WEEK 12 [ADN 220] the concept of sexuality

During a health​ history, a​ middle-aged single female client tells the nurse that questions about sex will not be answered because it is not anyone​'s business. What should the nurse ask the client in response to this​ statement?

How did your parents express ​love

The nurse suspects that a female client is experiencing adverse effects from the female infertility medication clomiphene. What did the nurse most likely assess in this​ client?

Jaundice of the skin and sclera This is the correct answer. Calf tenderness upon palpation This is the correct answer. Changes in the client​'s vision your answer is correct

The health care provider asks you to obtain a urine specimen for glucose and ketones. As you discuss this with​ Sarah, the student​ nurse, which statement indicates she understands this​ test? Only traces of glucose should be found in the urine. The urine normally contains glucose and ketones when the pancreas is functioning properly. If Mr. Walker is unable to urinate​ now, we can use the specimen he dropped off earlier this morning. Ketones indicate incomplete fat metabolism and a lack of insulin or diabetic ketoacidosis.

Ketones indicate incomplete fat metabolism and a lack of insulin or diabetic ketoacidosis.

Jim and Barbara Hernandez are attending a preconception appointment. During this​ appointment, Barbara becomes tearful and​ states, "I​ don't think that​ we'll ever have​ children." What recommendation should the nurse make to increase​ Barbara's chances of becoming​ pregnant? Request spouse to limit cigarette smoking Take​ 5,000 units of vitamin A each day Participate in 30 minutes of aerobic exercises daily Restrict alcohol intake to 1 glass of wine in the evenings

Participate in 30 minutes of aerobic exercises daily

What is assessed during the sexual history? (Select all that apply.) Past medical history Nutritional status Current sexuality problem Rest and activity status Psychosocial history

Past medical history Current sexuality problem Psychosocial history

The nurse is evaluating teaching provided to a​ 45-year-old-female client to promote healthy sexual functioning. Which observations indicate that teaching has been​ effective?

Riding a bicycle three times a week Your answer is correct. Ingesting fresh fruit with breakfast

The nurse is teaching a client about treatment options for erectile dysfunction​ (ED). Which explanation regarding pharmacological treatment is the most​ appropriate?

They help a man achieve an erection during sexual stimulation by enhancing the effects of n itrous oxide to relax the smooth muscle of the penis and increase the blood flow.

d (Rationale Perimenopausal women often complain of such psychological manifestations as fatigue. Decreased skin​ elasticity, increased vaginal​ pH, and irritability are physical manifestations of menopause.)

A client is diagnosed as perimenopausal. Which psychological manifestation is the client most likely​ experiencing? a Increased vaginal pH b Decreased skin elasticity c Irritability d Fatigue

d (Rationale When performing a physical examination on a perimenopausal​ client, the nurse needs to obtain the client​'s weight and height. The client​'s sexual and menstrual history and use of alcohol and drugs are data obtained when performing the health history.)

A​ 34-year-old client presents to the family practice clinic with complaints of not having a menstrual period in the past 14 months. What data should the nurse obtain when performing a physical examination on the​ client? a Drug and alcohol use b Sexual history c Menstrual history d Weight and height

What is the most common sexual disorder in men? Nocturnal emissions Climacteric Thelarche Erectile dysfunction

Erectile dysfunction

Which contraceptive is not a barrier method of​ contraception? Contraceptive sponge Diaphragm Vaginal contraceptive ring Spermicide

Vaginal contraceptive ring

In autosomal dominant​ disorders, the affected parent has what chance of passing the abnormal gene to each​ child? ​25% ​75% ​50% ​100%

​50%

c (Rationale: Night sweats is the only symptom that is subjective, reported by the client. Facial hair, decreased skin elasticity, and a rise in vaginal pH are all objective signs that can be observed by the nurse. )

During the examination portion of her annual checkup, a 55-year-old client has several new complaints. Which subjective symptoms of menopause would the nurse expect to find during data collection? a Hair growth on the upper lip b Decreased skin elasticity c Night sweats d Rise in vaginal Ph

Mr. Walker has been taking 8 tablets​ (325 mg​ each) of acetaminophen​ (Tylenol) every day. Given his​ diagnosis, his health care provided has ordered that he be limited to a maximum dosage of 15​ mg/kg per day of acetaminophen. You recall Mr. Walker is​ 5'11" tall and weighs 254 pounds. Calculate the maximum dose of acetaminophen​ (Tylenol) Mr. Walker can take each day. Please limit your answer to a numeral. Record your answer rounding to the nearest whole number

1732

You know that taking acetaminophen​ (Tylenol) is a precipitating factor to developing pancreatitis. Mr. Walker reports taking 8 tablets​ (325 mg​ each) of acetaminophen​ (Tylenol) every day. How many mg does Mr. Walker take​ daily? Please limit your answer to a numeral. Record your answer rounding to the nearest whole number.

2600

c (Rationale: FSH blood testing can be done after the woman has gone one year without a menstrual cycle. If the FSH is high, a diagnosis of menopause can be made. Complete blood count, estrogen levels, and BUN blood tests are not diagnostic for menopause)

A 53-year-old woman asks the nurse if there are any definitive laboratory tests that would show that she has entered menopause. The nurse responds that which test is done to clarify the diagnosis? a Complete blood count b Blood, urea, nitrogen (BUN) levels c Follicle-stimulating hormone (FSH) level d Estrogen levels

The nurse should teach the client with erectile dysfunction to alter his lifestyle to: A. Avoid alcohol B. Follow a low-salt diet C. Decrease smoking D. Increase attempts at sexual intercourse

A Avoidance of alcohol can improve the outcome of therapy. Alcohol and smoking can affect a man's ability to have and maintain an erection.

The client diagnosed with angina is prescribed nitroglycerin (Nitrobid) and tells the nurse, "I don't understand why I can't take my Viagra. I need to take it so that I can make love to my wife." Which statement is the nurse's best response? A. "If you take the medications together, you may get very low blood pressure." B. "You are worried your wife will be concerned if you cannot make love." C. "If you wait at least 8 hours after taking you nitroglycerin (NTG), you can take your Viagra." D. "You should get clarification with your HCP about your taking Viagra."

A Life-threatening hypotension can result with concurrent use of nitroglycerin and sildenafil (Viagra).

a,b,d,e (Rationale Decreased urine​ output, hypotension,​ tachycardia, and tachypnea are all related to shock due to uterine​ bleeding, and the nurse must use the nursing process of assessing and evaluating to determine necessary steps to be taken. One would expect​ delayed, not​ rapid, capillary refill for the client in shock.)

The nurse is caring for a client after a hysterectomy. Which assessment findings support the diagnosis of shock related to uterine​ bleeding? ​(Select all that​ apply.) a Tachypnea b Decreased urine output c Rapid capillary refill d Hypotension e Tachycardia

3 (While some areas may specify a minimum ate for treatment (usually 12-14 years old) generally adolescents have the right to seek treatment for STI's without parental consent. These medical records are not shared without the clients permission. However teens must be made aware that certain infections including gonorrhea must be reported by law to public health agencies. Patner notification will take place but methods vary.)

A 17 year old senoir calls the clinic because she thinks she might have gonorrhea. She wants to be seen but wants assurances that no one will know. Which is the most appropriate response by the nurse? 1. Because you are underage we will need your parents consent to treat you 2. we can treat you without your parents consent, but they have the right to review your medical record 3. we can see you without your parents consent but have to report any positive result to the public health department 4. we can see you and will not share your results with anyone.

b (Rationale: Older women and those experiencing menopause may have decreased vaginal secretions, causing a dry entry that can be painful and irritating to the vagina. The nurse could suggest using a lubricant to replace normal secretions. Before assessing for the problem, it is not appropriate to advise the client to tell the partner that sex is not desired. Advising the client to reduce sexual contact or use alcohol does not address the client's problem)

A 50-year-old client confides to the nurse that she is experiencing dyspareunia during sexual intercourse. The nurse recommends which therapy for this client? a Tell the partner that sex is no longer desired. b Use a vaginal lubricant. c Consume alcohol to reduce inhibitions. d Reduce sexual contact to once a month.

2 (managing stressful life events can decrease the incidence of outbreaks of HSV-2. Occlusive ointments should not be applied. Antiviral therapies will not cure herpes but can manage symptoms and decrease the incidence of outbreaks. Clients with HSV-2 should use condoms to prevent HSV transmission. Cells can be shed at other times, not only when vesicles are weeping)

A client diagnosed with genital HSV-2. The nurse should instruct the client that; 1. using occlusive ointments may decrease pain from the lesions 2. reducing stressful life events may decrease the incidence of herpetic outbreaks 3. there are no effective drug therapies to manage herpes symptoms 4. herpes is transmitted to partners only when lesions are weeping

a,b,c,d (Rationale Menopausal symptoms can be treated with medications or the use of alternative and complementary therapies. Medications include hormone replacement​ therapy, raloxifene,​ triphenylethylene, fluoxetine,​ paroxetine, and venlafaxine. Alternative and complementary therapies include bioidentical​ hormones, acupuncture,​ biofeedback, massage,​ meditation, yoga, and herbs.Gabapentin​ (Neurontin) is not used to treat manifestations of menopause.)

A client has been diagnosed with menopause and is complaining of increased severity of manifestations. Which treatments can be used for the treatment of menopausal​ symptoms? ​(Select all that​ apply.) a Hormone replacement therapy b Herbs c Acupuncture d Bioidentical hormones e Gabapentin​ (Neurontin)

3 (the client should be encouraged to report painful urination or urinary retention. lesions may appear 2-12 days after exposure. The client is capable of transmitting the virus even when asymptomatic, so a barrier contraceptive should be used. drinking extra fluids will not stop the lesions from forming)

A client tells the nurse that she has had sexual contact with someone whom she suspects has genital herpes. The nurse should instruct the client to: 1. anticipate lesions in 25-30 days 2. continue sexual activity unless lesions are present 3. report any difficulty urinating 4. drink extra fluids to prevent lesions from forming

4 (a woman with a uterus who takes unopposed estrogen has an increased risk of endometrial cancer. The addition of progesterone prevents the formation of endometrial hyperplasia. Progesterone does not prevent breast, liver, or cervical cancer)

A client who is post menopausal with an intact uterus asks the nurse why her hormone medicine has two drugs, estrogen and progesterone. Which statement by the nurse provides the client with accurate information? 1. The progesterone will help prevent cervical cancer 2. the progesterone will help prevent breast cancer 3. The progesterone will help prevent liver disease 4. The progesterone will help prevent endometrial cancer

3 (Zidovudine (AZT) interferes with the replication of HIV and thereby slows the progression of HIV infection to AIDS. There is no known cure for HIV. Today clients are not treated with monotherapy, but are usually on triple therapy due to much improved clinical response. Decreased viral loads with the drug combinations have improved the longevity and quality of life in clients with HIV/AIDS. AZT does not destroy the virus, enhance the bodies antibody production, or neutralize virus toxins)

A client with HIV infection is taking AZT the expected outcome of AZT is to : 1. destroy the virus 2. enhance the bodies antibody production 3. slow replication of the virus 4. neutralize toxins produced by the virus

3 (metronidazole can cause a disulfiram-like reaction if it is taken with alcohol. Tachycardia, N/V, and other serious interaction can occur. Flagyl will make the urine a darker color. Oral contraceptives should never be discontinued with trichomoniasis. The parner also requires treatment to prevent retransmission of the infection)

A female client is treated for trichomoniasis with metronidazole. The nurse instructs the client that: 1. the medication should not alter the color of the urine 2. she should discontinue oral contraceptive use during the treatment 3. she should avoid alcohol during treatment 4. her partner does not need treatment

a,b,d,e (Rationale The manifestations of menopause affect many body​ systems, including the vasomotor system. Vasomotor manifestations include hot​ flashes, palpitations,​ dizziness, headaches,​ insomnia, and night sweats. Decreased body hair is an​ integumentary, not​ vasomotor, manifestation of menopause. Menopausal clients have integumentary manifestations that include decreased body​ hair, decreased skin​ elasticity, and decreased subcutaneous tissue.)

A female client presents to her healthcare provider​'s office with manifestations of menopause. What are the VASOMOTOR manifestations of​ menopause? ​(Select all that​ apply.) a Hot flashes b Palpitations c Decreased body hair d Night sweats e Dizziness

d (Rationale: Women with HPV genital infection are advised to have an annual pelvic exam and PAP smear, since there is increased risk of cervical cancer. While a breast exam and mammogram are recommended, they are not screenings for cervical cancer. Stool testing for occult blood and CBC will not detect cervical cancer. )

A female client with genital warts caused by human papillomavirus (HPV) asks the nurse what future tests will be needed to monitor this disease. The nurse recommends a yearly: a complete blood count (CBC) to detect infection. b stool for occult blood. c breast exam and mammogram. d pelvic exam and PAP smear.

4 (Dysuria and mucopurulent urethral discharge characterize gonorrhea in men. Gonococcal symptoms are so painful and bothersome for men that they usually seek treatment with the onset of symptoms. Impotenence, scrotal swelling, and urine retention are not associated with gonorrhea.)

A female client with gonorrhea informs the nurse she has had sexual intercourse with her boyfriend and asks the nurse, "Would he have any symptoms?" The nurse responds that in men, the symptoms of gonorrhea include: 1. impotence 2. scrotal swelling 3. urine retention 4. dysuria

2 (endometrial cancer has very few warning signs; irregular bleeding may be the only sign. Any irregular bleeding in a menopausal woman should be investigated, and an endometrial biopsy may be prescribed. Hot flashes result from decreased estrogen levels that acompany menopause. Urinary urgency should be monitored and treated as a separete problem. Dyspareunia is the occurrence of pain in the labial, vaginal or pelvic areas during or after sexual intercourse. It may be caused by inadequate vaginal lubrication in the menopausal woman)

A menopausal woman is taking hormone replacement therapy (HRT). The nurse teaches the client that a warning sign for endometrial cancer that needs to be reported is: 1. hot flashes 2. irregular vaginal bleeding 3. urinary urgency 4. dyspareunia

a (Rationale: Hot flashes are a sign of menopause, not the flu. The nurse provides the client with education about symptoms and lifestyle changes for the woman entering menopause. Increasing calcium intake, weight-bearing exercises, and yearly mammograms are all recommendations for the perimenopausal woman.)

A nurse caring for a client who has begun menopause selects the nursing diagnosis of deficient knowledge when the client makes which statement? a "I must be coming down with the flu because I am having hot flashes." b "I need to begin weight-bearing exercises such as walking." c "I should increase my daily calcium intake to 1200 mg." d "I need to obtain yearly mammograms."

