Yoost Chapter 24 - Human Sexuality
A male patient tells the nurse, "I am unable to maintain an erection during sexual intercourse." Which question would the nurse ask the patient during the interview? A) "Do you drink alcohol frequently?" B) "Do you take phenytoin?" C) "Do you take diclofenac?" D) "Do you take any oral antihistamines?"
A) "Do you drink alcohol frequently?" Impotence is a fertility disorder characterized by the inability to maintain an erection during sexual intercourse. Alcohol is a depressant that delays brain function and can result in impaired penile erection. Therefore the nurse should inquire about the frequency of alcohol use. Phenytoin is an anticonvulsant drug that has a sedative effect and decreases sexual desire, but it does not cause impotence. Diclofenac is an analgesic used for pain relief and does not cause impotence. Antihistamine medications lead to vaginal dryness by decreasing glandular secretions.
When conducting a comprehensive sexual history assessment, which questions should the nurse include? Select all that apply. A) "How many babies have you given birth to?" B) "Do you know about contraception?" C) "Have you had a urinary tract infection?" D) "How many sexual partners have you ever had?" E) "Have you undergone a surgical removal of a kidney?"
A) "How many babies have you given birth to?" B) "Do you know about contraception?" D) "How many sexual partners have you ever had?" While assessing a patient's sexual history, questions that should be asked include the number of children and means of contraception used. An assessment also includes gathering information about past and present sexual practices, including the number of sexual partners. The information regarding urinary tract infection or surgical removal of a kidney is not part of a comprehensive sexual history assessment and should not be included.
The nurse is working with a patient who has a sexual dysfunction. What statement by the patient indicates progress toward an important goal? A) "I am beginning to enjoy sex more these days." B) "I'm glad my partner is understanding of the lack of sex." C) "I wish I didn't need these pills but I know they are important." D) "I hope one day to have a sexual partner again."
A) "I am beginning to enjoy sex more these days." According to NANDA, sexual dysfunction occurs when a person has a change in sexual function that the person finds "unsatisfying, unrewarding, or inadequate." To show that a goal has been met, the patient would state that sexual activity is more satisfying, rewarding, or adequate. The patient stating that he/she is beginning to enjoy sex more shows progress toward that goal.
The nurse at a community health center is teaching a group of menopausal women about normal changes in the female sexual response that occur with aging. Which patient statement indicates understanding of the teaching? A) "It's normal for me to take longer to reach an orgasm." B) "I might experience chest pain or shortness of breath during intercourse." C) "It's normal for me to lose interest in sexual relationships." D) "I don't need to be concerned about contraception or sexually transmitted infections because of my age."
A) "It's normal for me to take longer to reach an orgasm." Normal changes in the female sexual response include a decrease in sex hormone levels, decrease in vaginal lubrication, longer time to reach orgasm, and longer refractory times. Many factors such as chronic illness, medications, stress, or loss of partner can influence the older adult's sexual activity. However, it is not normal for women to experience chest pain or shortness of breath during intercourse. These are symptoms of angina or other heart-related problems and should be assessed by a health care professional immediately. It is not normal for older adults to lose interest in sexual relationships. Intimacy and sexuality are important to human identity and well-being at all stages of life. Older adults may not be as comfortable using barrier methods such as condoms and therefore are at increased risk for sexually transmitted infections.
A patient has been diagnosed with a sexually transmitted disease (STD) and the patient's partner is angry, saying, "She must have cheated on me." What response by the nurse is most appropriate? A) "This infection may have been present for a long time." B) "You need to be tested for this disease too." C) "Yes, you're right; if you don't have the STD, she cheated." D) "Now, now, getting angry will not help anything."
A) "This infection may have been present for a long time." Some STD symptoms may go unnoticed for a long time. Telling the partner to get tested as well without further explanation is likely to cause defensiveness. The nurse has no way of knowing if the patient "cheated" on the partner or not. Telling the partner not to get angry is dismissive of his/her concerns.
A parent confides to the nurse that the parent's 3-year-old son seems to be touching his genitals frequently. What response by the nurse is best? A) "This is normal behavior at his age." B) "Why do you think he is doing that?" C) "Does he complain of burning with urination?" D) "I'd ignore that behavior; it's attention-seeking."
A) "This is normal behavior at his age." Self-exploration of the body is a normal behavior at this age. The other responses are not necessary.
A nurse is interviewing a couple to determine if they are experiencing an infertility issue. Which questions would the nurse ask to determine infertility? Select all that apply. A) "What is the duration of having unprotected intercourse?" B) "Do you experience a sense of failure?" C) "Do you feel that your body is defective?" D) "Do you enjoy having sexual intercourse?" E) "Do you live in a city or suburban area?"
A) "What is the duration of having unprotected intercourse?" B) "Do you experience a sense of failure?" C) "Do you feel that your body is defective?" Couples with the female under the age of 34 years are diagnosed as infertile if they are unable to conceive after having 1 year of contraceptive-free sexual intercourse. Also couples with the female over the age of 35 years are diagnosed as infertile if they are unable to conceive after 6 months of contraceptive-free sexual intercourse. The patients may experience a feeling of failure and may even think that their bodies are defective. Fertility does not depend on seeking pleasure from sexual intercourse and enjoying the activity. The location of a residence does not affect fertility.
A nurse is caring for a patient with sexual dysfunction. The nurse uses the PLISSIT model when implementing nursing interventions. According to the PLISSIT model, in which order would the nurse perform the sexual assessment? A) 1. Obtain patient permission to discuss sexual concerns. B) 2. Gather information about sexual health problems. C) 3. Give suggestions about sexual health and related disorders. D) 4. Provide intensive therapy related to sexuality.
A) 1. Obtain patient permission to discuss sexual concerns. B) 2. Gather information about sexual health problems. C) 3. Give suggestions about sexual health and related disorders. D) 4. Provide intensive therapy related to sexuality. The nurse should first obtain permission from the patient to discuss sexuality issues. Obtaining information related to sexual health problems helps in planning the interventions. Specific suggestions should be given to help the patient manage a sexual problem. If needed, the patient may then be directed to a professional with advanced training for intensive therapy.
In which order does a man's sexual response occur? A) 1. Stimulation B) 2. Erection C) 3. Emission D) 4. Ejaculation E) 5. Detumescence
A) 1. Stimulation B) 2. Erection C) 3. Emission D) 4. Ejaculation E) 5. Detumescence There are five different phases of sexual response in men: stimulation, erection, emission, ejaculation, and detumescence. Stimulation is the first phase of the human sexual response, which can be psychological or genital. Erection is the second phase, which involves shunting of blood into the penis. Emission is the third phase, in which the sperm cells move from the epididymis to the urethra. Ejaculation occurs in the orgasmic phase, in which the sperm cells are expelled from the urethra. Detumescence is the last phase, in which the penis is no longer erect. Test-Taking Tip: Look for the first and/or last choices before ordering the rest of the choices. Eliminating one or two choices by knowing they are first or last makes ordering the fewer number of choices an easier task. For this question, you may know that detumescence is last and you may know that stimulation is first. That leaves just three choices to order, which is easier than juggling all five at once.
