Chapter 45: Sexuality (Combined)
The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following?
Antihypertensive medication Explanation: Antihypertensives are among the drugs implicated in sexual dysfunction. Antihypertensives can decrease forceful blood flow to the penis, making it difficult to achieve an erection. Antibiotics, bronchodilators, and NSAIDs do not typically have this effect.
A nurse is counseling a couple who expressed that they are having difficulty conceiving. What could the nurse consider as a cause?
Changing developmental stage Explanation: Changing developmental stages, such as menopause, can interfere with a couple's normal sexual expression. Masturbation, and "petting" or simple stroking as part of foreplay do not affect a couple being able to conceive. Having sex during ovulation would increase the likelihood of the client becoming pregnant.
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 Explanation: When assisting with or conducting a physical assessment of the genitalia, the nurse will keep the client comfortable and respect privacy and modesty. The nurse will explain what is being done after asking permission to complete the assessment. Documentation will include the chief complaint, location and appearance of the injury, drainage noted, and any report of discomfort.
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. Explanation: The nurse sets the tone or atmosphere for the interview. The nurse's attitudes will greatly affect the client's response to the sexual history, as clients will be more cooperative if they sense the nurse's security and ease during the interview. Privacy is essential for sexual history assessment. Doors should be closed and interruptions should not be allowed during the interview. The nurse should sit close to the client and speak in a quiet, relaxed, objective tone of voice, as well as use eye contact and open body posture. There is no need to hold the client's hand. The nurse should explain to the client that no one will have access to this information unless it is significant to the client's care.
Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina?
Trichomoniasis Explanation: Trichomoniasis is characterized by thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina; it is often asymptomatic in males. Nonspecific vaginitis is characterized by foul-smelling, thin, grayish-white vaginal discharge. Herpes simplex virus type 1 and 2 are characterized by lesions.
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. Explanation: The desire for human warmth and contact does not cease because of pain. Altered or modified positions for coitus are sometimes necessary and discussing these with clients can be an important part of implementing the nursing process. The nurse should not discourage the client from wanting to enjoy sex but should explore ways to help the client.
The nurse is discussing contraception with an adolescent client who asks the nurse: "What if I can't have an orgasm?" What is the nurse's best response?
"A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." Explanation: Simultaneous orgasms, or both people attaining orgasm at the same moment, are difficult to achieve. A preoccupation with attaining simultaneous orgasms might disrupt the ultimate intimacy and satisfaction possible during coitus. Multiple orgasms are not abnormal. The size of the penis does not affect whether an orgasm will occur. Having an orgasm is not the only indicator of sexual responsiveness; some individuals may have a pleasurable sexual experience without orgasm.
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." Explanation: Although studies have found only one response pattern in men, studies found variability in the patterns of sexual response among women. An intimacy-based circular model emphasized the multifactorial nature of the female sexual response, which encompasses emotional intimacy, sexual stimuli, psychological factors, and relationship satisfaction. Some women experience a plateau phase with several peaks without actually experiencing orgasm. Others experience a definite orgasm; still others experience multiple orgasms.
A nurse practitioner is teaching the student about sexual health and is evaluating the student's knowledge of sexual identity. The practitioner knows that the student understands when the student says which of the following?
"Gender role behavior is the behavior a person conveys about being male or female." Explanation: Sexual identity encompasses a person's self-identity, biologic sex, gender identity, gender role behavior or orientation, and sexual orientation or preference. Gender role behavior is the behavior a person conveys about being male or female. Biologic sex is the term used to denote chromosomal sexual development. Gender identity is the inner sense a person has of being male or female. Sexual orientation refers to the preferred gender of a person's partner.
A 16-year-old girl tells the nurse that her friend has genital warts and asks the nurse how to make sure that she does not get them. Which of the following should the nurse recommend?
"Get the human papillomavirus vaccine." Explanation: Human papillomavirus (HPV) is a DNA virus also called genital warts and is a sexually transmitted infection (STI). A vaccine is now available to prevent this disease. Male partners with HPV may or may not have lesions. Women should avoid douching to prevent STIs, as they remove normal protective bacteria in the vagina and increases the risk of getting some STIs. The Norplant system is a contraceptive method and does not prevent STIs.
A client presents to the office with concerns of low testosterone and feels it is due to a pituitary gland disorder. Which teaching would the nurse provide to educate this client on how testosterone is produced?
