have lost the ability to sleep.

ANS: A All of the patient's description are describing a loss of hope. While losses of energy, appetite, and sleep are indicated, they only address a part of patient's problems. A loss of hope encompasses the holistic view of the patient.

18. A nurse is providing spiritual care to patients. Which action is essential for the nurse to take? a. Know one's own personal beliefs. b. Learn about other religions. c. Visit churches, temples, mosques, or synagogues. d. Travel to other areas that do not have the same beliefs.

ANS: A Because each person has a unique spirituality, you need to know your own beliefs so you are able to care for each patient without bias. While learning about religions, visiting other religious areas of worship, and traveling to areas that do not have the same beliefs are beneficial, they are not essential.

13. In caring for the patient's spiritual needs, the nurse understands that a. Establishing presence is part of the art of nursing. b. Presence involves "doing for" the patient. c. A caring presence involves listening to the patient's wishes only. d. The nurse must use her expertise to make decisions for the patient.

ANS: A Establishing presence is part of the art of nursing. Presence involves "being with" a patient versus "doing for" a patient. Demonstrate a caring presence by listening to the patient's concerns and willingly involving family in discussions about the patient's health. Show self-confidence when providing health instruction, and support patients as they make decisions about their health.

9. The nurse is admitting a patient who is a member of the Seventh Day Adventist religion. The physician has written an order for specific tests to be done the next day, which is Saturday. The nurse should a. Discuss the patient's beliefs about the Sabbath. b. Order the tests without questioning. c. Inform the physician that the tests cannot be performed. d. Reorder the tests for Sunday.

ANS: A It is essential to consider cultural differences and explore personal preferences when determining nursing interventions to enhance spiritual well-being. Some Seventh Day Adventists may not mind having tests on the Sabbath. Others might. Ordering the tests without questioning may lead to patient refusal later and to wasted resources as well as spiritual distress for the patient. Informing the physician that the tests cannot be performed is premature without speaking with the patient first. It is not in the realm of the nurse to reorder tests. Some tests may be critical and may need to be done on the Sabbath.

8. The nurse is caring for a patient with a chronic illness who is having conflicts with beliefs. Which health care team member will the nurse ask to see this patient? a. The clergy b. A psychiatrist c. A social worker d. An occupational therapist

ANS: A Other important resources to patients are spiritual advisors and members of the clergy. Spiritual care helps people identify meaning and purpose in life, look beyond the present, and maintain personal relationships, as well as a relationship with a higher being or life force. A psychiatrist is for emotional health. A social worker focuses on social, financial, and community resources. An occupational therapist provides care with vocational issues and functioning within physical limitations.

18. In assessing the spiritual health of her patients, the nurse understands that a. Spiritual beliefs change as patients grow and develop. b. Spiritual health in older adults leads to peace and acceptance of others. c. Older adults often express spirituality by focusing on themselves. d. The basis of beliefs among older people is focused on one or two factors.

ANS: A Spiritual beliefs change as patients grow and develop. Health spirituality in older adults leads to peace and acceptance of self. However, older adults often express their spirituality by turning to important relationships and giving of themselves to others. Beliefs among older people vary based on many factors, such as gender, past experience, religion, economic status, and ethnic background.

6. A complex concept that is unique to each individual; is dependent upon a person's culture, development, life experiences, beliefs, and ideas about life; and is a unifying theme in peoples' lives is called a. Spirituality. b. Religion. c. Self-transcendence. d. Faith.

ANS: A Spirituality is a complex concept that is unique to each individual; is dependent upon a person's culture, development, life experiences, beliefs, and ideas about life; and is a unifying theme in peoples' lives. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. Self-transcendence is the belief that there is a force outside of and greater than the person. Faith allows people to have firm beliefs despite lack of physical evidence.

13. In caring for the patient's spiritual needs, the nurse asks 20 questions to assess the patient's relationship with God and a sense of life purpose and satisfaction. Which method is the nurse using? a. The spiritual well-being scale b. The FICA assessment tool c. Belief tool d. Hope scale

ANS: A The spiritual well-being scale (SWB) has 20 questions that assess a patient's relationship with God and his or her sense of life purpose and life satisfaction. The FICA assessment tool evaluates spirituality and is closely correlated to quality of life. This does not describe belief or hope.

1. The word spirituality derives from the Latin word spiritus, which refers to breath or wind. Today, spirituality is a. Awareness of one's inner self and a sense of connection to a higher being. b. Less important than coping with the patient's illness. c. Patient centered and has no bearing on the nurse's belief patterns. d. Equated to formal religious practice and has a minor effect on health care.

ANS: A Today, spirituality is often defined as an awareness of one's inner self and a sense of connection to a higher being, to nature, or to some purpose greater than oneself. Spirituality is an important factor that helps individuals achieve the balance needed to maintain health and well-being and to cope with illness. It positively affects and enhances health, quality of life, health promotion behaviors, and disease prevention activities. Nurses need an awareness of their own spirituality to provide appropriate and relevant spiritual care to others. The concepts of spirituality and religion are often interchanged, but spirituality is a much broader and more unifying concept than religion. The human spirit is powerful, and spirituality has different meanings for different people.

1. A nurse is evaluating a patient's spiritual care. Which areas will the nurse include in the evaluation process? (Select all that apply.) a. Review the patient's view of the purpose in life. b. Ask whether the patient's expectations were met. c. Discuss with family and friends the patient's connectedness. d. Review the patient's self-perception regarding spiritual health. e. Impress on the patient that spiritual health is permanent once obtained.

ANS: A, B, C, D In evaluating care include a review of the patient's self-perception regarding spiritual health, the patient's view of his or her purpose in life, discussion with the family and friends about connectedness, and determining whether the patient's expectations were met. Attainment of spiritual health is a lifelong goal; it is not permanent once obtained.

1. When evaluating a patient's risk for spiritual crises, which of the following are part of the evaluation process? (Select all that apply.) a. Review the patient's self-perception regarding spiritual health. b. Review the patient's view of his/her purpose in life. c. Discuss with family and associates the patient's connectedness. d. Ask whether the patient's expectations are being met. e. Impress on the patient that spiritual health is permanent once obtained.

ANS: A, B, C, D One critical thinking model for spiritual health evaluation lists the evaluation process as including a review of the patient's self-perception regarding spiritual health, the patient's view of his/her purpose in life, discussion with the family and close associates about the patient's connectedness, and determining whether the patient's expectations are being met. Attainment of spiritual health is a lifelong goal.

2. Spiritual distress has been identified in a patient who has been diagnosed with AIDS. Upon evaluating the following interventions, which are appropriate for the diagnosis of Spiritual distress? (Select all that apply.) a. Develop activities to heal body, mind, and spirit. b. Assess for potential suicide. c. Offer to pray with the patient. d. Teach relaxation, guided imagery, and meditation. e. Have patient avoid church attendance.

