Sexuality Prep-U

Applying the American Psychiatric Association description of sexual response, place the phases in the order in which they would occur from first to last.

Appetitive Excitement Orgasm Resolution

What are the uterus and vagina connected by?

Cervix

During the menstrual cycle, when does ovulation typically take place?

On day 14

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 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?

Use of Kegel exercises Rationale: 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.

After discussing the various methods of contraception with a female client and her partner, the couple decides to use depot injections of medroxyprogesterone. After teaching the couple about this type of contraception, which statement by the client indicates effective education?

"I have to get an injection once every 3 months." Transdermal patches stay on for seven days before being changed. Subdermal implants such as etonogestrel are effective for at least 3 years.

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." Factors that contribute to sexual dysfunction in the older adult are as follows: use of medications, especially antihypertensive medications; age-related metabolic disorders such as anemia, diabetes, malnutrition, and fatigue (may cause impotence). Sexual intercourse and similar forms of sexual expression are not considered dangerous for anyone able to walk around a room. Erectile dysfunction has treatments such as a penile prosthesis or pharmacologic management.

A nurse is educating a male client about testicular self-examination. The nurse would encourage the client to perform the exam at which frequency?

Once a month

During assessment of a female client, the client tells the nurse that she uses oral contraceptives. Based on the nurse's knowledge about the action of these drugs, which phase of the menstrual cycle would most likely be affected?

Ovulatory phase Rationale: Oral contraceptives suppress ovulation or the rupture of the oocyte from the ovary, which occurs during the ovulatory phase. During the proliferative phase, there is proliferation of the endometrium, or uterine lining. During the follicular phase, the ovarian follicles mature, with usually only one follicle reaching full maturity. During the luteal phase, the uterus prepares itself for possible implantation and maintenance of a fertilized ovum.

A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs?

STIs are most prevalent among teenagers and young adults.

An older adult couple who have just relocated to a long-term care facility have been unable to obtain a shared room. A staff member at the facility states that this should not be a concern and implies that sexual activity between the couple likely ceased many years ago. How should the nurse best respond to this individual's assertion?

"Actually it's not true that older people always stop having sexual activity when they get older."

Which assessment question is most likely to yield clinically meaningful data about a female client's sexual identity?

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

A female client experienced a pelvic fracture in a motor vehicle accident several months earlier and recovery has been slow. Among the challenges presented by this event is the fact that sexual activity causes a dull ache in her pelvis. Which nursing diagnosis is most appropriate for this client?

Alteration in Comfort: Pain

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

Antihypertensive medication

The nurse recommends a barrier method of contraception for a client who is concerned about the side effects of hormonal contraception. Which method might the nurse suggest?

Cervical cap 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 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

Which statement is true of gender identity?

It may be the same as or different from biologic identity. Rationale: Gender sex denotes chromosomal sexual development. Gender identity is the inner sense one has of being male or female, which may be the same or different from biologic gender. Gender role behavior is the behavior a person conveys about being male or female.

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. Rationale: 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.

A new client has come to the clinic requesting a method of birth control. The client asks about a diaphragm. What would the nurse teach this client about a diaphragm?

The diaphragm must be used during each episode of sexual activity. Rationale: The diaphragm must be used during each episode of sexual activity. It must be left in for 8 hours after intercourse and should be used with spermicidal jelly. There are different sizes of diaphragms, and the client needs to be fitted by the health care practitioner.

The nurse is talking with a young victim of sexual assault in the emergency department. The client states that she wants to take emergency contraception and asks the nurse what is recommended. What is the best response by the nurse? Select all that apply.

The health care provider will prescribe increased doses of oral contraceptives. The health care provider will order a copper IUD within 5 to 7 days of the unprotected sex. Plan B One-Step may be obtained without a prescription at a drugstore or family planning

The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by a male who eventually discloses to the nurse that, while he is happily married, he occasionally enjoys wearing his wife's undergarments when she is away. The term for this behavior is which of the following?

Transvestite

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

A client in a family planning clinic asks for oral contraceptives. The nurse is aware that oral contraceptives are contraindicated for which client?

Women who smoke

What do most nursing interventions pertaining to sexuality involve?

educating to promote sexual health

What term is used to describe painful intercourse?

Dyspareunia Rationale: Dysmenorrhea is pain with menstruation. Impotence is erectile failure. Vulvodynia is vulvar pain.

The school nurse is presenting a class on female reproductive health. While discussing prevention the nurse teaches what about a Pap smear?

"How many children do you have?" Rationale: A health history should include information regarding a client's reproductive and sexual health, depending on the circumstances in which the client is receiving care. Information is best obtained from the client by beginning with nonthreatening questions (number of children) and progressing to more sensitive concerns (HIV and other STIs). Asking about gender identity is a higher level question in the sexual health interview and requires the interviewer to have more sophisticated preparation and skills, such as a sex therapist.