"Gonads are the reproductive organs of the male and are responsible for the production of testosterone and spermatozoa." Explanation: The testes are the male gonads, which are the reproductive glands that produce male cells (spermatozoa) and testosterone (male hormone). The pituitary gland is the master gland that is responsible for producing the follicle stimulating hormone (FSH) which triggers the production of testosterone so this could very well be a reason for low testosterone. Injury to the testes can be a possible reason for reduced testosterone levels, but this is unusual and is not limited to manifestation through hair loss and weight gain. Seminal fluid, also known as semen, is an organic fluid that may contain spermatozoa. It is secreted by the gonads.
Which assessment question is most likely to yield data about a female client's sexual identity?
"How do you feel about yourself as a woman?" Explanation: Sexual identity is a broad concept that includes, but supersedes, sexual functioning. However, it is more specific than simply asking about the quality of relationships or if their health allows for a meaningful sex life. Asking an open-ended question about how the client feels about herself as a woman is likely to elicit important insights. Assessing the client's history of STIs does not directly address her sexual identity.
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." Explanation: Because of the sensitivity of the questions involved with a sexual history, it is helpful to start this section of the interview with a transitional statement, such as, "I am going to ask you some questions about your sexual health." This question focuses the client on the topic and demonstrates the nurse's comfort with the topic. The statement regarding the need to determine if the client is at risk of sexually transmitted infections may frighten the client and does not allow for good communication regarding this sensitive topic. The statements about the client being sexually active or engaging in safer sexual behaviors indicate assumptions on the part of the nurse and are judgmental.
A nurse is collecting a sexual health history from an older adult woman who is postmenopausal. Which client statement requires further education by the nurse?
"I have noticed I have less lubrication with sexual intercourse." Explanation: After menopause, certain physiologic changes result from decreasing amounts of estrogen. Women experience slower onset of and decreased amounts of lubrication, which could lead to painful intercourse. The clients comment about less lubrication should require follow-up to educate the client on the proper use of lubricants. Women may experience thinning of vaginal and vulvar tissues, genitourinary atrophy, and vasomotor symptoms that may disrupt daytime activities and sleep, resulting in heightened fatigue. The orgasmic phase may become shortened.
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." Explanation: Saying to the client, "Tell me more about what you know of masturbation" allows the client to talk openly and helps the nurse establish rapport with the client. It also gives the nurse an understanding of the client's baseline knowledge. Telling the client, "At least you cannot get pregnant with masturbation" is inappropriate and does not address the client's original concern. Telling the client that masturbation will lead to sexual promiscuity is unfounded and incorrect. Although masturbation is self-stimulation and may be practiced alone, it is inappropriate for the nurse to define wrong vs. right for the client.
A nurse expresses a desire to become culturally competent in the care of females from Africa after a mission trip to the continent. Which statement by the nurse demonstrates an understanding of this population of clients?
"Infibulation is the narrowing of the vaginal opening through the creation of a covering seal." Explanation: FGM includes procedures that intentionally alter or cause injury to the female genital organs for nonmedical reasons. Complications include increased risk of newborn deaths. It has no health benefits and is nearly always carried out on minors. Infibulation is the narrowing of the vaginal opening through the creation of a covering seal.
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." Explanation: Factors that contribute to sexual dysfunction in the older adult are as follows: use of medications, especially antihypertensive medications; age-related metabolic disorders such as anemia, diabetes, malnutrition, and fatigue (may cause impotence). Sexual intercourse and similar forms of sexual expression are not considered dangerous for anyone able to walk around a room. Erectile dysfunction has treatments such as a penile prosthesis or pharmacologic management.
A young client tells the nurse, "I am gay, and my family will not accept me." What is the nurse's best response?
"That must be very distressing. Let's talk more about it." Explanation: The best response from the nurse is to acknowledge the client's distress and ask the client to talk more about it. The client needs to voice frustrations and explain the situation to the nurse so that adequate interventions can be initiated. Sexual orientation develops in early childhood and gay, lesbian, and bisexual are part of normal sexual identity. Keeping sexual identity private is not good advice and is not therapeutic. Telling the young client that the family is being "ridiculous" is not addressing the distress. Emotions and feelings need to be expressed in a safe and accepting environment.
The nurse has provided information to a client about oral contraceptives. Which statement by the client would indicate a need for further education?