4 (HIV infection is transmitted through blood and body fluids particularly vaginal and seminal secretions. A blood transfusion is one way the disease is contracted. Other modes of transmission are sexual intercourse with an infected person and sharing IV needles with an infected person. Women now have the highest rate of newly diagnosed HIV infection. Many of these women contracted HIV from unprotected sex with male partners. HIV cannot be transmitted from hugging, inhaling cocaine, or sharing utensils)

A nurse is planning care for a 25 year old diagnosed with HIV. The client asks the nurse "How could this have happened?" The nurse responds to the question based on the the most frequent mode of transmission is: 1. hugging an HIV positive sexual partner without using barrier precautions 2. inhaling cocaine 3. sharing food utensils with an HIV positive person without proper cleaning of the utensils 4. having sexual intercourse with an HIV person without using a condom

1,2,3,4,6 (The client is suspected of having a STI. Therefore the clients sex history, assessment, and exam must be documented, including any symptoms (such as fever and chills, and enlarged glands) and their onset and duration. Allergies are critical to document for every client but are especially noteworthy in this case because of impending antibiotic orders. IF a STD is confirmed, sex contacts need treatment. To protect privacy, the names and phone numbers should never be placed in the medical record. The public health dept. will assist in obtaining the info and treating known sex contacts)

A sexually active male client has burning on urination, and a milky discharge from the urethral meatus. What documentation should be included on the clients medical record? Select all that apply 1. history of unprotected sex (sex without a condom) 2. length of time symptoms presented 3. history of fever and chills 4. presence of any enlarged lymph nodes on exam 5. names and phone numbers of all sexual contacts 6. allergies to any medications

b (Rationale: The priority of care is teaching the client lifestyle changes that can help reduce the risks associated with menopause. Referring the client to a support group may be a consideration, but is not the priority. The nurse can offer information regarding hormonal therapy, but it is the physician who makes the recommendation. Foot care is important to the woman who has diabetes. )

A spouse and his client who is perimenopausal is questioning the nurse regarding self-care during this process. The nurse plans to focus teaching for this client on which priority of care? a Referring the client to a support group b Reducing the risks associated with menopause c Recommending hormonal therapy d Stressing the importance of foot care

a (Rationale Hormone replacement therapy​ (HRT) may increase a woman​'s risk of gynecologic cancers and cerebrovascular accidents.​ Therefore, HRT is not safe for​ long-term use. Hormone replacement therapy will be prescribed​ short-term to alleviate severe manifestations to menopause. HRT does not improve bone density and serum lipids.)

A woman experiencing menopause has been placed on hormone replacement therapy​ (HRT) by her health care provider. What information regarding HRT should the nurse provide the​ client? ​a "Hormone replacement therapy will assist in alleviating severe manifestations when used on a​ short-term basis." b "You can stay on HRT as long as you need​ it." ​c "You will find that HRT will improve bone density and serum lipids. " ​d "Hormone replacement therapy is safe for​ long-term use.

c,d,e (Rationale Exercise can help manage the anxiety and mood swings associated with perimenopause. Dressing in loose layers of clothing that can be added or removed will increase comfort during hot flashes. Keeping the bedroom cool will help control and provide comfort during night sweats. Caffeine intake should be decreased during perimenopause because it can trigger hot flashes. Sexual intercourse does not have to be avoided during​ perimenopause, but lubricants may be used to decrease discomfort from vaginal dryness.)

A woman experiencing perimenopausal symptoms asks the nurse what she can do to help control the symptoms. What interventions should the nurse​ recommend? ​(Select all that​ apply.) a Increase caffeine intake b Avoid sexual intercourse c Start a regular exercise routine d Dress in layers e Keep the bedroom cool

The nurse is providing information to a woman deciding on a form of contraception. What should be considered when determining the best contraceptive​ method? ​(Select all that​ apply.) Affordability Ease of use Safety Effectiveness Accountability

Affordability Ease of use Safety Effectiveness Rationale Nurses should provide contraceptive information to the individual to assist in making the decision. In deciding on the best​ method, the individual will need to consider​ safety, effectiveness, ease of​ use, side​ effects, whether it is easily​ available, and whether it is affordable.

As part of the nursing​ process, it is important for you to inform Ms. Carter about some contributing factors that should be avoided or reduced to better control her symptoms. What contributing factors should Ms. Carter avoid to manage her ​condition?​ Select all that apply. Sexual intercourse Alcohol Exercise Anxiety Caffeine

Alcohol Exercise Caffeine

While conducting a physical​ assessment, the nurse notes a red rash in the axillary region of a young adult client. What should this finding suggest to the​ nurse?

Allergy Your answer is correct. Infection of the hair follicles Your answer is correct. Shaving

1 ( a frothy purulet vaginal discharge in a sexually active female client is typically caused by a STI such as trichomonas. Other disease such as chlamydia may be present. Both the client and the boyfriend need treatment after the disease is determined. Normal variations in female discharge should be clear to white, not frothy or purulent. The client should be instructed to wear cotton underwear and avoid pantyhose, wet gym clothes, and tight fitting garments, such as jeans, so that air can circulate)

An 18 year old female client who is sexually active with her boyfriend has a purulent vaginal discharge that is sometimes frothy. The nurse interprets this as suggesting; 1. sexually transmitted infection 2. normal variation in vaginal discharge 3. need for vaginal douching 4. side effect of birth control method

1 (asking the client to describe her nervousness gives her the opportunity to express her concerns. It also allows the nurse to understand her better and gives the nurse a base to respond to the clients stated fears, questions or needs for further info. Responses that make assumptions about the source of concern or offer reinforcement are not supportive and block successful communication)

An 18 year old is to have a pelvic exam. Which response by the nurse would be best when the client says that she is nervous about the upcoming pelvic exam? 1. Can you tell me more about how you are feeling? 2. You are not alone. Most women feel uncomfortable about this exam 3. Do not worry about Dr. Smith. He is a specialist in female problems 4. We will do everything we can to avoid embarassing you

Your assessment of Ms. Carter reveals that she has been experiencing painful period symptoms for less than one year. She reports that other aspects of her menstrual cycle have remained constant or​ normal, such as the amount of flow and regularity. You explain to Ms. Carter that you suspect she has a condition called dysmenorrhea. Ms. Carter does not know what dysmenorrhea​ is, so you must educate her. You begin by explaining that there are two types of​ dysmenorrhea: primary and secondary. Ms. Carter asks you about the difference between primary and secondary dysmenorrhea. Which are your best​ responses? Select all that apply. Secondary dysmenorrhea is genetic. Primary dysmenorrhea is caused by reproductive abnormalities. Approximately​ 75% of women have primary or secondary dysmenorrhea. Primary dysmenorrhea is a benign condition. Secondary dysmenorrhea implies that an underlying condition exists.

Approximately​ 75% of women have primary or secondary dysmenorrhea. Primary dysmenorrhea is a benign condition. Secondary dysmenorrhea implies that an underlying condition exists.

4 (The client is likely exhibiting symptoms of herpes genitalis, which include painful blisters or vesicles that appear 2-20 days after the transmission of the disease. The client was most likely exposed from her new partner. The client should be referred to an HCP for treatment. Having her partner wear a condom, increasing fluids, or using a lubricant jelly will not treat the infection. While having her partner wear a condom will not cure the infection, having future partners wear condoms will help prevent the transmission)

Assessment of a 36 year old woman who has malaise and dysuria reveals a temp of 100F and painful blisters on the outside of her vagina. The client tells the nurse she had intercourse with a new partner 5 days ago. What should the nurse do? 1. advise the client to ask her partner to use a condom 2. encourage the client to increase fluids to 3000 mL/day 3. Tell the client to use a lubricant jelly on the blisters 4. Refer the client to the healthcare provider

A client with sickle cell disease asks the nurse to explain how she has this disease when no one else in her family is affected. The nurse understands that sickle cell disease follows what type of genetic inheritance​ pattern? Autosomal dominant disorder Autosomal recessive disorder Mendelian inheritance disorder ​Sex-linked inheritance disorder

Autosomal recessive disorder Rationale Autosomal recessive disorders require two abnormal genes for an individual to be affected. If the individual has only one affected​ gene, he or she is considered a carrier of the disorder. For this client to be diagnosed with sickle cell​ disease, both parents are carriers of the genetic disorder. Autosomal dominant disorders are inherited if the disease trait is​ heterozygous; the abnormal trait overpowers the normal​ gene, producing the disorder. For these disorders to be​ diagnosed, one of the parents is affected by the disorder. Mendelian inheritance disorders are mathematically predictable and have fixed occurrence rates. The characteristics are inherited from the genes in each chromosome and are classified as dominant​ (strong) or recessive​ (weak). Inheritance is also determined by whether the chromosome is located on an autosome​ (body) or a gamete. Normal and abnormal characteristics are transmitted this​ way, and a parent can be a carrier for a​ single-gene disorder without having any observable characteristics.​ X-linked, or​ Sex-linked, inheritance disorders can be dominant or recessive and are carried on the X chromosome.​ X-linked recessive disorders are expressed in males who carry the disorder on their X chromosome. There are some conditions where the female will be​ affected, but the symptoms tend to be milder.

a,c,d,e (Rationale The client is undergoing menopause. The client with menopause may have problems understanding the natural female aging​ process, sexual​ dysfunction, low​ self-esteem, or disturbed body image. Interventions to help the client with these problems include explaining the physiological manifestations of​ menopause; providing information about medications that might be prescribed to help with menopausal​ symptoms; encouraging discussion of how menopausal symptoms are affecting sexual​ functioning; and instructing the client to use vaginal lubricants if experiencing decreased lubrication. Asking​ open-ended questions will further explore the client​'s thoughts and feelings about body image in a therapeutic manner.)

A​ 52-year-old woman complains of hot​ flashes, night​ sweats, irritability, decreased vaginal​ lubrication, and no menstrual period in the past 15 months. Over the past several​ weeks, the hot flashes and night sweats have increased in​ frequency, and she has noticed that she is more irritable. Laboratory values reveal increased​ follicle-stimulating hormone and luteinizing hormone levels. Which intervention should the nurse​ initiate? ​(Select all that​ apply.) a Asking​ open-ended questions about the​ client's body image b Instructing the client to avoid​ over-the-counter vaginal lubricants c Explaining such physiological manifestations of menopause as hot flashes and night sweats d Providing information about medications that might be prescribed to help with menopausal symptoms e Encouraging discussion of how menopausal symptoms are affecting sexual functioning

Ibrahim​ Moussad, an​ 18-year-old male, has come to the neighborhood clinic for an exam that is required before he can play sports. Ibrahim requests a male nurse. What will the nurse keep in mind as he takes​ Ibrahim's medical history and prepares to discuss contraceptive​ use? Be aware of the​ client's cultural and religious beliefs Influence the client so that he makes the choice recommended by the nurse Remember that a teenager will not be truthful about his sexual history Obtain​ Ibrahim's height and weight when obtaining the health history

Be aware of the​ client's cultural and religious beliefs

2 (because of the large dose the upper outer quadrant of the buttocks is recommended site. The deltoid and quadricepts lateralis of the thigh are not large enough for the recommended dose. In infants and small children, the midlateral aspect of the thigh may be preferred.)

Benzathine Penicillin G, 2.4 million units IM, is prescribed as treatment for an adult client with primary syphilis. The nurse should administer the injection in the : 1. deltoid 2. upper outer quadrant of the buttock 3. quadriceps lateralis of the thigh 4. midlateral aspect of the thigh

A​ 35-year-old client is interested in starting oral contraceptives. She smokes one pack of cigarettes a day. About which side effect should the nurse be most​ concerned? Vaginal infection Hypertension Allergic reaction Blood clot

Blood clot Rationale Women on oral contraceptives are at risk of developing blood clots. Women over the age of 35 who smoke are at an even greater risk. Some women may experience an increase in blood pressure while taking oral​ contraceptives, but it would not take priority over the possibility of the formation of blood clots. Vaginal infections are not the result of oral contraceptive use. Allergic reactions to oral contraceptives are rare.

The nurse is educating a​ client, who is trying to​ conceive, about nutrition. Which essential nutrients should the client include in her daily​ diet? ​(Select all that​ apply.) Calcium Iron Vitamin E Vitamin A Protein

Calcium Iron Protein Rationale A woman who is trying to conceive should include ample quantities of essential nutrients with emphasis on​ calcium, iron, and protein. Vitamin E and A are not essential for a client who is trying to conceive

A sexually active​ 33-year-old woman is interested in using a natural​ (fertility awareness​ based) contraceptive method. She works rotating shifts and has an irregular menstrual cycle. Which method would be best for the nurse to​ recommend? Calendar method Cervical mucus method Abstinence Basal body temperature

Cervical mucus method Rationale The cervical mucus method evaluates the changes in cervical mucus as ovulation​ approaches; this method is not affected by irregular menses or rotating shifts. Working rotating shifts can affect the basal body​ temperature, making the outcome difficult to determine. The calendar method is less effective if the woman​'s cycles are variable. Abstinence would not be recommended if the client has chosen to be sexually active.

The nurse is providing education to a community group. Which disorders presented are considered multifactorial inheritance​ disorders? ​(Select all that​ apply.) Huntington disease Cleft lip Clubfoot Spina bifida Neural tube defect

Cleft lip Clubfoot Spina bifida Neural tube defect Rationale Multifactorial inheritance disorders are a combination of environmental and genetic factors. Examples of multifactorial inheritance disorders include neural tube​ defects, spina​ bifida, clubfoot, and cleft lip. Huntington disease is an autosomal dominant disorder.

Which are characteristics of sexual development in the​ middle-aged adult? (Select all that​ apply.) Decreased hormone production Climacteric occurs in men and women Sexual activity may be less frequent May experiment with homosexual relationships Menopause occurs in women

Decreased hormone production Climacteric occurs in men and women Menopause occurs in women

The nurse is preparing to conduct a seminar about antianxiety agents for a group of college students. Which effects on sexual function should the nurse include when instructing about this group of​ medications?

Decreased sexual desire orgasmic dysfunction in women delayed ejaculation

During a woman​'s ​pre-pregnancy physical​ exam, what referral is essential for the nurse to​ make? Dentist Occupational therapist Ophthalmologist Social worker

Dentist Rationale During a woman​'s ​pre-pregnancy physical​ exam, the nurse should refer the client to a dentist in order to avoid exposure to radiation or infection while pregnant. Referral to a social​ worker, ophthalmologist, or occupational therapist is not essential.

