NURS230 Ch40- sexuality

During a physical assessment, a client tells the nurse that his penis "hurts" when the shaft is touched. What should the nurse suspect is occurring with this client? 1. Urethral stricture 2. Acute orchitis 3. Inflammatory disease 4. Acute epididymitis

1

A nurse colleague learns that a grandchilds day-care center is planning a class on sexuality for 3- and 4-year-olds. Discussion of this plan should include what concept? 1. At this age, education regarding sexuality should come from parents. 2. Children are sexual beings from before birth. 3. Understanding the body and sexuality are a part of growth and development. 4. Sexual activity is beginning at earlier and earlier ages.

1

A post-menopausal client is experiencing painful intercourse. What is the most appropriate response by the nurse? 1. "Using a water-based lubricant may be helpful." 2. "Reducing the frequency of intercourse may help you." 3. "I will refer you to a psychiatrist." 4. "Continue what you've been doing. Nothing should have changed."

1

A research article the nurse is reading discusses the prevalence of androgyny in persons 20 to 30 years old. What should the nurse keep in mind when caring for clients who are androgynous? 1. They do not limit behaviors to one gender over the other. 2. They are attracted to people of the same gender. 3. They often repress their sexual feelings. 4. They hold rigid stereotyped gender role expectations.

1

During a sexual assessment, a client tells the nurse about a preference for oralgenital sex. How should the nurse instruct this client? 1. Explain the need to follow safe sex practices. 2. Explain the need to use contraception. 3. Explain the importance of having an annual HIV test. 4. Explain thy routine gynecologic examinations are not necessary.

1

The high school student tells the school nurse that during biology the class learned that alcohol is associated with erectile dysfunction. The student wonders why so many girls get pregnant during evenings when alcohol is consumed. The nurse should plan a response based upon which concept? 1. Alcohol is a central nervous system depressant that affects judgment. 2. Erectile dysfunction only occurs after years of alcohol abuse. 3. Alcohol is a sexual stimulant. 4. Erectile dysfunction occurs only in men older than 50.

1

The nurse is counseling a woman who has multiple sexual partners and has recently been diagnosed with the human papillomavirus (HPV). The importance of regularly scheduled Pap smears is discussed primarily because: 1. This woman has a high risk for cervical cancer 2. Her sexual practices also put her at risk for HIV 3. This woman's age puts her at risk for uterine cancer 4. Regular screening results in improved client outcomes

1

The nurse is developing strategies for the relief of menstrual cramping to teach a group of young clients. What should be the focus of these strategies? 1. Increase of blood flow to the uterine muscle 2. Avoidance of uterine contraction 3. Minimization of menstrual flow 4. Decrease in estrogen production

1

The nurse is preparing educational materials to be used when instructing clients on testicu-lar and breast self-examination. What would be applicable for both sets of instructions? Page 948 1. Perform palpation in the shower. 2. Perform the examination lying down. 3. Perform the examination once each week. 4. Perform the examination bimonthly.

1

The nurse uses the PLISSIT format in helping clients who have sexual dysfunction. Which action by the nurse best reflects the SS section of this format? 1. Use the nurses knowledge about how disease affects sexuality to offer specific suggestions for the client. 2. Focus interventions on explaining the somatic sexual difficulties and their treatment. 3. Offer the client a list of expected sexual side effects of drugs or treatments. 4. Identify any concerns the client has regarding attraction to the same sex.

1

The parent of a 20-month-old is very concerned because the baby touches the genital area during diaper changes. How should the nurse respond to this concern? 1. At 20 months this touching is not a sexual experience. 2. Masturbation to orgasm is common and normal at this age. 3. Genital stimulation should not be occurring until the age of 2 1/2 or 3. 4. Babies are sexual beings, but this activity should be discouraged.

