5. Sexuality PrepU
Based on the nurse's knowledge of the probable first indicator of prostate cancer, which of the following questions should be included in the history and physical examination? "Are you waking up during the night to urinate?" "Do you have any perineal discomfort?" "Have you noticed a decrease in the volume of your urinary stream?" "Do you have abdominal straining with urination?"
"Do you have any perineal discomfort?" Explanation: Perineal and rectal discomfort may be the first indicators of prostate cancer. The other choices address symptoms of BPH, not cancer metastases.
A graduate nurse is completing her first health history questionnaire with a client. She needs to assess the client's sexual history at the end of the interaction. Which opening remark for this topic would be most appropriate? "How do you feel about your body?" "Now I need to ask some personal questions. Is that okay?" "Lastly, I need to ask about your sexual health and practices." "I see you have two children."
"Lastly, I need to ask about your sexual health and practices." Explanation: Obtaining the sexual history provides an opportunity to discuss sexual matters openly. This questioning should begin with an orienting sentence that will lead to a discussion of sexuality. Introducing the subject of sexuality indicates to the client that a discussion of sexual concerns is acceptable and necessary.
The nurse is reviewing the structure and function of various organs in the female reproductive system. Which information should the nurse include about the ovum in the review with the client? It contains a small nucleus, within which is a nucleolus called the germinal spot. It consists of protoplasm enclosed within a three-layered cell wall. All the ova a female will ever have are present at birth. The ovum is smaller than the sperm cell.
All the ova a female will ever have are present at birth. Explanation: It is believed that all the ova a female will ever have are present at birth. The human ovum consists of protoplasm enclosed within a two-layered cell wall. The outer layer is the zona pellucida; the inner layer is the vitelline membrane. The ovum cell contains a large nucleus, within which is a nucleolus called the germinal spot. The ovum is larger than the sperm cell, and it is the only human cell normally visible to the naked eye. Reference:
A nurse practitioner advised the mother of a 16-year-old girl, who was diagnosed with human papillomavirus (HPV), that the infection can cause cancer of the _______ in the future. Urethra Vagina Uterus Cervix
Cervix Explanation: Certain types of HPV can cause cells of the cervix to become abnormal, contributing to 70% of cervical cancers.
Culture of client's vaginal discharge reveals Gardnerella vaginalis. Which of the following would the nurse expect to assess? Yellowish white discharge Foul foamy discharge Thick curdy white discharge Fishy smelling watery discharge
Fishy smelling watery discharge Explanation: Gardnerella vaginalis is associated with a gray white, watery, fishy smelling vaginal discharge. The discharge associated with a Candida infection is curdy white, thick, and strong. Discharge due to trichomonas vaginalis is yellow white, foamy, and foul.
A nurse is obtaining health history from a young adult woman. Which of the following would alert the nurse to a possible problem? Age of 13 years at menarche Menstrual cycle averaging 28 to 29 days Mucus-like vaginal discharge Reports of dyspareunia
Reports of dyspareunia Explanation: Dyspareunia, or pain with intercourse, is an abnormal finding associated with numerous potential problems. Onset of menarche is usually between 12 to 14 years but could be as early as age 10 or 11 years. The menstrual cycle typically averages 28 days but it can vary from 21 to 42 days. A mucus-like vaginal discharge is normal.
The nurse is reviewing the causative organisms noted on laboratory reports. Which organism is transmitted solely by sexual contact? Bacillus Trichomonas Borelli Cholera Bacterium
Trichomonas Explanation: The organism transmitted solely by sexual contact is Trichomonas. The other organisms are causes of various infections and acquired in various ways.
A nurse is asking questions about a client's sexual history. It is important for the nurse to: pull the curtains in a semiprivate room. evaluate the client's past history of sexual dysfunction. provide a time that enhances openness. collect data in a quiet, private environment.
collect data in a quiet, private environment. Explanation: An assessment is best performed in a quiet, private setting that lends itself to the discussion of sensitive, personal, and confidential information.