A couple seeks advice from a nurse regarding nonprescriptive contraceptive methods. Which methods would the nurse discuss with the couple? A) Abstinence B) Skin patches C) Vaginal rings D) Condoms and spermicides E) Timing of intercourse
A) Abstinence D) Condoms and spermicides E) Timing of intercourse Nonprescriptive contraceptive methods include abstinence from sexual intercourse, condoms and spermicidal jellies, and timing the intercourse with the woman's ovulation cycle. Skin patches and vaginal rings contain hormonal substances that require a health care provider's prescription. Test-Taking Tip: Not all barrier methods are nonprescriptive. The diaphragm must be fitted by a health care practitioner and thus needs a prescription. Be sure you know which method of contraception is being discussed before you respond to a question.
A nurse is planning sexuality education programs. Which topics are important to each age-group? Select all that apply. A) Adolescents: contraception B) Adolescents: infertility C) Young adults: conception D) Middle adulthood: sexual dysfunction E) Old age: decreased sexuality
A) Adolescents: contraception C) Young adults: conception D) Middle adulthood: sexual dysfunction Antipsychotics can lead to erectile dysfunction. Phenytoin can lead to decreased desire and function. Antihistamines can cause decreased vaginal lubrication. SSRIs can lead to absent or delayed orgasm. Chronic marijuana used can lead to decreased desire.Adolescents need education on contraception and avoidance of unwanted pregnancy, STDs, HIV infection, sexual abuse, sexual orientation, and good decision making. Young adults particularly need information on conception and infertility. Middle adults need education on emotional and physical changes that occur during this age span including the empty nest syndrome and sexual dysfunction. Older adults need education on physical changes brought by age and encouragement that sexuality normally continues throughout life.
A nurse is teaching patients about their medications and implications for sexuality. Which combinations are correct? Select all that apply. A) Antipsychotics: erectile dysfunction B) Phenytoin: decreased desire C) Antihistamines: increased vaginal lubrication D) SSRIs: prolonged orgasm E) Marijuana: chronic use—reduced inhibitions
A) Antipsychotics: erectile dysfunction B) Phenytoin: decreased desire Antipsychotics can lead to erectile dysfunction. Phenytoin can lead to decreased desire and function. Antihistamines can cause decreased vaginal lubrication. SSRIs can lead to absent or delayed orgasm. Chronic marijuana used can lead to decreased desire.
The nurse uses the PLISSIT model while working with a couple experiencing sexual health problems. Which action would the nurse take first? A) Ask the couple permission to begin a discussion on sexuality B) Refer the couple to make an appointment with a sex therapist C) Recommend methods to improve the couple's sexual health D) Inform the couple about all of the available treatment options
A) Ask the couple permission to begin a discussion on sexuality. The PLISSIT model is a tool that is helpful in the assessment of sexual problems and designing the treatment plan accordingly. Before starting the assessment, the nurse seeks permission from the couple to help them feel comfortable about discussing their sexual issues. The nurse would refer the couple to a sex therapist only if any major problems are identified during the assessment. The nurse would also give suggestions to improve the couple's sexual health only after completing a thorough assessment. Information about available treatment options would be provided only after a diagnosis.
A woman comes to the clinic for her general health checkup. The patient expresses that she and her husband are exhausted because of their work schedules, and this has affected their sexual relationship. Which advice can the nurse provide to improve the couple's sexual relationship? A) Avoid alcohol and tobacco B) Do not have sexual intercourse until your workload decreases C) Eat well-balanced meals and follow a regular sleep pattern D) Plan sexual activities in the morning or another time when you are well rested E) Communicate your concerns with your partner
A) Avoid alcohol and tobacco C) Eat well-balanced meals and follow a regular sleep pattern D) Plan sexual activities in the morning or another time when you are well rested E) Communicate your concerns with your partner Modern working couples become exhausted due to hectic work schedules. This can affect their sex life and overall health. The couple should avoid alcohol, tobacco, and caffeine, as these have detrimental effects on their health. A well-balanced diet and regular sleep patterns help maintain good health and energy levels. Planning sexual activity in the mornings or another time when the couple is well rested solves the problem of tiredness. The partners should communicate to each other about their concerns so that they can deal with the problem together. It is incorrect to advise the couple to abstain from sexual activity until the workload decreases as it is not a solution to the problem.
A new graduate nurse is working in a rehabilitation center that specializes in the care of patients with spinal cord injuries (SCIs). The new graduate understands that sexual issues are common among patients with SCIs. Which actions enhance the nurse's comfort in discussing sexual issues with the patients? Select all that apply. A) Clarifying personal values related to sexuality B) Role-playing discussion of sexual concerns with another nurse C) Attending a conference to enhance knowledge about sexuality D) Avoiding a discussion of sexual concerns until after completing new nurse orientation E) Asking a nurse who is experienced in caring for patients with SCIs about common sexual concerns
A) Clarifying personal values related to sexuality B) Role-playing discussion of sexual concerns with another nurse C) Attending a conference to enhance knowledge about sexuality E) Asking a nurse who is experienced in caring for patients with SCIs about common sexual concerns Nurses often avoid discussing sexual issues with patients because they are uncomfortable, lack knowledge, or have personal values in conflict with the patients. Nurses who have difficulty addressing sexual issues need to seek education and experiences to increase knowledge and explore their personal values. Role play has been used in many different areas of health care to help alleviate fears and concerns that many nurses experience. Health care professionals should attend conferences and seminars to enhance their knowledge base regarding sexual assessment. A new nurse should always seek counsel from an experienced nurse when unsure about a policy or procedure.
Which barrier methods prevent pregnancy? Select all that apply. A) Condom B) Diaphragm C) Vaginal rings D) Spermicidal foam E) Oral contraceptives
A) Condom B) Diaphragm D) Spermicidal foam Condoms, diaphragms, and spermicidal foams are the mechanical barriers used for preventing pregnancy. A condom is a thin rubber sheath that prevents the entry of sperm cells into the vagina. A diaphragm is a barrier device that is inserted into the vagina. It prevents the sperm from entering the cervix. Spermicidal foams are placed in the vagina. The foam contains a chemical that kills the sperm cells and acts as a physical barrier by preventing the entry of sperm cells into the cervix. Vaginal rings and oral contraceptives do not act as mechanical barriers. Oral contraceptives are hormonal pills that alter the uterine environment and thicken the cervical mucus to reduce the chances of conception and stop ovulation. Vaginal rings contain a polymeric drug delivery system in soft plastic rings that are inserted into the vagina. These devices release hormones such as estrogen and progesterone that prevent ovulation and thicken the cervical mucus. This prevents the sperm cells from fertilizing an egg.
