Chapter 45 Sexuality PrepU

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 caring for a client diagnosed with vaginismus. When reviewing the client's history, what would the nurse would expect to find? a. past history of an STI b. past history of a rape c. The client is in the first trimester of pregnancy. d. multiple vaginal births

past history of a rape Vaginismus usually results from psychological problems, namely fear of penetration due to a negative association such as rape, sexual abuse, or fear of sexual intercourse.

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: a. transvestite. b. bisexual. c. transsexual. d. homosexual.

transsexual - A transsexual man views himself as a woman trapped in a man's body; the reverse is true for a female transsexual. Transvestite is an outdated term used to describe a person who dresses like someone of the opposite sex but views himself (or herself) according to his/her biological gender. Bisexuals are attracted to both males and females. Homosexuals are attracted to those of the same gender.

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 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.

In the female reproductive system, what corresponds with the male penis?

Clitoris

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. "A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." b. "The ability to achieve orgasm is the only indicator of a person's sexual responsiveness." c. "Women who have multiple orgasms are promiscuous." d. "The larger the penis, the greater the potential for achieving orgasm."

"A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." - Simultaneous orgasms, or both people attaining orgasm at the same moment, are difficult to achieve. A preoccupation with attaining simultaneous orgasms might disrupt the ultimate intimacy and satisfaction possible during coitus. Multiple orgasms are not abnormal. The size of the penis does not affect whether an orgasm will occur. Having an orgasm is not the only indicator of sexual responsiveness; some individuals may have a pleasurable sexual experience without 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." - Sexual identity encompasses a person's self-identity, biologic sex, gender identity, gender role behavior or orientation, and sexual orientation or preference. Gender role behavior is the behavior a person conveys about being male or female. Biologic sex is the term used to denote chromosomal sexual development. Gender identity is the inner sense a person has of being male or female. Sexual orientation refers to the preferred gender of a person's partner.

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 17-year-old girl tells the nurse she uses tampons and asks how she can cut down on odor during her period. What is the nurse's best response?

"The tampon should be changed frequently." T- o cut down on odor, and to decrease the risk for toxic shock syndrome, the tampon should be changed frequently, but every hour is too frequent. Nothing should be placed on a tampon prior to insertion as this can cause a serious infection and will not decrease odor. Tampons, if changed frequently, are not dangerous.

The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following? a. Antibiotics b. Antihypertensive medication c. Bronchodilators d. Non-steroidal anti-inflammatory drugs (NSAIDs)

Antihypertensive medication - Antihypertensives are among the drugs implicated in sexual dysfunction. Antihypertensives can decrease forceful blood flow to the penis, making it difficult to achieve an erection. Antibiotics, bronchodilators, and NSAIDs do not typically have this effect.

A male client was recently diagnosed with diabetes and tells the nurse that he is concerned about what effect his condition will have on his ability to participate in sexual activity. The nurse understands that the client is at risk for which condition?

Erectile dysfunction

A nurse is conducting a seminar for a group of young adult women about the menstrual cycle. When discussing the hormones involved during the various phases, the nurse explains that estrogen is dominant during which phases of the cycle? Select all that apply.

Follicular phase Proliferative phase - Estrogen is the dominant hormone during the follicular phase of the ovarian cycle and during the proliferative phase of the endometrial cycle. Progesterone is the dominant hormone during the luteal phase and during the secretory phase. The follicle ruptures during the ovulatory phase.

A client presents to the client reporting vaginal bleeding, feeling sad, headaches, increased acne, and recent weight changes. What information is important for the nurse to obtain during the assessment of this client?

Intrauterine device(IUD) placement within past 3 months

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. a. Nocturnal emissions are signs of a sexually transmitted infection. b. Nocturnal emissions are normal in men of all ages. c. Nocturnal emissions indicate the existence of a sexual disorder. d. No male or female should feel pressured into sexual activity at any age. e. Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. f. A larger penis allows for a more satisfying sexual experience.

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. - Masturbation or self-stimulation is natural. No one should ever feel pressured into having sex. Nocturnal emissions are normal and occur in about 85% of men. Penis size has no effect on the satisfaction of the sexual experience.

The school nurse is educating a group of 5th and 6th grade girls on menstruation. One girl asks if there is a name for having her first menstrual period. The nurse replies with which of the following terms?