A nurse is asked to teach a woman to take her basal body temperature daily to assess the time of ovulation. She can detect her day of ovulation, following ovulation, because her temperature will: decrease a degree. increase a degree. no longer reflect basal body temperature. fluctuate a degree daily.
increase a degree. Explanation: The effect of progesterone, released with ovulation, is to increase body temperature.
A female client comes to the clinic and tells the nurse, "I think I have another vaginal infection and I also have some wartlike lesions on my vagina. This is happening quite often." What should the nurse consult with the physician regarding? testing the client for the presence of HIV instructing the client to wear cotton underwear using a medicated douche in order to keep the vaginal pH normal having the client abstain from sexual activity for 6 weeks while the medication is working
testing the client for the presence of HIV Explanation: Abnormal results of Papanicolaou tests, genital warts, pelvic inflammatory disease, and persistent vaginitis may correlate with HIV infection. Wearing cotton underwear can help with the prevention of candidiasis but does not address the recurrent vaginal infection that may not be caused by a fungus. Abstaining from sexual intercourse does not address the recurrent vaginal infection. A medicated douche can alter the normal flora of the vaginal wall.
A school nurse is talking to an adolescent, who asks her about why she has monthly menstrual cycles. The best explanation that the nurse can offer the adolescent regarding the menstrual phase is to tell her that: her uterus fills up with blood each month and is passed during the menstrual cycle. the uterine lining is being shed due to lowering of hormone levels. each month, her uterine lining thins out and vessels close to the surface begin to fill with blood. her hormones cause her to accumulate blood in the uterus from ovulation.
the uterine lining is being shed due to lowering of hormone levels. Explanation: During the menstrual phase of the cycle, the endometrium, or lining of the uterus, is shed because of low estrogen and progesterone levels. The uterus does not fill up with blood monthly, nor does her hormones cause blood accumulation on the uterus. Also, the uterine lining thickens (rather than thins out) each month in preparation of implantation of the fertilized egg.
A nurse is instructing a client on birth control methods. The client asks about the cervical mucus method. When should the nurse tell the client she is fertile in relation to her mucus? Cervical mucus is not a reliable indicator. when it does not stretch when it is thin, watery, and copious when it is thick
when it is thin, watery, and copious Explanation: The cervical mucus method relies on the changes that occur naturally with ovulation. Before ovulation, cervical mucus is thick and does not stretch when pulled. With ovulation, the mucus becomes thin, copious, watery, transparent, and stretchy.
Which question would be most important for a nurse to ask when taking a history from a client who is suspected of having amenorrhea? "Are you sexually active?" "How many times a week do you exercise?" "What foods do you eat?" "When did you last see your medical provider?"
"Are you sexually active?" Explanation: Amenorrhea strongly suggests pregnancy in an adolescent and is the priority in a client with this diagnosis. Strenuous exercise can be a causative factor, but it is not the priority. Diet and medical visit history do not affect this current diagnosis.
The nurse educates a client who is confused about her ovarian cycle. Which client statement would best validate her understanding of the education? "My menstrual cycles are controlled by progesterone production." "Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." "When I ovulate, there is a follicle on my uterus that forms showing that an ova was released." "I will ovulate every month on Day 21 of my cycle."
"Two hormones control my ovulation, follicle-stimulating hormone (FSH) and luteinizing hormone (LH)." Explanation: Ovulation is controlled by FSH and LH, with the follicle-stimulating hormone encompassing days 1 to 14 of a 28-day cycle and the luteinizing hormone controlling the luteal phase, which is days 15 to 28. The follicle forms only in the ovary, not the uterus. Ovulation should occur on Day 14 of a normal 28 -day cycle. Both estrogen and progesterone are necessary to the menstrual cycle, not just progesterone.
Which of the following is the most immediate danger after prostate surgery? Obstructed urine flow Deep vein thrombosis Bleeding Infection
Bleeding Explanation: The immediate danger after prostate surgery is bleeding and hemorrhagic shock. If, after 20 minutes, the bleeding is not controlled, surgical exploration may be considered. Since bleeding is increased in the sitting position, which increases bladder and venous pressure, the patient is encouraged to rest in bed with the head of the bed slightly elevated.
