Med-Surg Chapter 46: Sexuality

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."

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?"

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."

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?

"People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria."

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."

Which example best supports the nursing concern of sexual dysfunction because of dyspareunia?

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

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

Antihypertensive medication

The Surgeon General's Call To Action To Promote Sexual Health and Responsible Sexual Behavior was released in 2001. The goal of this document was to achieve whatE?

Enhance general health and wellness across the population

T/F: Simultaneous orgasm is commonly achieved by couples who are in a healthy sexual relationship.

False

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?

History of hypertension

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

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.

T/F: The most significant difficulty that a hypertensive person faces regarding sexuality is that medication used to control the disease frequently causes a change in sexual functioning.

True

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

Use modified positions

A rare condition in which the vaginal opening closes tightly and prevents penile penetration is called:

Vulvodynia

The nurse knows that women may choose periodic abstinence for several reasons. In order to assist the client in her choice to return to sexual activity, while preventing pregnancy, what should the nurse discuss with the client?

how to chart her fertility pattern

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

"Malnutrition may cause impotence."

The nurse 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?"

In the female reproductive system, what corresponds with the male penis?

Clitoris

A nurse is explaining premenstrual syndrome to a female client. The client demonstrates understands when stating what may occur in the premenstrual phase?

Headache

During the orgasmic phase of the female sexual response, the client may experience what phenomenon?

Hypertension

Which of the following is a type of female genital mutilation (FGM) practiced in certain cultures, which involves narrowing of the vaginal opening through the creation of a covering or seal?

Infibulation

The forensic nurse is caring for a client who was raped four days ago. Which of the following could the nurse teach the client is an effective contraceptive?

Insertion of a copper intrauterine device (IUD)

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

Menarche

The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is:

condoms

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.

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."

An infant is identified as intersex at birth. Which education provided by the nurse is accurate?

"Your child has variations in the reproductive anatomy."

Applying the Masters and Johnson description of sexual response, place the phases in the order in which they would occur from first to last. -Plateau -Resolution -Excitement -Orgasm

-Excitement -Plateau -Orgasm -Resolution

For which of the following clients should the nurse make a referral due to the possibility of primary erectile dysfunction?

A 21 year-old client who discloses to the nurse that he has never been able to achieve an erection

The nurse is preparing a 15-year-old adolescent for the first gynecological examination to evaluate heavy menstruation. Which intervention by the nurse will help the client feel less anxious during the gynecological examination?

Offer to remain with the client during the examination.

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

The nurse should demonstrate ease

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

Vaginismus

A nurse 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."

The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education?

"I can leave my diaphragm in for up to 72 hours."

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

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

The parents of a 2-year-old are distraught because the discovered their child masturbating two occasions. How should the nurse best respond?

"This is normal and expected developmental activity."

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

-"If the condom does not have a nipple receptacle, leave a small space at the end for semen to collect." -"Use a condom with every act of intercourse." -"Immediately after ejaculation remove the condom and discard it."

An Emergency Department nurse has a desire to become competent to care for victims of sexual assault. What type of evaluation of self does the nurse need to make in order to be competent to care for this special population of client and meet their physical and psychosocial needs? Select all that apply. -Comfort with self sexual identity -Knowledge of reproductive anatomy and physiology -Therapeutic communication skills -Ability to practice reasonable sexual expression -Ability to project a subjective attitude

-Comfort with self sexual identity -Knowledge of reproductive anatomy and physiology -Therapeutic communication skills -Ability to practice reasonable sexual expression

A client tells a nurse that her menstrual cycle has become irregular. Which does the nurse consider as a cause of the irregularity? Select all that apply. -Diabetes -Infection of the reproductive organs -Anorexia nervosa -Primary ovarian insufficiency -Oral contraception taken every day year round

-Infection of the reproductive organs -Anorexia nervosa -Primary ovarian insufficiency -Oral contraception taken every day year round

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.

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

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

Condoms can protect the client from pregnancy.

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

Dyspareunia

T/F: Masochism refers to the practice of gaining sexual pleasure while inflicting abuse on another person.

False

Which of the following describes the inner sense a person has of being male or female?

Gender identity

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?

When a person's employment or well-being is dependent on agreeing to unsolicited and unwelcome sexual demands, this is referred to as:

Quid pro quo harassment

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?

Quid pro quo harassment.

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

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

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

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

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

Syphilis

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

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

The nurse takes into consideration developmental stage when assessing sexuality. Which is an example of a developmentally appropriate intervention?

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

Which of the following is an inclusive term used to describe those who feel that the sex that was assigned to them at birth incompletely describes or fails to describe them?

Transgender

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

Trichomonas vaginalis

T/F: Ejaculation and orgasm are most likely to remain intact in patients with spinal cord injuries of the lower spine.

True

T/F: LGBT youth are two to three times more likely to attempt suicide.

True

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

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

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

loss of muscular control during orgasm causing twitching of the arms and legs