(Fund Ch 45) PrepU

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A nurse is reading a journal article about the female sexual response cycle. Place the events of this cycle in the proper sequence from first to last that would demonstrate that the nurse has understood the information in the article. 1 Nipple erection 2 Clitoral retraction 3 Feelings of relaxation 4 Involuntary contraction of genitals

1. Nipple erection 2. Clitoral retraction 4. Involuntary contraction of genitals 3. Feelings of relaxation The sexual response cycle is manifested as follows: during the excitement phase, the woman's breasts swell and the nipples become erect and hard to the touch. During the plateau phase, the clitoris retracts and disappears under the clitoral hood. The orgasm phase in the female begins with a heightened feeling of physical pleasure, followed by overwhelming release and involuntary contractions of the genitals. The resolution phase is characterized by a return to normal body functioning present before the excitement phase. Feelings of relaxation, fatigue, and fulfillment are common.

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? a. "Gender role behavior is the behavior a person conveys about being male or female." b. "Sexual orientation is the term used to denote chromosomal sexual development." c. "Biologic sex is the inner sense a person has of being male or female." d. "Gender identity refers to the preferred gender of a person's partner."

a. "Gender role behavior is the behavior a person conveys about being male or female." 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? a. "Get the human papillomavirus vaccine." b. "Have the Norplant system implanted in your arm." c. "Douching will help to prevent them." d. "If your male partner doesn't have genital warts, you will not get them."

a. "Get the human papillomavirus vaccine." 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 contracteptive method and does not prevent STIs.

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? a. "Many unintended pregnancies result from the use of less effective methods of contraception." b. "Periodic abstinence involves not having any sex with a partner." c. "Coitus interruptus will prevent pregnancies." d. "Barrier methods include the vaginal sponge used in combination with an antibacterial agent."

a. "Many unintended pregnancies result from the use of less effective methods of contraception." Unintended pregnancy remains a significant women's health issue in the United States. Many unintended pregnancies result from the use of less effective methods of contraception, such as condoms, spermicide, or barrier methods. Continuous abstinence involves not having sex with a partner at all. In periodic abstinence, women chart their periods of fertility and abstain from vaginal intercourse during these periods. Barrier methods include the vaginal sponge used in combination with a spermicidal agent. Coitus interruptus, the withdrawal of the penis from the vagina before ejaculation, does not prevent all pregnancies. Pre-ejaculate can contain enough sperm to cause a pregnancy, and pre-ejaculate or semen may spill onto the vulva.

A nurse reads in a client's chart that he or she has gender dysphoria. The nurse determines that the client understands the diagnosis when making what statement? a. "People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria." b. "People who experience sexual fulfillment with a person of the opposite sex have gender dysphoria." c. "People who find pleasure with both opposite-sex and same-sex partners have gender dysphoria." d. "Gender dysphoria is a condition in which there are contradictions among chromosomal sex, internal organs, and external genital appearance."

a. "People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria." People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria. Heterosexuals experience sexual fulfillment with a person of the opposite sex. People who find pleasure with both opposite-sex and same-sex partners are bisexual. An intersex condition occurs in about 1 in every 2000 babies in which there are contradictions among chromosomal sex, internal organs, and external genital appearance, resulting in ambiguous gender.

The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following? a. Antihypertensive medication b. Antibiotics c. Non-steroidal anti-inflammatory drugs (NSAIDs) d. Bronchodilators

a. Antihypertensive medication 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.

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? a. Cervical cap b. Norplant system c. Sterilization d. Abstinence

a. Cervical cap 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.

A man 68 years of age comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the client's history, what might the nurse note that contributes to impotence? a. History of hypertension b. Lack of exercise c. Past history of infection d. Increasing age

a. History of hypertension Vascular problems cause about half the cases of impotence in men older than 50 years. Use of medications to decrease blood pressure such as diuretics cause erectile dysfunction by decreasing the force of blood flow into the penis. With advancing age the sexual function, libido, and potency decrease, but is not the primary reason for impotence. Past history of infection and lack of exercise does not contribute to impotence.

