Module 19 - Sexuality
10) A client who is postmenopausal confides in the nurse about pain experienced during intercourse. What should the nurse instruct the client to do? A) Use vaginal lubricants during intercourse. B) Avoid intercourse. C) Tolerate this problem because it is a normal part of aging. D) Decrease the frequency of intercourse to decrease the pain.
Answer: A
3) A client is concerned about becoming impotent because of the inability to sustain an erection and a history of a sexually transmitted infection as a young adult. What is the nurse's best response to this client's concerns? A) An occasional incident like this is normal and common, and there is no reason to be concerned. B) Sexually transmitted infections may result in sexual problems in adults. C) Erectile dysfunction is the correct term for the inability to achieve or sustain an erection. D) The medical diagnosis of erectile dysfunction is not made until the man has erection difficulties in 25% or more of his interactions.
Answer: A
4) A client with a history of breast cancer who is entering menopause is seeking information about how to manage hot flashes. What information can be provided to the client? A) Soy and black cohosh can be used to manage the hot flashes associated with menopause. B) The client should be advised that she will have to wait until menopause has finished for the hot flashes to cease. C) Estrogen is the only reliable method of treatment for hot flashes. D) Olive oil and black cohosh are effective in the management of hot flashes.
Answer: A
4) A female client tells the nurse that she does not want to have children because there is a history of Down syndrome in the family. What should the nurse respond to this client? A) "That is a common genetic defect caused by an extra chromosome." B) "Babies born with Down syndrome do not live very long." C) "It is probably best to not give birth to a baby with birth defects." D) "Down syndrome only occurs in the babies of women who are over the age of 40."
Answer: A
4) During a physical assessment, a client tells the nurse that his penis "hurts" when the shaft is touched. What should the nurse suspect is occurring with this client? A) Urethral stricture B) Acute orchitis C) Inflammatory disease D) Acute epididymitis
Answer: A
8) The nurse is evaluating care provided to a client experiencing menopause. Which observation indicates that the client is successfully managing menopausal symptoms? A) Weight loss of 5 pounds in 4 months after starting an exercise program at the local gym B) Client's stated desire to stay at home and limit social activities C) Weight gain of 10 pounds in 3 months D) Client's stated loss of interest in recreational activities
Answer: A
9) A client experiencing menopause voices an interest in using alternative and complementary therapies to manage symptoms. What initial response by the nurse is indicated? A) "What types of therapies are of interest to you?" B) "Those seldom work." C) "Have you discussed this with your physician?" D) "Many women report success with these measures."
Answer: A
3) The nurse identifies that a client is at risk for dysfunctional uterine bleeding. What did the nurse assess in this client? Select all that apply. A) High level of stress B) Weight gain of 20 lbs. in 2 months C) Uses birth control pills for contraception D) Has a history of peptic ulcer disease E) Limits intake of high-fat foods
Answer: A, B, C
6) During a health history, the nurse learns that a female client has been trying to conceive for 2 years and does not understand why she cannot become pregnant. For which causes of infertility should the nurse assess in this client? Select all that apply. A) Amount of alcohol consumed each day B) Dietary eating pattern C) Amount of exercise D) Employment status E) History of sexually transmitted infections
Answer: A, B, C, E
10) A client wants to use the vaginal sponge as a method of contraception. Which statement or statements indicate that the client needs further instruction? Select all that apply. A) "I need to leave it in no longer than 6 hours." B) "I need to use a lubricant prior to insertion." C) "I can insert the sponge no longer than 24 hours prior to having intercourse." D) "I need to add spermicidal cream prior to intercourse." E) "I need to moisten it with water prior to use."
Answer: A, B, D
7) A client with syphilis is allergic to penicillin. Which medication would the client need to be prescribed to treat the infection? Select all that apply. A) Doxycycline B) Amoxicillin C) Tetracycline D) Gentamicin E) Erythromycin
Answer: A, C
7) The nurse is caring for a client with erectile dysfunction (ED). Which medication should the nurse anticipate being prescribed for this client? Select all that apply. A) Sildenafil (Viagra) B) Methylphenidate (Ritalin) C) Vardenafil (Levitra) D) Buspirone (BuSpar) E) Tadalafil (Cialis)
Answer: A, C, E
6) The nurse instructs a married couple on the importance of treatment for a chlamydia infection. Which statement or statements indicate that teaching was effective? Select all that apply. A) "He could get an infection in the tube that carries the urine out." B) "She could have severe vaginal itching." C) "It could cause us to develop rashes." D) "She could develop a worse infection of the uterus and tubes." E) "She could become pregnant."