Ms. Carter undergoes a pelvic examination and a transvaginal ultrasound by the clinics health care provider. Later that​ week, when Ms. Carters test results are​ in, the health care provider determines that Ms. Carter has primary dysmenorrhea and that it is unnecessary to perform further diagnostic tests.​ Ms. Carter returns for her​ follow-up appointment. Upon hearing the​ diagnosis, she is slightly​ relieved, and asks you what she can do to lessen the severity of her symptoms. Which intervention is appropriate for her primary​ dysmenorrhea? Dietary modifications Hormone therapy​ (HRT) Hysterectomy Endometrial ablation

Dietary modifications

What preconception counseling may the nurse provide to the individual or couple who is of childbearing​ age? ​(Select all that​ apply.) Discuss the unreasonableness of not planning for a pregnancy Discuss the benefits of good nutrition and obtaining and maintaining a normal weight for the​ client's height . Encourage discussion of each​ partner's goals,​ expectations, and desire to be a parent Provide information on good exercise habits that can be maintained with the​ client's lifestyle Provide information on different kinds of birth control and their advantages and risks

Discuss the benefits of good nutrition and obtaining and maintaining a normal weight for the​ client's height . Encourage discussion of each​ partner's goals,​ expectations, and desire to be a parent Provide information on good exercise habits that can be maintained with the​ client's lifestyle Provide information on different kinds of birth control and their advantages and risks

You inform Ms. Carter that you will begin the examination by asking her some questions about the history of her symptoms and of her menstrual cycle. Which question asks for information that is NOT needed for the​ assessment? Do you use​ tampons? Does anyone in your family have a history of female reproductive​ problems? What is the amount of your period​ flow? What was your age of​ menarche?

Do you use​ tampons?

When planning care for a client with family planning​ needs, which interventions should the nurse​ include? ​(Select all that​ apply.) Encourage client to verbalize feelings about sexual health Consult social worker for genetic counseling Provide environment that promotes discussion Teach client about fertility and contraception Emphasize the importance of using condoms for disease prevention

Encourage client to verbalize feelings about sexual health Provide environment that promotes discussion Teach client about fertility and contraception Emphasize the importance of using condoms for disease prevention Rationale When planning care for a client with family planning​ needs, the nurse needs to provide a​ nonjudgmental, accepting atmosphere to promote discussion. Other interventions should include encouraging the client to verbalize feelings of sexual​ health, teaching regarding fertility and​ contraception, and to emphasize the importance of condom use for disease prevention. The social worker is not the appropriate person to provide genetic counseling.

During a preconception​ visit, the nurse recognizes that a​ 33-year-old client may benefit from genetic counseling based on what​ data? Exposure to secondhand smoke History of alcohol use Client​'s age Family history of genetic disorders

Family history of genetic disorders Rationale The nurse should suggest genetic counseling based on the couple​'s family history of genetic disorders. Genetic counseling should be suggested for a woman over 35 years. Genetic counseling is not recommended for a client exposed to secondhand smoke or with a history of alcohol use.

Which diagnostic tests do you anticipate the health care provider will order to evaluate Mr. Walkers pancreatic​ function? Select all that apply. Urinary​ 17-ketosteroids Glucagon level Fasting glucose Amylase and lipase Glycoslated hemoglobin​ (Hgb A1c)

Fasting glucose Amylase and lipase Glycoslated hemoglobin​ (Hgb A1c)

The nurse is discussing the need for therapeutic donor insemination​ (TDI) with a client. Which would be an indication for​ TDI? ​(Select all that​ apply.) Epispadias Genetic male​ sex-linked disorder Erectile dysfunction Severe oligospermia Azoospermia

Genetic male​ sex-linked disorder Severe oligospermia Azoospermia Rationale TDI is used in cases of severe oligospermia​ (low sperm​ count), in cases of azoospermia​ (absence of​ sperm), or in those with a history of genetic male​ sex-linked disorders. Epispadias is a penile anatomic abnormality. The male​'s sperm can be used for​ insemination; donor sperm is not needed. Sperm from men with erectile dysfunction can still be used for​ insemination; donor sperm is not needed.

Which data are included in a physical examination of a male with family planning​ needs? ​(Select all that​ apply.) Postcoital exam Genital examination Monitor weight Blood pressure . Inspect for varoceles

Genital examination Monitor weight Blood pressure . Inspect for varoceles

Which action is not a suspected or known health risk for the couple planning a​ pregnancy? Breathing secondhand smoke Getting a flu shot Taking prescription medicine Drinking coffee

Getting a flu shot

Mr. Walkers laboratory results return. Which significant laboratory results indicate a problem with Mr. Walkers pancreatic​ function? Select all that apply. Glycoslated hemoglobin​ (Hgb A1c) ​ 7.9% Amylase 12​ Units/L Fasting glucose 100​ mg/dL WBC​ 7200 mcL Urine glucose and ketones​ (positive)

Glycoslated hemoglobin​ (Hgb A1c) ​ 7.9% Amylase 12​ Units/L Urine glucose and ketones​ (positive)

Additional assessment and examination is needed to determine if Ms. Carters symptoms are due to dysmenorrhea. When you are testing a client for​ dysmenorrhea, what are the possible types of assessments that can be used for gathering the subjective and objective information you​ need? Select all that apply. Health assessment Transvaginal ultrasound Urinalysis Pelvic examination CT scan or MRI

Health assessment Transvaginal ultrasound Pelvic examination CT scan or MRI

In the nursing​ assessment, what health history questions may be asked of both male clients and female clients in need of family planning​ care? ​(Select all that​ apply.) History of contraceptive use with barriers to prevent STIs History of​ menses, including regularity and first onset History of sexual​ activity, including age at first intercourse History of premature ejaculation or impotence History of sexual​ trauma, including rape and incest

History of contraceptive use with barriers to prevent STIs History of sexual​ activity, including age at first intercourse History of sexual​ trauma, including rape and incest

Which screening tests for sexual health are appropriate for both men and women? (Select all that apply.) Mammography Hypercholesterolemia Physical examinations Hypertension Prostate specific antigen

Hypercholesterolemia Physical examinations Hypertension

Although Ms. Carter should be able to manage her dysmenorrhea without any​ complications, you educate her about symptoms that will require medical attention. After you complete your​ teaching, which statement by Ms. Carter indicates that she requires further​ teaching? I need to call the doctor if I experience a vaginal discharge. I need to call the doctor if I experience continuing stomach aches. I will call the doctor if I experience pain in between periods. I do not need to call the doctor if I experience noticeable bleeding between periods.

I do not need to call the doctor if I experience noticeable bleeding between periods.

Joseph Walker is a​ 56-year-old African American male. He is 511 and weighs 254 lbs. Mr. Walker comes to his health care providers office for his annual examination. You are the nurse conducting his initial assessment. Mr. Walker states he has been feeling a little tired lately. He blames his weight gain and age along with his long hours as a truck driver.You discuss the risk factors for developing pancreatitis with Mr. Walker. Which statements by Mr. Walker indicate a predisposing factor for developing​ pancreatitis? Select all that apply. I take Tylenol every day when my legs hurt. I drink a bottle of red wine each evening and have since I was in my early twenties. I have had gallstones before. I drink a couple of beers on special occasions. I take ibuprofen​ (Advil) every day before I drive the truck.

I take Tylenol every day when my legs hurt. I drink a bottle of red wine each evening and have since I was in my early twenties. I have had gallstones before.

After reviewing the laboratory​ results, the health care provider has ordered an oral glucose tolerance test. You discuss the test with Mr. Walker.​ Which statement indicates he needs further​ teaching? This test will take a couple of hours to​ complete, and I cant eat or drink anything for 12 hours before. If my glucose is too​ low, it means my pancreas did not produce enough insulin to decrease my blood sugar. The glucose result should be below 125​ mg/dL. I can eat after my blood is drawn

If my glucose is too​ low, it means my pancreas did not produce enough insulin to decrease my blood sugar

Mr. Walker states he still does not understand why he has to have further testing. He does not feel​ bad, but is only a little tired. You explain the importance of the hormonal balance of the endocrine system and pancreas. Mr. Walker​ says, I think I get it now. Which statement indicates he has a need for further teaching regarding pancreatic​ function? If my pancreas is not functioning​ properly, I will always have low blood​ sugar, and this will make me tired. My pancreas also aids in digestion of​ protein, fats, and carbohydrates. When my pancreas is functioning​ properly, I will have consistent blood glucose levels. If there is a problem with my thyroid or​ pancreas, I may only have vague​ symptoms, so it is important to do some more testing.

If my pancreas is not functioning​ properly, I will always have low blood​ sugar, and this will make me tired.

b (Rationale: Closed-ended, yes-or-no questions are a barrier to communication with the client. Using a nonjudgmental attitude enhances communication. When talking about sexual and sensitive matters, the client may be more comfortable if dressed. Use of culturally sensitive approaches enhances communication. )

In interviewing a client concerning sexually transmitted infections (STI), the nurse should recognize that which is a barrier to client disclosure? a Collecting information while the client is dressed b Use of yes-or-no questions c Use of a culturally sensitive approach d Nurse's use of nonjudgmental attitude

Sally​ Jones, a​ 25-year-old client, visits the clinic for evaluation of possible infertility. She states that she and her husband have been trying to conceive for over 3 months and are concerned that something is wrong with one of them. On what knowledge is the​ nurse's response​ based? Infertility is on the rise in the United States. Infertility is likely related to an underlying medical condition. Infertility is likely associated with​ Sally's age. Infertility is the inability to conceive after one year of unprotected regular intercourse.

Infertility is the inability to conceive after one year of unprotected regular intercourse.

Which information will the nurse include in the postoperative teaching for the client with a penile​ implant? (Select all that​ apply.) Teach client that sexual activity will be painful Inform client and his partner that they may resume sexual activity in​ 6-8 weeks Teach client to tape penis to abdomen while healing Teach client and his partner how to use the device Teach client how to conceal a semirigid prosthesis with clothes

Inform client and his partner that they may resume sexual activity in​ 6-8 weeks Teach client and his partner how to use the device Teach client how to conceal a semirigid prosthesis with clothes

b (Asking the client to describe her nervousness gives her the opportunity to express concerns and allows the nurse to understand the client better. The other three responses make​ assumptions, are not supportive of the​ client's feelings, and block therapeutic communication.)

Jenny​ Jones, a​ 20-year-old college​ student, is being seen at the university health center. The nurse gathers a health history and suspects Ms. Jones may have a sexually transmitted infection​ (STI). Which response by the nurse is best when the client says that she is nervous about the upcoming pelvic​ examination? ​a "We'll do everything we can to avoid embarrassing​ you." ​b "Can you tell me more about how you are​ feeling?" ​c "You are not alone. Most women feel uncomfortable about this​ examination." ​d "Do not worry about the doctor.​ He's a specialist in female​ problems."

The nurse is preparing teaching for home care to a client with family planning needs. What topics should the nurse​ address? ​(Select all that​ apply.) Participating in a weekly exercise class Maintaining a​ balanced, nutritional diet Making a dental appointment Avoiding all vaccines Smoking cessation

Maintaining a​ balanced, nutritional diet Making a dental appointment Smoking cessation Rationale When teaching on home care to a client with family planning​ needs, the nurse should include the importance of maintaining a​ balanced, nutritional diet and making a dental appointment. The nurse should also include smoking cessation or the importance of reducing the number of​ cigarettes, if possible. The client should maintain a regular exercise routine and not just participate in a weekly exercise class. The client should also receive the flu vaccine.

Ms. Carter informs you that she is more interested in nonpharmacologic approaches to managing the dysmenorrhea. She asks you if you know of any complementary and alternative medicines​ (CAM) that could relieve some of her discomfort. What are viable CAM options for Ms. Carter to help her manage her ​pain?​ Select all that apply. Massage therapy Dietary supplements Heat therapy Acupuncture Ice therapy

Massage therapy Dietary supplements Heat therapy Acupuncture

What is the most common noninvasive method for assessing ovulation in female​ clients? Performing an endometrial biopsy Conducting a postcoital examination Mapping menstrual cycles for 3 months Measuring basal body temperature

Measuring basal body temperature

Clinical interruption of a pregnancy in the first 7 to 9 weeks may be performed by what​ procedure? Surgical abortion by dilation and extraction and hypertonic saline Medical abortion by administration of mifepristone and misoprostol Medical abortion by dilation and curettage and minisuction Surgical abortion by dilation and curettage and minisuction

Medical abortion by administration of mifepristone and misoprostol

When contrasting Mendelian inheritance disorder with autosomal dominant​ disorder, the nurse needs to understand the characteristics of each disorder. Which statement about both disorders is​ correct? Mendelian inheritance disorders are mathematically​ predictable, whereas autosomal dominant disorders are inherited if the disease trait is heterozygous. Mendelian inheritance disorders are mathematically​ predictable, whereas autosomal dominant disorder is a combination of environmental and genetic factors. Mendelian inheritance disorders require two abnormal genes for an individual to be​ affected, whereas autosomal dominant disorders are inherited if the disease is heterozygous. Mendelian inheritance disorders are​ inherited, whereas autosomal dominant disorders are mathematically predictable.

Mendelian inheritance disorders are mathematically​ predictable, whereas autosomal dominant disorders are inherited if the disease trait is heterozygous. Rationale: Mendelian inheritance disorders are mathematically​ predictable. Autosomal dominant disorders are inherited if the disease trait is heterozygous. Two abnormal genes for an individual to be affected describe an autosomal recessive disorder. A combination of environmental and genetic factors refers to a multifactorial inheritance disorder.

What will the nurse include in the assessment of a client experiencing erectile​ dysfunction? (Select all that​ apply.) Methods of coping Religious affiliation Current sexual practices Risk factors Sexual dysfunction

Methods of coping Current sexual practices Risk factors Sexual dysfunction

The nurse is preparing a presentation about chromosome abnormalities. Nondisjunction involves an addition or deletion of a​ chromosome, and if it occurs after​ fertilization, the embryo may have two or more chromosomes that evolve into more than one cell line. What is this known​ as? Monosomy Trisomy 13 Mosaicism Trisomy 21

Mosaicism Rationale Mosaicism is nondisjunction that occurs after​ fertilization, and the embryo may have two or more chromosomes that evolve into one cell​ line, each with a different number of chromosomes. Trisomy 13 and 21 occur during the second meiotic division of a gamete before​ fertilization; the embryo or fetus will have abnormal chromosomes added to every cell. Monosomy is nondisjunction that deletes a chromosome and can result in Turner syndrome.

a (The nurse should educate the client to maintain adequate​ hydration, which will assist in management of menopausal symptoms. The nurse should educate the client to keep the bedroom cool to help with night sweats. Dressing in loose layers will provide comfort during hot flashes. Limiting sexual activities will not assist in managing menopausal symptoms.)

Mrs. Makepeace is a​ 49-year-old woman who is being seen in the clinic for her annual physical examination. After her​ examination, she talks about her menopausal symptoms. Which information should the nurse include regarding home care planning to assist in management of menopausal​ symptoms? a Maintain adequate hydration b Wear​ tight-fitting dark clothing c Limit sexual activity d Keep bedroom warm at night

a (Biofeedback is an effective nonpharmacologic therapy to alleviate symptoms of menopause. Because of her history of breast​ cancer, you would not anticipate Mrs. Wilson being placed on hormone replacement therapy. Bioidentical hormones are​ hormone-like substances that have not been proven safe or effective in the treatment of menopause. Because of​ this, this treatment should not be included in client education. Vitamin D does not alleviate symptoms of menopause. his is a custom wrong answer.)