During the menstrual cycle, when does ovulation typically take place? a. On day 14 b. On day 1 of a new cycle c. When sperm is present d. From days 15 to 28

a. On day 14 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 prepares to complete an exam on a 25 year old female. The client presents to the community health clinic reporting difficulty with urination. The nurse reviews the chart and sees that the client is originally from Africa. Which does the nurse suspect? a. Possible complications from female genital mutilation (FGM) requiring further physical assessment b. An acute urinary tract infection (UTI) c. Complications from an untreated sexually transmitted infection (STI) d. A diagnosis of interstitial cystitis

a. Possible complications from female genital mutilation (FGM) requiring further physical assessment Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It is a procedure that has no health benefits for girls and women and can cause severe bleeding, problems urinating, and later cysts, infections, infertility as well as complications in childbirth and increased risk of newborn deaths. The nurse may rule out UTI via urinalysis however, the nurse would want to rule out the presence of FGM in order to make sure the client receives appropriate long-term care. Nothing in the data provides the nurse with an indication of an untreated STI or interstitial cystitis.

A male client informs the urology nurse that he is embarrassed because his wife rarely has time to reach sexual satisfaction, since he experiences an orgasm as soon as he enters the vagina. What is this condition best known as? a. Premature ejaculation b. Impotence c. Erectile failure d. Retarded ejaculation

a. Premature ejaculation Premature ejaculation is a condition in which a man consistently reaches ejaculation or orgasm before or soon after entering the vagina. Erectile failure, also known as impotence, is the inability of a man to attain or maintain an erection to the extent that he cannot have satisfactory intercourse. Retarded ejaculation refers to a man's inability to ejaculate into the vagina, or delayed intravaginal ejaculation.

During hospitalization for a suicide attempt, the client informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he gives her a paycheck. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior and is called what? a. Quid pro quo harassment. b. Fetishism. c. Environmental harassment. d. Hostile environment harassment.

a. Quid pro quo harassment. Quid pro quo means that something is given or withheld in exchange for something else. It generally occurs when a person in a position of authority offers either direct or indirect reward or punishment based on the granting of sexual favors. Environmental harassment and hostile environment harassment are identical situations and occur when workplace behaviors of a sexual nature create a hostile, intimidating environment that interferes with a person's work performance. Fetishism is sexual arousal with the aid of an inanimate object not generally associated with sexual activity.

A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs? a. STIs are most prevalent among teenagers and young adults. b. The signs and symptoms of an STI are obvious. c. STIs disproportionately affect people with a lower socioeconomic status and education. d. The incidence of STIs is decreasing due to limited sex partners.

a. STIs are most prevalent among teenagers and young adults. STIs are most prevalent among teenagers 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.

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? a. inner sense of being male or female b. preferred gender of the partner of an individual c. behavior conveyed about being male or female d. desire to wear the clothes of the opposite sex

a. inner sense of being male or female Gender identity is the inner sense a person has of being male or female. 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. A transvestite is an individual who desires to take on the role (or wear the clothes) of the opposite sex.

Which assessment question is most likely to yield clinically meaningful data about a female client's sexual identity? a. "Have you ever had any sexually transmitted infections in the past?" b. "How do you feel about yourself as a woman?" c. "Do you find that your health allows you to enjoy a meaningful sex life?" d. "Are you satisfied with the quality of your relationships right now?"

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

The nurse has provided information to a client about oral contraceptives. Which statement by the client would indicate a need for further education? a. "Some hormonal contraceptives do not contain estrogen and rely instead on a progestin only." b. "Some oral contraceptives protect against STIs." c. "Oral contraceptives need to be taken on a daily basis." d. "Hormonal oral contraceptives reduce the risk of ovarian cancer."

b. "Some oral contraceptives protect against STIs." 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.

While teaching sex education to a group of high school students, the nurse talks about forms of birth control. Which of the following could the nurse say is 100% effective if practiced correctly and consistently? a. Oral contraceptives b. Abstinence c. Condoms d. Withdrawal prior to ejaculation

b. Abstinence Abstinence is not having sex. It is the most effective form of birth control, preventing pregnancy 100% of the time when practiced consistently. Oral contraceptives are hormonal preparations that may contain combinations of the hormones estrogen and progestin or progestin alone to prevent pregnancy. OC if not taken the same time everyday are not 100% effective in preventing pregnancy. Condoms provides protection from sexually transmitted infections and pregnancy but not as effective as abstinence. Withdrawl does not prevent pregnancy as sperm can be in the lubricant from the sexual stimulation from the male penis.

