NUR 108 Ch 45 Sexuality
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? "Sexual orientation is the term used to denote chromosomal sexual development." "Biologic sex is the inner sense a person has of being male or female." "Gender identity refers to the preferred gender of a person's partner." "Gender role behavior is the behavior a person conveys about being male or female."
"Gender role behavior is the behavior a person conveys about being male or female." Explanation: 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 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." "If your male partner doesn't have genital warts, you will not get them." "Douching will help to prevent them." "Have the Norplant system implanted in your arm."
"Get the human papillomavirus vaccine." Explanation: Human papillomavirus (HPV) is a DNA virus also called genital warts and is a sexually transmitted infection (STI). A vaccine is now available to prevent this disease. Male partners with HPV may or may not have lesions. Women should avoid douching to prevent STIs, as they remove normal protective bacteria in the vagina and increases the risk of getting some STIs. The Norplant system is a contracteptive method and does not prevent STIs.
While conducting a sexual history, the nurse asks a client about protection from sexually transmitted infections (STIs). Which question would be most appropriate for the nurse to ask? "Have you had any sexually transmitted infections and if so, which ones?" "Have you or your partner experienced erectile dysfunction?" "Are you comfortable with the way you are currently expressing yourself sexually?" "Do you find sex satisfying?"
"Have you had any sexually transmitted infections and if so, which ones?" Explanation: When asking about STI protection, a question such as "Have you had any sexually transmitted infections and if so, which ones?" provides the nurse with important information about STIs and behavioral risk. Erectile dysfunction is not an indicator of STIs or risk factors. How the client feels about expressing themselves sexually is more of a determining factor of sexual self-esteem. Asking the client if he finds sex satisfying provides information about sexual functioning, not STI protection.
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?" "Have you ever had any sexually transmitted infections in the past?" "Are you satisfied with the quality of your relationships right now?" "Do you find that your health allows you to enjoy a meaningful sex life?"
"How do you feel about yourself as a woman?" Explanation: Sexual identity is a broad concept that includes, but supersedes, sexual functioning. However, it is more specific than simply asking about the quality of relationships or if their health allows for a meaningful sex life. Asking an open-ended question about how the client feels about herself as a woman is likely to elicit important insights. Assessing the client's history of STIs does not directly address her sexual identity.
The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education? "I have to wash my cervical caps after each use." "I can leave my diaphragm in for up to 48 hours." "I can insert my female condoms up to 8 hours before intercourse." "Male latex condoms when used correctly are an effective means of contraceptive and very effective at preventing transmission of STIs."
"I can leave my diaphragm in for up to 48 hours." Explanation: The diaphragm stays in for 8 hours after intercourse; the FemCap can stay for 48 hours. Diaphragms and cervical caps are washable and reusable. Female condoms can be inserted up to 8 hours before intercourse to avoid interrupting sexual activity. Male condoms can be made of latex, polyurethane or natural membranes. Male latex condoms when used correctly are an effective means of contraceptive and very effective at preventing transmission of STIs.
The nurse is teaching a male adolescent how to use a condom. Which teaching points would the nurse include? Select all that apply. "Roll the condom onto the penis before it becomes erect." "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." "Do not use a spermicide with the condom." "If using a lambskin condom, the condom may be reused a second time."
"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." Explanation: If the condom does not have a nipple receptacle end, a small space should be left at the end of condom to collect the semen in order to provide a pocket to collect semen and prevent breakage. A condom should be used with every act of intercourse to help prevent STI transmission and pregnancy. Immediately after ejaculation, the penis and condom should be removed from the vagina by holding onto the base of the condom. This prevents spillage of semen into the vagina. The condom should be rolled onto the penis as soon as it becomes erect; this protects against sperm from secretions from Cowper's glands. Spermicide can be used with condoms to increase contraception properties. Condoms can never be used a second time.
A nurse expresses a desire to become culturally competent in the care of females from Africa after a mission trip to the continent. Which statement by the nurse demonstrates an understanding of this population of clients? "Female genital mutilation (FGM) is a procedure that has health benefits to young women under 13." "Infibulation is the narrowing of the vaginal opening through the creation of a covering seal." "FGM can increase the risk of newborn deaths." "FGM is usually carried out on adult women."
"Infibulation is the narrowing of the vaginal opening through the creation of a covering seal." Explanation: FGM includes procedures that intentionally alter or cause injury to the female genital organs for nonmedical reasons. Complications include increased risk of newborn deaths. It has no health benefits and is nearly always carried out on minors. Infibulation is the narrowing of the vaginal opening through the creation of a covering seal.
A young adult woman comes to the clinic for an evaluation. During the visit, the client asks the nurse, "I've heard about the morning-after pill that you can take in case you have unprotected sexual activity. What do I need to know?" Which response by the nurse would be appropriate? "You need to have a prescription to get the medication." "It's important to take the pill within 72 hours of having unprotected sex." "You use it about a week after you've had sex so you don't ovulate." "This pill only works if your menstrual cycles are regular."