ANS: A, C, D Interventions that are appropriate for the nursing diagnosis of Spiritual distress include (1) helping the patient develop/identify activities to heal body, mind, and spirit; (2) offering to pray with the patient; and (3) teaching relaxation, guided imagery, and medication. Assessing for potential suicide would be appropriate for the nursing diagnosis of Hopelessness. Attendance at church should be encouraged.

2. Spiritual distress has been identified in a patient who has been diagnosed with a chronic illness. Which interventions will the nurse add to the care plan? (Select all that apply.) a. Offer to pray with the patient. b. Avoid time with the support group. c. Have the patient avoid church attendance. d. Develop activities to heal body, mind, and spirit. e. Teach relaxation, guided imagery, and meditation.

ANS: A, D, E Interventions that are appropriate for spiritual distress include (1) helping the patient develop/identify activities to heal body, mind, and spirit; (2) offering to pray with the patient; and (3) teaching relaxation, guided imagery, and medication. Attendance at church should be encouraged as well as spending time with a support group.

16. The patient is having a difficult time dealing with an AIDS diagnosis. The patient states, "It's not fair. I'm totally isolated from God and my family because of this. Even my father hates me for this. He won't even speak to me." What should the nurse do? a. Tell the patient to move on and focus on getting better. b. Use therapeutic communication to establish trust and caring. c. Assure the patient that the father will accept this situation soon. d. Point out that the patient has no control and that he or she must face the consequences.

ANS: B Application of therapeutic communication principles and caring helps you establish therapeutic trust with patients. The nurse should not offer false hope (father will accept the situation soon). The nurse should help the patient maintain feelings of control, not no control. The nurse should encourage renewing relationships if possible and establishing connections with self, significant others, and God.

12. The patient is admitted with chronic back pain. The nurse who is caring for this patient should a. Focus on finding quick remedies for the back pain. b. Look at how pain influences the patient's ability to function. c. Realize that the patient's only goal is relief of the back pain. d. Help the patient realize that there is little hope of relief from chronic pain.

ANS: B Do not just look at the patient's back pain as a problem to solve with quick remedies, but rather look at how the pain influences the patient's ability to function and achieve goals established in life (not just pain relief). Mobilizing the patient's hope is central to a healing relationship.

9. The nurse is caring for a patient with a terminal disease. The nurse sits down and lightly touches the patient's hand. Which technique is the nurse using? a. "Doing for" b. Establishing presence c. Offering transcendence d. Providing health promotion

ANS: B Establishing presence by sitting with a patient to attentively listen to his or her feelings and situation, talking with the patient, crying with the patient, and simply offering time are powerful spiritual care approaches. Benner explains that presence involves "being with" a patient versus "doing for" a patient. Transcendence is the belief that a force outside of and greater than the person exists beyond the material world. In settings where health promotion activities occur, patients often need information, counseling, and guidance to make the necessary choices to remain healthy.

6. A nurse hears the following comments from different patients. Which patient comment does the nurse identify as faith? a. I go to church every Sunday. b. I believe there is life after death. c. I have something to look forward to each day. d. I get a feeling of awe when looking at the sunset.

ANS: B Faith allows people to have firm beliefs despite lack of physical evidence (life after death). Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality (go to church). When a person has the attitude of something to live for and look forward to, hope is present (look forward to each day). Self-transcendence is the belief that there is a force outside of and greater than the person (awe when looking at a sunset).

11. A nurse makes a connection with the patient when providing spiritual care. Which type of connectedness did the nurse experience? a. Intrapersonal b. Interpersonal c. Transpersonal d. Multipersonal

ANS: B Interpersonal means connected with others and the environment. Intrapersonal means connected within oneself. Transpersonal means connected with God or an unseen higher power. There is no such term as multipersonal for connectedness.

3. The nurse is caring for an Islam patient who wants a snack. Which action by the nurse is most appropriate? a. Offers a ham sandwich b. Offers a beef sandwich c. Offers a kosher sandwich d. Offers a bacon sandwich

ANS: B Islam religion does allow beef. Islam does not allow pork or alcohol. Ham and bacon are pork. Kosher is allowed for Judaism.

2. The nurse is caring for a patient who claims that he does not believe in God, nor does he believe in an "ultimate reality." The nurse realizes that this patient a. Is devoid of spirituality. b. Is an atheist/agnostic. c. Finds no meaning through relationships with others. d. Believes that what he does is meaningless.

ANS: B Some individuals do not believe in the existence of God (atheist) or believe that there is no known ultimate reality (agnostic). This does not mean that spirituality is not an important concept for the atheist or the agnostic. Atheists search for meaning in life through their work and their relationships with others. Agnostics discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that people bring meaning to what they do.

7. Which of the following statement about religion and spirituality is true? a. Religion is a unifying theme in people's lives. b. Spirituality is unique to the individual. c. Spirituality encompasses religion. d. Religion and spirituality are synonymous.

ANS: B Spirituality is a complex concept that is unique to each individual. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. People from different religions view spirituality differently. Although closely associated, spirituality and religion are not synonymous. Religious practices encompass spirituality, but spirituality does not need to include religious practice.

1. A co-worker asks the nurse to explain spirituality. What is the nurse's best response? a. It has a minor effect on health. b. It is awareness of one's inner self. c. It is not as essential as physical needs. d. It refers to fire or giving of life to a person.

ANS: B Spirituality is often defined as an awareness of one's inner self and a sense of connection to a higher being, to nature, or to some purpose greater than oneself. Spirituality is an important factor that helps individuals achieve the balance needed to maintain health and well-being and to cope with illness. Florence Nightingale believed that spirituality was a force that provided energy needed to promote a healthy hospital environment and that caring for a person's spiritual needs was just as essential as caring for his or her physical needs. The word spirituality comes from the Latin word spiritus, which refers to breath or wind. The spirit gives life to a person.

4. In discussing spiritual well-being, the nurse identifies that the vertical dimension involves a. The positive relationships and connections people have with others. b. The transcendent relationship between a person and God. c. Confidence in something for which there is no proof. d. Providing an attitude of something to live for and look forward to.

ANS: B The concept of spiritual well-being is often described as having two dimensions. The vertical dimension supports the transcendent relationship between a person and God or some other higher power. The horizontal dimension describes positive relationships and connections people have with others. Faith provides confidence in something for which there is no proof. When a person has the attitude of something to live for and look forward to, hope is present.

10. The nurse and the patient have the same religious affiliation. Because of this, the nurse a. Can assume that they have the same spiritual beliefs. b. Should not impose her personal values on the patient. c. Must use an assessment tool to assess the patient's beliefs. d. Can skip the spiritual belief assessment.