What is associated with the resolution phase of the male sexual response cycle? a. Increased blood flow to the penis b. Feelings of relaxation and fulfillment c. Intense physical pleasure d. The ability to begin the excitement phase again

b. Feelings of relaxation and fulfillment 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 explaining premenstrual syndrome to a female client. The client demonstrates understands when stating what may occur in the premenstrual phase? a. Water loss b. Headache c. Blurred vision d. Calmness

b. Headache Premenstruation is characterized by the appearance of one or more of the following symptoms several days before the onset of menstruation: (1) emotional symptoms such as depression, irritability, anxiety, changes in sleep habits, changes in sexual desire, poor concentration, crying, anger, and social withdrawal; and (2) physical symptoms such as appetite changes, breast tenderness, bloating and weight gain, aches and pains, swelling, acne, gastrointestinal issues, and fatigue. Blurred vision may be an ominous sign that is unrelated to premenstrual syndrome.

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? a. Menopause b. Menarche c. Follicular phase d. Menses

b. Menarche The first menstrual period, called menarche, is experienced at about 12 years of age. Menstruation is often referred to as a woman's "period" or "menses." Menopause is the cessation of a woman's menstrual activity. In the ovaries, in a typical 28-day cycle, the phase from day 4 to 14 is called the follicular phase.

Which of the following statements best describes the relationship between biologic sex and gender identity? a. Biologic sex is genetically determined but gender identity is chosen during adolescence. b. Sex is chromosomally determined, while gender is a psychosocial construct. c. Biologic sex and gender identity are both modifiable by surgery and medical interventions. d. Biologic sex and gender identity are considered synonymous in nursing practice.

b. Sex is chromosomally determined, while gender is a psychosocial construct. 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. As such, biologic sex is amenable to medical interventions, but surgery and hormone therapy will not change an individual's inner sense of being male or female. Gender identity is not commonly thought to be chosen or objectively selected during adolescence.

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? a. Dyspareunia b. Vaginismus c. Celibacy d. Orgasmic dysfunction

b. Vaginismus 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.

When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is: a. refractory phase. b. excitement phase. c. obligatory phase. d. orgasmic phase.

b. excitement phase. 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.

The nurse should instruct an Islamic female client who is reluctant to undergo pelvic examination from an assigned male health care provider to: a. ask her husband to be present during the examination. b. seek a female health care provider to perform the examination. c. tell her to refuse to have the examination based on beliefs. d. have the pelvic examination with another woman present.

b. seek a female health care provider to perform the examination. 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.

The nurse is preparing to provide education to a group of high school students on sexually transmitted infection (STI) prevention. The nurse knows that this age group often uses oral-genital stimulation as a way to prevent pregnancy. Which concept should the nurse make sure to convey to the group? a. avoid multiple partners to reduce the risk of being infected b. skin-to-skin contact can spread herpes and genital warts c. oral-genital contact is safe with use of a barrier method d. use of public restrooms increases the risk of contracting HIV

b. skin-to-skin contact can spread herpes and genital warts Some STIs spread through oral-genital sex, anal sex, or even intimate skin-to-skin contact without actual penetration (genital warts and herpes can be spread this way). Therefore, only avoiding all types of intimate genital contact can prevent these STIs. The use of a barrier method reduces the risk of STIs but should not be conveyed as "safe." HIV is contracted through direct contact with infected bodily secretions not through the use of public restrooms. While reducing sexual partners does reduce the risk of infection it only takes one exposure to contract a STI. The concept that should be conveyed is the risk that any skin-to-skin contact can spread herpes and genital warts.

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. "Women who have multiple orgasms are promiscuous." b. "The ability to achieve orgasm is the only indicator of a person's sexual responsiveness." c. "A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." d. "The larger the penis, the greater the potential for achieving orgasm."

c. "A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." 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.

The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education? a. "Male latex condoms when used correctly are an effective means of contraceptive and very effective at preventing transmission of STIs." b. "I can insert my female condoms up to 8 hours before intercourse." c. "I can leave my diaphragm in for up to 48 hours." d. "I have to wash my cervical caps after each use."

c. "I can leave my diaphragm in for up to 48 hours." The diaphragm stays in for 8 hours after intercourse; the FemCap can stay for 48 hours. Diaphragms and cervical caps are washable and reusable. Female condoms can be inserted up to 8 hours before intercourse to avoid interrupting sexual activity. Male condoms can be made of latex, polyurethane or natural membranes. Male latex condoms when used correctly are an effective means of contraceptive and very effective at preventing transmission of STIs.