"It's important to take the pill within 72 hours of having unprotected sex." Explanation: Emergency contraception, often called the "morning-after pill," is designed to reduce the risk of pregnancy after unprotected intercourse. Emergency contraception is provided in two ways. Increased doses of specific oral contraceptive pills can reduce the risk of pregnancy when taken up to 120 hours after unprotected intercourse (ideally within 72 hours). Most are up to 89% effective when taken within 72 hours after unprotected sex. They are less effective as time passes. Another method is insertion of a copper IUD within 5 to 7 days after unprotected intercourse. Planned Parenthood (2017) reports that anyone can obtain Plan B One-Step over the counter without a prescription at a drugstore or family planning clinic. All other brands of emergency contraception require a prescription from a clinician for those age 16 or younger.
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: "Antihypertensive medication will not affect sexual function." "Malnutrition may cause impotence." "I need to be able to walk a mile in order for sexual intercourse to not be dangerous." "Erectile dysfunction, caused by diabetes, has no treatment."
"Malnutrition may cause impotence." Explanation: Factors that contribute to sexual dysfunction in the older adult are as follows: use of medications, especially antihypertensive medications; age-related metabolic disorders such as anemia, diabetes, malnutrition, and fatigue (may cause impotence). Sexual intercourse and similar forms of sexual expression are not considered dangerous for anyone able to walk around a room. Erectile dysfunction has treatments such as a penile prosthesis or pharmacologic management.
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 mostaccurate? "Many unintended pregnancies result from the use of less effective methods of contraception." "Periodic abstinence involves not having any sex with a partner." "Barrier methods include the vaginal sponge used in combination with an antibacterial agent." "Coitus interruptus will prevent pregnancies."
"Many unintended pregnancies result from the use of less effective methods of contraception." Explanation: Unintended pregnancy remains a significant women's health issue in the United States. Many unintended pregnancies result from the use of less effective methods of contraception, such as condoms, spermicide, or barrier methods. Continuous abstinence involves not having sex with a partner at all. In periodic abstinence, women chart their periods of fertility and abstain from vaginal intercourse during these periods. Barrier methods include the vaginal sponge used in combination with a spermicidal agent. Coitus interruptus, the withdrawal of the penis from the vagina before ejaculation, does not prevent all pregnancies. Pre-ejaculate can contain enough sperm to cause a pregnancy, and pre-ejaculate or semen may spill onto the vulva.
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." "People who experience sexual fulfillment with a person of the opposite sex have gender dysphoria." "Gender dysphoria is a condition in which there are contradictions among chromosomal sex, internal organs, and external genital appearance." "People who find pleasure with both opposite-sex and sam-sex partners have gender dysphoria."
"People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria." Explanation: People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria. Heterosexuals experience sexual fulfillment with a person of the opposite sex. People who find pleasure with both opposite-sex and same-sex partners are bisexual. An intersex condition occurs in about 1 in every 2000 babies in which there are contradictions among chromosomal sex, internal organs, and external genital appearance, resulting in ambiguous gender.
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." "Hormonal oral contraceptives reduce the risk of ovarian cancer." "Oral contraceptives need to be taken on a daily basis." "Some hormonal contraceptives do not contain estrogen and rely instead on a progestin only."
"Some oral contraceptives protect against STIs." Explanation: Oral contraceptives need to be taken on a daily basis to prevent breakthrough ovulation. Oral contraceptives do not protect against STIs and clients still need to use STI protection such as condoms. In addition to preventing pregnancy, hormonal contraceptives have many health benefits, including reducing the risk for ovarian cancer and endometrial cancer, reducing symptoms of premenstrual discomforts, decreasing blood loss and anemia, reducing symptoms of endometriosis, and many other benefits.
The nurse assessing an adolescent's need for further information regarding sexual health should ask which question? "Are you involved in an intimate relationship at this time?" "How many sexual partners have you had?" "What questions or concerns do you have about your sexual health?" "Have you ever been diagnosed with a sexually transmitted infection?"
"What questions or concerns do you have about your sexual health?" Explanation: An open-ended, nonthreatening question related to the client's need for further information should be included while obtaining a sexual history. "Are you involved in an intimate relationship at this time?" and "Have you ever been diagnosed with a sexually transmitted disease?"are closed ended questions requiring a yes or no response. Asking how many sexual partners, while open ended, is threatening and assumes that the adolescent has had multiple partners.
Which example best supports the diagnosis of Sexual Dysfunction: Dyspareunia? A client with a colostomy believes she cannot have a sexual relationship with her husband because he will be repulsed by her stoma. A 50-year-old woman with a history of stroke is afraid to have sex with her partner for fear it will elevate her blood pressure. A 50-year-old woman in the process of menopause has pain and burning during intercourse. A 39-year-old alcoholic woman is no longer interested in having sex with her partner.