"Some oral contraceptives protect against STIs." Explanation: Oral contraceptives need to be taken on a daily basis to prevent breakthrough ovulation. Oral contraceptives do not protect against STIs and clients still need to use STI protection such as condoms. In addition to preventing pregnancy, hormonal contraceptives have many health benefits, including reducing the risk for ovarian cancer and endometrial cancer, reducing symptoms of premenstrual discomforts, decreasing blood loss and anemia, reducing symptoms of endometriosis, and many other benefits.
A female client has recently had surgery for cervical cancer and asks the nurse about other ways she can have sex with her husband. Which of the following statements by the nurse is most accurate?
"Stimulation of the genitals by the mouth and tongue may be used to reach orgasm." Explanation: Stimulation of the genitals by the mouth and tongue may be used as a way to reach orgasm. Abstinence is not having sex and would not meet the couple's needs. Anal intercourse, commonly practiced by gay men, is also used by heterosexual couples. Fellatio is stimulation of the male genitals; cunnilingus is stimulation of the female genitals.
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." Explanation: The most highly effective and reversible methods of birth control are subdermal implants and two forms of intrauterine devices (IUDs). The most common contraception method worldwide is surgical sterilization. It is responsible for less than one pregnancy per 100 women in a year, but pregnancy is still a possibility. A highly effective but temporary method of contraception is that of the lactation amenorrhea method (LAM) when strict criteria are met (exclusively breastfeeding, no onset of menses, and less than 6 months postpartum). Those methods considered least effective with 18 or more pregnancies per 100 women in a year are all nonhormonal methods of contraception, including withdrawal. The only method guaranteed to prevent pregnancy is abstinence.
Parent's of a 5-year-old child inform the nurse that they are concerned about finding their child masturbating in the bathroom. What is the best response to the parents by the nurse?
"This is a normal behavior for this age group, because 5-year-olds are increasingly aware of self." Explanation: The parents should be made aware that this is a normal developmental stage and the child is developing a sense of self. Parents may cause anxiety in the child by intolerance of inconsistency of sex-role behavior. Negative overreaction by parents to child's masturbating behavior can lead to a belief that the genitals and sex are bad and dirty.
The nurse assessing an adolescent's need for further information regarding sexual health should ask which question?
"What questions or concerns do you have about your sexual health?" Explanation: An open-ended, nonthreatening question related to the client's need for further information should be included while obtaining a sexual history. "Are you involved in an intimate relationship at this time?" and "Have you ever been diagnosed with a sexually transmitted disease? "are closed ended questions requiring a yes or no response. Asking how many sexual partners, while open ended, is threatening and assumes that the adolescent has had multiple partners.
The nurse is advising an adolescent male about sexual myths that have him concerned. Which client education accurately describe these concerns? Select all that apply. -A larger penis allows for a more satisfying sexual experience. -Nocturnal emissions indicate the existence of a sexual disorder. -Nocturnal emissions are signs of a sexually transmitted infection. -Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. -No male or female should feel pressured into sexual activity at any age. -Nocturnal emissions are normal in men of all ages.
-Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. -No male or female should feel pressured into sexual activity at any age. -Nocturnal emissions are normal in men of all ages. Explanation: Masturbation or self-stimulation is natural. No one should ever feel pressured into having sex. Nocturnal emissions are normal and occur in about 85% of men. Penis size has no effect on the satisfaction of the sexual experience.
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. Explanation: Dyspareunia refers to pain and burning during intercourse. This is a common cause of sexual dysfunction, especially during menopause. A colostomy, fear of blood pressure elevation, and lack of interest in sex may lead to the nursing diagnosis of Sexual Dysfunction, but not related to dyspareunia.
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. Explanation: As children become toddlers, they begin to explore their bodies even more while developing a body image that includes sexual identity. Toddlers may engage in masturbation, and parents should be reassured that this behavior is normal and healthy for development. Playing with friends and exploring their own bodies are normal activities. Children at this stage are curious about body parts and may often ask questions related to such things as where babies come from, breastfeeding, and physical differences between men and women and boys and girls. Body image should be modeled by the parents. Positive body image begins early in life.
A nurse is caring for a 55-year-old male on an orthopedic unit. When the nurse hands the client his morning medication, he grabs her breast and squeezes it. How should the nurse best respond to this situation?