Menarche

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? a. Complications from an untreated sexually transmitted infection (STI) b. An acute urinary tract infection (UTI) c. A diagnosis of interstitial cystitis d. Possible complications from female genital mutilation (FGM) requiring further physical assessment

Possible complications from female genital mutilation (FGM) requiring further physical assessment Female genital mutilation (FGM) includes procedures that intentionally alter or cause injury to the female genital organs for non-medical reasons. It is a procedure that has no health benefits for girls and women and can cause severe bleeding, problems urinating, and later cysts, infections, infertility as well as complications in childbirth and increased risk of newborn deaths. The nurse may rule out UTI via urinalysis however, the nurse would want to rule out the presence of FGM in order to make sure the client receives appropriate long-term care. Nothing in the data provides the nurse with an indication of an untreated STI or interstitial cystitis.

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.

The community health nurse is aware that many factors influence a client's decision for contraception. Which of the following is the most likely reason a client would select permanent contraception?

The choice not to start a family. - Some people choose a permanent method to prevent pregnancy from ever occurring. Factors that affect a person's choice of a contraceptive method include age, marital status, desire for future pregnancy, religious beliefs, level of education, cost, and ease of use. Permanent contraception offers no protection against sexually transmitted infections.

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? a. Vaginismus c. Orgasmic dysfunction c. Celibacy d. Dyspareunia

Vaginismus The client is experiencing an involuntary contraction of the muscles surrounding the vaginal orifice; this should be documented as vaginismus. Dyspareunia is painful intercourse. Difficulty achieving orgasm is documented as orgasmic dysfunction. Abstention from sexual intercourse is documented as celibacy.

What are the basic charting methods that can be used to predict ovulation to plan or prevent pregnancy. SELECT ALL THAT APPLY: a. Temperature method b. coitus interuptus c. cervical mucus method d. abstinence e. calendar method

a c e Temperature method: The woman takes her temperature every morning before getting out of bed. Her temperature will rise between 0.4°F and 0.8°F on the day of ovulation and will remain at that level until her next period. Cervical mucus method: The woman observes the changes in her cervical mucus throughout the first part of the menstrual cycle, until after ovulation. Cervical mucus is normally cloudy, but a few days before ovulation it becomes clear and slippery and can be stretched between the fingers. This indicates the most fertile phase of the cycle. The couple must abstain from vaginal intercourse or use a barrier method during this period to avoid pregnancy. Calendar method: The woman charts her menstrual cycle on a calendar. The couple must refrain from intercourse or use a barrier method during days when pregnancy is more likely.

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. - Condoms are recommended for anal and vaginal intercourse to prevent sexually transmitted diseases. Information should be talked about including that care should be used to avoid injury to the delicate rectal mucosa, and lubrication is necessary for comfort. It is not necessary to teach the client that anal intercourse should be avoided.

The nurse is providing education about sexuality to a group of college freshman. One of the terms he discusses is gender identity. Which of the following describes gender identity?

inner sense of being male or female

The nurse is providing education about sexuality to a group of college freshman. One of the terms he discusses is gender identity. Which of the following describes gender identity? a. behavior conveyed about being male or female b. preferred gender of the partner of an individual c. inner sense of being male or female d. desire to wear the clothes of the opposite sex

inner sense of being male or female Gender identity is the inner sense a person has of being male or female. Gender role behavior is the behavior a person conveys about being male or female. Sexual orientation refers to the preferred gender of the partner of an individual. A transvestite is an individual who desires to take on the role (or wear the clothes) of the opposite sex.

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. - Primary impotence refers to a man who has never been able to achieve an erection necessary for intercourse; secondary impotence refers to a man who was once successful in attaining and maintaining erections but who has subsequently experienced difficulty. Causes of impotence, whether primary or secondary, can be physiologic, psychological, or both. Certain manifestations may indicate the probability that the problem is secondary to a physiologic or a psychological factor.

The nurse should instruct an Islamic female client who is reluctant to undergo pelvic examination from an assigned male health care provider to: a. have the pelvic examination with another woman present. b. seek a female health care provider to perform the examination. c. ask her husband to be present during the examination. d. tell her to refuse to have the examination based on beliefs.

seek a female health care provider to perform the examination. The woman is from a culture or ethnic group whose values influence her feelings about a pelvic examination, particularly one done by a male health care provider.