Answer: A, D
1) A nurse is caring for a client who complains of pain with menstruation. What is true regarding the etiology and pathophysiology of this condition? A) Primary dysmenorrhea is caused by decreased levels of prostaglandins, causing the contractions of the uterus to increase in strength. B) Primary dysmenorrhea begins within the first 3 or 4 menstrual periods after menarche and will occur with each ovulatory cycle during the teens and 20s of a woman's life. C) Secondary dysmenorrhea is more common than primary dysmenorrhea. D) Primary dysmenorrhea causes include endometriosis, tumors, cysts, pelvic adhesions, pelvic inflammatory disease, infections, cervical stenosis, uterine leiomyomas, and adneomyosis.
Answer: B
1) A nurse is caring for a client who is perimenopausal who states that she has recently had frequent bacterial vaginal infections. The nurse understands that the reason this has occurred is likely due to which of the following? A) Decreased vaginal pH B) Increased vaginal pH C) Increased estrogen level D) Decreased vasomotor stability
Answer: B
1) During a health history, the nurse learns that a client has a recent onset of impotence. Which question will help identify a potential cause of this manifestation? A) "Does this occur often?" B) "For what diseases and disorders have you been treated?" C) "Are you on any medications?" D) "How does your partner feel about this problem?"
Answer: B
1) The nurse teaches families about recognizing signs of dating violence in their teenage children. Which participant statement indicates that teaching about safe sexual practices has been effective? A) "Our son has a new girlfriend." B) "Our daughter has come home with the odor of alcohol on her breath." C) "We taught our children about dating violence when they were 6 years old." D) "We noticed our daughter seems very happy lately."
Answer: B
2) A college student is being treated for Chlamydia. What should the nurse teach this student to decrease the risk of transmitting another sexually transmitted infection? A) Unprotected sex is acceptable if you know the partner well. B) Latex condoms should be used for all sexual activity. C) Birth control pills will help to decrease the risk of pregnancy and STDs. D) Condoms should be used with petroleum jelly.
Answer: B
3) A female client tells the nurse about wanting to wait to start a family even though the spouse has been "hinting" about it for some time. What is the best response by the nurse? A) "Maybe you should babysit a friend's child for a while to see if you really want children." B) "You and your spouse need to discuss the decision to start a family." C) "If you don't want to start a family then you don't have to." D) "What would you do if you became pregnant now?"
Answer: B
4) A client diagnosed with a sexually transmitted infection reports having "no idea" how the illness was contracted. Which nursing diagnosis would be appropriate for the client at this time? A) Anxiety B) Knowledge Deficit C) Ineffective Coping D) Sexual Dysfunction
Answer: B
4) A male client tells the nurse that he has no idea why his wife wants to stay married to him because he has not been able to "perform" sexually since his prostate surgery. Which diagnosis would be appropriate for this client? A) Ineffective Coping B) Situational Low Self-Esteem C) Hormonal Imbalance D) Sexual Dysfunction
Answer: B
5) The nurse is planning care for a client with a history of sexually transmitted infections. What should be included in this plan of care? A) Instruction to limit sexual contact until recovered from illness B) Plan for the client to contact sexual partners regarding the diagnosis C) Need to increase fluids and rest D) Importance of adequate nutrition
Answer: B
8) The nurse is planning care to address pain in the client with genital herpes. Which intervention would be appropriate for this client? A) Increase the intake of cranberry juice. B) Clean lesions 2 or 3 times a day with warm water and soap. C) Dry lesions with a hair dryer turned to the hot setting. D) Wear tight cotton clothing.