Assertively tell the client that this behavior is not acceptable Explanation: Squeezing the nurse's breast can be viewed as a type of sexual harassment by the client. An assertive response by the nurse is recommended as it supports the nurse in maintaining his or her self-respect and encourages the client to accept responsibility for his behavior. Inappropriate sexual behavior by a client may cause the nurse to inappropriately respond with either passive avoidance (switching assignments) or aggressive retaliation (withholding pain medication). Legal advice would only be an option if all efforts to stop the behavior were unsuccessful.
The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by John, a 22-year-old male, who eventually discloses to the nurse that, while he enjoys having sex with his girlfriend, he also has experienced pleasurable sex with males. The term for this behavior is which of the following?
Bisexual Explanation: A bisexual is a person who finds pleasure with both opposite-sex and same-sex partners. Biologic sex is the term used to denote chromosomal sexual development: male (XY) or female (XX), external and internal genitalia, secondary sex characteristics, and hormonal states. Gender role behavior is the behavior a person conveys about being male or female. Sexual orientation refers to the preferred gender of the partner of an individual.
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 Explanation: Barrier methods of birth control help in preventing pregnancy by using a device to block sperm from fertilizing an egg. Barrier methods include the cervical cap, condom, diaphragm, and vaginal sponge used in combination with a spermicidal agent. Abstinence means having no sexual intercourse. Norplant is a hormonal method of birth control. Sterilization is a surgical method of birth control.
In the female reproductive system, what corresponds with the male penis?
Clitoris Explanation: The clitoris corresponds to the penis in the male in that both organs respond to stimulation that can result in orgasm.
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. Explanation: An erection may occur in response to a full bladder, fantasy, or touch. Exposure of the male client by the nurse may cause an erection during a bed bath. An erection is a normal physiological response and not something the man can voluntarily control. It does not mean the client is attracted to the nurse. By continuing on with the bath the nurse creates a sense of normalcy. There is no need to tell the client's parents about this normal reaction.
What is associated with the resolution phase of the male sexual response cycle?
Feelings of relaxation and fulfillment Explanation: The resolution phase of the sexual response cycle is associated with feelings of relaxation, fatigue, and fulfillment. The most intense pleasure of a physical nature takes place during orgasm, and the male experiences a refractory period during which he is incapable of sexual response. Blood flow to the penis returns to normal levels during the resolution phase.
A nurse is planning strategies to address factors that affect sexual dysfunction in older adults. Which interventions would be appropriate? Select all that apply.
Educate older adult clients, intimate partners, and family about the sexual side effects of specific medications. Assist in attitude and value clarification about substance use, sexuality, and sexual behavior. Encourage older adult clients to have a thorough physical evaluation by a health care provider. Provide an open, nonjudgmental response when older clients display a need for warmth, close contact, and companionship. Explanation: Certain medications or multiple medications may cause sexual dysfunction. Dependence on alcohol or marijuana to cope with discomforts of aging may result in weakened erection, reduced desire, and delayed ejaculation. Age-related metabolic disorders such as anemia, diabetes, malnutrition, and fatigue may affect the quality of life and cause impotence. The need for warmth, close contact, and companionship is often associated with the loss of a spouse or significant other; encouraging older adults to attend a support group and become active socially helps meet these needs. Sexual intercourse is not considered dangerous for anyone able to walk around a room and may actually offer physiologic benefits.
A client has a history of poorly controlled diabetes. Which health concern will the nurse discuss with the client?
Erectile dysfunction Explanation: Diabetes is a significant risk factor for erectile dysfunction. The constant elevation of blood sugar in diabetes affects the vascular contraction of male clients. Diabetes does not create an appreciably increased risk of developing sexually transmitted infections, although clients with diabetes have an increased susceptibility to infections of all kinds. Retarded or premature ejaculation is less likely, as these problems do not have a vascular etiology.
Applying the Masters and Johnson description of sexual response, place the phases in the order in which they would occur from first to last.
Excitement Plateau Orgasm Resolution Explanation: The classic sexual response cycle outlined by Masters and Johnson (1966) is linear in nature and has four phases: excitement, plateau, orgasm, and resolution
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? Explanation: The FDA recommends the HPV vaccine be given beginning at the age 11 to 12 years to provide immunity prior to the adolescent becoming sexually active. The other questions can also be included in the exam as determined pertinent by the nurse; however, preventing the spread of HPV is the priority.