Mrs. Wilson is a​ 50-year-old woman who is being seen in the clinic for an annual physical examination. She indicates that she is tired all the​ time, snaps at her​ husband, and cannot sleep at night due to night sweats. She states that she does not smoke or drink. She is in good health after being successfully treated for breast cancer 7 years ago. She asks what can be done. What nonpharmacologic treatment would you include in your teaching regarding alleviation of menopausal​ symptoms? a Biofeedback b Hormone replacement therapy c Vitamin D d Bioidentical hormones

A client has just been fitted for a diaphragm. What information about the diaphragm should the nurse include in the client​ education? Must be left in place for 12 hours after intercourse Must be refitted after childbirth Can be used during menstrual period Should be replaced every 3 years

Must be refitted after childbirth Rationale: The nurse needs to educate the client being fitted for a diaphragm that it must be refitted after childbirth. The diaphragm must be left in place for 6 hours after intercourse. Diaphragms should not be used during a menstrual period. The diaphragm should be replaced every 2 years.

Sarah Carter is a​ 25-year-old. She is a recent college graduate with a steady​ boyfriend; she does not have any children. Ms. Carter scheduled an appointment at the clinic where you work because she is concerned about some of the symptoms she has been experiencing with her period.​ Recently, her​ boyfriend, Michael, brought to her attention the fact that she frequently complains that her back hurts when she is​ menstruating, and she always asks him to rub her back. She tells you that in the last few months her cramps have been worse than usual and she gets nauseous right before her period. At first I wondered if I was​ pregnant, because I thought the nausea was morning​ sickness, she​ reports, But my period always comes right on schedule.Ms. Carters vitals are T 99.2​°​F, P 85​ bpm, R​ 17/min, and BP​ 105/80 mmHg. Upon noticing that her temperature is slightly​ elevated, you ask Ms. Carter if she currently has had her period.​ No, she​ says, But it is about to come in a couple of days.You glance over at Ms. Carter and notice that she has her arms wrapped around her abdomen. She presents to be in a state of discomfort. You ask her to describe the symptoms she is experiencing right now. Which responses are indicative of potential ​dysmenorrhea?​ Select all that apply. There is a tightening in my chest. My pelvis feels full. There is pain radiating to my lower back and thighs. I feel bloated. I have a stomachache and a headache.

My pelvis feels full. There is pain radiating to my lower back and thighs. I feel bloated. I have a stomachache and a headache.

You explain to Ms. Carter that there are pharmacologic options that can help her manage menstrual pain. What might a health care provider recommend or prescribe for Ms. ​Carter?​ Select all that apply. NSAIDs Oral​ contraceptives/hormonal birth control Blood thinners Steroids Mild analgesics

NSAIDs Oral​ contraceptives/hormonal birth control Mild analgesics

The nurse is preparing information about sexual development for a group of parents with​ school-age children. What should the nurse include about​ puberty

Nocturnal emissions signal the beginning of puberty in boys. Your answer is correct. Pubic hair begins to grow. Your answer is correct. Breast buds appear in girls. Your answer is correct. Menstruation begins about 2 years after breast buds in girls. This is the correct answer.

The nurse is performing a health history on a woman with family planning needs. What data should the nurse​ collect? ​(Select all that​ apply.) Genital exam Vital signs Number of sexual partners Medication history Family history of breast cancer

Number of sexual partners Medication history Family history of breast cancer Rationale When performing a health history on a client with family planning​ needs, the nurse needs to obtain information on the client​'s medication​ history, family history of breast​ cancer, and number of sexual partners. Vital signs and genital exam are part of the physical examination of a woman with family planning needs.

What are the disadvantages of oral​ contraceptives? ​(Select all that​ apply.) Oral contraceptives often reduce menstrual cramping. Oral contraceptives carry an increased risk of blood clots. Oral contraceptives require daily use of medication. Oral contraceptives are extremely effective at preventing pregnancy. Oral contraceptives require a medical prescription.

Oral contraceptives require daily use of medication. Oral contraceptives are extremely effective at preventing pregnancy. Oral contraceptives require a medical prescription.

Which problems are associated with penile​ implants? Painful for partner Penile rupture Prostate hyperplasia Erectile dysfunction

Painful for partner

The nurse recognizes that family planning care involves more than preventing pregnancy. What are some other goals of family planning​ care? ​(Select all that​ apply.) Promoting a healthy body image Encouraging the use of one contraceptive method over another Promoting healthy sexual function Providing knowledge about sexual and reproductive health Recognizing acceptance of all available forms of fertility treatment and contraception methods

Promoting a healthy body image Promoting healthy sexual function Providing knowledge about sexual and reproductive health Rationale The role of the nurse is to help the client by promoting a healthy body​ image, promoting healthy sexual function and providing knowledge of sexual and reproductive health. The nurse does not encourage one contraceptive practice over another or try to influence a client to accept all available forms of fertility treatment or contraception. Nurses should present all the options available to the client.

A male client with erectile dysfunction is considering surgery to correct the problem. Which surgical procedures should the nurse prepare to review with the​ client?

Prosthetic device implant Penile vein blocking. Penile artery reconstruction

During a preconception exam of a​ 28-year-old client, the nurse identifies that which health risks may affect the pregnancy​ outcome? ​(Select all that​ apply.) Secondhand smoke Alcohol use Diabetes mellitus Hypotension Caffeine intake

Secondhand smoke Alcohol use Diabetes mellitus Caffeine intake Rationale Risk factors that may affect the client​'s pregnancy outcome include secondhand​ smoke, caffeine​ intake, alcohol​ use, and diabetes mellitus.​ Hypertension, not​ hypotension, is a risk factor.

A couple is beginning evaluation for infertility. Which diagnostic test would the nurse expect to be done first for evaluation of the male​ partner? Testicular biopsy Hormonal evaluation Semen analysis Scrotal ultrasound

Semen analysis Rationale Male infertility is usually identified from an abnormal semen analysis. This test is noninvasive and should be completed as the first step in assessment for male infertility. A scrotal ultrasound may be needed to help identify any structural​ abnormalities, a testicular biopsy is an invasive surgery that may be required for some​ conditions, and an evaluation of the male hormones may need to be​ done; however, a semen analysis should be completed first.

Ms. Carter asks you what types of abnormalities or conditions could cause secondary dysmenorrhea. Which conditions are clinically consistent with the causes of secondary ​dysmenorrhea?​ Select all that apply. Sexual transmitted infection Pelvic inflammatory disease​ (PID) Uterine fibroids Delayed menarche Endometriosis

Sexual transmitted infection Pelvic inflammatory disease​ (PID) Uterine fibroids Endometriosis

Alicia and Jeremy Brown are expecting their first child in a few weeks. Alicia voices concerns about sickle cell​ disease, a genetic disorder associated with the African American​ population, and asks you if their child will be affected. How do you​ respond? Sickle cell disease is not linked to either parent and therefore it is difficult to predict whether the child will be affected. Sickle cell disease is an autosomal recessive disorder requiring two abnormal genes for an individual to be affected. Sickle cell disease is a dominant disorder and the child is at high risk related to heredity. Sickle cell disease is more prevalently found in metropolitan areas.

Sickle cell disease is an autosomal recessive disorder requiring two abnormal genes for an individual to be affected.

Selective phosphodiesterase type 5 inhibitors are oral medications used to treat erectile dysfunction. Which medications are selective phosphodiesterase type 5​ inhibitors? (Select all that​ apply.) Prostaglandin E Sildenafil citrate Tadalafil Vardenafil hydrochloride Papaverine

Sildenafil citrate Tadalafil Vardenafil hydrochloride

What are the potential causes of erectile​ dysfunction? ​(Select all that​ apply.) Prostate surgery Spinal cord injury Tibial fracture Psychological stress Psychological stress

Spinal cord injury Psychological stress Psychological stress

Which are independent nursing interventions for the client with an alteration in sexuality? (Select all that apply.) Teach how to perform​ self-examination of the testicles Teach how to perform​ self-examination of the breasts Prescribe hormone replacement therapy Instruct on prevention of sexually transmitted infections Teach on the use of implantable penile devic

Teach how to perform​ self-examination of the testicles Teach how to perform​ self-examination of the breasts Instruct on prevention of sexually transmitted infections

d (Rationale: Menopause is a lengthy process since estrogen levels decrease gradually. The process may take years. Menopause is not a disease, but a normal physiological process. The client may miss several menstrual periods only to have one at a later time. Symptoms of menopause can last years, but do gradually decline with time.)

The nurse concludes that a client has understood teaching about menopause when the client states the following: a "I have missed two periods now and am grateful I will have no more." b "I will experience symptoms of menopause for 2 weeks." c "I am depressed about having this disease." d "I know I have begun menopause and it will take a while to finish."

c (Rationale: Endometrial implants tend to atrophy and disappear after menopause since ovarian hormones no longer stimulate them. Implants do not tend towards malignancy and, with no or little hormone stimulation, will not increase in size or number)

The nurse is caring for a client with an endometrial implant. The client asks the nurse what happens to the implant now that she is experiencing menopause. The best reply by the nurse is that the implant: a tends to become malignant. b enlarges in size. c tends to atrophy and disappear. d increases in numbers.

a (Rationale The age of perimenopause is genetically programmed and unrelated to the age of menarche. Cigarette smoking and living at high altitudes can lead to earlier menopause. Alcohol use and being sexually active does not influence perimenopause.)

The nurse is discussing menopause with a​ 40-year-old client. During this​ discussion, the nurse identified which factor that determines when perimenopause may​ occur? a Genetics b Age of menarche c Being sexually active d Alcohol use

d (Sweating at night is a manifestation during perimenopause. Cold​ intolerance, increased​ appetite, and constipation are not symptoms manifested with perimenopause.)

The nurse is interviewing Melinda Britt during her annual gynecologic exam. Which statement by Melinda would cause you to believe she is experiencing​ perimenopause? a ​"I am so cold​ lately." b ​"I feel that my appetite is really​ increasing." ​c "I have problems with​ constipation." ​d "I often experience sweating at​ night."

2 (An important aspect of controlling the spread of STD's is obtaining a list of sex partners/contacts of an infected individual. These contacts in turn, should be encouraged to obtain immed. care. Many people with STDS are reluctant to reveal their sex contacts, which makes controlling STDs difficult. Increasing clients knowledge of the disease, reassuring clients that their records are confidential can motivate them to seek treatment, which does not help control the spread of the disease, but it is not as critical as information about the clients sexual contacts.)

The nurse is interviewing the client newly diagnosed with syphilis. In order to prevent the spread of the disease, the nurse should focus the interview by: 1. motivating the client to undergo treatment 2. obtaining a list of the clients sexual contacts 3. increasing the clients knowledge of the disease 4. reassuring the client that medical records are confidential

a (Rationale: Initially, gonorrhea infects the male urethra and the female cervix. The vulva, vagina, prostate, and external genitalia are not initially infected by gonorrhea)

The nurse is teaching a group of clients about sexually transmitted infections (STI). The nurse knows that teaching is successful when the clients identify that the infective organism responsible for gonorrhea initially targets which body part? a Male urethra and female cervix b Female vulva and vagina c Male prostate d Male and female external genitalia

b,c,d (When performing a health history on a client experiencing​ menopause, the nurse should obtain information on the client​'s menstrual​ history, medications, and sleep pattern. Posture and vital signs are assessments that the nurse will include when completing the physical examination.)

The nurse is preparing to examine a client who is experiencing menopause. What information should the nurse obtain when performing a health​ history? ​(Select all that​ apply.) a Posture b Menstrual history c Medications d Sleep pattern e Vital signs

b,c,d,e (Rationale Exercise can help manage the anxiety and mood swings associated with perimenopause. Dressing in loose layers of clothing that can be added or removed will increase comfort during hot flashes. Keeping the bedroom cool will help control and provide comfort during night sweats. Caffeine intake should be decreased during perimenopause because it can trigger hot flashes. Sexual intercourse does not have to be avoided during​ perimenopause, but lubricants may be used to decrease discomfort from vaginal dryness.)

The nurse is providing education to a client who has been diagnosed with menopause. Which health promotion intervention should the nurse discuss with the​ client? ​(Select all that​ apply.) a Wearing tight clothing b Eating a balanced diet that includes​ fruits, vegetables, and​ high-fiber foods c Doing Kegel exercises d Avoiding alcohol and cigarette use e Participating in yoga classes

d (Rationale When providing home care​ instructions, the nurse should educate the client to perform deep breathing exercises to assist in managing mood swings. Avoiding cigarettes will help manage hot flashes. Doing Kegel exercises will assist with urinary leakage. Keeping the bedroom cool will assist in managing night sweats.)

The nurse is providing home care instructions to a client experiencing menopause. Which activity will assist in managing mood​ swings? a Doing Kegel exercises b Keeping the bedroom cool c Avoiding cigarettes d Performing deep breathing exercises

a,c,d,e (Rationale: Important client teaching for the male client learning to use a condom includes application of a new condom prior to each sex act as condoms should never be reused. Withdrawal of the penis while still erect and holding the base of the condom will prevent leakage of semen. The condom is made thin to allow for maximum sensation so it is easily torn or broken and must be handled carefully. The condom must be applied to allow air at the tip to provide space for the ejaculate to be collected. Oil-based lubricants should not be used as they can damage the condom and increase risk of condom failure. Water based lubricants may be used if needed. )

The nurse is teaching a male client about the use of condoms to reduce the risk of sexually transmitted disease (STD). The nurse includes which topics for discussion? (Select all that apply.) a Use a new condom with each sex act. b Use oil-based lubricants such as petroleum jelly. c Allow space at the tip of the condom. d Withdraw while the penis is erect. e Handle the condom carefully to ensure no damage.

c (​Rationale: The amount of estrogen produced by the ovaries​ decreases, leading to the symptoms of menopause. Progesterone will not be produced during anovulatory cycles but does not produce the symptoms of menopause.​ Follicle-stimulating hormone will increase in the​ body's attempt to stimulate the ovaries. The level of luteinizing hormone will vary depending on the ovulatory cycle but does not produce the symptoms of menopause.)

The nurse is teaching a woman about the hormonal changes that occur during menopause. Which hormonal change would the nurse state is responsible for the symptoms of​ menopause? a Decreased​ follicle-stimulating hormone b Decreased progesterone c Decreased estrogen d Decreased luteinizing hormone

b,c,d (Rationale: Due to hormonal changes, postmenopausal women have a greater risk for macular degeneration, breast cancer, and cognitive changes than do premenopausal women. Joint degeneration and gout are not associated with menopause.)