ANS: B The nurse can use an assessment tool or direct an assessment with questions based on principles of spirituality, but it is important not to impose personal value systems on the patient. This is particularly true when the patient's values and beliefs are similar to those of the nurse because it then becomes very easy to make false assumptions. It is important to conduct the spiritual belief assessment; conducting an assessment is therapeutic because it expresses a level of caring and support.

16. The patient is having a difficult time dealing with his AIDS diagnosis. He states, "It's not fair. I'm totally isolated from my family because of this. Even my father hates me for this. He won't even speak to me." The nurse needs to a. Assure the patient that his father will accept his situation soon. b. Use therapeutic communication to establish trust and caring. c. Point out that the patient has no control and that he has to face the consequences. d. Tell the patient, "If your father can't get over it, forget it. You have to move on."

ANS: B The nurse needs to use therapeutic communication to establish trust and a caring presence because providing spiritual care requires caring, compassion, and respect. The nurse should not offer false hope. The nurse should help the patient maintain feelings of control. The nurse should encourage renewing relationships if possible and establishing connections with self, significant others, and God.

14. A male patient in stable condition is in the intensive care unit (ICU) and is asking to see his spouse and two daughters. What should the nurse do? a. Allow only 5 to 10 minutes with the family. b. Allow the wife and daughters to visit at the patient's request. c. Allow the two daughters to visit, and let the wife visit when they leave. d. Allow the wife and one daughter to enter the ICU but not the other daughter.

ANS: B Use of support systems is important in any health care setting. Allowing the family to visit is appropriate since the patient is in stable condition. When patients depend on family and friends for support, encourage them to visit the patient. As long as no interference with active patient care is involved, there is no reason to limit visitation. Limiting the visit is not necessary since the patient is stable. Breaking the family apart is not needed; the patient is stable and can see all three at once.

3. The nurse is caring for a patient who is terminally ill with very little time left to live. The patient states, "I always believed that there was life after death. Now, I'm not so sure. Do you think there is?" The nurse states, "I believe there is." The nurse has attempted to a. Strengthen the patient's religion. b. Provide hope. c. Support the patient's agnostic beliefs. d. Support the horizontal dimension of spiritual well-being.

ANS: B When a person has the attitude of something to look forward to, hope is present. Religion refers to the system of organized beliefs and worship that a person practices to outwardly express spirituality. This is not evident here. Agnostics believe that there is no known ultimate reality. This would indicate a lack of belief in life after death. The horizontal dimension of spiritual well-being describes positive relationships and connections people have with others. In this case, the patient is more concerned with the vertical dimension, which supports the transcendent relationship with God or some other higher power.

12. The patient is admitted with chronic anxiety. Which action is most appropriate for the nurse to take? a. Focus on finding quick remedies for the anxiety. b. Realize that the patient's only goal is relief of the anxiety. c. Look at how anxiety influences the patient's ability to function. d. Help the patient realize that there is little hope of relief from anxiety.

ANS: C Do not just look at the patient's anxiety as a problem to solve with quick remedies, but rather look at how the anxiety influences the patient's ability to function and achieve goals established in life (not just anxiety relief). Mobilizing the patient's hope is central to a healing relationship.

17. The nurse is caring for a patient who is in the final stages of his terminal disease. The patient is very weak but refuses to use a bedpan, and wants to get up to use the bedside commode. What should the nurse do? a. Explain to the patient that he is too weak and needs to use the bedpan. b. Insert a rectal tube so that the patient no longer needs to actively defecate. c. Enlist assistance from family members if possible and assist the patient to get up. d. Put the patient on a bedpan and stay with him until he is finished.

ANS: C Establishing presence is part of the art of nursing. Presence involves "being with" a patient versus "doing for" a patient. Demonstrate a caring presence by listening to the patient's concerns and willingly involving family in discussions about the patient's health. The nurse should support patients as they make decisions about their health. If at all possible, the nurse should encourage the patient to maintain as much independence as possible. Inserting a rectal tube involves "doing for" instead of "being with." Placing the patient on the bedpan is against the patient's wishes and is another form of "doing for."

10. The nurse and the patient have the same religious affiliation. Which action will the nurse take? a. Must use a formal assessment tool to determine patient's beliefs. b. Assume that both have the same spiritual beliefs. c. Do not impose personal values on the patient. d. Skip the spiritual belief assessment.

ANS: C It is important not to impose personal value systems on the patient. This is particularly true when the patient's values and beliefs are similar to those of the nurse because it then becomes very easy to make false assumptions. It is not a must to use a formal assessment tool when assessing a patient's beliefs. It is important to conduct the spiritual belief assessment; conducting an assessment is therapeutic because it expresses a level of caring and support.

2. The nurse is caring for a patient who is an agnostic. Which information should the nurse consider when planning care for this patient? a. The patient is devoid of spirituality. b. The patient does not believe in God. c. The patient believes there is no known ultimate reality. d. The patient finds no meaning through relationship with others.

ANS: C Some people do not believe in the existence of God (atheist), or they believe that there is no known ultimate reality (agnostic). Nonetheless, spirituality is important regardless of a person's religious beliefs. Agnostics discover meaning in what they do or how they live because they find no ultimate meaning for the way things are. They believe that people bring meaning to what they do.

8. The nurse creates a referral to pastoral care when he/she realizes that the patient is in need of a. Psychiatric care. b. Return to religious affiliation. c. Spiritual care. d. Transfer to the psychiatric unit.

ANS: C Spiritual care helps people identify meaning and purpose in life, look beyond the present, and maintain personal relationships, as well as a relationship with a higher being or life force. The patient may need psychiatric care and may be transferred to the psychiatric unit, but referral to pastoral care will not provide that. Return to a religious affiliation may follow a return to spiritual health.

11. When caring for a terminally ill patient, the nurse should focus on the fact that a. Spiritual care is possibly the least important nursing intervention. b. Spiritual needs often need to be sacrificed for physical care priorities. c. The nurse's relationship with the patient allows for an understanding of patient priorities. d. Members of the church or synagogue play no part in the patient's plan of care.

ANS: C The nurse's relationship with the patient allows the nurse to understand the patient's priorities. Spiritual priorities do not need to be sacrificed for physical care priorities. When a patient is terminally ill, spiritual care is possibly the most important nursing intervention. If the patient participates in a formal religion, involve in the plan of care members of the clergy or members of the church, temple, mosque, or synagogue.

5. The nurse is admitting a patient to the hospital. The patient is a very spiritual person but does not practice any specific religion. How will the nurse interpret this finding? a. This indicates a strong religious affiliation. b. This statement is contradictory. c. This statement is reasonable. d. This indicates a lack of hope.

