MODULE 19- B,D,E
) A 30-year-old client is concerned that he will become impotent after experiencing difficulty ustaining an erection during a recent sexual encounter. What is the nurse's best response to this lient's concerns? 1) "An occasional incident like this is normal and common." 5) "Sexually transmitted infections may result in sexual problems in adults." ›) "Erectile dysfunction is the correct term for inability to achieve or sustain an erection." )) "A medical diagnosis of erectile dysfunction is not made until a man has experienced erectile ifficulties for a period of at least 3 months."
A
10) A client who is postmenopausal confides in the nurse that she has been experiencing pain during intercourse. What should the nurse instruct the client to do? A) Use vaginal lubricants during intercourse. B) Avoid intercourse. C) Tolerate this problem because it is a normal part of aging. D) Decrease the frequency of intercourse to decrease the pain.
A
11) Which of the following statements is true with regard to sexually transmitted infections (STIs) and older adults? A) Because pregnancy is no longer a concern, older adults may not use condoms, thereby increasing their risk of STIs. B) Normal age-related changes to the body put older adults at reduced risk of contracting STIs. C) STIs are rare among older adults because of decreased levels of sexual activity among the members of this population. D) Healthcare providers should avoid discussing STIs with older clients unless these clients initiate the conversation.
A
14) A 25-year-old client who is taking fluoxetine (Prozac) to treat depression reports decreased sexual desire since starting the medication. What can the nurse anticipate with regard to changes in the client's pharmacological regimen? A) Addition of bupropion to the client's drug regimen B) Immediate discontinuation of fluoxetine therapy C) Addition of flibanserin to the client's drug regimen D) Replacement of fluoxetine with paroxetine therapy
A
4) A client with a history of breast cancer who is entering menopause is seeking information about how to manage hot flashes. Which of information should the nurse provide to the client? A) Soy may be useful in reducing hot flashes, but researchers are still gathering evidence. B) Hot flashes will continue until menopause is complete. C) Estrogen is the only reliable treatment for hot flashes. D) Black cohosh is effective in the management of hot flashes.
A
8) A nurse is evaluating the care provided to a client who is experiencing menopause. Which observation indicates that the client is successfully managing her menopausal symptoms? A) The client has lost 5 pounds in 4 months after starting an exercise program. B) The client reports consuming about 800 mg of calcium per day. C) The client has gained 8 pounds in 3 months despite regularly engaging in non-weight-bearing exercise. D) The client states that she is "doing fine" so there's no need for her to keep talking about menopause.
A
9) A client who is experiencing menopause expresses an interest in using alternative and complementary therapies to manage her symptoms. Which initial response by the nurse is most appropriate? A) "What types of therapies are of interest to you?" B) "Those therapies seldom work." C) "Have you discussed this with your physician?" D) "Many women report success with these measures."
A
6) The nurse is caring for a client with erectile dysfunction (ED). Which medication(s) should the nurse anticipate being prescribed for this client? Select all that apply. A) Sildenafil (Viagra) B) Methylphenidate (Ritalin) C) Vardenafil (Levitra) D) Buspirone (BuSpar) T E) Tadalafil (Cialis)
A C E
1) A menopausal client is concerned that intercourse with her spouse has become increasingly painful. What should the nurse explain about the changes in this client's body after menopause? A) Cervical mucus is thicker. B) Estrogen levels increase. C) Sexual desire diminishes. D) Vaginal lubrication decreases.
D
6) The nurse is providing education to sexual partners about the importance of treatment for a chlamydia infection. Which client statements indicate this teaching was effective? Select all that apply. A) "Chlamydia can cause inflammation of the tube that carries urine from the bladder to outside the body." B) "Severe vaginal itching can be a consequence of chlamydia." C) "Rashes commonly occur with this disease." D) "Chlamydia can spread to the uterus and fallopian tubes and result in infertility." E) "Chlamydia can result in pregnancy complications.'
ADE
1) A nurse is caring for a client who is perimenopausal who states that she has recently had frequent bacterial vaginal infections. Which reason for these infections should the nurse inch in the response to the client? A) Decreased vaginal pH B) Increased vaginal pH C) Increased estrogen level D) Decreased vasomotor stability
B
10) A college student is being treated for chlamydia. What should the nurse teach this student to decrease the risk of transmitting another sexually transmitted infection? A) Unprotected sex is acceptable if you know the partner well. B) Latex condoms should be used for all sexual activity. C) Birth control pills will help decrease the risk of pregnancy and STDs. D) Condoms should be used with petroleum jelly.