A nurse working in a community health education program is assigned to educate community members about sexually transmitted infections (STIs). Which nursing strategy should be adopted to prevent the spread of STIs in the community? Discuss limiting the number of sex partners. Promote use of oral contraceptives. Emphasize not sharing personal items with others. Emphasize the importance of good body hygiene.
Discuss limiting the number of sex partners. Explanation: As a nursing strategy to prevent the spread of STIs, the nurse should discuss reducing the number of sex partners to diminish the risk of acquiring STIs. Oral contraceptives are not effective in preventing STIs, and barrier methods (condoms, diaphragms) should be promoted. The nurse should counsel and encourage sex partners of persons with STIs to seek treatment. Maintaining good body hygiene or not sharing personal items with others does not reduce the risk of spreading STIs.
A nurse is conducting a health promotion class about the female reproductive system and menstrual cycle for a group of young adult women. The nurse determines that the teaching was successful when the group identifies which of the following? If an ovum is fertilized, hormonal secretion falls. Progesterone secretion is highest at the beginning of the cycle. Ovulation usually occurs about 1 week before the next menstrual period. Estradiol is the most potent ovarian estrogen.
Estradiol is the most potent ovarian estrogen. Explanation: The ovarian follicle produces several different estrogens, the most potent being estradiol. Ovulation occurs usually 2 weeks prior to the next menstrual period. Progesterone secretion is highest in the luteal phase, which begins after ovulation. If an ovum is fertilized, estrogen and progesterone levels remain high.
The nurse is assessing a male neonate and notes that the urethral opening is on the ventral aspect of the penis. Which finding is documented? Bladder exstrophy Epispadias Patent urachus Hypospadias
Hypospadias Explanation: Hypospadias is a condition in which the urethral opening in on the ventral surface of the penis. Epispadias is present when the urethral opening is on the dorsal surface of the penis. Patent urachus refers to a fistula between the bladder and umbilicus. Bladder exstrophy involves the bladder lying open and exposed on the abdomen.
A client and her partner come to the clinic stating they have been unable to have sexual intercourse. The female client states she has pain and her "vagina is too tight." The client was raped at age 15 years of age. Which nursing problem is most appropriate for this client? Dysfunctional grieving related to loss of self- esteem because of lack of sexual intimacy Risk for trauma related to fear of vaginal penetration Vaginismus related to vaginal constriction Sexual dysfunction related to sexual trauma
Sexual dysfunction related to sexual trauma Explanation: Sexual dysfunction is the problem that is the most appropriate. Dysfunctional grieving because of lack of intimacy is not correct as the couple may have emotional intimacy. The trauma occurred when the female client was 15 years of age thus is not an acute problem. Vaginismus is a medical diagnosis.
A client in her second trimester of pregnancy reports discomfort during sexual activity. Which instruction should a nurse provide? Perform stress-relieving and relaxing exercises. Modify sexual positions to increase comfort. Perform frequent douching, and use lubricants. Restrict contact to alternative, noncoital modes of sexual expression.
Modify sexual positions to increase comfort. Explanation: The nurse should instruct the client to change sexual positions to increase comfort as the pregnancy progresses. Although the nurse should also encourage her to engage in alternative, noncoital modes of sexual expression, such as cuddling, caressing, and holding, the client need not restrict herself to such alternatives. It is not advisable to perform frequent douching, because this is believed to irritate the vaginal mucosa and predispose the client to infection. Using lubricants or performing stress-relieving and relaxation exercises will not alleviate discomfort during sexual activity.
A male client informs the urology nurse that he is embarrassed because his wife rarely has time to reach sexual satisfaction during their encounters. He says he experiences orgasm as soon as he enters the wife's vagina. What is this condition best known as? Impotence. Erectile failure. Premature ejaculation. Retarded ejaculation.
Premature ejaculation. Explanation: Premature ejaculation is when a man consistently achieves ejaculation or orgasm before or soon after entering the vagina. Erectile failure, also known as impotence, is the inability of a man to attain or maintain an erection to the extent that he cannot have satisfactory intercourse. Retarded ejaculation refers to a man's inability to ejaculate into the vagina or delayed intravaginal ejaculation.