The nurse is teaching older women about health risks for the postmenopausal period and would include which as health risks? (Select all that apply.) a Joint degeneration b Macular degeneration c Breast cancer d Cognitive changes e Gout

1

The parents of a 12 year old girl ask why their daughter who is not sexually active should receive the HPV vaccine. The nurse should tell the parents that: 1. the vaccine is most effective against cervical cancer if given before becoming sexually active 2. Parents are never sure when their child might become sexually active 3. HPV is most common in teens and women in their late 20's 4. If your daughter is sexually assaulted, she may be exposed to HPV

1 (HSV infection is one of a group of infections when diagnosed in the presence of HIV infection are considered to be diagnostic for AIDS. Other aids defining illnesses include Karposis sarcoma, cytomeglovirus of the liver, spleen, or lymph nodes; and pneumocystis carinii peneumonia. HSV is not curable and does not cause severe electrolyte imbalances. HPV leads to cervical cancer.)

The primary reason that a herpes simplex virus infection is a serious concern to a client with HIV infection is that it: 1. in an AIDS defining illness 2. is curable only after 1 year of antiviral therapy 3. leads to cervical cancer 4. causes severe electrolyte imbalances

You discuss with Mr. Walker the glycoslated hemoglobin​ (Hgb A1c) test. Which statements from Mr. Walker indicate he understands the information you​ provided? Select all that apply. This test will determine if I have diabetes. The result should be between​ 5.5% and​ 7% if it is normal. I can go to the lab in the morning after breakfast to get my labs drawn. It will show how well my glucose has been controlled over the past 3 months. I will make sure I don't have anything to eat or drink for 2 hours before the test.

The result should be between​ 5.5% and​ 7% if it is normal. I can go to the lab in the morning after breakfast to get my labs drawn. It will show how well my glucose has been controlled over the past 3 months.

What is a​ phenotype? The pattern of an​ individual's genetic makeup on the chromosomes The person who can pass on a​ single-gene disorder but has no observable characteristics of it The inherited disorders that are carried on the X chromosome The translation of an​ individual's genetic makeup into observable characteristics

The translation of an​ individual's genetic makeup into observable characteristics

3 (The chancre of syphilis is characteristically a painless, moist ulcer. The serous discharge is very infectious. Because the chancre is usually painless and disappears, the client may not be aware of it or may not seek care. The chancre does not appear as pimples or warts and does not itch, thus making diagnosis difficult)

The typical chancre of syphilis appears as: 1. a grouping of small tender pimples 2. an elevated wart 3. a painless moist ulcer 4. an itching, crusted area

Which laboratory tests would be indicated for either a male or female with a sexual disorder? (Select all that apply.) Urinalysis Hysteroscopic examination Serum hormone levels Complete blood count Pregnancy test

Urinalysis Serum hormone levels Complete blood count

Which are sexual pain disorders? (Select all that apply.) Vulvodynia Dysmenorrhea Vestibulitis Myotonia Vaginismus

Vulvodynia Dysmenorrhea Vestibulitis Vaginismus

a,b,c,d (The physical manifestations of menopause are thought to be related to diminishing estrogen. This accounts for the hot​ flashes, vaginal​ dryness, thinning​ hair, and headaches. Women experiencing menopause do not typically experience cold intolerance.)

What are the clinical manifestations of​ menopause? ​(Select all that ​apply.) a Vaginal dryness b Thinning hair c Headaches d Hot flashes e Cold intolerance

1 (The client with herpes should be taught to abstain from sexual intercourse while lesions are present. Condoms should be used at all times as the virus can be shed without lesions present. Multiple partners would promote the spread of genital herpes. There is no vaccine available to prevent genital herpes. Although periodic exams should be advised, a urologist does not necessarily need to be seen when lesions occur)

What is the most important information for the nurse to teach a client newly diagnosed with genital herpes? 1. use condoms at all times during sexual intercourse 2. A urologist should be seen only when lesions occur 3. Oral sex is permissible without a barrier 4. Determine if your partner has received a vaccine against herpes

1 (Chlamydia infection is associated with preterm labor and birth and with neonatal infection, and thus should be treated in pregnancy. Azithromycin is safe in pregnancy and is effective in curing chlamydia infection. Focus: Prioritization)

What would be accurate and priority information to give Ms. N about the positive chlamydia test result? 1. By taking the medication now and having her partner treated, she can help avoid complications in the pregnancy. 2. The medication for chlamydia infection is not safe in pregnancy, and she should use condoms until she can be treated postpartum. 3. Chlamydia infection cannot really be cured and may recur despite treatment. 4. Chlamydia infection does no harm to the baby during the pregnancy or at delivery, but treatment is recommended to avoid pelvic inflammatory disease in the woman.

Which are examples of inappropriate sexual behavior? (Select all that apply.) Whistling Making sexual statements Pulling at the condom catheter Touching the​ nurse's breasts Exposing the genitalia

Whistling Making sexual statements Touching the​ nurse's breasts Exposing the genitalia

4 (many women do not seek treatment because they are unaware that they have gonorrhea. They may be symptom free or have only very mild symptoms until the disease progresses to PID. Dysuria and vaginal bleeding are not present in gonorrhea. Gonorrhea can lead to very serious complication. It can be cured with proper treatment)

When educating a female client with gonorrhea, the nurse should emphasize that for women, gonorrhea: 1. Is often marked by symptoms of dysuria or vaginal bleeding 2. does not lead to serious complications 3. can be treated but not cured 4. may not cause symptoms until serious complications occur

Mr. Walkers vital signs are T 98.9°​F, P 74​ bpm, R​ 16/min, and BP​ 148/78 mmHg. Due to his weight gain and vague​ complaints, the health care provider decides to assess Mr. Walkers endocrine​ function, especially his pancreatic function.You provide teaching on the endocrine system and pancreatic function to Mr. Walker.​ Sarah, a student​ nurse, is shadowing you today. Which statement by Sarah indicates an understanding of pancreatic​ function? A normal blood glucose is 74 to 128​ mg/dL. When he eats​ food, his pancreas releases​ insulin, and when his blood sugar gets​ low, his pancreas releases glucagon. The pancreas releases glucose when the blood glucose level is at or​ below 70 mg/dL. The only function of the pancreas is regulation of blood glucose.

When he eats​ food, his pancreas releases​ insulin, and when his blood sugar gets​ low, his pancreas releases glucagon

c (When planning care for a​ client, potential for urinary dysfunction addresses a physical concern the client may experience with menopause. Impaired​ mood, risk of low​ self-esteem, and negative body image are nursing diagnoses that address psychological concerns.)

When planning care for a​ client, which nursing diagnosis addresses a physical concern associated with​ menopause? a Risk of low​ self-esteem b Impaired mood c Potential for urinary dysfunction d Negative body image

4 (Education to prevent behaviors that cause HIV transmission is the primary method of controlling HIV infection. Behaviors that place people at risk for HIV infection include unprotected sex, sharing needles for IV drug use. Educating clients about using condoms during sex is a priority in controlling HIV transmission)

When teaching the client about HIV, the nurse should take into account the most effective method known to control the spread of HIV infection is: 1. premarital serological screening 2. prophylactic treatment of exposed people 3. lab screening of pregnant women 4. ongoing sex education about preventative behaviors

1 (statistics reveal that the incidence of STDs is rising more rapidly in teenagers than among any other age group. Many reasons have been given for this trent, including a change in societal norms and increasingly sexual activity among teens. During this developmental stage, teens may engage in high risk behaviors because they are living in the present and feel it will not happen to them)

Which group has experienced the greatest rise in the incidence of STDs over the past two decades? 1. teenagers 2. divorced people 3. young married couples 4. older adults

2 (Women with HPV are much more likely to develop cervical cancer than women who have never had the disease. Cervical cancer is considered a STD. Regular exams, including papanicolaou tests are recommended to detect and treat cervical cancer at an early stage. Girls and women as well as boys and men around ages 9-26, depending on the vaccine, should receive the vaccine to prevent HPV. HPV does not cause sterility, uterine fibroid tumors, or irregular menses.)

Women who have HPV are at risk for development of : 1. sterility 2. cervical cancer 3. uterine fibroid tumors 4. irregular menses

b (Venlafaxine​ (Effexor) is an antidepressant used​ off-label to reduce the occurrence of hot flashes. Triphenylethylene​ (Tamoxifen) and raloxifene​ (Evista) are used to improve bone density and serum lipids in women who are menopausal. Levothyroxine​ (Synthroid) is ordered for a client with a history of hypothyroidism.)

Which medication is used​ off-label to reduce the occurrence of hot flashes associated with​ menopause? a Raloxifene​ (Evista) b Venlafaxine​ (Effexor) c Levothyroxine​ (Synthroid) d Triphenylethylene​ (Tamoxifen)

a,b,c,d (Rationale A client with menopause may have problems associated with impaired​ mood, low​ self-esteem, altered sleep​ pattern, and urinary dysfunction. Constipation is not a problem associated with menopause)

Which nursing diagnosis should the nurse include when planning care for a client experiencing​ menopause? ​(Select all that​ apply.) a Impaired mood b Altered sleep pattern c Potential for urinary dysfunction d Increased risk of low​ self-esteem e Constipation

d (The perimenopausal woman may complain of the following psychological​ symptoms: forgetfulness, difficulty​ concentrating, mood​ swings, and a loss of libido. The nurse does not anticipate the occurrence of anxiety in the perimenopausal or menopausal woman.)

Which psychological manifestation is not associated with ​perimenopause? a Mood swings b Forgetfulness c Loss of libido d Anxiety

b,c,d,e (​Herbs, yoga, bioidentical​ hormones, and massage are all considered alternative or complementary therapies when managing menopausal symptoms. Hormone replacement therapy is not considered an alternative or complementary therapy.)

Which treatment is considered an alternative or complementary therapy in managing a menopausal​ client? ​(Select all that​ apply.) a Hormone replacement therapy b Herbs c Yoga d Bioidentical hormones e Massage

An infertile couple will have follicular stimulation and retrieval of​ ovum, followed by mixing with washed donor sperm. One day​ later, the fertilized ovum will be placed in the fallopian tube. The nurse knows that education has been successful if the client says she is having what​ procedure? Tubal embryo transfer​ (TET) Zygote intrafallopian transfer​ (ZIFT) In vitro fertilization​ (IVF) Gamete intrafallopian transfer​ (GIFT)

Zygote intrafallopian transfer​ (ZIFT) Rationale ZIFT is the return of fertilized​ ovum, at the zygote​ stage, into the fallopian tube 18dash-24 hours after retrieval. GIFT is placing retrieved ovum and washed sperm into the fimbriated end of the fallopian tube. TET is placing embryos into the fallopian tube 42dash-72 hours after retrieval. IVF is the placement of embryos into the uterus 2dash-3 days after the ova are retrieved.

The nurse is discussing contraceptive options with Tina Jacobs. Tina is interested in information about intrauterine contraception​ (IUC). Which statement would the nurse include when discussing the disadvantages of these​ devices? ​"The device may cause cramping and heavier​ bleeding." ​"This type of contraceptive causes the loss of bone​ density." ​"You will need to insert the device​ daily." ​"These require the use of daily​ medication."

​"The device may cause cramping and heavier​ bleeding."

A couple going through fertility treatment is reviewing the process of in vitro fertilization​ (IVF) with the nurse. Which statement by either the man or woman indicates that the teaching has been​ effective? ​(Select all that​ apply.) ​"We can freeze embryos if we have​ extras." ​"The embryos will be placed in my uterus 7dash-10 days after​ retrieval." ​"My wife will have to have injections prior to the​ procedure." ​"An ultrasound will be used during the procedure to remove my​ eggs." ​"The sperm will be deposited into my​ uterus.

​"We can freeze embryos if we have​ extras." "My wife will have to have injections prior to the​ procedure." ​"An ultrasound will be used during the procedure to remove my​ eggs." Rationale For​ IVF, the woman will have to have injections to help the ova develop and to help prepare them for retrieval. Any extra embryos remaining after the IVF procedure can be frozen for use at a later date. With​ IVF, the ova and sperm will be manipulated in the lab for fertilization. The embryos will be placed in the uterus 2dash-3 days after retrieval. With​ IVF, ultrasound is used during the procedure to remove the​ woman's eggs.

The mother of a​ 3-year-old toddler is concerned because the child continues to open double quote "play with himself close double quote " in the most inappropriate situations. What should the nurse explain to the mother about this​ behavior?

Body exploration and fondling is normal for a child of this age

The nurse is caring for a client diagnosed with ED. The client has diabetes and hypertension and is recovering from having several toes on his left foot amputated due to diabetic complications. He asks you what his treatment options might be for ED. Which is least likely to be an effective treatment option for this client? A. Mechanical devices B. Selective phosphodiesterase type 5 inhibitors C. Revascularization surgery D. Injectable medications

C Revascularization surgery is usually not successful for a client where underlying vascular issues cannot be corrected.

The client, who had been prescribed sildenafil 2 weeks ago for erectile dysfunction, calls the clinic to report that nothing happens, despite taking sildenafil orally and waiting for his erection to develop, Which fact should the nurse consider before responding to the client? A. In clinical trials, the sildenafil was effective only 20% of the time B. Sildenafil is not effective if taken orally and should be taken rectally C. In the absence of sexula stimuli, sidenafil will not cause an erection D. Sildenafil is ineffective if taken with foods high in saturated fats

C Sildenafil (Viagra) enhances the normal erectile response to sexual stimuli by promoting relaxation of arterial and trabecular smooth muscle. The resultant arterial dilation causes engorgement of sinusoidal spaces in the corpus cavernsum. In the absence of sexual stimuli, however, nothing will happen.

The nurse is explaining to a student nurse that lifestyle choices often can be both a risk factor for and a cause of ED. The nurse knows that the student understands the explanation when stating which lifestyle choices as causes of ED? A. Stress, anxiety, low self-esteem B. Injury to the penis, COPD, diabetes mellitus C. Smoking, alcohol use, being overweight, not exercising D. Low level of testosterone, hypothyroidism

C Smoking, alcohol use, being overweight and not exercising are examples of lifestyle choices.

The nurse is caring for a client newly diagnosed with erectile dysfunction​ (ED). Which items are appropriate for the nurse to include in the assessment​ process?

Client​'s history of sexual dysfunction Client​'s risk factors for ED Client​'s current sexual practices

The nurse is caring for a client who was diagnosed with ED several months ago. Knowing that he has poor visual acuity and experiences a tremor in his left hand, which treatment choice for ED is likely not to meet his needs? A. Mechanical devices B. Penile implant C. Selective phosphodiesterase type 5 inhibitors D. Injectable medications

D Injectable medications are often not an acceptable treatment for clients. Many clients report dissatisfaction with them because of difficulty in self-injecting, pain, lack of spontaneity, and cost.