A nurse is reviewing the sexual and physical examination data of a patient diagnosed with sexual dysfunction. Which signs and symptoms might the nurse anticipate finding in the assessment data? Select all that apply. A) Dyspareunia B) Erectile dysfunction C) Nocturnal emissions D) Depression and guilt E) Foul-smelling genitals
A) Dyspareunia B) Erectile dysfunction D) Depression and guilt Sexual dysfunction is described as the inability to accomplish sexual desires. It can be due to many reasons. Dyspareunia is pain occurring with sexual intercourse that may lead to decreased sexual desire. Erectile dysfunction or impotence is the inability to achieve or maintain a penile erection for sexual intercourse and premature ejaculation, which occurs if a male ejaculates before his sex partner achieves an orgasm. Sexual dysfunction may also be related to various psychological factors, including anxiety, depression, and guilt. Nocturnal emissions are normal and may not cause dysfunction. Foul-smelling genitals call into question cleanliness or suggest the presence of infection.
A nurse is working with a patient using the PLISSIT model. In the LI phase, what is an appropriate activity? A) Educate the patient on water-based lubricants B) Ask the patient for permission to discuss sexuality C) Instruct the patient on positions acceptable after knee replacement D) Refer the patient and partner to a licensed therapist
A) Educate the patient on water-based lubricants The LI phase of the PLISSIT model stands for limited information, which would be information the patient needs to function sexually. Asking permission is P. Discussing specific concerns related to a specific medical condition is SS (specific suggestions). Referral to a therapist is IT (intensive therapy).
Since the majority of sexually transmitted infections (STIs) have few if any symptoms, which nursing action is essential? A) Encourage regular screenings in all sexually active individuals. B) Provide information about contraception options. C) Administer prescribed antibiotics for human papillomavirus (HPV) or genital herpes outbreaks. D) Ask all patients if they are experiencing any symptoms.
A) Encourage regular screenings in all sexually active individuals. One of the challenges in reducing the incidence of STIs is that most STIs have few symptoms in males or females. Asymptomatic STIs can be diagnosed during a physical examination with appropriate laboratory tests. Screening after each new sex partner is the most effective method to detect and manage STIs. The nurse should provide information about contraceptive options if asked; however, contraceptives will not protect patients against STIs. HPV and herpes are viral infections and cannot be treated with antibiotics.
A male patient comes for a follow-up visit a few months after experiencing a myocardial infarction. The nurse plans to interview the patient to assess his sexual health. Which precautions should the nurse take when assessing the patient's sexuality? Select all that apply. A) Ensure that the patient is comfortable discussing the issue. B) Ensure that the patient has privacy. C) Avoid talking to the patient. D) Ask open-ended questions. E) Include the family members in the discussion to get more information.
A) Ensure that the patient is comfortable discussing the issue. B) Ensure that the patient has privacy. D) Ask open-ended questions. When assessing a patient's sexuality, it is extremely important that the patient is comfortable discussing it. The nurse should maintain the patient's privacy by closing the doors and curtains. Asking open-ended questions gives the patient the opportunity to explore his situation completely and gives the nurse more information. The nurse should not avoid talking to the patient. This action does not allow the patient to speak freely, nor will it elicit important assessment information. The patient should be interviewed separately. Family members should not be included in the discussion, as it may be an invasion of the patient's privacy.
The student learns that which are cycles in the female sexual response cycle? Select all that apply. A) Excitement B) Orgasm C) Resolution D) Detumescence E) Plateau
A) Excitement B) Orgasm C) Resolution E) Plateau The female sexual response cycle includes the phases of excitement, plateau, orgasm, and resolution. Detumescence is when the penis is no longer erect after orgasm.
The nurse is assessing factors that affect sexual function in patients with chronic diseases. What topics does the nurse include in the assessment? Select all that apply. A) Fatigue B) Medications C) Pain D) Occupation E) Physical impairment
A) Fatigue B) Medications C) Pain E) Physical impairment Fatigue, medications, pain, and impairments all can have direct effects on sexuality. Lifestyle is another factor, but occupation does not in itself influence sexuality.
A nurse is educating a couple about sexually transmitted infections. Which sexually transmitted infections cannot be cured? Select all that apply. A) Herpes B) Syphilis C) Chlamydia D) Gonorrhea E) Human papillomavirus infection
A) Herpes E) Human papillomavirus infection Sexually transmitted infections that cannot be cured include herpes and human papillomavirus. Syphilis is caused by the bacteria Treponema pallidum. Chlamydia is caused by the infection of the bacteria Chlamydia trachomatis. Gonorrhea is caused by the bacteria Neisseria gonorrhoeae. Syphilis, chlamydia, and gonorrhea are sexually transmitted infections caused by bacteria that can be cured by antibiotics.
A nurse caring for an infertile couple learns that the couple is experiencing symptoms of chlamydia. Which statements by the nurse about chlamydia are appropriate? Select all that apply. A) It affects the genitourinary tract B) There is no cure for this disorder C) It does not cause ectopic pregnancy D) The rectum is resistant to chlamydia infection E) It may cause infection of the eyes and lungs in newborns
A) It affects the genitourinary tract. E) It may cause infection of the eyes and lungs in newborns. Chlamydia infection affects the genitourinary system and causes conjunctivitis and pneumonia in newborns. Chlamydia can be cured with antibiotics. Chlamydia infection may cause pelvic inflammatory disease (PID), infertility, and ectopic pregnancy. Chlamydia also infects the rectum.
A nurse is educating a couple about the human immunodeficiency virus (HIV). Which statements by the nurse about HIV are appropriate? Select all that apply. A) It is a blood-borne pathogen B) It spreads through oral-genital sex C) It is not found in bodily fluids D) It causes ectopic pregnancy E) Its risk can be reduced by the use of condoms
A) It is a blood-borne pathogen B) It spreads through oral-genital sex E) Its risk can be reduced by the use of condoms HIV is primarily a blood-borne pathogen. It spreads through vaginal and anal intercourse and through oral-genital sex. The use of condoms reduces the incidence of HIV infection, while unprotected sex increases the risk of HIV transmission. Bodily fluids contain HIV and any exchange of body fluids can result in HIV transmission. Unlike chlamydia, HIV infection is not known to cause ectopic pregnancy.
A nurse is discussing sexual issues with a patient. Which statements are true about sexuality? Select all that apply. A) It is influenced by personal beliefs B) It is not affected by the medications a patient uses C) It is influenced by your environment D) It may be affected by chronic respiratory disease E) Culture plays a role in shaping sexual values
A) It is influenced by personal beliefs C) It is influenced by your environment D) It may be affected by chronic respiratory disease E) Culture plays a role in shaping sexual values Sexuality is influenced by various factors. An individual's sexuality may be affected by personal beliefs and notions of sexual health. Environment influences sexual activity in that privacy may be an essential element for both sexual discussion and sexual activity. In addition, presence of disease conditions may shift the focus and energy of the patient toward healing, thus affecting sexuality. The sociocultural environment of a person always influences conduct. The rules and norms of society often determine the acceptable and unacceptable behavior within the culture affecting sexuality. Sexuality is affected by the medications a person takes.