Answer: B
9) A nurse is caring for a client who is prescribed a selective phosphodiesterase type 5 inhibitor for the treatment of erectile dysfunction. The nurse should include which statement when educating the client regarding this medication? A) "You should take this medication about 30 minutes before sexual activity." B) "The action of this medication will last up to 36 hours." C) "This medication will enhance erections with or without sexual stimulation." D) "This medication should not be taken more than twice daily."
Answer: B
5) The nurse is planning care for a client with erectile dysfunction. What should the nurse include in this client's plan of care? Select all that apply. A) Names of psychologists with experience in treating the disorder B) Information on medications for treatment C) Types of devices and surgeries available to help with the disorder D) Reason for disorder as being side effect of prescribed medication E) Information on exact cause
Answer: B, C
8) A female client is prescribed an androgen medication to treat an estrogen-sensitive type of breast cancer. What should the nurse instruct this client about the medication? Select all that apply. A) There is an increased risk of multiple births. B) Secondary male sex characteristics may develop. C) Monitor weight weekly. D) Report calf pain or dyspnea. E) It must be taken with food.
Answer: B, C
2) The nurse suspects a 20-year-old client is experiencing primary dysmenorrhea. Which did the nurse assess in this client? Select all that apply. A) Bleeding between menstrual periods B) Headache C) Fatigue D) Diarrhea E) Scant menses
Answer: B, C, D
5) During an evaluation for infertility, a male client is asked to provide a sperm sample. What information from the client's health history could impact the client's sperm? Select all that apply. A) Activity level B) Smoking C) Use of over-the-counter analgesics D) Mumps after adolescence E) Number of siblings
Answer: B, C, D
8) A high school student asks the school nurse what can be done for menstrual cramps. What should the nurse recommend to this student who is experiencing primary dysmenorrhea? Select all that apply. A) Increase caffeine intake. B) Use a heating pad. C) Try black cohosh. D) Engage in regular exercise. E) Avoid vitamin supplements.
Answer: B, C, D
1) During an assessment, the nurse suspects a client is experiencing genital herpes. What did the nurse assess in this client? Select all that apply. A) Low blood pressure B) Headache C) Fever D) Back pain E) Vaginal discharge
Answer: B, C, D, E
2) The nurse is conducting a health history with a client with erectile dysfunction. Which finding(s) could provide a possible cause for the client's problem? Select all that apply. A) Blood pressure of 118/68 mmHg B) Treatment for type 2 diabetes mellitus for 7 years C) Body mass index (BMI) of 24.5 D) Alcohol intake of 4 to 6 beers each day E) Plays golf twice a week
Answer: B, D
5) A female client complains of having a "strange discharge" from the vagina and "stinging" when voiding urine. Which diagnostic test(s) would be useful to aid in the diagnosis of this client's disorder? Select all that apply. A) Biopsy B) Urinalysis C) Complete blood count D) Serum hormone levels E) Papanicolaou smear
Answer: B, E
1) A nurse instructor is teaching a group of student nurses regarding problems of infertility and genetic inheritance of disease. Which statement made by the nurse indicates that teaching has been effective? A) "A person's genotype is the observable expression of the traits." B) "The total genetic makeup of an individual is referred to as the phenotype." C) "In an autosomal recessive inherited disorder, the individual must have two abnormal genes to be affected." D) "An individual is said to have an autosomal dominant inherited disorder if the disease trait is homozygous."
Answer: C
2) A female client tells the nurse about having difficulty with sexual relations because of a recent weight gain. Which interventions should the nurse include when planning this client's care? A) Sexual self-concept B) Gender identity C) Body image D) Gender-role behavior
Answer: C
2) A nurse who is working at an obstetrics clinic is caring for a client who desires more information regarding fertility awareness-based contraceptive methods. Which statement made by the nurse provides the client with correct information? A) "Maximum fertility for the woman occurs approximately 2 days before ovulation and decreases rapidly the day after." B) "The calendar rhythm method is based on the assumption that ovulation tends to occur about 7 days before the start of the next menstrual period." C) "To use the calendar rhythm method, the woman must record her menstrual cycles for 6 months to identify the shortest and longest cycles." D) "The calendar method is the most reliable of the fertility awareness methods."