ANS: C The patient's statement is reasonable and is not contradictory. Many people tend to use the terms spirituality and religion interchangeably. Although closely associated, these terms are not synonymous. Religious practices encompass spirituality, but spirituality does not need to include religious practice. When a person has the attitude of something to live for and look forward to, hope is present.

4. A nurse is teaching a patient how to meditate. Which information from the patient indicates effective learning? a. I will lie on the floor. b. I will breathe quickly. c. I will focus on an image. d. I will do this for 10 minutes every day.

ANS: C The steps of meditation include sitting in a comfortable position with the back straight; breathe slowly; and focus on a sound, prayer, or image. Meditation should occur for 10 to 20 minutes twice a day.

15. The nurse is caring for a patient who has been diagnosed with a terminal illness. The patient states, "I just don't feel like going to work. I have no energy, and I can't eat or sleep." The patient shows no interest in taking part in his care. The nurse should a. Not be concerned about self-harm because the patient has not indicated any desire toward suicide. b. Ignore individual patient goals until the current crisis is over. c. Encourage the patient to purchase over-the-counter sleep aids to help him sleep. d. Assess the potential for suicide and make appropriate referrals.

ANS: D A decreased appetite and level of energy and not wanting to be involved in care are signs of hopelessness. The nurse should assess for risk of the patient harming himself or others. The nurse should set goals that are important to the patient. Recommending good sleep hygiene habits is more appropriate than giving over-the-counter sleep aids.

7. A nurse is caring for a Hindu patient. Which action will the nurse take? a. Allow time to practice the Five Pillars. b. Allow time to practice Blessingway. c. Allow time for Holy Communion. d. Allow time for purity rituals.

ANS: D Hindus practice prayer and purity rituals. Blessingway is a practice of the Navajos that attempts to remove ill health by means of stories, songs, rituals, prayers, symbols, and sand paintings. Islams must be able to practice the Five Pillars of Islam. Holy Communion is practiced in the Christian religion.

5. The nurse is admitting a patient to the hospital. The patient states that he is a very spiritual person but does not practice any specific religion. The nurse understands that these statements a. Are contradictory. b. Indicate a strong religious affiliation. c. Indicate a lack of faith. d. Are reasonable.

ANS: D These statements are reasonable and are not contradictory. Many people tend to use the terms spirituality and religion interchangeably. Although closely associated, these terms are not synonymous. Religious practices encompass spirituality, but spirituality does not need to include religious practice. When a person has the attitude of something to live for and look forward to, hope is present.

14. The patient is in the intensive care unit (ICU), which has strict posted visiting hours and limits the number of visitors to two per patient at any one time. The patient is asking to see his wife and two daughters. The nurse should a. Tell the patient that they will be allowed to visit at the appropriate time. b. Allow the wife and one daughter to enter the ICU, but not the other daughter. c. Allow the two daughters to visit, and let the wife visit when they leave. d. Allow the wife and daughters to visit at the patient's request.

ANS: D Use of support systems is important in any health care setting. When patients depend on family and friends for support, encourage them to visit the patient regularly. As long as no interference with active patient care is involved, there is no reason to limit visitation.

patient presents with decreased libido, depression, and ineffective coping. Which nursing interventions would be helpful for the patient? Select all that apply. Assess for influence of cultural beliefs. Assess the causes of ineffective coping. Help the patient to set realistic goals. Encourage the patient to express feelings. Explain to the patient about the use of condoms.

Assess the causes of ineffective coping. Help the patient to set realistic goals. Encourage the patient to express feelings. Assessment of the cause of ineffective coping will help the nurse to understand the patient's problems and plan the treatment accordingly. Helping the patient to set realistic goals would help increase the patient's confidence and prevent frustration. Encouraging the patient to express feelings will provide greater insight into the problem. Assessing the influence of cultural beliefs is helpful regarding social isolation. Explaining to the patient about the use of condoms would not help increase libido or enhance coping.

A 35-year-old woman comes to the clinic for her general health checkup. She is the mother of a 6-year-old girl. The patient expresses that she and her husband are exhausted because of their work schedules and this has affected their sexual relationship. What advice can the nurse provide to improve the couple's sexual relationship? Select all that apply. Avoid alcohol and tobacco. Do not have sexual intercourse until your workload lightens. Have well-balanced meals and follow a regular sleep pattern. Plan sexual activities in the morning or another time when you are well rested. Communicate your concerns with your partner.

Avoid alcohol and tobacco Have well-balanced meals and follow a regular sleep pattern. Plan sexual activities in the morning or another time when you are well rested. Communicate your concerns with your partner. Modern working couples become exhausted due to hectic work schedules. This can affect their health as well. The couple should avoid alcohol, tobacco, and caffeine, as these have detrimental effects on their health. A well-balanced diet and regular sleep patterns help maintain good health and energy levels. Planning sexual activity in the mornings or another time when the couple is well rested solves the problem of tiredness. The partners should communicate to each other about their concerns so that they can deal with the problem together. It is incorrect to advise the couple to abstain from sexual activity until their workload lightens, because this does not solve the problem.

A 26-year-old married woman recently discovered that she is pregnant and is at her first prenatal visit. While assessing the patient, the nurse practitioner discovers that the patient has purulent vaginal discharge. The patient states, "It burns when I urinate, and I seem to have to go to the bathroom frequently." Based on these symptoms, what follow-up would the nurse practitioner likely advise for this patient? Be tested for human immunodeficiency virus (HIV). Be tested for a sexually transmitted infection (STI) such as Chlamydia. There is no need for follow-up as this is a normal sign of pregnancy. Obtain education on proper perineal hygiene

Be tested for a sexually transmitted infection (STI) such as Chlamydia. Chlamydia does not cause symptoms in about 75% of women; thus they are often unaware that they have a sexually transmitted infection (STI). It often causes genitourinary tract infections in men and women. Serious complications can result from untreated STIs in pregnancy such as preterm labor and rupture of membranes and premature delivery of the newborn. Purulent discharge indicates infection and is not an expected finding in pregnancy or from poor hygiene practices.

The nurse is providing a sex education session to a group of grade-school students. Which aspect of sexual education should the nurse include in the teaching? Select all that apply. Body changes Menstruation Sexually transmitted infections Contraception Sexual relationships

Body Changes Menstruation Sexually Transmitted Infections Contraception Sexual Relationships Menstruation is the periodic discharge of blood from the uterus through the vagina. Due to lack of information about menstruation, grade-school children may view it as a dreadful disease. Therefore, the nurse should teach or encourage parents or teachers to educate children about menstruation. School-age children have questions about changes in their bodies and emotions, and they need accurate information about these changes. Body changes are more evident in adolescents due to hormonal changes that influence their health. Adolescents who are sexually active may also have several sexual partners. They may seek sexual relationships to achieve the goals of intimacy and pleasure. Therefore, the nurse should teach adolescents (not grade-school children) about body changes, contraception, sexually transmitted infections, and sexual relationships.

