CHAPTER 4: SEXUALITY

An adolescent, aged 15 years old, seeks medical care after getting his penis caught in the zipper of his pants. Upon examination, the nurse observes an abrasion on the shaft of the penis, which is secreting a small amount of yellow discharge. Which information will the nurse document in the medical record? Select all that apply.

- Chief complaint - Location of injury - Appearance of injured area - Drainage noted - Report of discomfort

A 58-year-old client discloses to the nurse that she is no longer able to enjoy sex because it causes pain in the vagina. For which important information will the nurse assess this client?

Age of menopause onset

An older adult couple who have just relocated to a long-term care facility have been unable to obtain a shared room. A staff member at the facility states that this should not be a concern and implies that sexual activity between the couple likely ceased many years ago. How should the nurse best respond to this individual's assertion?

"Actually it's not true that older people always stop having sexual activity when they get older."

How would the nurse respond to a female client who says, "I do not think I have ever experienced an orgasm. Is that normal?

"A normal sexual response for women may include multiple plateaus without an orgasm as a result."

What term is used to describe painful intercourse?

Dyspareunia

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

Menarche

A nurse is obtaining a health history from a middle-age client. Which question would initially be appropriate to ask?

"How many children do you have?"

Which statement is true of gender identity?

It may be the same as or different from biologic identity

The nurse notes a 70-year-old male client is reporting low sexual desire and a decrease in sexual satisfaction. When assessing the client's past medical history, which factor will the nurse anticipate noting?

Orchiectomy

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

Ovulatory phase

The nurse is providing education about sexuality to a group of college freshman. One of the terms he discusses is gender identity. Which of the following describes gender identity?

inner sense of being male or female

A nurse is conducting a health history for a client at a local clinic. The client tells the nurse, "I feel like I am a man trapped in a woman's body." Which additional questions will the nurse ask?

"Can you tell me what makes you feel that way?"

After discussing the various methods of contraception with a female client and her partner, the couple decides to use depot injections of medroxyprogesterone. After teaching the couple about this type of contraception, which statement by the client indicates effective education?

"I have to get an injection once every 3 months."

The nurse is discussing the use of hormonal contraception with a woman who just delivered twins and is not ready to get pregnant in the near future. Which methods might the nurse recommend? Select all that apply.

- Oral contraceptives - Norplant system - Depo-Provera - Vaginal ring

Which example best supports the diagnosis of Sexual Dysfunction: Dyspareunia?

A 50-year-old woman in the process of menopause has pain and burning during intercourse.

A 19-year-old client scheduled for a vaginal exam is visibly upset and cancels the appointment when learning the clinic provider is a man. Which factor should the nurse prioritize when assisting this client?

Taught to avoid exposing herself to strangers

The nurse caring for clients in a physician's office takes into consideration developmental stage when assessing sexuality. Which is an example of a developmentally appropriate intervention?

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

The nurse is to fill in at a clinic for sexually transmitted infections (STI) and is aware of the need to perform focused sexuality assessments. The nurse spends some time reviewing questions to include for sexuality assessments and finds which question to be pertinent?

"Do you have concerns about infections?"

A nurse is conducting a health history on a 45-year-old client. The nurse is preparing to address the client's sexual history. Which statement by the nurse would be most appropriate at this time?

"I am going to ask you some questions about your sexual health."

A gerontology nurse is discussing sexual dysfunction with an older adult male client. The nurse determines that the education has been effective when the client states:

"Malnutrition may cause impotence."

The nurse is advising an adolescent male about sexual myths that have him concerned. Which statements describe accurate client education regarding these concerns? Select all that apply.

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

After receiving information on various forms of birth control, a young couple decides to use a barrier method because they would like to try and conceive in a year or two. Which barrier method uses a rubber barrier to hold spermicide against the cervix?

A diaphragm

During a well-check visit of a toddler, the parent mentions that the child is exhibiting sexual behaviors. Which information on growth and development of a toddler will the nurse discuss with the parent?

Acknowledge that masturbation is normal.

The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following?

Antihypertensive medication

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

Cowper glands

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

Dyspareunia

What is associated with the resolution phase of the male sexual response cycle?

Feelings of relaxation and fulfillment

The nurse is assessing a 27-year-old female client who reports she recently got married but is concerned her new spouse does not love her anymore. The client continues explaining that she just does not like having sex and it is really frustrating as she tries to fake it but it is not working. Which medication could the nurse anticipate the health care provider might prescribe?

Flibanserin

A nursing instructor is teaching a class of nursing students about female reproductive structure and function. As part of the class, the instructor discusses menstruation. The instructor determines that the education was successful when the students identify which statement as true about the hormonal interplay related to menstruation?

Follicle-stimulating hormone stimulates the ovary.

The nurse is assessing a 57-year-old female client who has recently moved to the area. On assessment the client tells the nurse about a new romantic friend and how nice it is to not be lonely anymore. What assessment should the nurse prioritize for this client?

HIV

A client has been diagnosed with human papillomavirus (HPV) infection. Which information about HPV is essential for the nurse to explain to the client?

HPV is linked to cervical cancer.

A 13-year-old female client comes in for a sports physical for school. During the exam, the client mentions she has a great boyfriend. Which question should the nurse prioritize with this client?

Have you received a human papillomavirus (HPV) vaccination?

A group of nursing students is reviewing information about reproductive structure and function. The students demonstrate understanding of the information when they identify which structure of the male reproductive system as a major storage area for seminal fluid?

Prostate gland

A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs?

STIs are most prevalent among teenagers and young adults.

Which of the following statements best describes the relationship between biologic sex and gender identity?

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

The nurse is conducting an assessment on a 42-year-old female client. The client admits to having unprotected sex with multiple individuals over the years. Based on the data collected during the assessment, which disorder should the nurse suspect this client has?