A nurse is planning an educational event on safer sex. What topics does the nurse include? Select all that apply. A) Proper use of condoms B) Avoidance of risky behaviors C) Need for routine examinations D) Avoidance of homosexual activity E) Symptoms of common STDs
A) Proper use of condoms B) Avoidance of risky behaviors C) Need for routine examinations E) Symptoms of common STDs Safe sex education includes proper use of condoms, avoidance of risky behaviors (and what those are), the need for routine examinations, and symptoms of common STDs. The nurse should not include judgmental comments about sexual practices; all people need information on safer sex practices.
A nurse understands that which characteristics of family dynamics impact a patient's sexuality? Select all that apply. A) Religion B) Age C) Ethnicity D) Culture E) Geographic location
A) Religion B) Age C) Ethnicity D) Culture Religion, values, age, ethnicity, and culture all impact family dynamics, which in turn affect expressions of sexuality. Although geographic location can influence culture, it is not a specific family dynamic important to sexuality.
A nurse wishes to incorporate an assessment of patient sexuality into all patient encounters but is concerned about appearing inappropriate. What action by the nurse is best? A) State, "I always ask my patients permission to discuss sexuality. Is this alright?" B) Wait for the patient to bring the subject of sexuality up to the nurse C) Give the patient written material on sexuality, then ask if he/she has questions D) Tell patients that if they have any sexual concerns, you would be happy to discuss them.
A) State, "I always ask my patients permission to discuss sexuality. Is this alright?" A matter-of-fact, organized approach to sexuality will decrease anxiety in both patient and nurse. Stating that all patients are asked about this topic makes it appear to be a normal part of the assessment. The other options put the responsibility for discussing sexuality on the patient when the nurse should be directing the process.
Which sexually transmitted disease is known to cause paralysis and psychosis? A) Syphilis B) Chlamydia C) Gonorrhea D) Genital herpes
A) Syphilis Treponema pallidum is the causative organism for syphilis. In the late stages of the disease, T pallidum enters the brain and causes stroke, loss of memory, psychosis, depression, mania, paralysis of the limbs, and blindness. Chlamydia produces flulike symptoms, genital discharge, and a burning sensation during urination. Gonorrhea causes genital discharge, burning, and pain in the genital areas. Genital herpes causes genital discomfort and sores.
A nurse is uncomfortable with a patient's comments, which are sexual in nature. Which actions by the nurse are most appropriate? Select all that apply. A) Tell the patient to stop making sexual comments B) Try joking with the patient to establish rapport C) Tell the patient you are leaving and will return in a few minutes D) Inform the patient he/she can be sued for this behavior E) Explain to the patient how you feel about the comments
A) Tell the patient to stop making sexual comments C) Tell the patient you are leaving and will return in a few minutes E) Explain to the patient how you feel about the comments There are several steps a nurse can take when patients are displaying inappropriate sexual behavior. First, the nurse should tell the patient to stop what he/she is doing. The nurse can also tell the patient that he/she is leaving for a few minutes and will return when the patient can control this behavior. The nurse can also tell the patient how he/she feels about the comments or actions. The nurse should not joke with the patient or in any way participate in this behavior. The nurse should not threaten a patient with a lawsuit.
Which teaching would the nurse include when explaining to a patient how hormonal contraceptives work? Select all that apply. A) They alter the uterine environment B) They prevent ovulation C) They reduce sperm motility D) They act as a spermicidal barrier E) They thicken the cervical mucus
A) They alter the uterine environment B) They prevent ovulation E) They thicken the cervical mucus Hormonal contraceptives work by altering the uterine environment, thus reducing the chance of ovum implantation. Hormonal contraceptives prevent ovulation and thicken the cervical mucus, preventing sperm cells from ascending into the uterus. Hormonal contraceptives do not affect the motility of sperm and do not have any spermicidal effect. Spermicidal creams and jellies kill sperm cells before they enter the uterus. Test-Taking Tip: On questions about one type of contraceptive, the incorrect choices may be true for other methods of contraception. For instance, in this question, "act as a spermicidal barrier" is correct for condoms; and "reduce sperm motility" is correct for spermicides. Be sure you know which contraceptive method is being discussed as you choose responses.
The nurse has assessed a patient and determined that the patient has a sexual issue that needs to be addressed. What actions by the nurse are most appropriate? Select all that apply. A) Use information from multiple sources to help plan care B) Collaborate with other health professionals to develop the plan C) Involve the patient and significant other in the process D) Use standard care plans to limit patient embarrassment E) Examine one's own biases before implementing the plan
A) Use information from multiple sources to help plan care B) Collaborate with other health professionals to develop the plan C) Involve the patient and significant other in the process E) Examine one's own biases before implementing the plan A good care plan uses information from multiple sources, involves other disciplines as appropriate, and involves the patient and significant other. In matters related to sexuality, the nurse also must examine his/her own biases so they do not limit the ability of the nurse to work with the patient. Using standard care plans does not address the patient's unique needs.
The nurse is providing education about condom use at a community clinic for older adults. Which statements demonstrate that the adults understand correct use of condoms? Select all that apply. A) "I can use any kind of lubricant such as lotions or baby oil." B) "Before using the condom, I should check the package for damage or expiration." C) "I need to use a condom to help reduce the risk of sexually transmitted infections." D) "A good place to store condoms is in the bathroom so they don't dry out." E) "I should not use a condom because I have a latex allergy."
B) "Before using the condom, I should check the package for damage or expiration." C) "I need to use a condom to help reduce the risk of sexually transmitted infections." Condoms have an expiration date. A condom should not be used if it is expired or if the package has been damaged or tampered with. An expired or damaged condom could easily rip or tear, predisposing the vagina to semen or sexually transmitted diseases. Condom users should be taught to use water-based lubricants because oil-based products contribute to breakage of latex condoms. Condoms need to be stored in a cool and dry location away from sunlight. Condoms are available in non latex varieties.
A patient presents with decreased libido, depression, and difficulty coping. Which nursing interventions would be helpful for the patient? Select all that apply. A) Formulate a nutrition plan for the patient. B) Assess the causes of coping difficulties. C) Help the patient to set realistic goals. D) Encourage the patient to express feelings. E) Explain to the patient about the use of condoms.
