Chapter 45- Sexuality
The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is:
condoms.
The nurse is discussing contraception with an adolescent client who asks the nurse: "What if I can't have an orgasm?" What is the nurse's best response?
"A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm."
A nurse practitioner is teaching the student about sexual health and is evaluating the student's knowledge of sexual identity. The practitioner knows that the student understands when the student says which of the following?
"Gender role behavior is the behavior a person conveys about being male or female."
A 16-year-old girl tells the nurse that her friend has genital warts and asks the nurse how to make sure that she does not get them. Which of the following should the nurse recommend?
"Get the human papillomavirus vaccine."
Which assessment question is most likely to yield clinically meaningful data about a female client's sexual identity?
"How do you feel about yourself as a woman?"
The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education?
"I can leave my diaphragm in for up to 48 hours."
A gerontology nurse is discussing sexual dysfunction with an older adult male client. The nurse determines that the education has been effective when the client states:
"Malnutrition may cause impotence."
A teenage female client tells the nurse that she is having intercourse with her boyfriend. The client asks the nurse about methods to prevent pregnancy. Which statement by the nurse would be most accurate?
"Many unintended pregnancies result from the use of less effective methods of contraception."
A nurse reads in a client's chart that he or she has gender dysphoria. The nurse determines that the client understands the diagnosis when making what statement?
"People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria."
The nurse has provided information to a client about oral contraceptives. Which statement by the client would indicate a need for further education?
"Some oral contraceptives protect against STIs."
Parent's of a 5-year-old child inform the nurse that they are concerned about finding their child masturbating in the bathroom. What is the best response to the parents by the nurse?
"This is a normal behavior for this age group, because 5-year-olds are increasingly aware of self."
A middle-aged male client is in the clinic for a routine blood pressure check. During the health history he mentions to the nurse that he is concerned that his wife is "unhappy with their love life." Which of the following question is best for the nurse to ask?
"What makes you think she is unhappy? What has happened?"
The nurse assessing an adolescent's need for further information regarding sexual health should ask which question?
"What questions or concerns do you have about your sexual health?"
The nurse is teaching a male adolescent how to use a condom. Which teaching points would the nurse include? Select all that apply.
-"If the condom does not have a nipple receptacle, leave a small space at the end for semen to collect." -"Use a condom with every act of intercourse." -"Immediately after ejaculation remove the condom and discard it."
A 28-year-old male comes to the clinic for an evaluation. The client complains of a penile discharge. After completing an assessment, the nurse suspects that the client has a chlamydia infection based on which finding? Select all that apply.
-Burning on urination -Swollen testes -Testicular pain
The nurse is advising an adolescent male about sexual myths that have him concerned. Which statements describe accurate client education regarding these concerns? Select all that apply.
-Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. -No male or female should feel pressured into sexual activity at any age. -Nocturnal emissions are normal in men of all ages.
Applying the American Psychiatric Association description of sexual response, place the phases in the order in which they would occur from first to last.
1. Appetitive 2. Excitement 3. Orgasm 4. Resolution
The nurse recommends a barrier method of contraception for a client who is concerned about the side effects of hormonal contraception. Which method might the nurse suggest?
Cervical cap
A nurse is counseling a couple who expressed that they are having difficulty conceiving. What could the nurse consider as a cause?
Changing developmental stage
A woman age 49 years has sought care from her primary care provider because of "intimacy problems." Upon questioning, the woman reveals that she is experiencing sexual desire, but that intercourse causes her significant pain. In the absence of sexual activity, the woman states that she does not have any significant vaginal discomfort. What would the clinician recognize that this client is most likely experiencing?
Dyspareunia
A nurse is explaining premenstrual syndrome to a female client. The client demonstrates understands when stating what may occur in the premenstrual phase?
Headache
A man 68 years of age comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the client's history, what might the nurse note that contributes to impotence?
History of hypertension
The forensic nurse is caring for a client who was raped four days ago. Which of the following could the nurse teach the client is an effective contraceptive?