The nurse is advising an adolescent male about sexual myths that have him concerned. Which client education accurately describe 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. Explanation: Masturbation or self-stimulation is natural. No one should ever feel pressured into having sex. Nocturnal emissions are normal and occur in about 85% of men. Penis size has no effect on the satisfaction of the sexual experience.
The clinic nurse is explaining the action of sildenafil (Viagra) to a client. The nurse should assess his medication regimen to determine if he is taking medications that are contraindicated with Viagra. Which of the following medications is contraindicated with Viagra?
Nitrates Explanation: One concern with sildenafil is its potential to cause hypotension. It is contraindicated in men who take nitrates or use nitrate patches.
During the menstrual cycle, when does ovulation typically take place?
On day 14 Explanation: Ovulation generally occurs on day 14 when the mature ovum ruptures from the follicle and the surface of the ovary and is swept into the fallopian tube. From day 15 to day 28, the phase in the ovaries is called the luteal phase. On day 1 of a new cycle begins the new menstrual cycle. Menstrual flow might occur every 21 to 35 days or the last two to seven days. Ovulation does not begin when sperm is present. If ovulation and sperm engage, then pregnancy occurs.
The nurse is preparing a 27-year-old female client for a pelvic examination and notes bruises of various stages on the arms, legs, and stomach, as well as swelling and redness in the groin. The client is reluctant to discuss it with the nurse and just brushes if off, explaining her partner likes hard sex. Which action should the nurse prioritize?
Report intimate partner violence to the authorities Explanation: If the nurse suspects intimate partner violence, the nurse is obligated by both ethics and standards of practice to report this to the proper authorities. The nurse would still want to ensure all findings are properly documented to provide legal documentation. It would also be appropriate for the nurse to refer the client to resources where she can get assistance to escape this situation, if she desires. It would not be appropriate for the nurse to confront and discuss this situation with the partner as it may exacerbate the situation and place the client in more danger.
A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs?
STIs are most prevalent among adolescents and young adults. Explanation: STIs are most prevalent among adolescents and young adults, and nearly two- thirds of all STIs occur in people younger than 25 years of age. The incidence of STIs is increasing due to multiple sex partners and sexual activity at a younger age. STIs affect men and women of all backgrounds and economic levels. Not all signs and symptoms of STI's are obvious such as HIV/AIDS.
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 Explanation: Some cultures forbid the woman from exposing herself to a man who is not her spouse. The nurse should ask about cultural practice and alert the health care provider to the situation. The other factors can be explored after the nurse determines the cultural aspect is clarified.
The community health nurse is aware that many factors influence a client's decision for contraception. Which of the following is the most likely reason a client would select permanent contraception?
The choice not to start a family. Explanation: Some people choose a permanent method to prevent pregnancy from ever occurring. Factors that affect a person's choice of a contraceptive method include age, marital status, desire for future pregnancy, religious beliefs, level of education, cost, and ease of use. Permanent contraception offers no protection against sexually transmitted infections.
A client calls the clinic and tells the nurse they have a foamy, greenish, and itchy vaginal discharge. The client asks the nurse what the significance of this discharge is. What is the best response by the nurse?
The client may have trichomoniasis. Explanation: Mucus or white discharge from the vagina is physiologic and normal. Drainage caused by Candida is curd-like and white, while infection with trichomonas is often foamy and green in color. Vaginal dryness causes scant and mucoid drainage that may be blood-tinged. Many people with Chlamydia are asymptomatic without discharge.
The nurse prepares to discuss emergency contraception with a client who reportedly had unprotected sex the day before. What information should be covered when counseling the client? Select All That Apply
The need to take oral contraceptives within 120 hours after intercourse. Oral contraceptives are up to 89% effective in preventing pregnancy. A copper intrauterine device (IUD) can be inserted five to seven days after sex. Explanation: Emergency contraception is provided in two ways: 1)Increased doses of specific oral contraceptive pills. Emergency contraceptive pills can reduce the risk of pregnancy when taken up to 120 hours after unprotected intercourse (ideally within 72 hours). Most are up to 89% effective when taken within 72 hours after unprotected sex. They are less effective as time passes. 2)Insertion of a copper IUD within 5 to 7 days after unprotected intercourse. Discussing the over the counter availability may or may not be appropriate depending on the age of the client. There is a strong likelihood that a client may become pregnant if ovulating during one sexual encounter.