B) Assess the causes of coping difficulties. C) Help the patient to set realistic goals. D) Encourage the patient to express feelings. Assessment of the causes of coping difficulties will help the nurse understand the problems of the patient and plan the treatment accordingly. Helping the patient set realistic goals will help increase the patient's confidence and prevent frustration. Encouraging the patient to express feelings will provide greater insight to the problem. Formulating a nutrition plan for the patient will not directly address the patient's main problems of decreased libido, depression, and difficulty coping. Explaining to the patient about the use of condoms will not help in increasing libido, managing depression, or enhancing coping. Test-Taking Tip: Look for answers that focus on the patient or are directed toward feelings.
Which symptom is observed in the late stage of syphilis? A) Chancres B) Blindness C) Headache D) Weight loss
B) Blindness Syphilis is a sexually transmitted disease caused by the bacteria Treponema pallidum. It develops in three stages. In the late stage, the disease advances and damages different parts of the body. The cornea of the eye is completely damaged in the late stage, leading to blindness. In the first stage (primary) a painless ulceration called a chancre develops in the areas of sexual contact and transforms into a rash. Headache and weight loss are the symptoms observed in the second stage of syphilis.
Which nursing action takes priority when working with a patient who chooses to have an abortion? A) Explain that abortion means killing a life. B) Clarify his or her personal values. C) Convince the patient that abortion is a crime. D) Criticize the patient for her decision.
B) Clarify his or her personal values. Before a nurse can be helpful to patients opting for an abortion, the nurse must be aware of and comfortable with feelings about his or her own values. The nurse should not provide wrong and biased information to the patient to influence her decision. As a corollary, nurses must be comfortable with the idea that patients have a right to their own values. Nurses must also avoid criticism and censure.
Which parts belong to the external female reproductive system? Select all that apply. A) Uterus B) Clitoris C) Vagina D) Mons pubis E) Labia majora
B) Clitoris D) Mons pubis E) Labia majora The parts of the external female reproductive system include the mons pubis, labia majora, labia minora, and clitoris. They can be seen and inspected directly. The clitoris is a small sensitive organ located outside the body in front of the vaginal opening near the urethra. The mons pubis is fatty tissue that covers the symphysis pubis. The labia majora cover the vaginal orifice. The internal parts of the female reproductive system include the uterus, vagina, fallopian tubes, and ovaries. The vagina is the connection between the external vulva and the internal uterus. The uterus is a muscular organ located between the bladder and the rectum. Test-Taking Tip: Recall Latin and Greek medical terminology word parts! An exit (ex- = outside) takes you outside, so external parts of the female reproductive system are located on the outside of the body. If you misread external as internal, you would have the opposite (and incorrect) answer—so read carefully for Latin and Greek word parts in the question.
A 35-year-old woman comes to the clinic for her general health checkup. She is the mother of a 6-year-old girl. The patient wants to know about various non prescriptive methods of contraception. Which method of contraception does not require a prescription and can be independently taught by the nurse? A) Intrauterine device B) Condom C) Vaginal ring D) Subdermal implant
B) Condom Condoms are a contraceptive measure that is available over the counter and does not require a prescription from a health care provider. Other methods of contraception, including diaphragms, intrauterine device, vaginal rings, and subdermal implants, require a prescription.
A patient presents with impaired sexual functioning (ICNP). Which strategies does the nurse suggest to enhance sexual functioning in the patient? Select all that apply. A) Discourage the use of pain medications. B) Discourage the use of alcohol and tobacco. C) Encourage touching and kissing. D) Discourage the use of pillows during sex. E) Communicate concerns and fears with the partner.
B) Discourage the use of alcohol and tobacco. C) Encourage touching and kissing. E) Communicate concerns and fears with the partner. Alcohol and tobacco may decrease sexual functioning and should be discouraged. Touching, kissing, and tactile stimulation are forms of intimacy that support healthy sexual functioning and should be encouraged. Communicating concerns and fears with the partner and health care provider helps in better understanding the problem. Pain medication may be promoted before intercourse in the patient who has chronic pain. The use of pillows should not be discouraged if they promote comfort and support sexual functioning.
Which question represents a nonjudgmental approach when gathering a sexual health history? A) How do you and your wife/husband feel about intimacy? B) Do you have sex with men, women, or both? C) Are you heterosexual or homosexual? D) Do you identify as straight?
B) Do you have sex with men, women, or both? A nonjudgmental attitude facilitates trust and open communication between the nurse and patient. The nurse represents a nonjudgmental approach when he or she asks about sexual preferences: men, women, or both. Using terms such as partner versus wife or husband allows the patient to identify his or her sexual preference. The terms gay, lesbian, bisexual, or transgender are preferred over the terms heterosexual or homosexual and are more specific in reference to sexual practices. Asking a patient if he or she identifies as straight may relay a judgmental approach.
A patient presents to the emergency department with a cough and fever. Upon examination, the nurse finds several bruises that are in various stages of healing and suspects that the patient may be a victim of sexual abuse. Which action should the nurse perform first? A) Refer the patient to a sexual counselor B) Educate the patient about an escape plan and available community resources C) Ask the patient to describe how she got the bruises D) Report the abuse immediately to the proper authorities
B) Educate the patient about an escape plan and available community resources The first action is to educate the patient about available community resources and to help her develop an escape plan. The nurse suspects sexual abuse; therefore a sexual counselor would not be appropriate at this time. As part of the assessment process, the nurse would inquire about how the bruises came about, but that would not be the nurse's first action. The nurse is mandated to report the suspected abuse. This action may put the patient at an increased risk for violence.
A woman complains that her partner threatens her and berates her in front of the children. She denies being in an abusive relationship or being the victim of physical violence. What action by the nurse is best? A) Tell the woman to leave the abusive partner B) Educate the woman on forms of domestic abuse C) Help the woman work on a physical safety plan D) Insist the woman take written information
B) Educate the woman on forms of domestic abuse. This woman first needs to understand she is indeed in an abusive relationship. The nurse gently educates her on the type of abuse that is possible. Telling the woman what to do is likely to be met with resistance, plus the time of leaving is the most dangerous part of the relationship. The woman may not be accepting of a physical safety plan, since she states there is no physical violence. The woman may be fearful of taking written information because the abuser may find it.
The nurse is caring for a patient who has received the medication haloperidol. Which side effects would the nurse expect in the patient? Select all that apply. A) Vaginal dryness B) Erectile dysfunction C) Loss of sexual desire D) Ejaculation dysfunction E) Increased testosterone levels
B) Erectile dysfunction C) Loss of sexual desire D) Ejaculation dysfunction Haloperidol is an antipsychotic medication. Erectile dysfunction is a fertility disorder characterized by the inability to maintain an erection during sexual intercourse. Antipsychotic medications may decrease blood pressure, which results in reduced blood flow to the penis and leads to erectile dysfunction. Antipsychotic medications may cause sedation and decreased sexual desire. Ejaculation dysfunction is associated with the problems encountered during the ejection of semen from the body. Antipsychotic drugs are known to cause ejaculation problems in men. Antihistamines decrease the secretions necessary for the lubrication of the vagina, which can lead to painful intercourse. Antipsychotic drugs decrease sexual desire by reducing testosterone levels.