A woman has been diagnosed with infertility. The nurse finds that the patient has multiple sexual partners and suspects a correlation between the patient's infertility and her promiscuous lifestyle. Which could have caused infertility in this patient? Human immunodeficiency virus (HIV) Chlamydia Herpes simplex Human papillomavirus

Chlamydia Chlamydia trachomatis infection, if left untreated, may cause infertility, pelvic inflammatory disease, and ectopic pregnancy. Most chlamydia infections are not treated because they do not cause any symptoms in women. Human immunodeficiency virus (HIV) usually does not cause infertility. Herpes causes painful genital lesions but does not cause infertility. Human papillomavirus causes warts and cervical and anogenital malignancies.

Which is the most commonly reported bacterial sexually transmitted infection (STI) in the United States? Syphilis Gonorrhea Genital herpes Chlamydia

Chlamydia Syphilis, gonorrhea, genital herpes, and chlamydial infections are all commonly reported; however, infection with Chlamydia organisms is the most common bacterial sexually transmitted infection (STI) in the United States. Other STIs include syphilis, gonorrhea, and genital herpes. Syphilis is caused by Treponema pallidum. Gonorrhea is caused by Neisseria gonorrhoeae. Genital herpes is caused by herpes simplex virus.

Which nursing action takes priority when working with a patient who opts for an abortion? Explain that abortion means killing a life. Clarify the nurse's own personal values. Convince the patient that abortion is a crime. Criticize the patient for the decision.

Clarify the nurse's own personal values. Before nurses can be helpful to patients opting for an abortion, they must be aware of and comfortable with their own feelings and values. The nurse should not provide wrong and biased information to the patient to influence the decision. As a corollary, nurses must be comfortable with the idea that patients have a right to their own values. Nurses must also avoid criticism and censure.

The nurse is counseling a couple on contraceptive methods. Which nonprescription method should the nurse recommend? Condom Diaphragm Vaginal ring Subdermal implant Transdermal skin patch

Condom Condoms are nonprescription methods of contraception. A condom prevents entry of sperm into the vagina. It is made of a thin rubber sheath and fits over the penis. A diaphragm is a barrier with spermicide to be used in females; it must be fitted by a gynecologist and so requires a prescription. Vaginal contraceptive rings, subdermal implants, and transdermal skin patches are hormonal methods of contraception and require a health provider's prescription.

A middle-aged patient is diagnosed with erectile dysfunction. Which associated conditions might the nurse find in the patient? Select all that apply. Diabetes Hypertension Anorexia Hyperlipidemia Hyperthyroidis

Diabetes Hypertension Hyperlipidemia Diabetes mellitus, hypertension, and hyperlipidemia are risk factors associated with erectile dysfunction. Obesity, not anorexia, is a risk factor for erectile dysfunction. Hypothyroidism, not hyperthyroidism, is associated with erectile dysfunction.

The nurse finds that a 12-year-old girl displays physical aggression, excessive masturbation, poor school performance, and poor peer relationships. Which other findings observed in the girl indicate a history of being sexually abused? Select all that apply. Difficulty eating Difficulty walking or sitting Unusual odor in the genital area Vomiting or abdominal tenderness Fractures of the face, nose, and arms

Difficulty walking or sitting Unusual odor in the genital area Physical aggression, excessive masturbation, poor school performance, and poor peer relationships are behavioral symptoms of sexual abuse. Symptoms such as difficulty walking or sitting and an unusual odor in the genital area often indicate sexual abuse. Therefore, the nurse should confirm the history of sexual abuse during assessment. Difficulty eating occurs due to anorexia, which is a common finding in adults. Vomiting or abdominal tenderness and fractures of the face, nose, and arms are physical signs that often indicate sexual abuse in adults.

A 50-year-old woman complains of dyspareunia. Which is a possible cause of dyspareunia in the patient? Diminished sexual desire Diabetes and hypertension Diminished vaginal lubrication Increased vaginal elasticity

Diminished vaginal lubrication Dyspareunia is painful sexual intercourse. In perimenopausal women, estrogen secretion decreases and leads to diminished vaginal lubrication and elasticity. These changes may cause dyspareunia. Diminished sexual desire could be due to low estrogen but does not lead to dyspareunia. Diabetes and hypertension do not cause dyspareunia.

A patient presents with ineffective sexual functioning. Which strategies should the nurse suggest to enhance sexual functioning in the patient? Discourage the use of pain medications. Discourage the use of alcohol and tobacco. Encourage touching and kissing. Discourage the use of pillows during sex. Communicate concerns and fears with the partner.

Discourage the use of alcohol and tobacco. Encourage touching and kissing. Communicate concerns and fears with the partner. Alcohol and tobacco may decrease sexual functioning and should be discouraged. Touching, kissing, and tactile stimulation are forms of intimacy and should be encouraged. Communicating concerns and fears with the partner and health care provider help in better understanding the problem. Pain medication may be promoted before intercourse in the patient who has chronic pain that could affect intercourse.

The nurse is reviewing the sexual and physical examination data of a patient diagnosed with sexual dysfunction. Which signs and symptoms might the nurse anticipate finding in the assessment data? Select all that apply. Dyspareunia Erectile dysfunction Uncontrolled hypertension Depression and guilt Foul-smelling genitals

Dyspareunia Erectile dysfunction Uncontrolled hypertension Depression and guilt Sexual dysfunction is the inability to accomplish sexual desires. It can be due to many reasons. Dyspareunia is pain occurring with sexual intercourse that may lead to decreased sexual desire. Erectile dysfunction that prevents erection required for satisfactory copulation may also lead to decreased desire. Sexual dysfunction may also be related to various psychological factors, including anxiety, depression, and guilt. Uncontrolled hypertension is a risk factor for sexual dysfunction. Foul-smelling genitals call into question cleanliness or suggest the presence of infection.

Which priority nursing intervention should be included in the plan of care based on the fact that the majority of sexually transmitted infections (STIs) have few if any symptoms? Encourage regular screenings in all sexually active individuals. Provide information about contraception options. Administer prescribed antibiotics for human papillomavirus (HPV) or genital herpes outbreaks. Ask all patients if they are experiencing any symptoms.

Encourage regular screenings in all sexually active individuals. One of the challenges in reducing the incidence of sexually transmitted infections (STIs) is that most STIs have few symptoms in males or females. Asymptomatic STIs can be diagnosed during a physical examination with appropriate laboratory tests. Screening after each new sex partner is the most effective method to detect and manage STIs. Human papillomavirus (HPV) and herpes are viral infections and cannot be treated with antibiotics.