1

The client exhibits inappropriate sexual behavior. What are some strategies the nurse should use? (Select all that apply) 1. Communicate that the behavior is not acceptable 2. Tell the client how the behavior makes you feel 3. Set firm limits on the behavior 4. Report the incident to the facility's security officer

1,2,3

The nurse is preparing to assess a client's sexual health. What will the nurse include in this assessment? Select all that apply. Page 938 1. Sexual self-concept 2. Body image 3. Gender identity 4. Contraceptive choices 5. Employment

1,2,3

The nurse who is discussing responsible sexual behavior with a group of clients should include which of the following points? Select all that apply. 1. Limit the number of sexual partners 2. Talk openly to your partner about how to have "safe sex" 3. Effectiveness and cost of various contraceptive methods 4. The only goal is to avoid sexual harassment and abuse

1,2,3

After an assessment, the nurse determines that a client has strong sexual health. What did the nurse assess in the client? Select all that apply 1. Knowledge about sexual behavior 2. Discussing sexual problems with healthcare provider 3. Reluctance to discuss sexual history 4. Utilization of birth control method that fits lifestyle 5 Statement that there are no issues with sexuality

1,2,4

The nurse who is teaching a client breast self-examination describes inspection of the breasts before a mirror. Which findings should the nurse tell the client should be evaluated by a health care provider? (Select all that apply.) page 948 1. Puckering of the skin 2. Flattening of the breast from the side view 3. Free movement of the breast over the chest wall 4. Symmetry of the nipples 5. Change in shape

1,2,5

What are factors affecting sexuality? (Select all that apply) 1. Culture 2. Root beer consumption 3. Religion 4. Medications

1,3,4

When discussing sexually transmitted diseases (STDs) with a group of college students, the nurse identifies which of the following as the more common signs and symptoms? (Select all that apply.) 1. Fever 2. Joint pain 3. Anal discharge 4. Genital lesions 5. Painful urination

1,3,4,5

When discussing the orgasmic phase of the sexual response cycle, what should the nurse include as physiological changes that affect both sexes? Select all that apply 1. Systolic blood pressure can increase 20-30 mm Hg above normal. 2. The heart rate decreases to 20 beats below normal. 3. Involuntary muscle spasms occur throughout the body. 4. Diastolic blood pressure can decrease 20-50 mm Hg below normal. 5. The respiratory rate can increase up to 40 breaths per minute.

1,3,5

The most common characteristics shared by individuals most likely to contract a sexually transmitted disease (STD) are which of the following? (Select all that apply.) 1. Frequently engage in unprotected sex 2. Possess poor reading skills 3. Are economically deprived 4. Have multiple sexual partners

1,4

The nurse is teaching a class of young adult men and women. What self-examination schedules should the nurse instruct these participants to follow? Standard Text: Select all that apply. 1. Monthly breast self-exams for women 2. Yearly breast self-exams for men 3. Weekly testicular self-exams for men 4. Monthly breast self-exams for men 5. Yearly vulvar self-exams for women

1,4

A school nurse is responsible for teaching adolescents about sexually transmitted infections (STIs). When discussing chlamydia, the nurse explains that it is: 1. A viral infection that cannot be cured 2. Treated with a full course of antibiotics 3. Contracted via blood-borne exchange 4. Prevented with the use of spermicides

2

A young adult single mother of a second-grade child has to make a decision regarding the teacher her child will have in third grade and asks the nurse for advice. All other variables being equal, which choice is best? 1. A woman with 35 years of teaching experience 2. A man who is 40 years old 3. A newly graduated 22-year-old man 4. A 30-year-old woman

2

During a health history, the nurse learns that a client has a recent onset of impotence. Which question will help identify a potential cause of this manifestation? 1. "Does this occur often?" 2. "For what diseases and disorders have you been treated?" 3. "Are you on any medications?" 4. "How does your partner feel about this problem?"

2

During a routine physical, an 11-year-old tells the nurse that many students in school are doing it. How should the nurse respond to this statement? 1. Tell the client to talk with parents about sexual matters. 2. Ask what doing it means to this client. 3. State that sexual activity is not appropriate at age 11. 4. Stay silent and wait for the client to continue the discussion.

2

In discussion with teenagers, the nurse chooses to use the term sexually transmitted infection rather than sexually transmitted disease. What is the rationale for this choice? 1. Infection is a much more precise term for the transmission that occurs. 2. The word disease may elicit guilt, shame, and fear in the client. 3. Sexually transmitted disease does not receive as much third-party reimbursement as does sexually transmitted infection. 4. These terms can be used interchangeably and there is no good rationale for using one over the other.