An emergency department (ED) manager wants to improve care for victims of sexual assault. What action by the manager is best? A) Designate a private area of the ED for examinations B) Establish a SART team for the department C) Ask nurses to volunteer to be advocates for these patients D) Have victims examined immediately, rather than waiting their turn
B) Establish a SART team for the department Although all options would improve care for these patients, a SART (Sexual Abuse Response Team) approach offers comprehensive, evidence-based practice for these patients
A patient constantly asks the nurse inappropriate questions constituting sexual harassment. Which response by the nurse would be appropriate? Select all that apply. A) Respond to all of the questions that the patient is asking. B) Explain to the patient that the behavior is totally inappropriate. C) Ignore the patient and begin to talk to another staff member nearby. D) Do not reply to any of the patient's sexually inappropriate questions. E) Admonish the patient for using this sexually inappropriate behavior.
B) Explain to the patient that the behavior is totally inappropriate. C) Ignore the patient and begin to talk to another staff member nearby. D) Do not reply to any of the patient's sexually inappropriate questions. The nurse should patiently explain how he or she feels about this behavior; this may bring some change in the person. If the patient continues behaving in this manner, the nurse should continue to ignore the patient and begin a conversation with another staff member. This response restricts privacy, and the patient may stop the behavior. The nurse maintains a professional relationship with the patient, and hence he or she need not answer questions about personal issues. When a patient asks inappropriate questions, the nurse should not answer any such queries and should remain calm. This response indicates to the patient that the questions asked were inappropriate. The nurse should not lose his or her temper by scolding or admonishing the patient. However, the nurse should make it clear that this behavior is not acceptable.
A teenage girl states that she is having unprotected intercourse with her boyfriend. She asks for more information regarding birth control methods. Which options would the nurse discuss with this patient? Select all that apply. A) Condoms or diaphragms must be used with each sexual encounter. B) Hormonal methods offer little protection against sexually transmitted infections (STIs). C) Barrier methods offer some protection against STIs. D) Sterilization is an effective option that she should consider. E) The rhythm method is effective for preventing pregnancy.
B) Hormonal methods offer little protection against sexually transmitted infections (STIs). C) Barrier methods offer some protection against STIs. The nurse should inform the patient about safe sex practices and about the pros and cons of contraceptive devices. The patient should be informed that hormonal methods such as "the pill" do not offer any protection against STIs. Barrier methods prevent entry of sperm into the vagina to reduce the chance of conception and may offer some protection against STIs. In order for condoms and diaphragms to be effective, they must be worn with each sexual encounter. The age of the patient must be considered; therefore this would not be a good option. Sterilization is the most effective method besides abstinence but would not be a good option for a young woman since it is not easily reversible. The rhythm method is effective for preventing pregnancy; however, it would not be a good option for this patient due to her age.
A patient is recovering from colostomy surgery and states, "I guess I'll never be able to have sex again... who would want me?" What Nursing diagnosis is most important for this patient? A) Sexual dysfunction B) Ineffective sexuality pattern C) Knowledge deficit D) Ineffective coping
B) Ineffective sexuality pattern Ineffective sexuality patterns refer to a patient who expresses concern about his/her own sexuality. This patient is concerned about the effect of this surgery on his/her attractiveness and desirability. Sexual dysfunction relates more to the physical problems. The patient may have a knowledge deficit or ineffective coping, but these are not apparent from the question.
A 50-year-old male patient comes for a follow-up visit a few months after a myocardial infarction. The nurse plans to interview the patient to assess his sexual health using the PLISSIT model. Which components are included in the PLISSIT model of assessment? Select all that apply. A) Palliation B) Permission C) Limited information D) Specific suggestions E) Intravenous therapy
B) Permission C) Limited information D) Specific suggestions The PLISSIT model is used for assessment of a patient dealing with sexual health. P stands for permission from the patient to discuss sexual history. LI stands for limited information regarding sexual health problems. SS stands for specific suggestions for the person with sexual relations. IT stands for intensive therapy by a professional, which surrounds the issues of sexuality for the patient. Palliation and intravenous therapy are not part of the PLISSIT model.
A nurse is educating a couple about sexually transmitted infections caused by bacteria. Which sexual diseases are caused by bacteria? Select all that apply. A) Herpes B) Syphilis C) Chlamydia D) Gonorrhea E) Genital warts
B) Syphilis C) Chlamydia D) Gonorrhea Sexually transmitted infections caused by bacteria include syphilis, chlamydia, and gonorrhea. Herpes and genital warts are sexually transmitted but are caused by viruses. Herpes is caused by the herpes simplex virus, and genital warts are caused by the human papilloma virus. STUDY TIP: Notice that the bacterial STIs are treatable with antibiotics and curable. Remembering that herpes and genital warts are not curable may help you remember that they are viruses.
A nurse is working with a patient after the patient had a heart attack and is using the PLISSIT model to address sexuality needs. For the SS phase, what action by the nurse is best? A) Ask the patient if he wants to discuss sexuality B) Teach the patient positions that require less stress C) Offer the patient a referral to a sex therapist D) Direct the patient to speak with the doctor about sex
B) Teach the patient positions that require less stress The PLISSIT model is a framework for addressing sexuality. In the SS (specific suggestions) phase, the nurse provides information that allows the patient to proceed with sexual relations. Informing the patient about sexual positions that are less stressful on the heart is an example. P stands for permission. LI stands for basic, limited information, and IT stands for intensive therapy.
The nurse learns that spermatozoa are produced in which sexual organ? A) Scrotum B) Testes C) Glans D) Prostate
B) Testes The male testes produce spermatozoa and the male hormone testosterone
A patient has developed vaginal discharge accompanied by pain and flu-like symptoms after having unsafe sex. Which disease should the nurse assess for in the patient? A) Syphilis B) Gonorrhea C) Chlamydia D) Genital herpes
C) Chlamydia Chlamydia is a sexually transmitted disease caused by a bacterial infection. Painful urination, genital discharge, fever, and flu-like symptoms are the symptoms of chlamydia. Syphilis and gonorrhea are sexually transmitted bacterial infections that present with sores and mucous membrane lesions. Genital discharge is a symptom of gonorrhea; however, flu-like symptoms are not evident. Genital herpes is a virally transmitted sexual infection; its symptoms include sores and itching.
A male patient experiencing dysuria and urethral discharge is diagnosed with nongonococcal urethritis. Which sexually transmitted infection is responsible for urethritis in the patient? A) Human immunodeficiency virus (HIV) B) Syphilis C) Chlamydia D) Mycoplasma
C) Chlamydia Chlamydia is responsible for causing nongonococcal urethritis in male patients. HIV is not directly involved in causing urethral infections. HIV presents with nonspecific symptoms such as fever, headache, and sore throat. Syphilis does not cause urethritis. The first sign of syphilis is a painless chancre in the genitals. Mycoplasma usually causes respiratory infections.