The nurse is caring for a male client, with a history of coronary artery disease and hypertension, who smoked one pack per day of cigarettes for 30 years before quitting 2 years ago. Which is the most likely etiology of the client's newly diagnosed ED? A. Nurogenic B. Hormonal C. Latrogenic D. Vascular

D Vascular causes of ED include atherosclerosis, hypertension, heart disease, and diabetes mellitus.

The nurse suspects that a male client with a sexual disorder is experiencing a problem with elimination. What did the nurse assess to cause this​ concern?

Difficulty voiding

During a sexual​ history, the nurse learns that a client experiences vaginal discomfort during intercourse. What should the nurse recommend to the​ client?

Have testing for sexually transmitted infections Your answer is correct. Use topical lidocaine before having intercourse

While discussing sexual​ development, a​ middle-aged female adult client with arthritis begins to cry softly because sexual activity is painful and she does not know what to do. What should the nurse respond to this​ client?

Maybe you can take pain medication before having sexual activity

The nurse is caring for a male client being discharged from the hospital with a nitroglycerin prescription for chest pain. The client states that he takes Viagra for erectile dysfunction​ (ED), but he knows this is no longer safe. Which treatment option for ED would be appropriate for the nurse to include in the discharge​ instructions?

Mechanical device

The nurse is explaining to a student nurse that lifestyle choices often can be both a risk factor for and a cause of erectile dysfunction​ (ED). The nurse knows that the student understands the explanation when stating which lifestyle choices as causes of​ ED?

Smoking, alcohol​ use, being​ overweight, not exercising

After morning​ report, the nurse responds to the call light of a​ 35-year-old male client who is naked in bed. What actions should the nurse take with this client​'s ​behavior?

State that the nurse will return once the client is dressed State that clothing is required to be worn while hospitalized Inform the charge nurse of the clients behavior

c (Rationale Individuals between the ages of 15 and 24 account for half of the 20 million new cases of STIs each year. The adolescent​ male, age​ 17, is at the greatest risk for contracting an STI.)

The community nurse is teaching a group of clients about STIs. Which client is at the greatest risk for contracting an​ STI? a A married male​ client, age 50 b A divorced female​ client, age 32 c An adolescent male​ client, age 17 d An older adult female​ client, age 65

b (The nurse educates women of reproductive age about STIs and risks and complications associated with untreated infections. Congenital syphilis is transferred to the fetus via placental​ circulation; therefore, mother and neonate need treatment.)

The nurse counsels a group of pregnant women about potential complications to unborn children that result from untreated sexually transmitted infections. What information will the nurse include in the​ presentation? a "Newborns born to mothers with Human Papillomavirus​ (HPV) are at risk for wart formation later in life. " b "Congenital syphilis is transferred to the fetus through the placental circulation. c "There is a​ 75% chance of fetal anomalies if the mother has genital herpes during pregnancy. d "The fetus is protected from any complication related to an untreated sexually transmitted infection if it is born by Cesarean section.

a,b,d (Rationale Secondary dysmenorrhea is associated with pathologies that affect the uterus and pelvic area. It is likely to occur in women ages​ 30-50. Endometriosis is an example of secondary dysmenorrhea. With secondary​ dysmenorrhea, pain is likely to occur anytime through the menstrual cycle and can be severe. Pelvic pain generally on or before the first day of menses that radiates to the groin is the main symptom of primary dysmenorrhea. It generally diminishes with time or after childbirth.)

The nurse educator is presenting material about secondary dysmenorrhea to a group of students. Which information should be included in the​ presentation? ​(Select all that​ apply.) a It can be associated with several disorders including​ tumors, pelvic​ adhesions, and infections. b It generally affects women age 30 - 50. c The pain diminishes with time and is often much less after childbirth. d Endometriosis is an example of a secondary dysmenorrhea and is considered to be one of the most painful gynecologic disorders. e Pain is always on the first day of menses and radiates to the groin.

a (Rationale: All partners have been exposed and should be made aware, tested, and treated as indicated. A cesarean is needed only if herpes lesions are present or there are prodromal symptoms at delivery. Genetic evaluation and more frequent monitoring of hemoglobin and hematocrit are not indicated. )

The nurse explains to a 24-year-old pregnant client with a sexually transmitted disease (STD) that follow-up care includes: a contacting and treating all sexual partners. b delivery by cesarean section. c amniocentesis for evaluation of genetic damage. d close monitoring of hemoglobin and hematocrit.

d (he client acknowledging that she will not have unprotected sex and will notify her sexual partners is a preventive measure and indicates understanding. The other options are not protective measures and indicate the need for additional teaching.)

The nurse has completed discharge teaching to Angel​ Reese, a​ 33-year-old treated for a sexually transmitted infection​ (STI). Which statement by Ms. Reese indicates that the discharge instructions were​ understood? ​a "I don't need to have my sexual partner wear a condom because​ I'm not allergic to penicillin and​ I'll come for a shot at the first sign of​ infection." ​b "I will be careful not to have intercourse with someone who has an​ STI." ​c "If you're going to get​ it, you're going to get​ it." ​d "I will notify my sex partners and not have unprotected sex from now​ on."

d (Gardasil and Cervarix may be used as vaccines to prevent HPV infection as well as cervical cancer. The vaccine is recommended for​ females, ages 11 to 26 and​ males, ages 11 to​ 21; therefore, this client is within the acceptable age range to receive the vaccine. There are no vaccines against syphilis and chlamydia.)

The nurse in the health department is speaking with Susie​ Munde, a​ 12-year-old girl, and her mother about sexually transmitted infections​ (STIs). The mother​ asks, "I heard there is a shot that can help against STIs. Is this​ true?" Which is the​ nurse's best​ response? ​a "Yes, there is a vaccine available to prevent​ syphilis." ​b "Yes, and you would use it along with medication to prevent​ chlamydia." ​c "Yes, but your daughter is too young for this​ vaccine." ​d "Yes, Gardasil and Cervarix may be used as vaccines to prevent human papillomavirus​ infections."

b (Rationale: The client is exhibiting symptoms of premenstrual syndrome (PMS), and the nurse would ask the client when and how often the symptoms occur in an effort to determine if the menses is the problem. These symptoms are not those of a person experiencing trauma or a chronic disease. The client may well have edema, but asking that elicits only more symptoms; the goal is to associate the symptoms with the menstrual cycle to diagnose PMS.)

The nurse is assessing a 37-year-old woman who is complaining of mood swings, breast tenderness, and food cravings. The nurse asks the client for which additional information? a "Do you have edema as well?" b "When and how often do these symptoms appear?" c "Have you been in an accident?" d "Do you have a chronic disease?"

d (Rationale: Primary dysmenorrhea is treated by reducing symptoms. Secondary dysmenorrhea is the result of an organic problem requiring diagnosis with a laparoscopy, MRI, or CT scan and then surgery to correct the problem, if appropriate)

The nurse is caring for a client who has been diagnosed with primary dysmenorrhea and tells the client about which treatment for the disorder? a "Treatment will include surgery to correct the defect." b "You will need to have a laparoscopy to cure the disorder." c "You will be scheduled for an MRI to determine treatment." d "Treatment is aimed at reducing symptoms."

d (Rationale The adolescent will need to continue oral medication completely as prescribed. The client would not need to return for the second dose of oral antibiotics. Treatment will require more than one oral dose. No injection was​ prescribed, only oral antibiotic therapy.)

The nurse is caring for a female adolescent who has been diagnosed with gonorrhea. The client will be placed on oral antibiotic therapy. The nurse knows that the adolescent has understood the teaching when she makes which​ statement? ​a "I will need to take this one dose with​ food." ​b "I will need to have an injection of penicillin​ G." ​c "I will need to come back to the healthcare center in 12 hours for my second dose of oral​ antibiotics." ​d "I will need to take all my medication as​ prescribed."

c (Rationale Chlamydia is usually asymptomatic. When symptoms do​ occur, female clients may experience cervicitis and pelvic inflammatory​ disease, and male clients may experience urethritis.)

The nurse is caring for a female client with possible chlamydia. With which sign or symptom is this client most likely to​ present? a Urethritis b Cervicitis c No specific symptoms d Pelvic inflammatory disease

a,b,c,e (Rationale The nurse assesses an adolescent client diagnosed with an STI for​ pain, impaired skin​ integrity, deficient​ knowledge, and disturbed body image. There is no need to assess the client for risk of altered parenting.)

The nurse is caring for an adolescent client who has been diagnosed with an STI. For which problem should the nurse assess this​ client? ​(Select all that​ apply.) a Deficient knowledge b Pain c Disturbed body image d Risk of altered parenting e Impaired skin integrity

b (Rationale Seven days of doxycycline hyclate or erythromycin is an appropriate option for treatment of chlamydia. A single dose of intramuscular ceftriaxone or a single dose of oral cefixime is an appropriate option for treatment of gonorrhea. A single oral dose of metronidazole or tinidazole is an appropriate option for treatment of trichomoniasis.)

The nurse is caring for an adolescent client who has been diagnosed with chlamydia. Which treatment option is most appropriate for this​ client? a A single dose of oral cefixime b Doxycycline hyclate or erythromycin for 7 days c A single dose of intramuscular ceftriaxone d A single oral dose of metronidazole or tinidazole

a,c,e (Rationale Risk factors for endometriosis include menstrual cycles that are less than 27​ days, heavy and prolonged​ menses, and a sedentary lifestyle. Increased dietary fat and menarche before the age of 11 would also support this diagnosis.)

The nurse is conducting a health history on a client being seen for a yearly gynecological examination. The client states that she believes she has endometriosis. Which findings in the client​'s health history support this​ diagnosis? ​(Select all that​ apply.) a Menstrual cycle less than 27 days b Menarche before age 14 c Sedentary lifestyle d Decreased dietary fat e Heavy prolonged menses

c (Rationale Herpes is a viral STI.​ Chlamydia, gonorrhea, and syphilis are bacterial STIs.)

The nurse is educating a group of adolescent clients about STIs. The nurse has divided the infections into two​ groups: bacterial and viral. Which infection should the nurse discuss when teaching about viral​ STIs? a Syphilis b Gonorrhea c Herpes d Chlamydia

d (Rationale: STIs can be contracted by any type of sexual​ contact, including oral and anal sex. STIs cannot be contracted from a toilet seat or by sharing a towel or a drinking glass with someone.)

The nurse is educating a group of adolescents on ways to decrease the risk of contracting an STI. Which information should the nurse include in the​ session? ​a "STIs can be contracted from shared​ towels." ​b "STIs can be contracted by sharing drinking​ glasses." ​c "STIs can be contracted from toilet​ seats." ​d "STIs can be contracted by oral​ sex."

b (Rationale Teaching the client about the importance of proper nutrition is an intervention that is specific for this diagnosis. Monitoring vital​ signs, assessing level of​ pain, and preparing the client for surgical intervention are not nursing interventions that support the potential for enhanced wellness.)

The nurse is planning care for a client with endometriosis. The nursing diagnosis for this client is the potential for enhanced wellness. Which nursing intervention is appropriate to include in the plan for care for this​ diagnosis? a Monitor the client​'s vital signs per order b Teach the client about the importance of proper nutrition c Prepare the client for surgical intervention d Assess the client​'s level of pain

d (Rationale The nurse should encourage the client to receive the hepatitis B vaccination. Although the nurse should encourage the client to tell her​ family, confidentiality should be maintained. The nurse should maintain a nonjudgmental attitude when providing education. The nurse should encourage the adolescent to notify sexual partners.)

The nurse is providing care in an outpatient clinic for an adolescent female who has been diagnosed with a sexually transmitted infection​ (STI). When providing​ care, it is important for the nurse to carry out which​ action? a Notifying the adolescent​'s family of the STI b Being judgmental when providing education c Telling the adolescent that she does not need to notify any sexual partners d Encouraging the client to receive the hepatitis B vaccination

a.b.d.e (Rationale The Pap test is used to diagnose cervical cancer and dysplasia. FSH and LH levels are used to help correlate the luteal phase of the menstrual cycle. Progesterone and estradiol levels are used to assess ovarian function. Colposcopy is used to inspect the cervix and help determine areas for biopsy. Hysteroscopy is used to inspect the endometrial lining. Hysterectomy would not be used as a diagnostic test.)

The nurse is providing care to a client experiencing abnormal uterine bleeding and menstrual pain. Which lab and diagnostic tests does the nurse anticipate to determine hormonal​ imbalances, pathologic​ conditions, or structural anomalies that are causing the client​'s ​symptoms? ​(Select all that​ apply.) a Papanicolaou​ (Pap) test b Colposcopy c Hysterectomy d Progesterone and estradiol levels e FSH and LH level

b (Rationale Greater than normal vaginal flow should be reported as it assesses for hemorrhage. Temperature greater than​ 100°F can be indicative of infection. Some pain is expected but it should not be severe. Bright red bleeding should be reported. Appetite may be depressed and bowel may be sluggish as a result of anesthesia.)

The nurse is reviewing a client medical record to gain an understanding regarding the absence of menstruation. As the nurse speaks with the​ client, she mentions that she has really been working out a lot at her gym.​ Which menstrual dysfunction does the nurse suspect the client is​ experiencing? a Menorrhagia b Amenorrhea c Metrorrhagia d Dysmenorrhea

c (Rationale: An NSAID is effective for pain and the reduction of inflammation that may be causing pain. The client is helped to be free of pain, not to endure it. Antibiotics are not effective against pain and increasing sodium intake will increase edema and possibly the discomfort. )

The nurse is talking with a 15-year-old client experiencing dysmenorrhea who asks if there are any remedies for the pain. The nurse responds with which advice? a "Increase the intake of sodium." b "Antibiotics will help the symptoms to subside." c "The recommended medication is an NSAID." d "Pain lasts only a few days and does not need treatment."

c (Rationale Engaging in sex is a personal​ choice, and partners should never​ pressure, threaten, or abuse to obtain sexual favors. Safer sex does not include applying spermicides directly on female genitalia. Responsible sexual behavior involves more than just the physical act of sex itself. It also involves knowing how to identify the warning signs​ of, and how to protect​ against, dating violence and date rape. Showing a​ long-term commitment to a partner involves more than having sex.)

The nurse is teaching a group of adolescents about safer and more responsible sex practices. In addition to discussing​ abstinence, which information is the most appropriate for the nurse to include in the​ session? a "Having sex with someone you love shows the partner that you are committed to staying with him or her for the long term. " b "Safer sex includes applying spermicides on female genitalia to reduce transmission of infections before intercourse. " c "Engaging in sex is a personal choice that you should prepare for without ever feeling pressured by another. " d "Responsible sex involves knowing who your partner had sex with in the immediate past.

b,d,e (Rationale: Those most at risk for developing PMS are over the age of 30, are experiencing major life stressors, and have a history of depression. This condition is not necessarily seen in the teenage group or those with heart disease)

The nurse is teaching a group of women with premenstrual syndrome (PMS). A client asks what the major risk factors are for developing this disorder. The nurse replies that the risk factors include: (Select all that apply.) a teenage women. b Age greater than 30 years. c heart disease. d Depression. e major life stressors.

a (Rationale The HPV vaccine decreases the risk of cervical cancer and should be encouraged for all adolescents. When one partner is diagnosed with an​ STI, both partners should be​ treated; however, this does not decrease the risk of cervical cancer. Avoiding all sexual contact decreases the risk of an STI. Completing all medication as prescribed is important when treating an STI but does not decrease the risk of cervical cancer.)