After assessing a female adolescent, a nurse collects the following data: development of breast tissue, growth spurt in height and weight, appearance of axillary hair, and initiation of menarche. Which stage of sexual development does this data confirm? Pubescence Postpubescence Precocious puberty Prepubescence
Pubescence Explanation: Adolescent sexual development is divided into three categories: prepubescence, pubescence, and postpubescence. Prepubescence would be defined by rounding of the hips, appearance of breast buds, and appearance of downy pubic hair. Pubescence would be defined by development of breast tissue, growth spurt in height and weight, appearance of axillary hair, and initiation of menarche. Postpubescence would be defined by completion of sexual growth and development and fertility. Precocious puberty is puberty that begins prior to age 8 in girls, and age 9 in boys. Certain conditions such as infections, brain abnormalities, tumors, or hormone disorders may cause precocious puberty.
A school nurse is teaching a class about sexually transmitted infections (STIs). Which statement is correct regarding STIs? The incidence of STIs is decreasing due to limited sex partners. STIs are most prevalent among teenagers and young adults. The signs and symptoms of an STI are obvious. STIs disproportionately affect people with a lower socioeconomic status and education.
STIs are most prevalent among teenagers and young adults. Explanation: STIs are most prevalent among teenagers and young adults, and nearly two thirds of all STIs occur in people younger than 25 years. The incidence of STIs is increasing due to multiple sex partners and sexual activity at a younger age. STIs affect men and women of all backgrounds and economic levels.
Which statement best expresses the role of the corpus luteum? Increasing amounts of cervical mucus are produced as a result of the luteinizing hormone produced by the corpus luteum. During the luteal phase, the corpus luteum secretes glycogen. The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. The corpus luteum promotes the increased production of estrogen before ovulation.
The corpus luteum secretes progesterone to promote the preparation of the endometrium for implantation. Explanation: The mature ovum is released from the ovary, resulting in the corpus luteum. Progesterone is produced by the corpus luteum. Estrogen is secreted by the ovaries. Glycogen is secreted by the endometrial glands during the luteal phase. Luteinizing hormone is not a product of the corpus luteum.
The client states to the nurse that he is very anxious about having prostate cancer ever since his prostate-specific antigen (PSA) test came back elevated. The client asks, "Which diagnostic test produces definitive results if cancer is present?" The nurse is most correct to state which of the following? Tumor marker studies Digital rectal exam Transrectal ultrasonography Tissue biopsy
Tissue biopsy Explanation: Obtaining an actual piece of the tissue and analyzing it for cancer is a definitive test when cancer is found. A transrectal ultrasonography is a test to view the prostate gland from different angles. This test provides additional data on the status of the prostate gland. The tumor marker studies include the prostate-specific antigen (PSA) level. This antigen indicates a potential problem but is not definitive. PSA elevations have been noted for reasons other than cancer. A digital rectal exam provided data on the shape, size, and texture of the prostate gland.
An 56-year-old menopausal client comes to the clinic reporting painful intercourse. Her pelvic examination reveals vaginal dryness. Which suggestion would be most appropriate? "Practice your Kegel exercises several times each day." "Try using a water-soluble lubricant before intercourse." "Make sure you take your calcium supplement everyday." "Drink at least 6 to 8 glasses of water daily."
Try using a water-soluble lubricant before intercourse." Explanation: Dyspareunia (painful intercourse) in a menopausal woman is most likely from vaginal dryness. Use of a water-soluble lubricant can be helpful in adding moisture to the area and relieving the pain of intercourse. Kegel exercises would be helpful to combat problems related to bladder control. Calcium supplements would be helpful to prevent osteoporosis. Drinking 6 to 8 glasses of water daily helps reduce the woman's risk for urinary tract infections.
A 36-year-old was diagnosed with uterine fibroids (leiomyomas). The nurse teaches the client to expect which clinical manifestation? acute abdominal pain decrease in fibroid size if pregnancy occurs diarrhea abnormal uterine bleeding
abnormal uterine bleeding Explanation: Fibroids are dependent on estrogen and grow rapidly during the childbearing years unless menopause occurs. Abnormal uterine bleeding is a clinical manifestation. Diarrhea is not a factor; constipation and abdominal pain can occur if fibroids are getting larger.
