Foundations Chapter 35 Sexuality
2, 3 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.
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. 1 Condoms or diaphragms are the most effective methods. 2 Hormonal methods offer little protection against sexually transmitted infections (STIs). 3 Barrier methods offer some protection against STIs. 4 Sterilization is an effective option that the patient should consider. 5 The rhythm method is effective for preventing pregnancy.
2 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.
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? 1 Refer the patient to a sexual counselor. 2 Tell the patient about the safe house for women. 3 Ask the patient to describe how she got the bruises. 4 Report the abuse immediately to the proper authorities.
1, 3, 4, 5 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 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. 1 Avoid alcohol and tobacco. 2 Do not have sexual intercourse until your workload lightens. 3 Have well-balanced meals and follow a regular sleep pattern. 4 Plan sexual activities in the morning or another time when you are well rested. 5 Communicate your concerns with your partner.
4, 5 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 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. 1 Perform exercise to increase sexual desire. 2 Use contraceptive medications and devices. 3 Avoid the overuse of alcohol and cigarettes. 4 Use water-soluble lubricants before sexual intercourse. 5 Explore alternative, acceptable, and more satisfying sexual practices.
4 Contraception, also known as birth control, is the method or device used to prevent pregnancy. The nurse teaches about contraception to people who are sexually active in order to provide higher protection against a number of diseases. However, methods that are effective for contraception do not always reduce the risk of sexually transmitted infection (STIs). Therefore, the nurse should correct the statement about using a combined method of contraception to reduce the risk of STIs. A vasectomy or male sterilization is a permanent contraceptive surgical method. A condom is the most effective barrier method. A condom is a thin rubber sheath that fits over the penis to prevent the entrance of sperm into the vagina. The use of hormonal contraception requires a primary health care provider's prescription. Therefore, the young adult will consult a health care provider before beginning a suitable therapy.
After teaching a group of young adults about contraception, the nurse concludes that there is a need for further teaching. Which statement made by a young adult supports the nurse's conclusion? 1 "A vasectomy is a contraceptive method that is permanent." 2 "A condom is the most effective barrier method for contraception." 3 "I consult a health care provider before starting hormonal contraceptive therapy." 4 "I prefer to use a combined method of birth control to reduce the risk of sexually transmitted infections (STIs)."
1, 4 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.
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. 1 Expectations about behavior by men or women in the culture 2 Higher percentages of lesbian, gay, bisexual, or transgender individuals in the culture 3 Genetic predisposition to the disease in the culture 4 Communication patterns and language practiced by the culture 5 Varied climate in different geographic locations
1 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.
Decreased levels of which hormone may result in painful sexual intercourse? 1 Estrogen 2 Testosterone 3 Growth hormone 4 Follicle-stimulating hormone (FSH)
4 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.
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? 1 Diarrhea 2 Vomiting 3 Pain in the testicles 4 Sores on the penis
3 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.
How can a nurse establish trust and encourage patient disclosure about sexuality? 1 Ask how often the patient has sexual intercourse. 2 Ask the patient to disrobe in preparation for the physical assessment. 3 Request permission to discuss sexual issues. 4 Request specific examples of sexual practices and problems.
1 Normal changes in the female sexual response include a decrease in sex hormone levels, decrease in vaginal lubrication, longer time to reach orgasm, and longer refractory times. Many factors such as chronic illness, medications, stress, or loss of partner can influence the older adult's sexual activity. Older adults may not be comfortable using barrier methods such as condoms and therefore are at increased risk for sexually transmitted infections.
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? 1 "It's normal for me to take longer to reach an orgasm." 2 "I might experience chest pain or shortness of breath during intercourse." 3 "It's normal for me to lose interest in sexual relationships." 4 "I won't need to be concerned about contraception or sexually transmitted infections because of my age."
1, 5 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.
The nurse is educating a couple about sexually transmitted infections. Which sexual infections cannot be cured? Select all that apply. 1 Herpes 2 Syphilis 3 Chlamydia 4 Gonorrhea 5 Human papillomavirus infection
2 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.