Answer: C
2) A nursing working in an outpatient women's health clinic is caring for a client in menopause. When discussing hormone replacement therapy (HRT) with the client, the nurse should include which statement? A) "Most healthy, recently menopausal women should not use HRT for relief of hot flashes and vaginal dryness." B) "HRT is the least effective treatment of menopausal hot flashes and vaginal dryness." C) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal estrogen is preferred." D) "The risk of blood clots in the legs or lungs is further increased by using transdermal patches, gels, or sprays."
Answer: C
3) A female client asks what causes the symptoms of menopause. On which hormonal function should the nurse focus when responding to this client's question? A) Increased estrogen levels B) Increased progesterone levels C) Estrone as the major hormone D) Increased luteinizing hormone levels
Answer: C
4) A young adolescent client is concerned about experiencing severe cramps with menstruation. What should the nurse respond to this client? A) "This is not normal but is something that can be treated." B) "You have cramps because you started your periods too early." C) "Cramps are seen in those who just start having periods and will become less severe as you get older." D) "You need to see a gynecologist for a pelvic examination."
Answer: C
5) The nurse has identified the diagnosis of Ineffective Coping for a client with severe premenstrual syndrome. What should be included in this client's plan of care? A) Encourage frequent rest periods. B) Suggest 4 ounces of wine each day. C) Encourage exercise and relaxation techniques. D) Instruct to avoid contraception during menstruation if engaging in sexual intercourse.
Answer: C
6) A premenopausal client tells the nurse that she is not looking forward to menopause because it means her life is over. Which nursing diagnosis would be appropriate for the client at this time? A) Ineffective Sexuality Pattern B) Deficient Knowledge C) Situational Low Self-Esteem D) Disturbed Body Image
Answer: C
6) During a sexual history, a female client tells the nurse that because she is in a committed relationship, sexual relations are more satisfying and frequent. What should the nurse realize the client is describing? A) Emptiness B) A lack of intimacy C) The feeling of connectedness D) Disconnection
Answer: C
6) The nurse is developing strategies for the relief of menstrual cramping to teach a group of young women. What should be the focus of these strategies? A) Minimization of menstrual flow B) Avoidance of uterine contraction C) Increase of blood flow to the uterine muscle D) Decrease in estrogen production
Answer: C
6) The nurse is instructing a client about the medication sildenafil (Viagra). Which client statement indicates teaching has been effective? A) "Viagra should be taken with food." B) "I can take Viagra anywhere from 1 to 6 hours before sex." C) "I can take only one pill in a 24-hour period." D) "Grapefruit juice will decrease the effects of Viagra."
Answer: C
7) A client approaching menopause is interested in oral hormone replacement therapy to manage the symptoms. Which should the nurse include in this client's teaching plans? A) Hormone replacement therapy is linked to higher rates of deep vein thrombosis and colorectal cancer. B) Estrogen is cardio-protective for women. C) Hormone replacement therapy is useful for women who are at an increased risk for the development of osteoporosis. D) Hormone replacement therapy is associated with a reduced incidence of breast cancer and pulmonary embolism.
Answer: C
8) The nurse is teaching a client with infertility about the medication clomiphene (Clomid). Which client statement indicates that teaching has been effective? A) "This medication stimulates gonadotropin-releasing hormone." B) "This medication stimulates follicle-stimulating hormone (FSH)." C) "This medication stimulates luteinizing hormone (LH)." D) "This medication increases my estrogen levels so I can ovulate."
Answer: C
9) A client plans to use oral contraceptives for birth control. Which client behavior would cause the nurse the most concern? A) The client has several sexual partners. B) The client is being treated for bipolar disorder. C) The client smokes one-half pack of cigarettes a day. D) The client drinks two glasses of wine a day.
Answer: C
9) A public health nurse is educating a group of adults regarding sexually transmitted infections. Which is an appropriate statement by the nurse? A) "Males have higher rates of gonorrhea and Chlamydia, whereas women have higher rates of syphilis." B) "Men are disproportionately affected by STIs compared to women and infants." C) "Women often experience few early manifestations of the infection, delaying diagnosis and treatment." D) "The incidence of STIs is highest among young Caucasian females."