The nurse is preparing a presentation for a local community group about sexually transmitted infections (STIs). Which most common STI in the United States would the nurse expect to include? gonorrhea genital herpes chlamydia syphilis
chlamydia Explanation: Chlamydia is the most common and fastest-spreading bacterial STI in the United States, with 2.8 million new cases occurring each year. Gonorrhea is the second most frequently reported communicable disease in the U.S. The incidence of syphilis had been increasing for the past 6 years. One in five people older than age 12 is infected with the virus that causes genital herpes.
A group of nursing students are comparing the male and female reproductive organs. The instructor determines the class is successful when the students correctly deduce the male glans penis is complementary to which female structure? vulva clitoris vagina labia majora
clitoris Explanation: The female clitoris is equitable to the glans; both of these are composed of erectile tissue and are the primary organs responsible for orgasm. Other comparable structures include the testes and ovaries, and scrotum and labia majora. The vagina does not have a comparable male structure.
A nurse is putting together educational material for clients who desire to learn about how to get pregnant. Part of this information will explain that fertilization occurs: in the vagina. in the ovaries. in the fallopian tubes. in the uterus.
in the fallopian tubes. Explanation: Fertilization of the ovum can occur in the distal portion of the fallopian tubes. If the egg is fertilized, it will then be moved through the fallopian tube towards the uterus where it implants in the thick endometrium and begins its development.
An adolescent informs the school nurse that she is afraid of contracting an STI but her boyfriend does not want to use condoms. What is the best response by the nurse? "If he won't use a condom, then he doesn't care about you." "The use of condoms is one of the best ways to reduce the risk of acquiring an STI." "You are too young to be having sex at all." "I can understand your concern and you should bring him here so that I can talk with him about STIs."
"The use of condoms is one of the best ways to reduce the risk of acquiring an STI." Explanation: The use of condoms to provide a protective barrier from transmission of STI related organisms has been broadly promoted, especially since the recognition of HIV/AIDS. At first referred to as a method to ensure safe sex, the use of condoms has been shown to reduce but not eliminate the risk of transmission of HIV and other STIs.
The school health nurse is conducting a teaching session for parents to provide information about the human papillomavirus (HPV) vaccination. What prevention information should the nurse include in the session? The vaccination is available only to girls but, in the long term, protects both genders from sexually transmitted infections. The effect of the vaccination is optimized if it is administered before the child becomes sexually active. A Pap smear test is required prior to administration of the HPV vaccination. The HPV vaccination prevents the future need for cervical cancer screening in women.
he effect of the vaccination is optimized if it is administered before the child becomes sexually active. Explanation: The nurse should advise the parents that the vaccination should ideally be administered before the onset of sexual activity, to prevent genital warts. The vaccination is available and effective when administered to both men and women. The HPV vaccination does not preclude women from having regular cervical cancer screening in the future. A Pap smear prior to the administration of the vaccination is not required, particularly for those woman who are not yet sexually active.
A 47-year-old woman is being seen at the local clinic reporting irregular menstrual cycles. The nurse would explain to the client that the irregularity is most likely due to: menopause. hormonal fluctuations. pregnancy. an underlying endocrine problem.
menopause. Explanation: As a woman's reproductive capabilities end, her menstrual cycles will become irregular and finally cease. The average age for menopause is 47 to 55 years. This client meets these criteria. Pregnancy would cause absence of menstrual cycles. Hormonal fluctuations and underlying endocrine problems would not be the anticipated causality.
A young woman presents with vaginal itching and irritation of recent onset. Her labia are swollen, and she has a frothy yellowish discharge with an unpleasant smell and a pH of 6.8. She has been celibate during the last six months and has been taking antibiotics for a throat infection. Which medication is most likely to clear her symptoms? valacyclovir metronidazole azithromycin penicillin
metronidazole Explanation: The character of the discharge, lack of recent sexual activity, and current antibiotic treatment point to infection with Trichomonas vaginalis, which can exist asymptomatically and flare up only if conditions, such as an imbalance in normal vaginal flora resulting from antibiotic treatment, enable the protozoan to proliferate. Trichomoniasis responds well to treatment with metronidazole.