B
12) Which of the following statements is true with regard to surgical menopause and oophorectomy? A) Natural conception is not an option for women who have undergone single oophorectomy. B) Surgical menopause may be successfully treated with hormone replacement therapy. C) Onset of surgical menopause is usually gradual. D) Oophorectomy is always accompanied by either hysterectomy or salpingectomy.
B
15) Which of the following terms describes involuntary tightening of the pelvic muscles that prevents penetration from occurring? A) Female orgasmic disorder B) Vaginismus C) Genito-pelvic pain/penetration disorder D) Dyspareunia
B
3) A male client tells the nurse that he has no idea why his wife wants to stay married to him because he has not been able to "perform" sexually since his prostate surgery. Based on the client's statement, which nursing diagnosis would be most appropriate? A) Ineffective Coping B) Situational Low Self-Esteem C) Hormonal Imbalance D) Sexual Dysfunction
B
4) A client diagnosed with a sexually transmitted infection reports having "no idea how the illness was contracted. Which nursing diagnosis would be appropriate for the client at this ti A) Anxiety B) Deficient Knowledge C) Ineffective Coping D) Sexual Dysfunction
B
4) During a health history, the nurse learns that a male client has a recent onset of erectile dysfunction (ED). Which assessment question is likely to elicit the most useful information about factors that may be contributing to the client's ED? T A) "Does this occur often?" B) "For what diseases and disorders have you been treated?" C) "Are you on any medications?" D) "How does your partner feel about this problem?"
B
5) The nurse is planning care for a client with gonorrhea who also has a history of prior transmitted infections (STIs). What is the priority nursing action for this client? A) Instruction about the need to avoid all future sexual contact B) A plan for the client to contact sexual partners regarding the diagnosis C) Recommendation that the client increase fluids and rest D) Teaching regarding the importance of adequate nutrition
B
8) A client reports that he is having difficulty ejaculating during sexual activity, even though he is able to maintain an erection for 30-45 minutes. The client tells the nurse that this problem began about 6 months ago and has been a source of significant worry for both him and his partner. Based on this description, the client is most likely affected by which of the following conditions? A) Retrograde ejaculation B) Delayed ejaculation C) Erectile dysfunction D) Male hypoactive sexual desire disorder
B
8) The nurse is planning care to address pain in a client with genital herpes. Which intervention would most be appropriate for this plan of care? A) Do not submerge lesions in water. B) Clean lesions two or three times a day with warm water and soap. C) Dry lesions with a hair dryer turned to the hot setting. D) Wear tight cotton clothing.
B
9) During a vaginal examination, a woman's cervix and vaginal fornices, are found to have a bluish cast to them. This finding suggests that the client A) is experiencing menopause. B) may be pregnant. C) has a pelvic infection. D) is likely anemic.
B
I 7) A client with genital herpes asks the nurse how to manage pain when urinating and difficulty voiding. Which response by the nurse is correct? A) "Try to limit your fluid intake. That way, you won't have to void so often." B) "Pouring room-temperature water over your genitals may make it easier for you to start urinating." C) "Be sure to keep your genitals as dry as possible. Unnecessary exposure to water can worsen your infection and cause even greater pain upon urination." D) "Unfortunately, there's nothing you can do to eliminate your discomfort. It won't go away until your current herpes outbreak is over."
B
8) A female client is prescribed an androgen medication to treat an estrogen-sensitive type of breast cancer. What should the nurse instruct the client about this medication? Select all that apply. A) This medication is associated with an increased risk of multiple births. B) Secondary male sex characteristics may develop from use of this medication. C) Monitor your weight on a weekly basis when using this medication. D) When taking this medication, immediately report any calf pain or dyspnea to your healthca provider. E) This medication must be taken with food.