A 50-year-old male patient comes for a follow-up visit a few months after a myocardial infarction. The nurse plans to interview the patient to assess his sexual health. What precautions should the nurse take when assessing the patient's sexuality? Select all that apply. Ensure that the patient is comfortable discussing the issue. Ensure that the patient has privacy. Close the door or curtains of the room. Avoid talking to the patient. Hand him a questionnaire and ask him to complete it. Ask open-ended questions, such as how the patient's health problem has affected his sexual activity. Include the family members in the discussion to get more information.

Ensure that the patient is comfortable discussing the issue. Ensure that the patient has privacy. Close the door or curtains of the room. Ask open-ended questions, such as how the patient's health problem has affected his sexual activity. When assessing a patient's sexuality, it is extremely important that the patient is comfortable discussing it. The nurse should maintain privacy by closing the doors and curtains of the room. Asking open-ended question gives the patient the opportunity to explore his situation completely. It is an incorrect nursing practice to avoid discussion with the patient and just handing him a questionnaire. Family members should not be included in the discussion, because that may be an invasion of the patient's privacy.

A 50-year-old male reports he is experiencing issues related to his sexual performance. His blood levels are normal except for a high glucose level. His semen analysis is within normal limits. Which disorder is likely responsible for his condition? Hypoactive sexual desire Erectile dysfunction Dyspareunia Infertility

Erectile dysfunction High blood sugar often leads to sexual dysfunction. Erectile dysfunction is a type of sexual dysfunction in which the person cannot have or sustain an erection. Hypoactive sexual desire disorder is a disorder in which the person has no or very low sexual desire. Dyspareunia is the occurrence of pain during intercourse, which can be the result of decreased levels of estrogen in perimenopausal women. Infertility is the inability to conceive after 1 year of unprotected intercourse.

Decreased levels of which hormone may result in painful sexual intercourse? Estrogen Testosterone Growth hormone Follicle-stimulating hormone (FSH)

Estrogen Decreased estrogen levels result in decreased vaginal lubrication and vaginal tissue thinning. These changes can result in painful sexual intercourse. Testosterone, growth hormone, and follicle-stimulating hormone (FSH) do not affect the vaginal tissues and do not cause painful intercourse when their levels decrease. Testosterone is responsible for sexual growth and development in males. Growth hormone is responsible for overall growth and development in an individual. FSH promotes sexual growth in females.

Certain cultural groups in the United States are disproportionately affected by infectious diseases such as human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). Which factors increase the risk for HIV and AIDS? Select all that apply. Expectations about behavior by men or women in the culture Higher percentages of lesbian, gay, bisexual, or transgender individuals in the culture Genetic predisposition to the disease in the culture Communication patterns and language practiced by the culture Varied climate in different geographic locations

Expectations about behavior by men or women in the culture Communication patterns and language practiced by the culture Cultural factors such as gender, education, socioeconomic status, religion, language, and values influence the use of the health care system. Populations that are at increased risk for human immunodeficiency virus (HIV) include those who are intravenous drug users, those with hemophilia, and those who practice unprotected sex. Genetic factors often increase the risk for certain health problems such as cardiovascular disease or cancers, but do not usually increase the risk for HIV, because it is a viral infection and not a genetic disease. Climate does not increase the risk for HIV.

The nurse is educating a couple about sexually transmitted infections. Which sexual infections cannot be cured? Select all that apply. Herpes Syphilis Chlamydia Gonorrhea Human papillomavirus infection

Herpes Human papillomavirus infection Sexually transmitted infections that cannot be cured include herpes and human papillomavirus. Syphilis, chlamydia, and gonorrhea are sexually transmitted infections caused by bacteria; they can be cured by antibiotics. Syphilis is caused by the bacteria Treponema pallidum. Chlamydia is caused by the bacteria Chlamydia trachomatis. Gonorrhea is caused by the bacteria Neisseria gonorrhoeae.

A 15-year-old girl states that she is having unprotected intercourse with her boyfriend. She asks for more information about birth control methods. Which information should the nurse include in patient education? Select all that apply. Condoms or diaphragms are the most effective methods. Hormonal methods offer little protection against sexually transmitted infections (STIs). Barrier methods offer some protection against STIs. Sterilization is an effective option that the patient should consider. The rhythm method is effective for preventing pregnancy.

Hormonal methods offer little protection against sexually transmitted infections (STIs). Barrier methods offer some protection against STIs. The most effective methods are longer-acting methods, such as an intrauterine device (IUD) or hormonal injection, which are not associated with the sexual act itself. Sterilization is the most effective method besides abstinence but would not be a good option for a young woman, because it is not easily reversible. Hormonal methods do not provide any barrier against sexually transmitted infections (STIs), whereas barrier methods may help reduce the risk. The rhythm method would not be an effective method of birth control for a 15-year-old girl. Couples who use this method need to understand the reproductive cycle of the woman's body and the subtle signs and signals that her body gives during the cycle. To prevent pregnancy, couples abstain from sexual intercourse during designated fertile periods.

The nurse is caring for a patient who is a sex worker. Against which sexually transmitted diseases can the patient be vaccinated? Human immunodeficiency virus (HIV) Herpes Chlamydia Human papillomavirus (HPV) infection

Human papillomavirus (HPV) infection A vaccine is available for various strains of the human papillomavirus (HPV). This virus is known to cause cervical cancer in women and anogenital cancers and genital warts, which cause health concerns in males and females. There are no vaccines for human immunodeficiency virus (HIV), herpes, or chlamydia. However, chlamydia can be cured by antibiotics. HIV and herpes have no cure.

A patient with heart disease asks the nurse if medications for heart disease can cause erectile dysfunction. Which drugs can cause erectile dysfunction? Select all that apply. Illicit drugs Antidiabetics Diuretic agents Antiplatelet drugs Antihypertensives

Illicit drugs Diuretic agents Antihypertensives Drugs that have been associated with erectile dysfunction include illicit drugs, diuretic agents, and antihypertensive medications. Antidiabetics and antiplatelet drugs are not associated with erectile dysfunction. Antidiabetic and antiplatelet drugs are associated with minor side effects such as nausea, diarrhea, and itchy skin.

The nurse reviews the health history of a 24-year-old woman who indicates that she has had three new sexual partners since her previous examination 2 years ago. The nurse discusses the need for screening for sexually transmitted infection (STI) even though the patient denies symptoms or discomfort. Which is the most serious complication from untreated STIs in females? Genital discharge and dyspareunia Painful menstrual cycles Infertility and pelvic inflammatory disease Genital warts

Infertility and pelvic inflammatory disease Sexually transmitted infections (STIs) can certainly cause discharge, discomfort, and genital warts; however, the most serious complications from untreated bacterial STIs are damage to the reproductive organs and increased risks of pelvic inflammatory disease, ectopic pregnancy, and infertility.