A nurse is teaching a sex education class and is discussing sexual response. She describes a 30-minute period during which external and internal genital organs return to an unaroused state. What is this phase of sexual response known as? resolution excitement plateau orgasm
resolution Explanation: Resolution, the fourth and final phase of sexual response, is a 30-minute period during which the external and internal genital organs return to an unaroused state. Excitement, the first phase, occurs with physical and psychological stimulation (sight, sound, emotion, or thought) that causes parasympathetic nerve stimulation. The plateau stage, which is the second phase, is reached just before orgasm. Orgasm, the third phase, occurs when stimulation proceeds through the plateau stage to a point at which a vigorous contraction of muscles in the pelvic area expels or dissipates blood and fluid from the area of congestion.
The nursing instructor is teaching a group of nursing students about the menstrual cycle. The instructor determines the session is successful when the students correctly choose which action as responsible for the increased thickness of the endometrium? the level of the FSH the decreasing level of the progesterone the increasing level of estrogen the dropping level of LH
the increasing level of estrogen Explanation: Estrogen levels increase after menstruation. These levels promote a thickening of the endometrial tissue. FSH and LH are responsible for ovarian changes. Progesterone will be increasing not decreasing, and works with estrogen in influencing the menstrual cycle.
The nurse is conducting a health history when a middle-aged client states that her last menstrual period was 6 months ago. Upon further questioning, the client also states that symptoms of hot flashes and mood fluctuations. Which question should the nurse ask next? "Do you feel like hurting yourself?" "Are you taking any hormone replacement therapy?" "Are you finished having children?" "When was your first menstrual period?"
"Are you taking any hormone replacement therapy?" Explanation: To ensure a thorough health history, a client who exhibits symptoms of perimenopause should be assessed for the use of hormone replacement therapy to alleviate the symptoms. This information adds to the data reported by the client. Asking if the client feels like hurting herself may be extreme with the report of mood fluctuations. Asking if the client is finished having children produces little additional data. Asking the first menstrual period is part of the health history but not the best question to ask after the client's statement.
A 15-year-old adolescent is scheduled for a pelvic ultrasound to evaluate for a possible ovarian cyst. Which instruction by the nurse would be most appropriate? "You won't be able to drink any water before or during the test." "Limit your level of physical activity for one-half hour before the test." "You need to remain very still for the entire test." "Drink plenty of fluids because you need to have a full bladder."
"Drink plenty of fluids because you need to have a full bladder." Explanation: A full bladder is needed for an ultrasound of the pelvic region. The client needs to remain still for a computed tomography or magnetic resonance imaging scan, not an ultrasound. Water is withheld during a water deprivation test used to detect diabetes insipidus. Limiting stress and physical activity for 30 minutes before the test is required for the growth hormone stimulation test.
The nurse is assessing a client's risk for sexually transmitted infections. Which statement by the client would be cause for concern? "I needed RhoGAM after my last pregnancy. Will I need it again?" "I am unsure who the father of the baby is. I will be raising it alone." "I only want my family to see the baby after it is born." "I am not sure if I want to keep the baby. It is a hard decision."
"I am unsure who the father of the baby is. I will be raising it alone." Explanation: While many individuals have complex social issues, if a client states that she is unsure of the father of the baby, it is understood that she has had recent, multiple sex partners. Sex with multiple partners places the client and fetus at risk for a sexually transmitted infection. Not wanting to keep the baby, needing RhoGAM and having social issues does not place the client at risk for sexually transmitted infections.
A 20-year-old female comes to the sexual health clinic for follow up related to a positive test for the human papillomavirus (HPV). The client asks the nurse, "Is there anything I can do to get rid of this?" What is the nurse's best response? "The health care provider will prescribe antibiotics to cure this infection." "The lumps on your cervix can be cured by cryosurgery." "There is currently no medical treatment to cure HPV." "This can be cured with medications such as the recombinant human papillomavirus quadrivalent vaccine."