B C
1) The nurse is conducting a history and physical assessment of a sexually active teenage client. Which findings should the nurse identify as consistent with genital herpes? Select all that apply. A) Low blood pressure B) Headache C) Fever D) Dysuria E) Vaginal discharge
B C D E
1) A nurse is gathering the health history of a client with erectile dysfunction (ED). W finding(s) could indicate a possible cause for the client's ED? Select all that apply. A) Blood pressure of 118/68 mmHg B) Treatment for type 2 diabetes mellitus for 7 years C) Body mass index (BMI) of 24.5 D) Alcohol intake of 4 to 6 beers each day E) Engaging in moderate exercise twice a week
B D
5) A female client complains of having a "strange discharge" from her vagina and "stinging" when voiding urine. Which diagnostic tests) would be useful to aid in the diagnosis of this client's disorder? Select all that apply. A) Biopsy B) Urine culture C) Pregnancy test D) Serum hormone levels E) Papanicolaou test
B E
4) What should the nurse include in the plan of care for a client experiencing erectile dysfunction due to a chronic health condition? Select all that apply. A) Information about herbal supplements that can help treat ED B) Information on prescription medications used in ED treatment C) Brief description of types of devices and surgeries available to help with ED D) Explanation of how to discontinue any prescribed medications that may be contributing to the client's ED E) Information on the exact cause of the client's ED
B c
10) The nurse is planning care for a client with female orgasmic disorder. Which of the following elements would least likely be included in the client's plan of care? A) Referral to a sex therapist B) Information on the use of vibrators and other mechanical aids C) Teaching on how to perform pelvic floor exercises D) Instruction on how to obtain and use vaginal dilators
D
12) A client who gave birth 10 weeks ago via cesarean section tells the nurse that she is having difficulty resuming sexual relations with her husband. She reports both reduced desire for sex and pain upon penetration. What is the nurse's best response to this client? A) "Are you breastfeeding? If so, switching to formula will help resolve these issues." B) "Most women don't report these sorts of problems unless they've delivered vaginally." C) "These problems are common during the postpartum period and usually resolve with time." D) "Based on the symptoms you're reporting, I'm concerned you might be experiencing a postpartum mood disorder."
C
2) A female client tells the nurse she is having difficulty with sexual relations because of a recent weight gain. When planning this client's care, the nurse should prioritize interventions related to which of the following areas? A) Sexual self-concept B) Gender identity C) Body image D) Gender-role behavior
C
2) A nurse is caring for a client in menopause. When discussing hormone replacement therapy (HRT) with the client, the nurse should include which of the following statements? A) "Most healthy, recently menopausal women should not use HRT for relief of hot flashes and vaginal dryness." B) "HRT is the least effective treatment of menopausal hot flashes and vaginal dryness." C) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal estrogen is preferred." D) "The risk of blood clots in the legs or lungs is further increased by using transdermal patches, gels, or sprays."
C
3) A female client asks what causes the symptoms of menopause. On which hormonal function should the nurse focus when responding to this client's question? A) Increased estradiol levels B) Increased progesterone levels C) Decreased estrogen levels D) Increased luteinizing hormone levels
C
5) The nurse is instructing a client about the medication sildenafil (Viagra). Which statement on the part of the client indicates that this teaching has been effective? A) "Viagra should be taken with food. T B) "I can take Viagra at the same time I take my daily alpha-adrenergic blocker." C) "I can take only one pill in a 24-hour period. D) "Viagra works by decreasing blood flow to the penis."
C
6) A premenopausal client tells the nurse that she is not looking forward to menopause because it means her life is over. When the nurse asks what she means by this statement, the client says, "I can't imagine that anyone will have much use for an old woman who can't have children anymore." Based on this statement, which nursing diagnosis would most likely be appropriate for the client at this time? A) Ineffective Sexuality Pattern B) Deficient Knowledge C) Situational Low Self-Esteem D) Disturbed Body Image
C
7) A client who is approaching menopause is interested in oral hormone replacement therapy (HRT) to manage her symptoms. Which of the following points should the nurse include in this client's teaching plans? A) HRT decreases a woman's risk for deep vein thrombosis. B) HRT helps protect women against stroke and congestive heart failure. C) HRT is often useful for women who are at increased risk for osteoporosis. D) HRT is associated with a reduced incidence of breast cancer and pulmonary embolism.
C
9) A 45-year-old female client tells the nurse that she has not had any interest in sex for about 8 months. During this time, she has also had difficulty with arousal. Which response by the nurse is best? A) "Don't worry; all women go through periods where they are uninterested in sex." B) "It sounds like you might be experiencing female sexual interest/arousal disorder, although your symptoms need to be present for 12 full months before this diagnosis applies." C) "You are not alone. Lack of interest and arousal is the most common sexual problem reported by female clients." D) "A lack of interest in sex is a normal consequence of the aging process, and it often begins around the time a woman enters menopause.