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: a. "Erectile dysfunction, caused by diabetes, has no treatment." b. "I need to be able to walk a mile in order for sexual intercourse to not be dangerous." c. "Malnutrition may cause impotence." d. "Antihypertensive medication will not affect sexual function."

c. "Malnutrition may cause impotence." 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.

The nurse assessing an adolescent's need for further information regarding sexual health should ask which question? a. "Have you ever been diagnosed with a sexually transmitted infection?" b. "Are you involved in an intimate relationship at this time?" c. "What questions or concerns do you have about your sexual health?" d. "How many sexual partners have you had?"

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

Which diagnostic test is used to diagnose a chlamydial infection? a. Wet preparation with KOH b. Blood work c. Cervical culture d. Pap smear

c. Cervical culture Cervical culture or urine analysis is used to diagnose Chlamydia. A pap smear is performed to detect cellular changes in the cervix and cervical cancer. Blood work is used to detect various abnormalities. Wet preparation with KOH is used to detect Candida, Gardnerella, and Trichomonas vaginalis.

The nurse is preparing a talk on health issues in the LGBTQ population. Which statistic would the nurse include? a. LGBTQ populations have lower rates of tobacco, alcohol, and other drug use. b. Lesbians are more likely to get preventive services for cancer. c. LGBTQ youth are 2 to 3 times more likely to attempt suicide. d. Lesbians and bisexual females are more likely to be underweight or anorexic.

c. LGBTQ youth are 2 to 3 times more likely to attempt suicide. Healthy People 2020 found that LGBTQ youth are 2 to 3 times more likely to attempt suicide. Lesbians and bisexual females are more likely to be overweight or obese. LGBTQ populations have higher rates of tobacco, alcohol, and other drug use than other populations. Lesbians are more likely to get preventive services for cancer.

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? a. Religious beliefs which prevent reproduction. b. The desire to have multiple sex partners. c. The choice not to start a family. d. To reduce the risk of sexually transmitted diseases.

c. The choice not to start a family. 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.

The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by Cathleen, a 54-year-old female, who eventually discloses to the nurse that, while she is happily married, she feels like a man inside. Cathleen describes this as feeling "trapped" inside her female body. The term for this behavior is which of the following? a. Transvestite b. Bisexual c. Transsexual d. Gender role behavior

c. Transsexual A transsexual is a person of a certain biologic gender who has the feelings of the opposite sex. A bisexual is a person who finds pleasure with both opposite-sex and same-sex partners. A transvestite is an individual who desires to take on the role or wear the clothes of the opposite sex. Gender role behavior is the behavior a person conveys about being male or female.

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? a. Acquired immunodeficiency syndrome (AIDS) b. Chlamydia trachomatis c. Trichomonas vaginalis d. Neisseria gonorrhoeae

c. Trichomonas vaginalis Trichomonas vaginalis is characterized by foul-smelling vaginal discharge that is thin, foamy, and green in color; itching of vulva and vagina; and burning on urination. Fatigue, diarrhea, weight loss, enlarged lymph nodes, fever, anorexia, and night sweats are common with AIDS. Vaginal discharge, burning on urination, urinary frequency, dysuria, and urethral soreness is common with Chlamydia trachomatis. Neisseria gonorrhoeae may be symptom free, or may present in males with purulent penile discharge, dysuria, and frequency of urination; women typically present with dysuria, abnormal menses, vaginal discharge, or pelvic inflammatory disease.

Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina? a. Herpes simplex 2 b. Herpes simplex 1 c. Trichomoniasis d. Nonspecific vaginitis

c. Trichomoniasis 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.

When the mother of a 2-year-old tells the pediatric nurse that the child masturbates, the nurse informs the mother that the child: a. should have a physical examination. b. may have an identity crisis. c. is exhibiting normal behavior. d. needs family counseling.

c. is exhibiting normal behavior. Toddlers may engage in masturbation, and parents should be assured that this behavior is normal and healthy for development.