A couple approaches the nurse for advice on contraception. Which method suggested by the nurse does not require a health care provider's prescription? A) Hormonal injection B) Subdermal implant C) Condom D) Intrauterine device
C) Condom A condom is a barrier method of contraception. It is a thin rubber sheath worn on the penis to prevent sperm from entering the vagina. Hormonal injections are hormonal preparations to prevent pregnancy and must be prescribed by a health care provider. The subdermal implants are hormonal preparations placed under the skin. They must be prescribed by a health care provider. An intrauterine device is a plastic or copper device placed inside the uterus through the cervical opening. An IUD is inserted by a health care provider.
A patient who is on antihistamine therapy reports vaginal dryness. Which reason explains the patient's discomfort? A) Increased secretions of the Brunner's glands B) Increased secretions from the prostatic gland C) Decreased secretions of the Bartholin's glands D) Decreased secretions of the Montgomery's glands
C) Decreased secretions of the Bartholin's glands The Bartholin's glands are present in the vaginal vestibule of the female reproductive system. These glands help in lubricating the vaginal introitus during sexual intercourse. Antihistamines decrease the secretions from the Bartholin's glands, which leads to vaginal dryness and discomfort during intercourse. Brunner's glands are present in the duodenum; their secretions lubricate the intestinal walls and protect the duodenum from the acidic contents of the stomach. The prostate gland is a part of the male reproductive system that aids in the production of semen, which helps in the nourishment and protection of sperm cells against the acidic environment of the vagina. Montgomery's glands are located near the female breasts and secrete a fluid that helps lubricate and protect the breasts while lactating.
A nurse in the emergency department wants to screen a patient for domestic violence, but the woman's partner won't leave. What action by the nurse is best? A) Ask the questions anyway B) Tell the partner to leave C) Go with the patient to the bathroom D) Skip the abuse assessment
C) Go with the patient to the bathroom Nurses are required to screen for domestic abuse. The nurse needs to provide complete privacy during this assessment. If the partner won't leave, the nurse can go with the patient to the bathroom under the guise of obtaining a urine sample and ask the questions there. Telling the partner to leave will most likely increase the partner's vigilance. Skipping the assessment is not an option.
A woman comes to the clinic for a general health checkup. The patient wants more information about intrauterine devices (IUDs). Which information would the nurse include when teaching the patient about IUDs? A) It is an oral medication to be consumed regularly B) It is a surgery in which fallopian tubes are ligated C) It is a copper or plastic contraceptive device that is inserted in the uterus through the cervical opening D) It is a round rubber dome that is inserted in the vagina with spermicide and acts as barrier during intercourse
C) It is a copper or plastic contraceptive device that is inserted in the uterus through the cervical opening An IUD is copper or plastic and is inserted in the uterus through the cervical opening. An IUD may contain progesterone or copper which change the uterine lining, thus reducing the chance of implantation. Oral contraceptive pills are consumed on a daily basis for contraception. Tubal ligation is a surgery in which the fallopian tubes are ligated to avoid pregnancy. A diaphragm or cervical cap is a rubber dome that is inserted in the vagina with spermicide by the patient before intercourse. A diaphragm or cervical cap acts as a barrier during intercourse, and the spermicide kills sperm that get past it.
A patient has decided to use a diaphragm as a mode of contraception. Which advice does the nurse provide to the patient? Select all that apply. A) It should be used along with an intrauterine device (IUD) B) It should be used along with condoms C) It should be refitted after pregnancy D) It should be used with a contraceptive cream E) It should be removed after 3 weeks
C) It should be refitted after pregnancy D) It should be used with a contraceptive cream Diaphragms require refitting after pregnancy due to cervical changes during and after childbirth. Diaphragms should always be used with contraceptive creams (spermicides) to ensure their effectiveness. An IUD is placed inside the uterus for its contraceptive effects. A patient using an IUD need not use a diaphragm. Although not necessary for contraception in addition to a diaphragm with spermicide, condoms can be used with a diaphragm and spermicide to decrease transmission of sexually transmitted infections. Vaginal rings, not diaphragms, should be used for 3 weeks of every month and removed the remaining week.
A nurse is caring for a victim of domestic violence. What charting by the nurse is most appropriate? A) Patient allegedly beat up by her boyfriend B) Patient has several bruises on the legs C) Patient states, "My boyfriend hit me with a hammer." D) Patient claims she was assaulted last night.
C) Patient states, "My boyfriend hit me with a hammer." Good charting is objective and detailed. Using the patient's own words, in quotation marks, is the most accurate example of documentation. The nurse should not use words like "allegedly" or "claims" because they seem to cast doubt on the patient's story. The bruises on the legs need to be measured and described more fully.
Which sexual health characteristics would the nurse find in a 10-year-old child? Select all that apply. A) The child explores masturbation B) The child explores homosexuality C) The child makes same-sex friends D) The child asks questions about sex E) The child explores his or her body parts
C) The child makes same-sex friends. D) The child asks questions about sex. Children are usually aware of their gender identity by the age of 10 years; hence they show a preference for friendship with children of the same gender. Children at this age begin to ask questions about physical and emotional aspects of sex. Adolescents are children between the ages of 13 and 18 years. It is during the adolescent stage that children begin to explore masturbation and homosexuality. Preschoolers, those between 3 and 5 years of age, are curious about changes in their body, so they begin to explore their body parts.
A patient states, "I just don't conform to my gender role." What does the nurse understand about this statement? A) The patient is a homosexual B) The patient's behaviors are abnormal C) The patient's actions differ from what is expected D) The patient is having a gender crisis
C) The patient's actions differ from what is expected Gender roles are socially imposed "rules" about the behavior appropriate for men and women. When someone does not conform to gender role expectations, his/her behaviors are at odds with those expected by society. The patient is not necessarily homosexual, abnormal, or having a crisis.
A couple has tested positive for the human immunodeficiency virus (HIV). Which education would the nurse include for this couple? A) They should not engage in sexual intercourse. B) Their children will also be HIV positive. C) Their duration of survival would increase with treatment. D) They can be cured by highly active antiretroviral therapy (HAART).
C) Their duration of survival would increase with treatment. The survival rate for HIV-positive individuals is approximately 10 years if left untreated. Survival rates have improved with the use of antiretroviral drugs. This couple already has the disease; therefore they may have sexual intercourse with each other. Children are at risk, but not all children born to HIV-positive mothers are positive for HIV. HAART greatly increases the longevity of infected individuals, but does not cure the disease.