C
9) A public health nurse is educating a group of adults about the incidence and prevalence of sexually transmitted infections (STIs. Which statement should be included? A) "Males have higher rates of gonorrhea and chlamydia, whereas women have higher rates of syphilis." B) "Men are disproportionately affected by STIs as compared to women and infants." C) Women often experience few early manifestations of infection, which causes them to delay diagnosis and treatment." D) "The incidence of STIs is highest among young Caucasian females."
C
3) A client is experiencing dysuria, urinary frequency, and vaginal discharge. For which sexually transmitted infection(s) should the nurse prepare the client for testing? Select all that apply. A) Syphilis B) HIV C) Chlamydia D) Human papillomavirus (HPV) E) Gonorrhea
C E
11) The nurse is teaching a client about sexual activity during the pregnancy. Which of the client statements indicate that this teaching has been successful? A) "The elevated androgen levels that accompany pregnancy might reduce my desire for sex." B) "It's a good idea to avoid vaginal sex during the last few weeks of pregnancy, so I don't risk hurting the baby." C) "Sexual dysfunction is uncommon during pregnancy, although many women suffer from low desire during the postpartum period." D) "Pregnant women are most likely to experience sexual difficulties during the third trimester."
D
11) Which of the following clients would be described as experiencing premature ovarian failure? A) A 29-year-old woman who is receiving chemotherapy that damages her ovaries B) A 43-year-old woman who has irregular periods as a result of ovarian dysfunction C) A 35-year-old woman who recently underwent an oophorectomy D) A 32-year-old woman who does not ovulate because of an abnormally low number of ovarian follicles
D
12) Which of the following actions on the part of the nurse is most appropriate when treating an 8-year-old client who is exhibiting the symptoms of a sexually transmitted infection (STI? A) Immediately perform a detailed examination and collect relevant specimens B) Assume that the child acquired the infection during the perinatal period C) Initiate presumptive treatment of the STI as soon as possible D) Anticipate the need to follow mandatory reporting guidelines
D
13) A postmenopausal client says to the nurse, "I've lost interest in sex over the past few months, but that's normal for women my age." Based on the client's statement, which nursing diagnosis would be most appropriate? A) Situational Low Self-Esteem B) Readiness for Enhanced Communication C) Readiness for Enhanced Relationship I D) Deficient Knowledge
D
2) The nurse is assessing a client who presents with an open sore on his penis. Which question by the nurse best elicits additional data related to this finding? A) "Do you think you have a disease?" T B) "Have you had sexual intercourse recently?" C) "Are you promiscuous?" D) "When did you initially notice this open area?"
D
3) Which of the following statements is true with regard to human sexuality? A) The term "intersex" is used to describe individuals whose gender identity and/or gender expression differs from the gender they were assigned at birth. B) Members of the medical and psychological professions believe that all transgender individuals are affected by gender dysphoria. C) Today, the terms "transgender" and "transsexual" are typically used interchangeably. D) Transgender individuals are at increased risk for violence, discrimination, poverty, and limited access to healthcare.
D
5) The nurse is assessing a postmenopausal client. Which client statement indicates the need for further assessment by the nurse? A) "I use water-soluble lubricant to treat my vaginal dryness." B) "For some reason, I have more sexual desire than ever." C) "Sex certainly takes longer than it used to, but I'm getting used to that." D) "I am so glad that I don't need to worry about sex anymore."
D
6) A community health nurse is educating a group of teenage girls about the prevention of datin; violence. Which statement should the nurse include in teaching? A) "Studies suggest that males who monitor their partners' whereabouts are less likely to engage in violence than males who do not keep tabs on their partners." B) "Females can reduce their risk of becoming victims of violence by adopting a submissive rol in the dating relationship." C) "Males who own weapons are no more likely to perpetrate dating violence than males who don't have access to weapons." D) "Males with a history of aggressive behavior are more likely to behave violently toward their partners."
D
7) A client asks for a prescription for tadalafil (Cialis). Given this information, what should the nurse ask the client prior to creating a plan of care? A) "Do you have diabetes mellitus?" B) "Are you comfortable taking this medication twice per day?" C) "Do you have any sexually transmitted infections?" D) "Do you use nitroglycerine?"
D
7) An older adult client tells the nurse that he still has erections and wants to have sex with his wife, but she does not have the same interest in sexual activity as he does. What should the nurse do to assist this client? A) Explain that women lose interest in sex as part of the aging process. B) Suggest that the client wait a while and his urge to have sex will pass. C) Ask what the client has been doing to fulfill himself sexually. D) Encourage the client to ask his wife to discuss her lack of interest in sexual activity with her healthcare provider. Answer: D
D