The nurse is caring for an infertile couple and learns that the couple is suffering from chlamydia. Which statement by the nurse about chlamydia is appropriate? Select all that apply. It affects the genitourinary tract. There is no cure for this disorder. It does not cause ectopic pregnancy. The rectum is resistant to chlamydia infection. It may cause infection of the eyes and lungs in newborns.

It affects the genitourinary tract. It may cause infection of the eyes and lungs in newborns. Chlamydia infection affects the genitourinary system and causes conjunctivitis and pneumonia in newborns. Chlamydia can be cured with antibiotics. Chlamydia infection may cause pelvic inflammatory disease (PID), infertility, and ectopic pregnancy. Chlamydia also infects the rectum.

The nurse is educating a couple about the human immunodeficiency virus (HIV). Which statements by the nurse about HIV are appropriate? Select all that apply. It is a blood-borne pathogen. It spreads through oral-genital sex. It is not found in bodily fluids. It causes ectopic pregnancy. Its risk can be reduced by the use of condoms.

It is a blood-borne pathogen. It spreads through oral-genital sex. Its risk can be reduced by the use of condoms. Human immunodeficiency virus (HIV) is primarily a blood-borne pathogen. It spreads through vaginal and anal intercourse and through oral-genital sex. The use of condoms reduces the incidence of HIV infection, whereas unprotected sex increases the risk of HIV transmission. Bodily fluids contain HIV, and any exchange of body fluids can result in HIV transmission. Unlike chlamydia, HIV infection is not known to cause ectopic pregnancy.

The nurse is discussing sexual issues with a patient. Which statements hold true about sexuality? Select all that apply. It is influenced by personal beliefs. It is not affected by medications in use. It is influenced by the place where one lives. Pregnancy may affect sexual interest. It may be affected by chronic respiratory disease. Ethnicity plays a role in shaping sexual values.

It is influenced by personal beliefs. Pregnancy may affect sexual interest. It may be affected by chronic respiratory disease. Ethnicity plays a role in shaping sexual values. Sexuality is influenced by various factors. An individual's sexuality may be affected by personal beliefs and notions of sexual health. Pregnancy leads to fluctuation in sexual desire due to the hormonal and bodily changes that occur. In addition, presence of disease conditions may shift the focus and energy of the patient towards healing, thus affecting sexuality. The sociocultural environment of a person always influences conduct. The rules and norms of society often determine acceptable and nonacceptable behavior within the culture, thus affecting sexuality. Sexuality is affected by the medications in use. The global location of a person has not been found to affect sexuality.

A patient has opted for a diaphragm as a mode of contraception. Which advice should the nurse provide to the patient? Select all that apply. It should be used along with an intrauterine device (IUD). It should be used along with condoms. It should be refitted after pregnancy. It should be used with a contraceptive cream. It should be refitted after a significant change in weight.

It should be refitted after pregnancy. It should be used with a contraceptive cream. It should be refitted after a significant change in weight. Diaphragms require refitting after pregnancy and after a significant change in the patient's weight (more than a 10-lb gain or loss). Diaphragms are always used with contraceptive creams (spermicides) to ensure their effectiveness. An intrauterine device (IUD) is placed inside the uterus for its contraceptive effects. A patient using an IUD need not use a diaphragm. Although not necessary for contraception when using a diaphragm with spermicide, condoms can be used with a diaphragm and spermicide to decrease transmission of sexually transmitted infections.

A female patient is advised to use a diaphragm for contraception. The nurse understands that any weight change necessitates a resizing of the diaphragm. How much change in weight would be significant? Loss or gain of 4 lbs Loss or gain of 6 lbs Loss or gain of 8 lbs Loss or gain of 10 lbs

Loss or gain of 10 lbs A diaphragm is a round, rubber dome that is fitted into the cervical opening to provide contraception. It must be used with a contraceptive cream or jelly. It must be refitted if the patient has a weight gain or loss of 10 lbs. Weight changes of 4, 6, or 8 lbs have no adverse effect on the placement of the diaphragm and thus do not require the patient to be refitted.

The nurse is gathering a sexual history from a 68-year-old man in a nursing home. Which is important for the nurse to keep in mind? Older adults are usually not part of a sexual minority group. Older adults sometimes do not reveal intimate details. Older men and women lose interest in sex. Older adults in nursing homes do not usually participate in sexual activity.

Older adults sometimes do not reveal intimate details. Older adults are sometimes hesitant to reveal information relating to sexual issues because they are embarrassed. It is important that the nurse include a sexual history as a routine aspect of assessment to communicate that sexual activity is normal. Studies have shown an increase in sexual dysfunction with aging but no decrease in sexual activity or interest.

A patient has been diagnosed with cervical cancer. The patient is a commercial sex worker. Which infection could be responsible for this malignancy? Chlamydia infection Gonorrhea infection Herpes simplex infection Papillomavirus infection

Papillomavirus infection Human papillomavirus causes cervical cancer in women and anogenital cancers and warts in both men and women. Chlamydia trachomatis infection does not cause malignancies but can cause urinary and pelvic symptoms. Neisseria gonorrhoeae infection causes urethritis and does not lead to any malignancy. Herpes simplex causes recurrent genital lesions.

A 50-year-old male patient comes for a follow-up visit a few months after a myocardial infarction. The nurse plans to interview the patient to assess his sexual health using the PLISSIT model. Which components are included in the PLISSIT model of assessment? Select all that apply. Palliation Permission Limited information Specific suggestions Intravenous therapy

Permission Limited information Specific suggestions The PLISSIT model is used for sexual assessment of the patient. P stands for permission from the patient to discuss sexual history. LI stands for limited information regarding sexual health problems. SS stands for specific suggestions made when the nurse is clear about the problem. IT stands for intensive therapy by a professional. Palliation and intravenous therapy are not part of the PLISSIT model.

How can a nurse establish trust and encourage patient disclosure about sexuality? Ask how often the patient has sexual intercourse. Ask the patient to disrobe in preparation for the physical assessment. Request permission to discuss sexual issues. Request specific examples of sexual practices and problems.

Request permission to discuss sexual issues. According to the PLISSIT assessment of sexuality, the nurse should first ask for permission to discuss sexual issues with the patient, followed by open-ended questions to determine the patient's concerns.

While caring for a pregnant patient who is in the first trimester of pregnancy, the nurse discusses sexual activity during pregnancy with the patient. During which trimester are pregnant women most likely to experience increased libido? First trimester Second trimester Third trimester It is unaffected during pregnancy.

Second trimester During the second trimester of pregnancy, patients are most likely to experience an increased libido due to an increased blood supply to the pelvic area to nourish the placenta. In the first trimester, there is usually a decrease in libido due to nausea and vomiting. In the third trimester, a comfortable position for sex is difficult. Therefore, sexual desire is usually not equal during all trimesters of pregnancy.