The nurse is teaching an adolescent client about decreasing the risk of cervical cancer. Which information is most important for the nurse to include in this​ session? a Encouraging administration of the human papillomavirus​ (HPV) vaccine b Avoiding all sexual contact c Completing all medication as prescribed d Completely treating both partners when one is diagnosed with an STI

a (Rationale: In a vaginal hysterectomy, only the uterus is removed. The ovaries are left in place so that the hormonal cycle continues and menopause does not ensue. The client will no longer have menstrual periods and there is no need to continue oral contraceptives since pregnancy cannot occur.)

The nurse teaches a client who is to undergo a vaginal hysterectomy for dysfunctional uterine bleeding. The nurse knows the client has met teaching goals when she makes which statement? a "I will not begin menopause because only the uterus will be removed." b "I will continue to have menstrual periods." c "I will continue to take my oral contraceptives." d "I will no longer have ovaries."

b (The nurse anticipates the client will be diagnosed with secondary amenorrhea due to the risk​ factors/causative factors for this disorder obtained during the health​ history, including a history of thyroid disorder and recent weight loss. The assessment findings do not support the diagnosis of​ endometriosis, primary​ amenorrhea, or oligomenorrhea)

Theresa​ Jones, a​ 28-year-old female, is being seen in the clinic. Ms. Jones tells you the following during the health​ history: three skipped menstrual​ periods, history of thyroid​ disorder, recent weight loss following a strict diet and exercise regimen. She is not sexually active so she does not believe she is pregnant. Which diagnosis does the nurse anticipate for this client based on the assessment​ data? a Primary amenorrhea b Secondary amenorrhea c Oligomenorrhea d Endometriosis

The nurse is caring for a client who is newly diagnosed with erectile dysfunction​ (ED). The client asks why his diabetes caused this to happen. The nurse bases the response on which​ rationale?

Vascular disease often associated with diabetes contributes to ED.

c (In a female​ client, human papillomavirus​ (HPV) presents as​ painless, wartlike growths on the external and internal genitalia. Pediculosis pubis is nits on and around the pubic hair that cause itching. Syphilitic lesion is a​ nontender, solitary papule that changes to a draining wound.)

What abnormal finding of the female genitalia is represented by​ painless, wartlike growths on the​ vulva, inner​ vagina, and​ cervix? ​a Fluid-filled blisters b Syphilitic lesion c Human papillomavirus d Pediculosis pubis

The nurse is caring for a postoperative client with an inflatable penile implant. Which statements from the client indicate the need for further​ instruction?

What if we can't get the hang of this? What should we do? Next week is our anniversary-- we can be intimate for the first time in years.

b (Amenorrhea is the clinical term for lack of menses. Oligomenorrhea is the clinical term for infrequent or light menses. Menorrhagia is the clinical term for very heavy menses. Metrorrhagia is the clinical term for abbreviated menses or breakthrough bleeding between menstrual periods.)

What is the clinical term for a lack of​ menses? a Oligomenorrhea b Amenorrhea c Menorrhagia d Metrorrhagia

a (​Rationale: In a​ D&C, the cervical canal is dilated and the uterine wall is scraped. With an​ ablation, extreme heat or​ cold, or energy waves are used to vaporize the endometrial lining. A hysterectomy involves removal of the uterus in totality or partially and can be vaginally or abdominally accomplished.)

What is the order of least invasive to most invasive for procedures related to menstrual​ dysfunction? a Therapeutic dilation and curettage​ (D&C), endometrial​ ablation, hysterectomy b ​Hysterectomy, therapeutic dilation and curettage​ (D&C), ablation c Therapeutic dilation and curettage​ (D&C), hysterectomy, ablation ​d Hysterectomy, ablation, therapeutic dilation and curettage​ (D&C)

c (Rationale: For a woman with PMS, the nurse would recommend a decrease in sodium intake to help minimize the fluid retention due to increased production of aldosterone, which results in sodium retention and edema. Sodium does not increase reactive hypoglycemia and does not reduce cancer risks. Sodium does increase thirst but is not the reason for restriction in this case.)

When discussing dietary guidelines with a woman who has premenstrual syndrome (PMS), the nurse recommends that the client reduce sodium intake for which reason? a Sodium increases reactive hypoglycemia, increasing physical manifestations. b Sodium increases thirst, thereby facilitating increased oral fluid intake. c Sodium restriction helps minimize fluid retention. d In and of itself, sodium is not harmful, but it may reduce cancer risks.

d (Rationale Many women do not seek treatment because they are unaware that they have gonorrhea. They may be​ symptom-free or have very mild symptoms until the disease progresses to pelvic inflammatory disease. If​ untreated, gonorrhea can lead to pelvic inflammatory disease. If the woman is pregnant and the infant is infected at​ delivery, it can cause blindness in the newborn. Gonorrhea can be cured with proper treatment. Dysuria or vaginal bleeding is not present with gonorrhea)

When educating a female client with​ gonorrhea, the nurse should emphasize which information is true about women with​ gonorrhea? a It can be treated but not cured. b It does not lead to serious complications. c It is often marked by symptoms of dysuria or vaginal bleeding. d It may not cause symptoms until serious complications occur.

b (Examining one​'s own readiness to engage in intimate behavior with​ another, considering one​'s own thoughts and feelings associated with sexual​ behavior, and verbalizing how to identify the warning signs of dating violence and date rape all demonstrate that the client is exhibiting responsible sexual behavior. Engaging in sex with an untreated partner exhibits irresponsible sexual behavior.)

Which behavior exhibits irresponsible sexual​ behavior? a Examining one​'s own readiness to engage in intimate behavior with another b Engaging in sex with an untreated partner c Verbalizing how to identify the warning signs of dating violence and date rape d Considering one​'s own thoughts and feelings associated with sexual behavior

a,b,c,e (Small, flat,​ flesh-colored warts are a symptom of HPV.​ Itching, bleeding, and burning in the affected area are common manifestations of HPV in female clients. Ulcerations do not occur with genital warts.)

Which clinical manifestations are expected for a client diagnosed with human papillomavirus​ (HPV)? ​(Select all that​ apply.) a Burning b Bleeding c Itching d Ulcerations ​e Small, flat,​ flesh-colored warts

a,d,e (Diagnostic tests used to recognize structural​ abnormalities, hormone imbalances and abnormal pathologies with menstrual disorders include pelvic​ examinations, pap​ tests, and ultrasounds. A bronchoscopy is use to diagnosis lung disorders. A colonoscopy is use to diagnosis bowel disorders.)

Which diagnostic tests are used to recognize structural​ abnormalities, hormone​ imbalances, and abnormal pathologies with menstrual​ disorders? ​(Select all that​ apply.) a Pelvic exam b Bronchoscopy c Colonoscopy d Pap test e Ultrasound

c (Rationale: Menstrual blood can affect the results of a gonorrhea culture. Douching within 24 hours may affect results. Persistent discharge and recent diagnosis of herpes are not barriers to specimen collection.)

Which factor, if reported to the nurse by a client prior to collection of a gonorrhea culture, would result in postponing the specimen collection? a Persistent vaginal discharge b Recent diagnosis and treatment for vaginal herpes c Currently menstruating d Douching 3 days ago

a,c (Rationale Only certain types of birth control allow for safer sex and reduce risk for sexually transmitted infections​ (STIs). Male and female condoms offer barrier protection. Petroleum jelly does not provide additional barrier protection. Partners should never​ pressure, threaten, or abuse to obtain sexual favors.)

Which information regarding safer and more responsible behavior should the nurse provide when counseling adolescent clients who have chosen to be sexually​ active? ​(Select all that​ apply.) a "You can choose to say ​'No​' to​ sex, even if your​ long-term partner says that your relationship has matured beyond the mutual masturbation stage. b "Insist that your opposite sex partner use birth control to reduce the risk of HIV. c "Women should carry and use female condoms. d "If your partner insists on having sex even though you don​'t want​ to, you should comply to show you really love him. " e "Latex condoms lubricated with petroleum jelly provide for comfort and additional barrier protection.

b (Bloating associated with the menstrual cycle may be treated with diuretics. NSAIDs are used to treat cramping. COCs are used to treat secondary dysmenorrhea or abnormal uterine bleeding. Oral iron supplements may be used to treat anemia associated with heavy menstrual periods.)

Which medication might be prescribed for the bloating associated with the menstrual​ cycle? a Oral iron supplements b Diuretic medications c Nonsteroidal​ anti-inflammatory drugs​ (NSAIDs) d Combined oral contraceptives​ (COCs)

c (An appropriate nursing intervention for a client with menstrual dysfunction is to administer​ analgesics, per order. The nurse would encourage​ resting, eating foods high in​ iron, and using​ open-ended questions when talking with the client.)

Which nursing intervention is appropriate for a client experiencing menstrual​ dysfunction? a Using​ close-ended questions b Teaching about foods low in iron c Administering analgesics d Encouraging frequent exercise

b (Teaching importance of abstinence from sexual activity while being​ treated, demonstrating proper placement of​ condoms, and supporting the client with the decision to contact partners who may be infected are all appropriate nursing interventions in helping teach clients about STIs. The nurse would encourage the client to complete the entire course of antibiotic treatment and not to stop taking them when symptoms resolve.)

Which nursing intervention would be inappropriate for the nurse to teach a client about sexually transmitted infections​ (STIs)? a Supporting the decision to contact partners who may be infected b Encouraging the use of antibiotics until symptoms resolve c Abstaining from sexual activity while being treated d Demonstrating proper placement of condoms

a (During the primary stage of​ syphilis, the client will experience​ chancre-like painless ulcerations that last for up to 5 weeks. The second stage occurs up to 10 weeks after initial infection. The client will experience​ fever, malaise,​ lymphadenopathy, patchy​ alopecia, and a diffuse rash. During the latent​ stage, the client is asymptomatic for years to a lifetime. The tertiary stage can occur 2 years after onset of symptoms and includes changes in the cardiovascular​ system, bone,​ skin, or viscera.)

Which stage of syphilis is characterized by​ chancre-like, painless ulcerations on the genital​ area? a Primary stage b Secondary stage c Latent stage d Tertiary stage

a,c,d (Syphilis is a sexually transmitted disease. The microorganism is transmitted when the open lesions are present. The incubation period is the time the microorganism takes to become established in the body. The microorganism invades the body through blood and lymph. A lesion will develop.​ However, these lesions are often overlooked. In this particular​ case, the incubation period is 10 to 90 days. Syphilis spreads through blood and lymph. The lymph nodes become enlarged as the disease progresses. Both men and women can be infected with syphilis.)

Which statements regarding syphilis are​ true? ​(Select all that​ apply.) a It has an incubation period of 10 to 90 days. b It is only contracted through anal sex. c It is contracted by unprotected sex. d It spreads through the body by way of blood and lymph. e Only women are at risk for syphilis.

d (Rationale Condoms should be used for every sexual encounter. Application of petroleum jelly to a condom does not provide an additional barrier. The retesting time frame for HIV is 6 months. The relative comfort of different types of condoms is an individual preference.)

Which teaching about reducing the risk of sexually transmitted infections​ (STIs) should the nurse provide to sexually active adolescent male​ clients? a "Natural or​ animal-skinned condoms feel more comfortable than latex versions. b "An initial HIV test result needs to be followed up with a retest exactly 1 month after the initial test. c "Application of petroleum jelly to the condom provides an additional barrier. d "Condoms should be used for every sexual encounter.

c (Syphilis affects the central nervous system in the tertiary or final stage. This occurs after many years of untreated infection. Improperly treated syphilis will invade the central nervous system. This can take many years to​ occur, but it will occur over a period of time. The ulcer occurs early in the disease during the first stage. The central nervous system is affected during the last stage of syphilis. Central nervous system damage occurs during the tertiary or last stage. This stage begins many years​ later, long after the secondary stage has ended.)

Which teaching statement by the nurse correctly demonstrates knowledge of when syphilis affects the nervous​ system? ​a "Syphilis rarely affects the central nervous​ system." ​b "Syphilis affects the central nervous system during the secondary stage when there is a​ rash." ​c "Syphilis affects the central nervous system during the final​ stage." ​d "Syphilis affects the central nervous system during the incubation​ period."

b (Rationale The most important aspect in controlling the spread of an STI is obtaining a list of the client​'s sexual contacts. Reassuring the client that records are​ confidential, motivating the client to undergo​ treatment, and increasing the client​'s knowledge can help control the spread of the infection but are not as critical as information about the client​'s sexual contacts)

he nurse is interviewing a client newly diagnosed with syphilis. Which nursing action is most important to control the spread of the​ infection? a Motivating the client to undergo treatment. b Obtaining a list of the client​'s sexual contacts. c Reassuring the client that records are confidential. d Increasing the client​'s knowledge of the infection

A female client is prescribed leuprolide acetate as treatment for endometriosis. What should the nurse instruct the client about this​ medication?

hot flashes may occur

The nurse is providing discharge instructions to a client and his partner regarding a new penile implant. Which teaching point is not appropriate for the nurse to include in the teaching session A. An implant is softer than a natural penis and may not provide usual partner satisfaction B. Men are usually satisfied with their implant C. It is important to practice with the pump D. Sexual activity can be resumed in six to eight weeks

A Teaching is an essential part of the nurse's role in the discharge process. The nurse would not include the statement that the implant is softer than the natural penis.

Which male client should the nurse consider at risk for complications when taking sildenafil (Viagra), a sexual stimulate? A. A 56-year-old client with unstable angina B. An 87-year-old client with glaucoma C. A 44-year-old client with type 2 diabetes D. A 32-year-old client with an L1 spinal cord injury (SCI)

A Viagra should be used cautiously in clients with coronary heart disease because during sexual activity the client could have a myocardial infarction from the extra demands on the heart. Specifically, clients taking nitroglycerin or any nitrate medication should not take Viagra because the vasodilatation effect of Viagra may cause hypotension. A client with unstable angina would be taking a nitrate medication.

c (Rationale: Vaginal fluid pH is slightly alkaline, as is semen. Spermatozoa cannot survive in an acidic environment. This disorder does not use glycogen, block the fallopian tubes, or increase the temperature inside the vagina.)