2

The daughters of an 80-year-old man who is aphasic after suffering a cerebrovascular acci-dent (stroke) express concern that their father is "always exposing and playing with him-self and his catheter" while they are in the room. Upon assessment, the nurse finds the cli-ent pulling on and rubbing his penis. What is the nurse's priority action? Page 951 1. Tell the client to keep his hands away from his penis. 2. Assess the client's penis for irritation from the catheter. 3. Ask the client to keep his linens at waist level when he has visitors. 4. Collaborate with the physician regarding medications to control this behavior.

2

The mother of a 5-year-old tells the nurse that her daughter has always been closer to her than to her husband. The mother expresses concern that, over the last 2 months, the little girl wants to spend all of her time with her father instead of with the mother. The nurse recognizes that this behavior: page 935 1.May indicate sexual abuse by the father and should be further investigated. 2. Is a normal expectation of a preschooler developing sexuality. 3. Indicates that the girl is overidentifying with the male gender. 4. Can be a sign of precocious puberty and should be monitored.

2

The nurse is discussing the resolution phase of the sexual response cycle with a group of students in a health education class. What should be included as a physiological change that affects males only? 1. Genitalia and breasts return to pre-excitement states. 2. There is a refractory period during which the body will not respond to sexual stimulation. 3. The heart rate returns to normal. 4. Possible sleepiness or intense relaxation may occur.

2

The nurse uses the PLISSIT format in helping clients who have sexual dysfunction. Which action by the nurse best reflects the LI section of this format? 1. In order to avoid causing anxiety, limit the amount of information given to clients regarding adverse sexual side effects of treatments or medications. 2. Give the client accurate but concise information in regard to any sexual questions that might be asked. 3. State information using slang terms to refer to sexual body parts because the client is not likely to know the proper terms. 4. Review current research literature associated with the sexual concerns of the client and partner.

2

What is the most common reason for clients with sexually transmitted infections (STIs) to remain untreated? 1. Inability to access health care services 2. Feelings of shame, guilt, and fear 3. Insufficient respect for the seriousness of the disease 4. Not recognizing that there is a problem

2

Which of the following is prevalent among adolescent females? 1.Vaginal dryness 2.Dysmenorrhea 3.Decreased vaginal elasticity 4. Pain during intercourse

2

Which statement made by a postmenopausal client should the nurse evaluate as indicating the need for further assessment? 1. For some reason, I have more sexual desire than ever." 2. I am so glad that I don't need to worry about sex anymore." 3. I use water-soluble lubricant to treat my vaginal dryness." 4. Sex certainly takes longer than it used to, but I'm getting used to that."

2

he nurse enters the room and finds the adult client masturbating. What action should the nurse take? Page 937 1. Tell the client that masturbation is harmful to sexual well-being. 2. Say "excuse me" and leave the room. 3. Request that the client stop so that care can be provided. 4. Ask the client if there are any sexual concerns that should be discussed.

2

The nurse is conducting a sexual health history with a client. What questions should the nurse ask during this history? Standard Text: Select all that apply. 1. What are your erotic fantasies? 2. Are you currently sexually active? 3. Do you experience any pain with sexual interaction? 4. Do you have difficulty with sexual desire? 5. What do you like the best about having sex?

2,3,4

After reviewing a list of prescribed medications, the nurse plans to complete a sexual histo-ry with the client. Which medications in the client's list caused the nurse to make this clini-cal decision? Select all that apply. Page 944 1. Antibiotics 2. Antipyretics 3. Cardiotonics 4. Beta-blockers 5. Anticoagulants

3,4

While the nurse is measuring blood pressure, the client lifts his hand and fondles the nurse's breast. What should the nurse do about this behavior? Select all that apply. Page 951 1. Ignore the fondling. 2. Move the client's hand away. 3. Refocus the client on appropriate behavior. 4. Tell the client to stop performing the behavior. 5. Communicate that the behavior is not acceptable.