During an interview of a 35-year-old male patient, the nurse finds that the patient has multiple sex partners and is at risk for contracting a sexually transmitted infection (STI). Which symptom should the nurse look for in the patient? Diarrhea Vomiting Pain in the testicles Sores on the penis

Sores on the penis The presence of sores on the penis is a symptom of sexually transmitted infections (STI). STI present with few symptoms and most of them are related to the genital area. Diarrhea and vomiting indicate a gastrointestinal problem. Pain in the testicles is not commonly seen in STIs. It may occur due to injury to the testes or in the case of testicular torsion.

A 25-year-old patient is in the emergency department and states that she has had a cough and fever for the past 3 days. While performing a physical assessment, the nurse finds several bruises that are in various stages of healing and suspects that the patient may be a victim of sexual abuse. Which is the nurse's first action? Refer the patient to a sexual counselor. Tell the patient about the safe house for women. Ask the patient to describe how she got the bruises. Report the abuse immediately to the proper authorities.

Tell the patient about the safe house for women. The first action is to educate the patient about available resources in the community to help her develop an escape plan. Reporting the abuse to authorities may put her at increased risk for violence but is legally required.

The nurse is teaching a patient how to use a condom. Which statement by the nurse about using a condom is appropriate? Select all that apply. The air should be squeezed out of the condom. The condom should be applied when the penis is hard. The condom should be unrolled to the base of the penis. The condom should be pulled out during ejaculation. Massage oils should be used for lubrication.

The air should be squeezed out of the condom. The condom should be applied when the penis is hard. The condom should be unrolled to the base of the penis. The air in the condom should be squeezed out. It should be put on as soon as the penis becomes hard and before making any contact with vagina, anus, or mouth. It should be unrolled to the base of the penis to prevent any leakage. The condom should be pulled out after ejaculation and not during ejaculation; pulling it out during ejaculation may cause the semen to pass into the partner. Only water-based lubricants should be used with a condom. Massage oils should not be used, because they may contribute to the condom breaking.

A couple is diagnosed as positive for the human immunodeficiency virus (HIV). Which information should the nurse include when educating this couple about HIV? They should not engage in sexual intercourse. Their children will also be HIV positive. Their duration of survival would increase with treatment. They can be cured by highly active antiretroviral therapy (HAART).

Their duration of survival would increase with treatment. Individuals infected with human immunodeficiency virus (HIV) can survive for about 10 years if left untreated. Because they are already infected, they may have sexual intercourse with each other. Their children are at risk, but not all children born to HIV mothers test positive for HIV. Highly active antiretroviral therapy (HAART) greatly increases the longevity of infected individuals but does not cure the disease.

The nurse is communicating with a gay patient. Which statements hold true for this patient group? Select all that apply. They belong to a sexual minority. They do not readily seek preventive care. They are comfortable revealing their sexual orientation. They are concerned about discrimination. They are more prone to getting sexually transmitted diseases.

They belong to a sexual minority. They do not readily seek preventive care. They are concerned about discrimination. Gay patients belong to a sexual minority group often described as lesbian, gay, bisexual, or transgender (LGBT). Current evidence indicates that they experience decreased access to health care and do not readily seek preventive care (Lim et al., 2014; Williamson, 2010), and may limit access to health care due to the fear of discrimination. Although a lot of advancements and modernization has happened, somehow the sexual minority group is not yet well accepted, and hence many of them are not comfortable revealing their sexual orientation. Sexually transmitted diseases can occur in any sexually active person irrespective of the category they belong to.

A woman wishes to use hormonal contraceptives. How do they work? Select all that apply. They cause thinning of the lining of the uterus. They prevent ovulation. They reduce sperm motility. They act as a spermicidal barrier. They thicken the cervical mucus.

They cause thinning of the lining of the uterus. They prevent ovulation. They thicken the cervical mucus. Hormonal contraceptives work by thinning the uterus so that the fertilized ovum does not get implanted. They also prevent ovulation and thicken the cervical mucus, preventing sperm cells from ascending into the uterus. Hormonal contraceptives do not affect the motility of sperm and do not have any spermicidal effect. Spermicidal creams and jellies kill sperm cells before they enter the uterus.

The nurse is conducting a sexual assessment of an adolescent. Which should the nurse keep in mind when interacting with this age group? Select all that apply. Use simple language. Check for signs of physical injuries. Keep the findings private and confidential. Use a closed and positive approach. Inform patients that answering questions is normal.

Use simple language. Check for signs of physical injuries. Inform patients that answering questions is normal. When interacting with an adolescent about sexuality, use simple and understandable language. The physical examination should involve checking for any signs of injuries to assess for abuse. The patient may be hesitant to interact and hence should be informed that answering such questions is normal. The findings should be shared with the parent or guardian when dealing with a minor. The nurse's approach should be open and positive, because a closed approach may make the patient uncomfortable while responding.

A patient complains of dyspareunia. She is diagnosed with sexual dysfunction related to decreased sexual desire. Which instructions should be provided to the patient? Select all that apply. Perform exercise to increase sexual desire. Use contraceptive medications and devices. Avoid the overuse of alcohol and cigarettes. Use water-soluble lubricants before sexual intercourse. Explore alternative, acceptable, and more satisfying sexual practices.

Use water-soluble lubricants before sexual intercourse. Explore alternative, acceptable, and more satisfying sexual practices. Dyspareunia is painful sexual intercourse. The goal for treatment would be to devise a plan to decrease pain and to obtain greater satisfaction during sexual activity. The use of lubrication may ease sexual intercourse, making it less painful. Teaching alternative and less painful practices also adds to the plan. Exercising, use of contraception, or asking patients to avoid alcohol and cigarettes may not be useful in this type of sexual dysfunction but may be useful in dysfunctions related to lifestyle.

A couple does not desire to have any more children. Which contraceptive method should the nurse suggest to the couple? Skin patch Abstinence Intrauterine device Vasectomy

Vasectomy Because the couple does not wish to have any more children, it is advisable for the couple to opt for permanent contraception. Vasectomy is usually a permanent sterilization procedure for men and involves tying and cutting of the vas deferens. Skin patches and intrauterine devices are not as effective and do not offer permanent contraception. Abstinence from sex is difficult to maintain for most couples.

A male patient approaches the nurse for advice on permanent methods of contraception. What should the nurse suggest to the patient? Tubal ligation Vasectomy Subdermal implants Transdermal skin patches

Vasectomy Vasectomy is a permanent method of contraception in males. In the procedure, the vas deferens, which carries the sperm away from the testicles, is cut and tied. Tubal ligation is a surgical procedure done in females that involves cutting the fallopian tube. Subdermal implants and transdermal skin patches are hormonal methods for temporary contraception.