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: a. decrease fear of sexual expression. b. stop sexual promiscuity in the country. c. promote general health and wellness. d. enhance prevention with free care.

c. promote general health and wellness. 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 is teaching a male adolescent how to use a condom. Which teaching points would the nurse include? Select all that apply. a. "Immediately after ejaculation remove the condom and discard it." b. "Use a condom with every act of intercourse." c. "Roll the condom onto the penis before it becomes erect." d. "If the condom does not have a nipple receptacle, leave a small space at the end for semen to collect." e. "Do not use a spermicide with the condom." f. "If using a lambskin condom, the condom may be reused a second time."

d. "If the condom does not have a nipple receptacle, leave a small space at the end for semen to collect." b. "Use a condom with every act of intercourse." a. "Immediately after ejaculation remove the condom and discard it." If the condom does not have a nipple receptacle end, a small space should be left at the end of condom to collect the semen in order to provide a pocket to collect semen and prevent breakage. A condom should be used with every act of intercourse to help prevent STI transmission and pregnancy. Immediately after ejaculation, the penis and condom should be removed from the vagina by holding onto the base of the condom. This prevents spillage of semen into the vagina. The condom should be rolled onto the penis as soon as it becomes erect; this protects against sperm from secretions from Cowper's glands. Spermicide can be used with condoms to increase contraception properties. Condoms can never be used a second time.

In the female reproductive system, what corresponds with the male penis? a. Mons pubis b. Skene glands c. Urethral meatus d. Clitoris

d. Clitoris The clitoris corresponds to the penis in the male in that both organs respond to stimulation that can result in orgasm.

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? a. Vaginismus b. A sexually transmitted infection (STI) c. Vulvodynia d. Dyspareunia

d. Dyspareunia Dyspareunia is painful intercourse. Vaginismus is characterized by difficult penetration rather than acute pain during intercourse. Vulvodynia is associated with pain that is not limited to intercourse. Sexually transmitted infections (or STIs) are infections that can be caught or passed on from unprotected sex, or close sexual contact. An STI may or may not be contributing to the woman's problem, though most cases of dyspareunia are unrelated to infections.

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. a. Nocturnal emissions indicate the existence of a sexual disorder. b. Nocturnal emissions are signs of a sexually transmitted infection. c. No male or female should feel pressured into sexual activity at any age. d. Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. e. Nocturnal emissions are normal in men of all ages. f. A larger penis allows for a more satisfying sexual experience.

d. Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. c. No male or female should feel pressured into sexual activity at any age. e. Nocturnal emissions are normal in men of all ages. 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 nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by Cathleen, a 54-year-old female, who eventually discloses to the nurse that she is having a sexual affair with a female partner. The term for an individual's preference for a partner of a particular gender is which of the following? a. Gender role behavior b. Transsexual c. Transvestite d. Sexual orientation

d. Sexual orientation Sexual orientation refers to the preferred gender of the partner of an individual. A transvestite is an individual who desires to take on the role or wear the clothes of the opposite sex. Gender role behavior is the behavior a person conveys about being male or female. A transsexual is a person of a certain biologic gender who has the feelings of the opposite sex.

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? a. Masturbation b. Voyeurism c. Use of the BETTER model d. Use of Kegel exercises

d. Use of Kegel exercises Some women who practice Kegel exercises, which promote good vaginal tone, have found their sexual satisfaction is improved. The BETTER model is a tool used in conducting sexual assessments. Voyeurism and masturbation are techniques of self-stimulation that would not involve the client's partner.

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? a. HPV b. Wet preparation c. Pap smear d. VDRL

d. VDRL 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 should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is: a. a cervical cap. b. spermicides. c. a diaphragm. d. condoms.

d. condoms. Condoms provide effective (though imperfect) protection against STIs. Spermicides, diaphragms, and cervical caps do not provide effective protection against STIs.

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: a. secondary impotence. b. ejaculatory dysfunction. c. sexual identity problems. d. primary impotence.

d. primary impotence. 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.

A client presents to the clinic seeking the safest contraceptive method to use. The nurse reviews the client's health history and notes that the client is 26 years old, married with no children, and a smoker. Based on the client's history the nurse identifies which methods are the most appropriate for this client? (Select All That Apply) a. Depo-Provera b. Transdermal Contraceptive Patch c. Oral Contraceptives d. Implanon e. Norplant System

e. Norplant System d. Implanon a. Depo-Provera According to the client's history she is a smoker. Smoking increases the risks associated with oral contraceptives. The transdermal contraceptive patch has the same contraindications as oral contraceptives. All of the other options are not contraindicated based on the client's history.


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