Insertion of a copper intrauterine device (IUD)
During the menstrual cycle, when does ovulation typically take place?
On day 14
The nurse prepares to complete an exam on a 25 year old female. The client presents to the community health clinic reporting difficulty with urination. The nurse reviews the chart and sees that the client is originally from Africa. Which does the nurse suspect?
Possible complications from female genital mutilation (FGM) requiring further physical assessment
The nurse is assessing the sexual health of a female client age 20 years. During the interview, the client says, "I feel that my vaginal opening constricts whenever I am about to have intercourse. I seem to have no control over it." What would the nurse use when documenting the client's report?
Vaginismus
During hospitalization for a suicide attempt, the client informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he gives her a paycheck. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior and is called what?
Quid pro quo harassment.
A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs?
STIs are most prevalent among teenagers and young adults.
Which of the following statements best describes the relationship between biologic sex and gender identity?
Sex is chromosomally determined, while gender is a psychosocial construct.
The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by Cathleen, a 54-year-old female, who eventually discloses to the nurse that she is having a sexual affair with a female partner. The term for an individual's preference for a partner of a particular gender is which of the following?
Sexual orientation
A client tells the nurse that she and her husband have selected periodic abstinence as their choice of contraception. Which is the best method for the nurse to recommend to monitor fertility?
Symptothermal method
Traditionally, the male sexual response is thought to be broken up into three phases. Which occurrence is part of the plateau phase?
The circumference of the penis thickens at the coronal ridge and a few drops of fluid appear at the urethral meatus.
The nurse caring for clients in a physician's office takes into consideration developmental stage when assessing sexuality. Which is an example of a developmentally appropriate intervention?
The nurse teaches parents of a 4-year-old that they may cause anxiety in the child by intolerance of inconsistency of sex-role behavior.
A client visits a community clinic reporting a foul-smelling vaginal discharge that is thin, foamy, and green in color; itching of vulva and vagina; and burning on urination. Which STI would the nurse suspect?
Trichomonas vaginalis
Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina?
Trichomoniasis
A female client tells the nurse that vaginal intercourse with her partner is not as exciting as it used to be. Which of the following could the nurse teach her?
Use of Kegel exercises
A male client comes to the clinic because he thinks that he has syphilis. Which test would the nurse expect the client to have done?
VDRL
During a routine physical exam, a male client informs the nurse that he frequently participates in anal intercourse with his new girlfriend. The nurse discusses this practice with the client by informing him that:
condoms are recommended for anal intercourse.
When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is:
excitement phase.
During the orgasmic phase of the sexual response, the woman may experience:
hypertension.
When the mother of a 2-year-old tells the pediatric nurse that the child masturbates, the nurse informs the mother that the child:
is exhibiting normal behavior.
A nurse is teaching a sex education class to a group of teenage girls. They ask the nurse about the sexual response cycle in females. Which physiologic response does the nurse tell them is only seen in females?
loss of muscular control during orgasm causing spastic contractions
During the plateau phase of the sexual response, the man may experience:
nipple erection.
The nurse is caring for a client diagnosed with vaginismus. When reviewing the client's history, what would the nurse would expect to find?
past history of a rape
When a 19-year-old male client tells the nurse that he has never been able to achieve an erection, the nurse recognizes that the client is experiencing:
primary impotence.
The Surgeon General's Call To Action To Promote Sexual Health and Responsible Sexual Behavior was released in 2001. The goal of this document is to:
promote general health and wellness.
The nurse should instruct an Islamic female client who is reluctant to undergo pelvic examination from an assigned male health care provider to:
seek a female health care provider to perform the examination.
The nurse is preparing to provide education to a group of high school students on sexually transmitted infection (STI) prevention. The nurse knows that this age group often uses oral-genital stimulation as a way to prevent pregnancy. Which concept should the nurse make sure to convey to the group?
skin-to-skin contact can spread herpes and genital warts
The nurse is speaking to a client regarding his sexual history. The client states, "I was born with a penis but I should have had a vagina." The nurse would document the client's gender identity as:
transsexual.