Which nursing action takes priority when working with a patient who opts for an abortion? 1 Explain that abortion means killing a life. 2 Clarify the nurse's own personal values. 3 Convince the patient that abortion is a crime. 4 Criticize the patient for the decision.
2 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.
Which question represents a nonjudgmental approach when gathering a sexual health history? 1 "How do you and your wife/husband feel about intimacy?" 2 "Do you have sex with men, women, or both?" 3 "Are you heterosexual or homosexual?" 4 "What is your sexual orientation?"
3 An intrauterine device (IUD) is copper or plastic and is inserted in the uterus through the cervical opening. Oral contraceptive pills are consumed on a daily basis for contraception. Tubal ligation is a surgery in which the fallopian tubes are ligated to avoid pregnancy. A diaphragm is a rubber dome that is inserted in the vagina with spermicide by the patient before intercourse. A diaphragm acts as a barrier during intercourse and the spermicide kills sperm that get past it.
A 35-year-old woman comes to the clinic for her general health checkup. The patient wants information about intrauterine devices (IUDs). What information should the nurse include when teaching the patient about IUDs? 1 It is an oral medication to be consumed regularly. 2 It is a surgery in which fallopian tubes are ligated. 3 It is a plastic contraceptive device that is inserted in the uterus through the cervical opening. 4 It is a round rubber dome that is inserted in the vagina with spermicide and acts as a barrier during intercourse.
2, 3, 4 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.
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. 1 Palliation 2 Permission 3 Limited information 4 Specific suggestions 5 Intravenous therapy
3 Sexuality may be altered by disease states such as myocardial infarction, unstable angina, diabetes, and spinal cord injury. Medications such as antihypertensives also alter sexual function. These alterations are usually temporary and resolve with time. Because the patient is only 50 years old, his decline in sexual activity is not related to age alone. The patient doesn't need to undergo surgery or medication therapy; he should return to normal without them.
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. During assessment, the patient expresses that he is not able to perform well sexually. Which explanation should the nurse give to the patient? 1 The patient's sexuality is affected by his age and is absolutely normal. 2 The patient must undergo surgery and extensive medication therapy to get back to normal. 3 Sexuality can be affected by ailments such as myocardial infarction, but the patient should return to normal soon. 4 Sexuality can be affected by ailments such as myocardial infarction, and the damage is permanent.
1, 2, 4 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 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. 1 Ensure that the patient is comfortable discussing the issue. 2 Ensure that the patient has privacy. Close the door or curtains of the room. 3 Avoid talking to the patient. Hand him a questionnaire and ask him to complete it. 4 Ask open-ended questions, such as how the patient's health problem has affected his sexual activity. 5 Include the family members in the discussion to get more information.
2 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.
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? 1 Hypoactive sexual desire 2 Erectile dysfunction 3 Dyspareunia 4 Infertility
3 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 50-year-old woman complains of dyspareunia. Which is a possible cause of dyspareunia in the patient? 1 Diminished sexual desire 2 Diabetes and hypertension 3 Diminished vaginal lubrication 4 Increased vaginal elasticity
4 Many drugs can affect sexual function. Antidepressants can alter sexual functioning by blocking neurotransmitters. The decision to screen a patient should be based on health history, assessment, and sexual practices.
A 54-year-old male patient who is being seen for an annual physical tells the nurse that he is having difficulty sustaining an erection. The nurse reviews his health history and notes no current health problems except medical treatment for depression. What should the nurse understand about this? 1 A personal issue such as this is best addressed by a male physician during the examination. 2 Erectile dysfunction affects most men over the age of 50. 3 The patient needs to be screened for sexually transmitted infections (STIs). 4 Antidepressant medication may be affecting the patient's sexual functioning.
1, 4, 5 Nonprescription contraceptive options for couples include abstinence from sexual intercourse, condoms and spermicidal jellies, and timing intercourse with the woman's ovulation cycle. Skin patches and vaginal rings contain hormonal substances that require a health care provider's prescription for use.
A couple approaches the nurse for advice about nonprescription contraceptive methods. Which methods should the nurse mention to the couple? Select all that apply. 1 Abstinence 2 Skin patches 3 Vaginal rings 4 Condoms and spermicides 5 Timing of coitus
3 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.