"There is currently no medical treatment to cure HPV." Explanation: It is a lifelong recurrent viral disease treated but not cured with medical treatment. Immunization regimes such as the recombinant human papillomavirus quadrivalent vaccine are for HPV prevention not cure. Cryosurgery will eliminate HPV warts but not cure it. Antibiotics will not be effective for a virus.
A female client with genital herpes is prescribed acyclovir as treatment. After teaching the client about this treatment, which statement by the client indicates effective teaching? "This drug will help reduce my risk for a recurrence after discontinuing it." "This drug will help to suppress any symptoms of the infection." "The severity of future attacks will be much less after using this drug." "If I use this drug, I will be cured of the infection."
"This drug will help to suppress any symptoms of the infection." Explanation: No cure exists, but antiviral drug therapy helps to reduce or suppress symptoms, shedding, and recurrent episodes. Advances in treatment with acyclovir 400 mg orally three times daily for 7 to 10 days, famciclovir 250 mg orally three times daily for 7 to 10 days, or valacyclovir 1 g orally twice daily for 7 to 10 days have resulted in an improved quality of life for those infected with HSV. However, according to the CDC, these drugs neither eradicate latent virus nor affect the risk, frequency, or severity of recurrences after the drug is discontinued.
The nurse is teaching a female client about early-stage pelvic organ prolapse. Which statement that centers on dietary and lifestyle changes will promote pelvic relaxation and decrease chronic problems later in life? "You will want to add high-impact exercise to your routine or increase time spent on it." "You will need to avoid products that contain caffeine." "You will need to increase fiber in your diet." "You will want to avoid increasing your fluid intake."
"You will need to increase fiber in your diet." Explanation: A dietary fiber increase and an increase in fluids will help avoid constipation, which puts a strain on the intra-abdominal cavity and pelvic organs. An increase in fiber will help to stimulate peristalsis. The recommended amount of fiber is 25 mg daily. Avoiding caffeine will not change symptoms. The client should avoid high-impact exercise because it increases intra-abdominal pressure.
A nurse is attending to a group of boys at a school. The nurse is required to document the sexual development in boys on a regular basis. The nurse would anticipate which clients having the highest incidence of nocturnal emissions? Clients in the age group of 18 to 20 years Clients who have reached adulthood Clients who are showing pubertal changes Clients with strong, muscular appearance
Clients who are showing pubertal changes Explanation: The nurse should know that boys who are undergoing pubertal changes are more likely to experience nocturnal emissions. In late adolescence, which lasts from age 18 to 20, the transition into adulthood is completed. The nurse should also know that boys in the age group of age 12 to 20 experience various chemical and physical changes taking place within their body. A strong, muscular appearance does not indicate the presence of nocturnal emissions.
The husband of a client with terminal cancer is afraid of hurting his wife during sexual intercourse. Which action by the nurse is likely to be most helpful in reducing this client's fears? Inform the client's husband that the client cannot have sexual intercourse due to fatigue Suggest other ways the couple can spend time together, such as watching television together Reassure the client's husband that he cannot hurt the client during sexual intercourse Encourage discussion between the husband and wife regarding their intimacy needs
Encourage discussion between the husband and wife regarding their intimacy needs Explanation: Partners of terminally ill clients may wish to be physically intimate with the dying person but are afraid of "hurting" him or her and may also be afraid that an open expression of sexuality is somehow "inappropriate" when someone is dying. Encourage discussion and suggest ways to be physically intimate that will meet the needs of both partners, such as a foot massage or embrace, and not just watching TV. Telling the client that he cannot have relations based on the fatigue of the client's spouse is not appropriate. Reassuring the client that he will not cause pain is incorrect.
A client with erectile disorder is taking sildenafil. What instructions should the nurse give the client? Take up to three tablets within 24 hours. Use nitroglycerine if chest pains occur during intercourse. Expect an erection that may last up to 4 hours. Take the medication 8 hours before having intercourse.