Syphilis

The school nurse is presenting a class on female reproductive health. While discussing prevention the nurse teaches what about a Pap smear?

The Pap smear detects cervical cancer.

Which of the following occurs in the male during the resolution phase of the sexual response cycle?

The male experiences a period during which he is incapable of sexual response.

The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by a male who eventually discloses to the nurse that, while he is happily married, he occasionally enjoys wearing his wife's undergarments when she is away. The term for this behavior is which of the following?

Transvestite

A client visits a community clinic reporting a foul-smelling vaginal discharge that is thin, foamy, and green in color; itching of vulva and vagina; and burning on urination. Which STI would the nurse suspect?

Trichomonas vaginalis

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

Vaginismus

A nurse is preparing an education plan about sexual response for a male client who is experiencing changes in this area. The nurse plans to review the phases of the male sexual response. Which topic would the nurse expect to integrate into the discussion as occurring during the orgasm phase?

expulsive contractions of the urethra

A nurse is teaching a sex education class to a group of teenage girls. They ask the nurse about the sexual response cycle in females. Which physiologic response does the nurse tell them is onlyseen in females?

loss of muscular control during orgasm causing spastic contractions

A client in a family planning clinic asks for oral contraceptives. The nurse is aware that oral contraceptives are contraindicated for which client?

Women who smoke

Which assessment question is most likely to yield clinically meaningful data about a female client's sexual identity?

"How do you feel about yourself as a woman?"

A client that is 90 days postpartum states to the nurse, "I have not had a period since I had the baby. Do you think something may be wrong?" What is the best response by the nurse?

"If you are breastfeeding, it is common for there to be a delay before resuming menstruation."

The nurse recommends a barrier method of contraception for a client who is concerned about the side effects of hormonal contraception. Which method might the nurse suggest?

Cervical cap

What are the uterus and vagina connected by?

Cervix

A male client age 15 years is experiencing nocturnal emissions. What nursing intervention would be appropriate for this client?

No intervention is necessary as this is a normal phenomenon.

Which education topic will the nurse discuss with a 70-year-old woman who tells the nurse that she is sexually active?

Sexually transmitted infections

As part of a class project, a nursing student is to discuss the anatomic and physiologic changes that occur in a woman's breast during pregnancy and lactation. What would the student be most likely to include?

The alveolar cells begin to secrete colostrum.

The nurse is providing education about sexuality to a group of college freshmen. The first term the nurse discusses is "biologic sex." Which of the following describe(s) a person's biologic sex? Select all that apply.

Chromosomal sexual development External genitalia Breasts Internal genitalia

Which question or statement would be most useful in beginning to elicit information about a client's sexual history?

"I know this might be hard to talk about, but it is important."

A teenage female client tells the nurse that she is having intercourse with her boyfriend. The client asks the nurse about methods to prevent pregnancy. Which statement by the nurse would be most accurate?

"Many unintended pregnancies result from the use of less effective methods of contraception."

Which response will the nurse provide to a 13-year-old female client who says to the nurse, "My parents said masturbation is wrong. Is that true?"

"Tell me more about what you know of masturbation."

While teaching sexual education to a group of high school students, the nurse talks about forms of birth control and when a woman can become pregnant. Which explanation by the nurse about the chance of the woman becoming pregnant is accurate?

"The intrauterine device is a highly effective and reversible contraceptive."

12s Report this Question A nurse is taking sexual history on an adolescent who has come into the free clinic. What question best demonstrates an appropriate nursing approach to effective assessment of the client's need for further information?

"What questions or concerns do you have about your sexual health?"

A nurse is taking sexual history on an adolescent who has come into the free clinic. What question best demonstrates an appropriate nursing approach to effective assessment of the client's need for further information?

"What questions or concerns do you have about your sexual health?"

A nurse is conducting a healthy living workshop with a group of female college students. Which information will the nurse include in the teaching plan about condoms?

Condoms can protect the client from pregnancy.

A female nurse is giving a complete bed bath to a young male client. The nurse notices the client has an erection. Which action will the nurse take?

Continue bathing the client.

A client has a history of poorly controlled diabetes. Which health concern will the nurse discuss with the client?

Erectile dysfunction

A nurse is explaining the use of an IUD to a female client interested in obtaining contraception. Which of the following statements regarding the IUD is correct?

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

During the menstrual cycle, when does ovulation typically take place?

On day 14

A nurse is educating a male client about testicular self-examination. The nurse would encourage the client to perform the exam at which frequency?

Once a month

Which of the following is considered external male genitalia? Select all that apply

Testes Scrotum Penis

Traditionally, the male sexual response is thought to be broken up into three phases. Which occurrence is part of the plateau phase?

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

The nurse is meeting with a couple who are undergoing fertility treatment. The couple has brought notes of the times they engaged in intercourse. As the nurse reviews the data which factor should the nurse further explore?

The comment, "Sex is no fun anymore"

The nurse is conducting an interview with a client who has a sexual concern. To obtain accurate and complete information from the client, which method will the nurse use to create a comfortable environment to encourage communication?

The nurse should demonstrate ease.

The nurse is caring for a client, 29 years of age, who is admitted with chronic pain secondary to rheumatoid arthritis. The client confides in the nurse about a desire to be able to have sex with the spouse but it just "hurts too much." Which information will the nurse discuss with the client about how to manage chronic pain during sexual intimacy?

Use modified positions.

A female client tells the nurse that vaginal intercourse with her partner is not as exciting as it used to be. Which of the following could the nurse teach her?

Use of Kegel exercises

A male client comes to the clinic because he thinks that he has syphilis. Which test would the nurse expect the client to have done?

VDRL

What do most nursing interventions pertaining to sexuality involve?

educating to promote sexual health