A couple is diagnosed as positive for the human immunodeficiency virus (HIV). Which information should the nurse include when educating this couple about HIV? 1 They should not engage in sexual intercourse. 2 Their children will also be HIV positive. 3 Their duration of survival would increase with treatment. 4 They can be cured by highly active antiretroviral therapy (HAART)
2 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.
A male patient approaches the nurse for advice on permanent methods of contraception. What should the nurse suggest to the patient? 1 Tubal ligation 2 Vasectomy 3 Subdermal implants 4 Transdermal skin patches
1, 2, 4 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.
A middle-aged patient is diagnosed with erectile dysfunction. Which associated conditions might the nurse find in the patient? Select all that apply. 1 Diabetes 2 Hypertension 3 Anorexia 4 Hyperlipidemia 5 Hyperthyroidism
1, 2, 3, 5 Nurses often avoid discussing sexual issues with patients because they are uncomfortable, lack knowledge, or have personal values in conflict with the patients' values. Nurses who have difficulty addressing sexual issues need to seek education and experiences to increase knowledge and explore their personal values.
A new graduate nurse is working in a rehabilitation center that specializes in the care of patients with spinal cord injuries (SCIs). The new graduate knows that sexual issues are common among patients with SCIs. Which actions can enhance the nurse's comfort in discussing sexual issues with patients? Select all that apply. 1 Clarifying personal values related to sexuality 2 Role playing discussion of sexual concerns with another nurse 3 Attending a conference to enhance knowledge about sexuality 4 Avoiding a discussion of sexual concerns until after completing new nurse orientation 5 Asking a nurse who is experienced in caring for patients with SCIs about common sexual concerns
3, 4, 5 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 patient has opted for a diaphragm as a mode of contraception. Which advice should the nurse provide to the patient? Select all that apply. 1 It should be used along with an intrauterine device (IUD). 2 It should be used along with condoms. 3 It should be refitted after pregnancy. 4 It should be used with a contraceptive cream. 5 It should be refitted after a significant change in weight.
2, 3, 5 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.
A patient presents with ineffective sexual functioning. Which strategies should the nurse suggest to enhance sexual functioning in the patient? 1 Discourage the use of pain medications. 2 Discourage the use of alcohol and tobacco. 3 Encourage touching and kissing. 4 Discourage the use of pillows during sex. 5 Communicate concerns and fears with the partner.
1, 3, 5 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.
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. 1 Illicit drugs 2 Antidiabetics 3 Diuretic agents 4 Antiplatelet drugs 5 Antihypertensives
2 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.
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? 1 Human immunodeficiency virus (HIV) 2 Chlamydia 3 Herpes simplex 4 Human papillomavirus
1, 2, 5 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.
A woman wishes to use hormonal contraceptives. How do they work? Select all that apply. 1 They cause thinning of the lining of the uterus. 2 They prevent ovulation. 3 They reduce sperm motility. 4 They act as a spermicidal barrier. 5 They thicken the cervical mucus.
2, 3 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.
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. 1 Difficulty eating 2 Difficulty walking or sitting 3 Unusual odor in the genital area 4 Vomiting or abdominal tenderness 5 Fractures of the face, nose, and arms
2, 3 Unprotected sexual intercourse is associated with possible pregnancy and increases the risk of sexually transmitted infections. Unprotected sex is not known to be associated with breast cancer. Unprotected intercourse may increase the pleasure of sexual intercourse. It does not initiate premature ejaculation.
The nurse is advising a young couple about healthy sexual practices. Which statement by the nurse about unprotected sex is appropriate? Select all that apply. 1 It reduces the risk of breast cancer. 2 It might result in pregnancy. 3 It carries the risk of infection. 4 It reduces the pleasure of intercourse. 5 It initiates premature ejaculation.
4 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.
The nurse is caring for a patient who is a sex worker. Against which sexually transmitted diseases can the patient be vaccinated? 1 Human immunodeficiency virus (HIV) 2 Herpes 3 Chlamydia 4 Human papillomavirus (HPV) infection
1, 2, 3, 4 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.