2,3,4,5

A female client complains of having a "strange discharge" from the vagina and "stinging" when voiding urine. Which diagnostic test(s) would be useful to aid in the diagnosis of this client's disorder? Select all that apply. 1. Biopsy 2. Urinalysis 3. Complete blood count 4. Serum hormone levels 5. Papanicolaou smear

2,5

A client experienced female circumcision as a puberty ritual while living in Africa as a child. For which health problem should the nurse monitor the client as an adult? Page 941 1. Early menopause 2. Increased menstrual flow 3. Chronic urinary tract infection 4. Tendency for postpartum hemorrhage

3

A client is concerned because he was unable to achieve an erection during his last sexual encounter with his wife. He tells the nurse that he has worried about becoming impotent because he had a sexually transmitted infection as a young adult. What is the nurses best response to this clients concerns? 1. Sexually transmitted infections may result in sexual problems in adults. 2. Erectile dysfunction is the correct term for the inability to achieve or sustain an erection. 3. An occasional incident like this is normal and common and there is no reason to be concerned. 4. The medical diagnosis of erectile dysfunction is not made until the man has erection difficulties in 25% or more of his interactions.

3

A client speaks about an adult son who is a practicing homosexual and expresses concern by stating: I am so worried about him and I know he is going to hell. What is the most important fact for the nurse to consider in formulating a response to this clients concern? 1. Normal sexuality is described as whatever behaviors give pleasure and satisfaction to those adults involved. 2. Because alternative lifestyles are now so well accepted in society, this parent should not feel so much concern. 3. What constitutes normal sexual expression varies among cultures and religions. 4. Sexual development is genetically determined and not affected by environment.

3

A female client tells the nurse about having difficulty with sexual relations because of a re-cent weight gain. Which interventions should the nurse include when planning this client's care? 1. Sexual self-concept 2. Gender identity 3. Body image 4. Gender-role behavior

3

A female client wishes to increase the tone and sensation of the pelvic floor. What should the nurse teach the client? 1. Vaginal dilation 2. stop start technique 3. Kegel exercises 4. sensate focus exercises

3

A recently married couple is trying to conceive a child. The husband is a collegiate athlete and his coach forbids sexual activity for 2 days prior to a game. The wife asks the nurse if abstinence before the game is necessary. What is the best response? 1. As long as intercourse is not involved, there is no reason to avoid sexual activity. 2. Some residual physical weakness is common for up to 18 hours after sex. 3. This is a common myth among athletes, but there is no basis in fact. 4. In fact, sexual activity before intense physical exercise increases stamina and endurance.

3

The 45-year-old client reports that she has no interest in sex and that she and her husband have not had intercourse in 16 years. How does the nurse interpret this assessment data? 1. This couple is experiencing sexual dysfunction. 2. The woman's lack of sexual desire has resulted in impotence in her husband. 3. If both partners share the same lack of desire, there is often not a problem. 4. This situation is so unnatural, that some dysfunction is present.

3

The client tells the nurse that she makes her boyfriend stop intercourse before she has an orgasm so she will not get pregnant. What teaching is necessary for this client? 1. Even though she doesn't get pregnant, she might still get a sexually transmitted infection. 2. Intercourse until orgasm may actually reduce conception because the vaginal contractions help to expel sperm. 3. Conceiving is not related to whether or not the female partner experiences an orgasm. 4. As long as her boyfriend does not ejaculate in her vagina, conception is unlikely.

3

The female client has experienced recurrent candidiasis with intense vaginal itching and ex-coriation. After treatment the client is reexamined, and the nurse practitioner finds pres-ence of a white, cheesy discharge. What recommendation is necessary? 1. Referral to a surgeon for excision of infected tissue 2. Treatment with a stronger oral antibiotic 3. Examination and treatment of sexual partner 4. Routine douches with a topical antibiotic solution

3

The nurse has completed an assessment on an adult male client and finds that he is having difficulty having an erection. Which piece of data would most likely be the cause of the dysfunction? 1. He is over the age of 70 2. He is taking amphetamines 3. He is taking an anti-hypertensive medication 4. He is taking alpha-blockers

3

The nurse is instructing a client about the medication sildenafil (Viagra). Which client statement indicates teaching has been effective? 1. "Viagra should be taken with food." 2. "I can take Viagra anywhere from 1 to 6 hours before sex." 3. "I can take only one pill in a 24-hour period." 4. "Grapefruit juice will decrease the effects of Viagra."