Answer: C
9) The nurse is caring for a client recovering from a total hysterectomy. What should the nurse include when instructing this client prior to discharge? A) The importance of douching after intercourse for at least 6 weeks B) Why bed rest is indicated for at least a month after the surgery C) The risks and benefits of hormone replacement therapy D) The importance of returning to normal activities of daily living as soon as possible
Answer: C
3) A female client tells the nurse about having no interest in sex since it has become painful. Which intervention(s) would be appropriate to help the client with this problem? Select all that apply. A) Ask when the last Pap smear was performed. B) Discuss the need to be screened for sexually transmitted infections. C) Instruct on the use of artificial lubrication. D) Encourage the client to discuss with the healthcare provider because there are medications to help with this problem. E) Suggest antibiotics to treat the pain.
Answer: C, D
7) A client is prescribed an oral contraceptive with estrogen and progesterone. What should the nurse instruct the client about this contraceptive? Select all that apply. A) An increase in appetite and weight gain is caused by the estrogen. B) Headaches and nausea are caused by the progesterone. C) Breast tenderness occurs because of the estrogen. D) An increase in blood pressure is caused by the progesterone. E) Acne and oily skin can occur because of the progesterone.
Answer: C, E
1) A 58-year-old female client is concerned that intercourse with her spouse has become increasingly painful. What should the nurse explain about the changes in this client's body? A) Cervical mucus is thicker after menopause. B) Estrogen levels increase after menopause. C) Sexual desire diminishes after menopause. D) Vaginal lubrication decreases after menopause.
Answer: D
10) A nurse is treating a client with diabetes mellitus who complains of erectile dysfunction (ED). Which hormonal cause contributes to ED? A) Increased prolactin levels B) Decreased aldosterone levels C) Decreased circulating catecholamines D) Decreased thyroid-stimulating hormone
Answer: D
2) A client reports an open area on the penis. Which question will help the nurse with data collection? A) "Do you think you have a disease?" B) "Have you had sexual intercourse recently?" C) "Are you promiscuous?" D) "When did you initially notice this open area?"
Answer: D
3) A community health nurse is educating a group of teenage clients regarding the prevention of date violence and rape. Which statement will the nurse include in teaching? A) "Caucasian girls report dating violence more commonly than Hispanic or African American girls." B) "Girls who report dating violence are less likely to report other at-risk behaviors, such as using illegal substances." C) "Although previous violence in a teenage male is a problem, it is not associated with an increased risk of dating violence." D) "A decreased use of birth control is associated with an increased risk of dating violence and rape."
Answer: D
5) The nurse is assessing a postmenopausal client. Which client statement should indicate further assessment by the nurse? A) "I use water-soluble lubricant to treat my vaginal dryness." B) "For some reason, I have more sexual desire than ever." C) "Sex certainly takes longer than it used to, but I'm getting used to that." D) "I am so glad that I don't need to worry about sex anymore."
Answer: D
7) An older client tells the nurse that he still has erections and wants to have sex with his wife, but she does not have the same interest as he does. What should the nurse do to assist this client? A) Explain that women lose interest in sex as part of the aging process. B) Suggest that he wait awhile and the urge to have sex will pass. C) Ask what he has been doing to fulfill himself sexually. D) Encourage the client to ask his wife to discuss the lack of interest with her physician.
Answer: D
7) The nurse instructs a client on ways to reduce premenstrual difficulty. Which client statement indicates the instruction was beneficial? A) The client states the need to increase dietary sugar intake to promote energy. B) The client states that guided imagery does not help with the symptoms. C) The client states the need to increase intake of simple carbohydrates. D) The client states that reducing caffeine intake will help.
Answer: D
8) A client asks for a prescription for tadalafil (Cialis). What would be important for the nurse know prior to planning interventions for this client? A) "Do you have diabetes mellitus?" B) "Do you take blood pressure medication?" C) "Do you have any sexually transmitted infections?" D) "Do you use nitroglycerine?"
Answer: D
3) A client is experiencing dysuria, urinary frequency, and vaginal discharge. For which sexually transmitted infection(s) should the nurse prepare the client for testing? Select all that apply. A) Syphilis B) Vaginitis C) Chlamydia D) Trichomoniasis E) Gonorrhea
Answer: C, E