A client has been diagnosed with trichomoniasis vaginitis. The nurse explains during client teaching that this infection can affect fertility by: a utilizing the glycogen in vaginal secretions, leaving no nutrients for spermatozoa. b increasing the temperature inside the vagina, which decreases the motility of the spermatozoa. c decreasing the pH of the vaginal secretions, thereby destroying most spermatozoa. d creating a blockage of the fallopian tubes that prohibits spermatozoa from reaching the ovum.

a,e (Rationale: Because it frequently involves tissue trauma that facilitates invasion of pathogens, anal intercourse is considered a high-risk sexual behavior, as is having intercourse with a partner who is infected with an STD. Use of oral contraceptives, monogamous relationships, and age of 23 years are not risks for STD. )

A client is admitted to the clinic with a nursing diagnosis of Acute Pain in her pelvis region. When taking a sexual history for a female client, the nurse recognizes that which factor puts the client at risk for sexually transmitted disease (STD)? (Select all that apply.) a Report of anal intercourse b Use of oral contraceptives c Current monogamous relationship d 23-year-old client e Partner has an STD

d (Rationale Oligomenorrhea describes a condition in which there are infrequent or light menstrual periods. The client who has never had a menstrual period at age 15 may be experiencing amenorrhea. This term also refers to cessation of menstrual flow after initially having a period. Breakthrough​ bleeding, or bleeding in between​ periods, is referred to as metrorrhagia. Unusually heavy menstrual blood flow is called menorrhagia.)

A client is complaining of menstrual problems. Which statement indicates that the client may be experiencing​ oligomenorrhea? ​a "I usually have bleeding in between my periods every other​ month." ​b "I saturate a pad in 1 hour when I am on my​ period." ​c "I am 15 and I have still not started my​ period." d "My periods are very light and some months I don​'t have​ one

b (Rationale COCs help suppress ovulation. NSAIDs are utilized to decrease​ cramping, and diuretics decrease bloating. SSRIs may be prescribed to help the client regulate mood or control chronic pain.)

A client is prescribed combined oral contraceptives​ (COCs) for treatment of dysfunctional uterine bleeding. The client asks the nurse why this will be helpful. The nurse bases the response on which​ rationale? a COCs act as selective serotonin reuptake inhibitors​ (SSRIs) and help control mood and chronic pain. b COCs help suppress ovulation. c COCs help reduce bloating. d COCs are​ anti-inflammatory agents and will decrease cramping.

d (Rationale: The woman who is bleeding heavily is losing hemoglobin and is usually fatigued, which affects interest in sex. The nurse plans interventions aimed at conserving energy in this client. Obesity, edema, and sweating are not usually associated with the lack of sexual desire in the client with DUB. )

A client with dysfunctional uterine bleeding (DUB) tells the nurse that she is having problems with sexual performance. The nurse selects sexual dysfunction as a nursing diagnosis and suspects that the dysfunction is related to which factor? a Edema b Obesity c Sweating d Fatigue

a (Rationale Menorrhagia causes heavy menstrual bleeding and may increase the risk of anemia. A CBC may be completed to assess for the presence of anemia in these clients. Menorrhagia does not cause infection. The nurse is able to answer basic questions about laboratory tests.)

A client with menorrhagia asks why a complete blood count is being done. Which response by the nurse is the most​ appropriate? ​a "This will tell us if your blood count is low due to your increased​ bleeding." ​b "Because this may cause​ infection, we need to look at your white blood​ cells." c ​"You will have to speak to the midwife about​ this." ​d "The midwife ordered​ this; let​'s walk down to the​ lab."

a (Rationale: The client with menorrhagia (excessive or prolonged menstruation) should be evaluated for thyroid disorders, use of anticoagulants, and other uterine disorders. Intake of sodium and the flu are not associated with menorrhagia. Strenuous exercising is associated with amenorrhea. )

A client with suspected menorrhagia is being assessed by the nurse at the clinic. What is the priority assessment the nurse must make in an effort to determine the cause of the disorder? a "Are you taking anticoagulants?" b "Have you increased your sodium intake?" c "Do you exercise vigorously?" d "Have you had the flu recently?"

d (Chlamydia is caused by​ bacteria, and not by​ protozoa, a​ fungus, or a virus)

A nurse in the health department is providing information about sexually transmitted infections​ (STIs) to Rachel​ Herrera, a​ 24-year-old with chlamydia. Ms. Herrera​ states, "I know I got this infection from my​ boyfriend, but what germs caused my​ infection?" Which response by the nurse is​ accurate? ​a "Your infection was caused by a​ virus." ​b "Your infection was caused by​ protozoa." ​c "Your infection was caused by a​ fungus." ​d "Your infection was caused by​ bacteria."

a,c,d,e (Rationale ​Iron-rich foods are encouraged to stave off anemia from abnormal bleeding.​ Eggs, beans, beef and shrimp are foods that are rich in​ iron; therefore the client should not avoid them.​ Hydration, self-care to minimize clinical​ manifestations, and stress reduction strategies are all appropriate interventions. Clients will be better able to cope with abnormal uterine​ bleeding, both long term and on a​ day-to-day basis, if they understand the disorder and possible interventions.)

A nurse is reviewing information about abnormal uterine bleeding with a client. Which important aspects of client teaching should the nurse​ include? ​(Select all that​ apply.) a The importance of adequate fluid intake b Avoid foods such as​ eggs, beans,​ beef, and shrimp c Stress reduction and relaxation strategies d The importance of eating foods rich in iron e Information about​ self-care in order to minimize the clinical manifestations

b,c (Rationale Greater than normal vaginal flow should be reported as it assesses for hemorrhage. Temperature greater than​ 100°F can be indicative of infection. Some pain is expected but it should not be severe. Bright red bleeding should be reported. Appetite may be depressed and bowel may be sluggish as a result of anesthesia.)

A nurse is reviewing orders for a client who is being discharged after having a hysterectomy. Which symptoms will the nurse include that require notification of the healthcare​ provider? ​(Select all that​ apply.) a Decreased bowel elimination b Vaginal bleeding greater than a normal menstrual flow c Temperature greater than 100degrees°F ​(37.7degrees°​C) d Any reports of pain e Brown vaginal bleeding

The nurse is discharging a male client with a semirigid penile implant. Which statements by the client indicate the instruction has been successful? (Select all that apply) A. "I think this will take some time to get used to with my partner." B. "If we have problems adjusting to this, I have the number of the therapist you gave me." C. "I guess I'll need to buy some different trousers so my implant won't be so noticeable." D. "I can't wait to try this out tomorrow with my partner." E. "I bet my partner will have a great time - I'll be able to go for hours!"

A,B,C With a simirigid implant, the type of clothing worn can be used to conceal it and decrease self-consciousness. it will take a period of adjustment for the man and his partner to get used to the implant.

The nurse is caring for a client newly diagnosed with ED. Which items are appropriate for the nurse to include in the assessment process? (Select all that apply) A. Client's current sexual practices B. Client's socioeconomic status C. Client's risk factors for ED D. Client's religious affilation E. Client's history of sexual dysfunction

A,C,E In order to assist a client in coping with ED, the nurse should assess risk factors for ED, sexual dysfunction, and the client's current sexual practices.

The nurse is caring for a postoperative client with an inflatable penile implant. Which statements from the client indicate the need for further instruction? (Select all that apply) A. "Next week is out anniversary - we can be intimate for the first time in years" B. "I think this is going to work very well for us" C. "I think this will take some practice and patience once we get back to sexual activity again" D. "I guess we can practice with this as much as we want" E. "What if we can't get the hang of this? What should we do?"

A,E In teaching the client and his partner about penile implants of the inflatable variety, let them know that practice is important - both to learn how to use the implant and to maintain its position and help tissue grow around it to hold it in place.

a,c,e (Rationale: Goal achievement is indicated by the​ client's ability to describe preventive​ behaviors, health​ practices, and treatment modalities. The client acknowledging to not have unprotected sex and planning to notify sexual partners are necessary measures to prevent the spread of the infection. Herpes is a virus and cannot be​ cured, but an antiviral medication will help shorten and prevent outbreaks. Triggers for exacerbation include​ stress, menses, or trauma.)

After a nurse has completed discharge​ teaching, which statements made by a client treated for genital herpes would indicate that discharge instructions were​ understood? ​(Select all that​ apply.) ​a "I'll try to keep my stress level​ down." b ​"I don't need to use a​ condom." ​c "I understand this antiviral medication will help shorten and prevent​ outbreaks." d ​"I'm glad the medication prescribed will cause this infection to be​ cured." e "I will notify my sex partners so they can get​ treatment."

The nurse is preparing teaching material to support the sexual development of an older couple. When using the PLISSIT model of​ assessment, the nurse will collect which​ data?

Ask permission to validate desire for sexual activity Refer to another healthcare provider regarding sexual activity Offer specific suggestions regarding sexual positioning

c (The most appropriate question for the nurse to ask this client is the date of her last menstrual period. The dates of her last sexual experience and last gynecological examination are not typically questions the nurse asks during the health history. There is no indication the client has a sexually transmitted infection and asking the client if she has ever been tested is not appropriate for this situation.)

A​ 22-year-old woman, Tamara​ Woodard, is being seen in the clinic for a yearly examination. Ms. Woodard states she is experiencing worsening monthly dysmenorrheal and postcoital bleeding. Which question will the nurse ask during the health history portion of the nursing assessment based on the data collected from Ms.​ Woodard? a ​"When was the last time you had sexual​ intercourse?" ​b "Have you ever been tested for sexually transmitted​ infections?" c ​"When did you have your last menstrual​ period?" ​d "When was your last gynecological​ examination?"

a,b,c,e (Rationale The client​'s sexual​ history, assessment, and examination must be​ documented, including symptoms​ (e.g., fever,​ chills, burning on​ urination, vaginal​ drainage) and their onset and duration. It is critical to document allergies for every​ client, especially because antibiotics may be ordered. An STI has not yet been​ confirmed, so a list of sexual contacts is not needed.)

A​ 24-year-old sexually active female client comes to the clinic with a complaint of burning on urination and a vaginal discharge. Documentation on the client​'s chart should include which​ information? ​(Select all that​ apply.) a History of unprotected sex b Allergies to any medications c Length of time since symptoms presented d Names and phone numbers of all sexual contacts e History of fever or chills

a (The nurse will prepare the client for a pelvic examination based on the symptoms the client is experiencing. A transvaginal​ ultrasound, not an abdominal​ ultrasound, may be required during the visit. There is no reason for a urine drug screen or therapeutic​ D&C based on the assessment findings.)

A​ 35-year-old woman, Shineka​ Majors, is being seen by the healthcare provider. The nurse collects the following data during the​ assessment: monthly​ dysmenorrhea, high stress​ job, and IUC device in place for 1 year. Which diagnostic test will the nurse prepare the client for during this​ appointment? a A pelvic exam b Therapeutic dilation and curettage​ (D&C) c Abdominal ultrasound d Urine drug screen

A male client reports having impotence. The nurse examines the client's medication regimen and determines that a contributing factor to impotence could be: A. Aspirin B. Antihypertensives C. Nonsteroidal anti-inflammatory drugs D. Anticoagulants

B Antihypertensives, especially beta-blockers such as propranolol, can cause impotence. When a male client has impotence, the nurse should always examine his medication regimen as a potential contributing factor.

The nurse is caring for a client who is newly diagnosed with ED. The client asks why his diabetes caused this to happen. The nurse bases the response on which rationale? A. ED is a normal part of aging that happens to all men at some point B. Vascular disease often associated with diabetes contributes to ED C. The medications he is on for diabetes are iatrogenic causes of ED D. The psychological stress of having a chronic disease brought on the ED

B Damage to arteries and vascular disease, which occurs in diabetes, are a common cause of ED.

A 65-year-old male client with erectile dysfunction asks the nurse, "Is all this just in my head? Am I crazy?" The best response by the nurse is based on the knowledge that: A. ED is believed to be psychogenic in most cases B. More than 50% of the cases are attributed to organic causes C. Evaluation of nocturnal erection does not help differentiate psychogenic or organic causes D. ED is an uncommon problem among men older than age 65

B ED is multifactorial in origin, and more than 50% of the cases can be attributed to organic causes, which include alteration in vascular supply, hormonal changes, neurologic dysfunction, medications, and associated systemic diseases, such as diabetes mellitus or alcoholism.

The nurse is caring for a male client being discharged from the hospital with a nitroglycerin prescription for chest pain. The client states that he takes Viagra for ED, but he knows this is no longer safe. Which treatment option for ED would be appropriate for the nurse to include in the discharge instructions? A. Topical cream B. Mechanical device C. Acupuncture D. Biofeedback device

B If a client is unable to take selective phosphodiesterase type 5 inhibitors, unwilling to try injectable medications, and not a candidate for surgery, a mechanical device such as a vacuum constriction device (VCD) may be prescribed.

The nurse is caring for a client who presents with an exacerbation of hypertension. While obtaining the nursing admission history, the nurse learns that he recently stopped taking his blood pressure medication. When asked why, he is initially reluctant to answer but eventually states that it made him 'have problems in the bedroom.' What is the cause of this client's erectile dysfunction? A. Lifestyle choices B. Latrogenic C. Hormonal D. Psychological

B Latrogenic causes of ED are side effects of medication and surgical procedures.

The nurse is teaching a client about treatment options for ED. Which explanation regarding pharmacological treatment is the most appropriate? A. They allow a man to relax enough to reduce the psychological stress of ED in order to achieve an erection B. They help a man achieve an erection during sexual stimulation by enhancing the effects of nitrous oxide to relax the smooth muscle of the penis and increase blood flow C. They dilate blood vessels all over the body except in the penis, to allow the man to achieve an erection D. They constrict blood flow to other parts of the body in order to shunt it to the penis during sexual stimulation

B Selective phosphodiesterase type 5 inhibitors enhance erections in the presence of sexual stimulation. They increase the effects of nitrous oxide to relax smooth muscle in the penis and increase blood flow during sexual stimulation.

The client is taking sildenafil orally for erectile dysfunction. What instruction should the nurse give the client? A. Sildenafil may be taken more than one time per day B. The HCP should be notified promptly if the client experiences sudden or diminished vision C. Sildenafil offers protection again some STDs D. Sildenafil does not require sexual stimulation to work

B The client should notify his HCP promptly if he experiences sudden or decreased vision loss in one or both eyes.

The nurse teaches the client with erectile dysfunction about the use of alprostadil via subcutaneous penile injection. Which statement indicates the client needs further teaching? A. "I need to keep the needle sterile before I inject my penis" B. "The erection won't last long after alprostadil is injected" C. "The injection will produce an erection within 30 minutes" D. "I should report if I am feeling dizzy after an injection"

B The nurse should correct the statement about an erection not lasting long. Alprostadil (Caverject) injection therapy has the potential of producing a prolonged erection.