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 Explanation: VDRL is a blood test done to detect syphilis in males and females. HPV is a test done to detect the human papilloma virus. Pap smear is performed on females to evaluate for changes in the cervix. A wet preparation is a sample of vaginal secretions done to detect Candida, Gardnerella and Trichomonas.
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 Explanation: The client is experiencing an involuntary contraction of the muscles surrounding the vaginal orifice; this should be documented as vaginismus. Dyspareunia is painful intercourse. Difficulty achieving orgasm is documented as orgasmic dysfunction. Abstention from sexual intercourse is documented as celibacy.
During a routine physical exam, a male client informs the nurse that he frequently participates in anal intercourse with his new girlfriend. The nurse discusses this practice with the client by informing him that:
condoms are recommended for anal intercourse. Explanation: Condoms are recommended for anal and vaginal intercourse to prevent sexually transmitted diseases. Information should be talked about including that care should be used to avoid injury to the delicate rectal mucosa, and lubrication is necessary for comfort. It is not necessary to teach the client that anal intercourse should be avoided.
The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is:
condoms. Explanation: Condoms provide effective (though imperfect) protection against STIs. Spermicides, diaphragms, and cervical caps do not provide effective protection against STIs.
When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is:
excitement phase. Explanation: The excitement phase is characterized by rapid erection of the penis with tensing and thickening of the scrotal skin and elevation of the scrotal sac. Therefore, if a man cannot achieve an erection, the difficulty occurs in the excitement phase of the sexual response.
The nurse is providing education about sexuality to a group of college freshmen. Which terms(s) describe a client's sexual orientation? Select all that apply.
heterosexual (straight) gay lesbian Explanation: Sexual orientation refers to the preferred gender of the partner of an individual, such as heterosexual (straight), gay, and lesbian. A transgender person is when a person of a certain biologic gender expresses gender differs from what is associated with the gender assigned at birth. A cross dresser is an individual who dresses like someone of the opposite sex but views oneself according to biologic gender. Gender identity is the inner sense a person has of being male or female.
A nurse reads a client's chart and sees that she may have dyspareunia. Which of the following would be priority assessments? Select all that apply.
history of hormonal imbalance client's ability to use vaginal lubricants during sexual act physical assessment of internal and external genitalia Explanation: Dyspareunia is painful intercourse. Assessment priorities for these clients include determining if the client has a history of hormonal imbalances, assessing the client's ability to use vaginal lubrication during the sexual act, and performing a physical assessment of internal and external genitalia. Assessing for the use of antihypertensive medication is important in the client with erectile dysfunction. History of neurologic disorders is associated with retarded ejaculation.
When a 19-year-old male client tells the nurse that he has never been able to achieve an erection, the nurse recognizes that the client is experiencing:
primary impotence. Explanation: Primary impotence refers to a man who has never been able to achieve an erection necessary for intercourse; secondary impotence refers to a man who was once successful in attaining and maintaining erections but who has subsequently experienced difficulty. Causes of impotence, whether primary or secondary, can be physiologic, psychological, or both. Certain manifestations may indicate the probability that the problem is secondary to a physiologic or a psychological factor.
The Surgeon General's Call To Action To Promote Sexual Health and Responsible Sexual Behavior was released in 2001. The goal of this document is to:
promote general health and wellness. Explanation: The Surgeon General's Call to Action To Promote Sexual Health and Responsible Sexual Behavior, was released by the U.S. Office of the Surgeon General. Approaching sexuality issues from a public health perspective, this document emphasizes the challenges to promoting responsible sexual behavior with the goal of promoting general health and wellness in our society.
The nurse should instruct an Islamic female client who is reluctant to undergo pelvic examination from an assigned male health care provider to:
seek a female health care provider to perform the examination. Explanation: The woman is from a culture or ethnic group whose values influence her feelings about a pelvic examination, particularly one done by a male health care provider.
A pregnant adolescent did not understand the process of fertilization. The school nurse's best explanation of fertilization is that:
the fertilization process occurs in the outer third of the fallopian tube. Explanation: Fertilization of one ovum with one spermatozoon normally occurs in the outer third of the fallopian tube. The time period in which the woman can be impregnated is only a few days.