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. 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. 4. Refer to a professional with advanced training
1, 5 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 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. 1 It affects the genitourinary tract. 2 There is no cure for this disorder. 3 It does not cause ectopic pregnancy. 4 The rectum is resistant to chlamydia infection. 5 It may cause infection of the eyes and lungs in newborns.
1, 2, 4 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.
The nurse is communicating with a gay patient. Which statements hold true for this patient group? Select all that apply. 1 They belong to a sexual minority. 2 They do not readily seek preventive care. 3 They are comfortable revealing their sexual orientation. 4 They are concerned about discrimination. 5 They are more prone to getting sexually transmitted diseases.
1, 2, 5 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.
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. 1 Use simple language. 2 Check for signs of physical injuries. 3 Keep the findings private and confidential. 4 Use a closed and positive approach. 5 Inform patients that answering questions is normal.
1 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.
The nurse is counseling a couple on contraceptive methods. Which nonprescription method should the nurse recommend? 1 Condom 2 Diaphragm 3 Vaginal ring 4 Subdermal implant 5 Transdermal skin patch
1, 4, 5, 6 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.
The nurse is discussing sexual issues with a patient. Which statements hold true about sexuality? Select all that apply. 1 It is influenced by personal beliefs. 2 It is not affected by medications in use. 3 It is influenced by the place where one lives. 4 Pregnancy may affect sexual interest. 5 It may be affected by chronic respiratory disease. 6 Ethnicity plays a role in shaping sexual values.
2, 3, 4 Sexually transmitted infections caused by bacteria include syphilis, chlamydia, and gonorrhea. Herpes and genital warts are sexually transmitted but are caused by viruses. Herpes is caused by the herpes simplex virus, and genital warts are caused by the human papillomavirus.
The nurse is educating a couple about sexually transmitted infections caused by bacteria. Which sexual diseases are caused by bacteria? Select all that apply. 1 Herpes 2 Syphilis 3 Chlamydia 4 Gonorrhea 5 Genital warts
1, 2, 5 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 educating a couple about the human immunodeficiency virus (HIV). Which statements by the nurse about HIV are appropriate? Select all that apply. 1 It is a blood-borne pathogen. 2 It spreads through oral-genital sex. 3 It is not found in bodily fluids. 4 It causes ectopic pregnancy. 5 Its risk can be reduced by the use of condoms.
1, 2 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.
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. 1 Body changes 2 Menstruation 3 Sexually transmitted infections 4 Contraception 5 Sexual relationships
2, 3 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.
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. 1 "I can use any kind of lubricant such as lotions or baby oil." 2 "Before using the condom, I should check the package for damage or expiration." 3 "I need to use a condom to help reduce the risk of sexually transmitted infections." 4 "A good place to store condoms is in the bathroom so they don't dry out." 5 "I should not use a condom because I have a latex allergy."
3 Many sexually transmitted infections (STIs) have few symptoms and are often detected during routine screening. The risk of infection is higher in people who are under the age of 25 and who have multiple sex partners. Viral infections cannot be cured with antibiotics, but medication is available to suppress outbreaks. Bacterial infections can be treated with antibiotics, but the infection can recur with new exposure.
The nurse is providing education on sexually transmitted infections (STIs) to a group of adolescents. Which statement by an adolescent indicates the need for further teaching? 1 "A vaccine is available to reduce infection from certain types of human papillomavirus." 2 "I should be screened for an STI after I am with a new partner." 3 "I know I'm not infected if I don't have any symptoms such as discharge or sores." 4 "A viral infection such as herpes or human papillomavirus cannot be treated with antibiotics."
1, 2, 3, 4 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.
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. 1 Dyspareunia 2 Erectile dysfunction 3 Uncontrolled hypertension 4 Depression and guilt 5 Foul-smelling genitals
1 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.
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? 1 Encourage regular screenings in all sexually active individuals. 2 Provide information about contraception options. 3 Administer prescribed antibiotics for human papillomavirus (HPV) or genital herpes outbreaks. 4 Ask all patients if they are experiencing any symptoms.