3

The nurse is teaching a class on body development to a group of middle school girls. One of the girls asks about using tampons for sanitary protection during menstruation. What ad-vice should the nurse include? Page 936 1. Tampons should not be used until the menstrual cycle is well established, usually 2 to 3 years after the first period occurs. 2. Super absorbent tampons should be used at night to protect from overflow accidents. 3. Tampons should be alternated with sanitary pads to help decrease infection. 4. Tampons should be changed at least every 8 hours.

3

The nurse uses the PLISSIT format in helping clients who have sexual dysfunction. Which action by the nurse best reflects the P section of this format? Page 949 1. Ask the physician for permission to discuss sexual topics with the client. 2. Obtain signed informed consent from both the client and the spouse or partner prior to providing them with sexual information. 3. Acknowledge the client's spoken and unspoken sexual concerns when providing care. 4. Document precertification for benefits from the client's insurance company regarding sexual teaching.

3

The nurse is preparing an educational session on the sexual response cycle. What should be included when discussing the physiological changes in females during the excitement phase? Standard Text: Select all that apply. 1. The vagina dries. 2. The length of the vagina narrows and swells. 3. Erection of the clitoris occurs. 4. The breasts enlarge. 5. The uterus elevates.

3,4,5

Before giving nitroglycerin to a client the nurse should ensure that the client is not taking a medication in which class of medications? 1. Anti-hypertensives 2. Anti-depressants 3. Beta-blockers 4. Phosphodiesterase Type 5 (PDE5) Inhibitors (management of Erectile Dysfunction; exam-ple: Viagra, Cialis, Levitra)

4

During an assessment, a client tells the nurse of a desire to wear clothing that is typically associated with the opposite sex. The nurse realizes this client is describing which gender identity? 1. Intersex 2. Transgenderism 3. Homosexuality 4. Cross-dressing

4

The nurse is conducting a health history with an older client with arthritis and heart dis-ease. When gathering the sexual history for this client, what question should the nurse ask? Page 946 1. Do you have any difficulty with sexual desire and orgasm? 2. How often do you have sexual relations? 3. What type of contraception do you use? 4. Have there been any changes in your sexual functioning that might be related to your illness or the medications you take?

4

The nurse is discussing various sexual issues with a group of clients who have experienced spinal cord injuries. Which of the following statements best addresses the issue of alternative methods of personal sexual gratification? 1. "People do whatever works best for them and their partner." 2. "You don't need anyone else to approve how you engage in sex." 3. "Sex practices are private and need only to be discussed with your sexual partner." 4. "Any form of stimulation that is mutually agreed upon and satisfying is acceptable sexual practice."

4

The nurse is preparing for pelvic physical examination of a woman who has been medically diagnosed with vaginismus. What equipment should the nurse obtain for this examination? 1. Culture tubes to assess expected vaginal infection 2. Extra cleaning supplies to remove thick external secretions 3. Equipment for a pre-examination douche. 4. Smaller-than-normal vaginal speculums

4

The nurse uses the PLISSIT format in helping clients who have sexual dysfunction. Which action by the nurse best reflects the IT section of this format? 1. Use information technology such as the Internet to obtain guidance suggestions for the client. 2. Use the technique of informal therapeutic groups to assist the client and partner. 3. Evaluate previous interventions and treatment for success. 4. Recommend intensive therapy with a qualified sex therapist.

4

There is disagreement among the nursing unit staff regarding how much sexual history should be included in adult admission assessments. What standard is generally the most applicable? 1. A complete sexual history must be included in the admission history and physicals. 2. Sexual information should be pursued only if the clients chief complaint indicates possible sexual dysfunction. 3. Sexual assessment should be done by the physician and not repeated by the nurse. 4. The amount of sexual information taken will vary on a case-by-case basis.

4