Expect an erection that may last up to 4 hours. Explanation: An expected outcome of taking sildenafil is an erection that can last up to 4 hr. The nurse instructs the client to take the medication 1 hour before having intercourse as an erection will occur within 1 hour, and to take only take one tablet in 24 hours. The nurse advises the client to avoid taking the drug if he takes nitrate therapy, such as nitroglycerine, to avoid unsafe decreases in blood pressure.
A female client has just been diagnosed with condylomata acuminata (genital warts). What information is appropriate to tell this client? The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. The human papillomavirus (HPV), which causes condylomata acuminata, can't be transmitted during oral sex. The potential for transmission to her sexual partner will be eliminated if condoms are used every time she and her partner have sexual intercourse. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually.
This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. Explanation: Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection. Because condylomata acuminata is a virus, there is no permanent cure. Because condylomata acuminata can occur on the vulva, a condom won't protect sexual partners. HPV can be transmitted to other parts of the body, such as the mouth, oropharynx, and larynx.
A client asks the nurse which vitamins should be taken daily for feelings of fatigue, anxiety, and depression 1 week before menses. Which of the following is the correct response by the nurse? Vitamin C Vitamin A Vitamin B6 Vitamin D
Vitamin B6 Explanation: The nurse should encourage taking Vitamin B6 daily, as it may be effective at relieving symptoms of irritability, fatigue, and depression related to the premenstrual period. Vitamin A supports growth and bone development, vision, reproduction, and development and maintenance of skin tissue. Vitamin C protects against immune system deficiencies, cardiovascular disease, prenatal health problems, eye disease, and even skin wrinkling. Vitamin C may protects against immune system deficiencies, cardiovascular disease, prenatal health problems, eye disease, and even skin wrinkling.
The nurse is developing a community health education program about sexually transmitted infections. Which information about women who acquire gonorrhea should be included? Women with gonorrhea are usually asymptomatic. Women are more reluctant than men to seek medical treatment. Gonorrhea is usually a mild disease for women. Gonorrhea is not easily transmitted to women who are menopausal.
Women with gonorrhea are usually asymptomatic. Explanation: Many women who acquire gonorrhea are asymptomatic or experience mild symptoms that are easily ignored. They are not necessarily more reluctant than men to seek medical treatment, but they are more likely not to realize they have been affected. Gonorrhea is easily transmitted to all women and can result in serious consequences, such as pelvic inflammatory disease and infertility.
The dermatologist treating a 16-year-old girl with a history of severe acne has ordered a pregnancy test so she can be started on a course of isotretinoin. The teen's caregiver has said that her daughter is a virgin and she refuses to allow her to have the required pregnancy testing. What would be the best action for the nurse to take? Arrange for the daughter to have the pregnancy testing without the caregiver's knowledge. Speak with the teen alone to ask her if she is sexually active. If she says she is not sexually active, let the provider know that it is okay to write the prescription. Acknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. Have the caregiver sign a permission form acknowledging that the girl has been given the drug without pregnancy testing.
cknowledge the caregiver's discomfort about the pregnancy testing but encourage her to allow the daughter to have the testing so that she can use the medication. Explanation: Isotretinoin is a pregnancy category X drug: It must not be used at all during pregnancy because of serious risk of fetal abnormalities. To rule out pregnancy, a urine test is done before beginning treatment. For the sexually active adolescent girl, an effective form of contraception must be used for a month before beginning and during isotretinoin therapy. The risk to the fetus, should pregnancy occur, should be discussed with the girl whether she is sexually active or not.
A middle-aged woman is seen in the OB/GYN clinic and reports abdominal bloating, fatigue, abdominal pain, urinary frequency, and constipation. She also says that she had lost 24 pounds in the last month without trying to lose. For which disease should the primary care provider screen this client? breast cancer pelvic organ prolapse (POP) fibroids ovarian cancer
ovarian cancer Explanation: The most common early signs for ovarian cancer include abdominal bloating, early satiety, fatigue, vague abdominal pain, urinary frequency, diarrhea or constipation, and unexplained weight loss or gain. Fibroids do not have these same symptoms, nor does breat cancer or POP.