A female patient asks the nurse to identify the most effective contraceptive method. Which contraceptive method should the nurse suggest to the patient? A) Diaphragm B) Cervical cap C) Tubal ligation D) Oral contraceptive pills
C) Tubal ligation A tubal ligation is a surgical procedure in which the fallopian tubes are severed or tied. As a result, the egg cannot travel through the tube, so sperm cells are unable to fertilize the egg. If the tubes are ligated, the sperm cells cannot fuse with the egg. Besides abstinence, tubal ligation is the most effective contraceptive method. A diaphragm is a barrier device that is inserted into the vagina to prevent the entry of sperm cells. These are available in various sizes. If a proper-fitting diaphragm is not inserted into the vagina, the patient may become pregnant. A cervical cap is a small barrier device that covers the cervix. It is effective only when used properly, and the patient should ensure that the device covers the cervix before each act of intercourse. Oral contraceptive pills are effective when used as directed; however, when a patient on contraceptive pills takes certain antibiotics and antacids, the pill's effectiveness is reduced. STUDY TIP: Use caution when characterizing sterilization methods (tubal ligation or vasectomy) as just contraception with patients. Most contraceptive methods can be reversed; sterilization can only sometimes be reversed. Although sterilization via tubal ligation is the most effective contraceptive method for women other than abstinence, patients need to be sure they do not want to be pregnant for the rest of their lives before using this method.
A male patient takes a medication known to cause erectile dysfunction. What action by the nurse is best? A) State, "If this medication has bad side effects, talk to your doctor." B) Ask, "Are you having any sexual problems in your life right now?" C) Give the patient written information on the side effects of the drug. D) State, "Many men have erectile dysfunction on this drug."
D) State, "Many men have erectile dysfunction on this drug." Giving the patient factual information is best. The nurse can follow up on this statement by asking the patient if the medication is affecting his sexuality. "Bad side effects" is vague, as is "any sexual problems." Written information may be helpful, but the patient may not be literate and this does not allow the nurse to be engaged with the patient.
Which medication prescribed by a health care provider might be responsible for a patient developing erectile dysfunction? A) Antibiotics B) Anticoagulants C) Antiulcer agents D) Antihypertensives
D) Antihypertensives Ejaculation is a phase of sexual intercourse. During this phase, the sperm cells reach the tip of penis. It is a complex process controlled by the alpha-receptors in the prostate gland and seminal vesicles. Antihypertensive drugs used for controlling high blood pressure block the alpha-receptors, which leads to altered sexual functioning. Hence antihypertensive drugs may be responsible for erectile dysfunction. Antibiotics are used for the treatment of infections; these do not affect the alpha-receptors and therefore do not interfere with the process of ejaculation. Anticoagulants are used to dissolve blood clots and have no effect on the ejaculation process. Antiulcer agents are used to treat stomach and duodenal ulcers and do not act on alpha-receptors or ejaculation. STUDY TIP: Medication that affects the vasculature can affect erection, because erection relies on the shunting of blood to the penis.
Which gland in the vagina secretes lubricants during sexual stimulation? A) Skene's gland B) Cowper's gland C) Brunner's gland D) Bartholin's gland
D) Bartholin's gland Bartholin's gland is located in the vagina; it secretes vaginal lubricants during sexual stimulation. Skene's gland also produces vaginal lubricants during sexual stimulation, but it is located in the urethra. Cowper's gland is located at the base of the penis; its secretions protect sperm cells as they pass through the urethra during ejaculation. Brunner's glands are located in the duodenum; their secretions lubricate the intestinal walls and protect the duodenum from the acidic contents of the stomach.
During an interview of a male patient, the nurse finds that the patient has multiple sex partners and is at risk for contracting a sexually transmitted infection (STI). Which symptom may suggest an STI? A) Diarrhea B) Vomiting C) Pain in the testes D) Blisters or sores on the penis
D) Blisters or sores on the penis Identification of a STI can be difficult, because symptoms may go unnoticed or be ignored. Common STI symptoms include pain during sexual intercourse or on urination; genital blisters or lesions; discharge from the penis, anus, or vagina; and an elevated temperature. Diarrhea and vomiting indicate a gastrointestinal problem. Pain in the testicles is not commonly seen in STIs. It may occur due to injury to the testes or in the case of testicular torsion.
A school nurse is planning a sex education activity. What information from research does the nurse apply to this education? A) Sex education should be taught in high school B) The school nurse should be the primary source of sex education C) The method of birth control that should be presented is abstinence. D) Parents' open communication regarding sex education has a positive impact on their children.
D) Parents' open communication regarding sex education has a positive impact on their children. According to research, parents should be encouraged to have open communication with their children regarding sex educations. The study noted sex education initiated in the sixth grade had an overall positive effect in delaying sexual activity. The school-based program is secondary to parental input and supports that input by providing knowledge and skill building. Open communication would encourage discussion of a variety of birth control methods.
The nursing student learns that the function of the hypothalamus is to do which of the following? A) Cause lactation to begin B) Produce spermatozoa C) Release follicle-stimulating hormone D) Release gonadotropin-releasing hormone
D) Release gonadotropin-releasing hormone. The menstrual cycle is under the influence of the hypothalamus and gonadotropin-releasing hormone.
A patient is prescribed antihypertensive therapy. Which information should the nurse provide to the patient about sexual activity? A) The patient may have delayed ejaculation B) The patient's sexual desire may increase C) The medication may lessen vaginal lubrication D) The medication may cause erectile dysfunction
D) The medication may cause erectile dysfunction Erectile dysfunction is a fertility disorder characterized by an inability to achieve or maintain an erection during sexual intercourse. Antihypertensive medications reduce blood pressure, which results in decreased blood flow to the penis and in turn leads to erectile dysfunction. Antihypertensive medications, especially calcium channel blockers, may decrease male and female desire. Ejaculation may be delayed in patients who take narcotics or antipsychotic medications. The use of anticonvulsant medications leads to an impaired orgasmic phase and results in decreased sexual desire. Antihistamines decrease the secretions necessary for the lubrication of the vagina and lead to painful intercourse.
A patient complains of dyspareunia. She is diagnosed with impaired sexual functioning (ICNP) associated with decreased sexual desire. Which instructions should be provided to the patient? Select all that apply. A) Perform exercise to increase sexual desire. B) Suggest the use of contraceptive medications and devices. C) Suggest increasing the amount of alcohol consumption per day. D) Use water-soluble lubricants before sexual intercourse. E) Explore alternative, acceptable, and more satisfying sexual practices.
D) Use water-soluble lubricants before sexual intercourse. E) Explore alternative, acceptable, and more satisfying sexual practices. Dyspareunia is defined as painful sexual intercourse. Goals for a patient with dyspareunia are less pain and greater satisfaction during sexual activity. The use of a water-soluble lubricant may reduce friction during sexual intercourse, making it less painful. Learning alternative sexual practices may be beneficial to a patient experiencing dyspareunia. Exercise may help with endurance but will not increase sexual desire. Contraceptive medications and devices may prevent pregnancy but will not increase sexual desire or resolve dyspareunia. A moderate amount of alcohol may lower inhibition but may actually reduce sexual function.