A 50-year-old woman in the process of menopause has pain and burning during intercourse. Explanation: Dyspareunia refers to pain and burning during intercourse. This is a common cause of sexual dysfunction, especially during menopause. A colostomy, fear of blood pressure elevation, and lack of interest in sex may lead to the nursing diagnosis of Sexual Dysfunction, but not related to dyspareunia.
The nurse is justified in assessing for sexual dysfunction among male clients who are receiving which of the following? Antihypertensive medication Antibiotics Bronchodilators Non-steroidal anti-inflammatory drugs (NSAIDs)
Antihypertensive medication Explanation: 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.
Applying the American Psychiatric Association description of sexual response, place the phases in the order in which they would occur from first to last. 1Appetitive 2Excitement 3Orgasm 4Resolution
Appetitive Excitement Orgasm Resolution Explanation: The American Psychiatric Association has developed a slightly different description of the sexual response, consisting of four phases: appetitive, excitement, orgasm, and resolution.
The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by John, a 22-year-old male, who eventually discloses to the nurse that, while he enjoys having sex with his girlfriend, he also has experienced pleasurable sex with males. The term for this behavior is which of the following? Biologic sex Bisexual Gender role behavior Sexual orientation
Bisexual Explanation: A bisexual is a person who finds pleasure with both opposite-sex and same-sex partners. Biologic sex is the term used to denote chromosomal sexual development: male (XY) or female (XX), external and internal genitalia, secondary sex characteristics, and hormonal states. 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 woman has been diagnosed with human papillomavirus (HPV) infection. When teaching the woman about this condition, the nurse would emphasize the need for screening for which type of cancer? Cervical Colorectal Breast Lung
Cervical Explanation: One STI, human papillomavirus infection (HPV), causes genital warts and cervical and other genital cancers. Therefore the nurse would emphasize screening for cervical cancer.
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? Abstinence Cervical cap Norplant system Sterilization
Cervical cap Explanation: Barrier methods of birth control help in preventing pregnancy by using a device to block sperm from fertilizing an egg. Barrier methods include the cervical cap, condom, diaphragm, and vaginal sponge used in combination with a spermicidal agent. Abstinence means having no sexual intercourse. Norplant is a hormonal method of birth control. Sterilization is a surgical method of birth control.
An adolescent female is in the community health clinic seeking contraception since becoming sexually active. The community health nurse demonstrates effective health promotion and prevention with the client when what is included in the health education teaching plan? Contraception plans prior to initiation of sexual activity. Correct use of the contraception method selected. The importance of using a barrier method to prevent risk of HIV transmission. The need for a back-up contraceptive method when using antibiotics.
Contraception plans prior to initiation of sexual activity. Explanation: The prevention of unwanted pregnancy must be a conscious decision. Anyone who is unprepared for pregnancy should refrain from intercourse or obtain a contraceptive method from a healthcare provider or from the pharmacy; it is too late to think about contraception during sexual intercourse. To practice responsible sexuality, the contraceptive method must be used consistently and according to instructions.
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 Vaginismus Vulvodynia A sexually transmitted infection (STI)
Dyspareunia Explanation: Dyspareunia is painful intercourse. Vaginismus is characterized by difficult penetration rather than acute pain during intercourse. Vulvodynia is associated with pain that is not limited to intercourse. Sexually transmitted infections (or STIs) are infections that can be caught or passed on from unprotected sex, or close sexual contact. An STI may or may not be contributing to the woman's problem, though most cases of dyspareunia are unrelated to infections.
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 Vaginismus Vulvodynia A sexually transmitted infection (STI)
Dyspareunia Explanation: Dyspareunia is painful intercourse. Vaginismus is characterized by difficult penetration rather than acute pain during intercourse. Vulvodynia is associated with pain that is not limited to intercourse. Sexually transmitted infections (or STIs) are infections that can be caught or passed on from unprotected sex, or close sexual contact. An STI may or may not be contributing to the woman's problem, though most cases of dyspareunia are unrelated to infections.
What is associated with the resolution phase of the male sexual response cycle? Feelings of relaxation and fulfillment Intense physical pleasure The ability to begin the excitement phase again Increased blood flow to the penis
Feelings of relaxation and fulfillment Explanation: The resolution phase of the sexual response cycle is associated with feelings of relaxation, fatigue, and fulfillment. The most intense pleasure of a physical nature takes place during orgasm, and the male experiences a refractory period during which he is incapable of sexual response. Blood flow to the penis returns to normal levels during the resolution phase.
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? Past history of infection History of hypertension Increasing age Lack of exercise
History of hypertension Explanation: Vascular problems cause about half the cases of impotence in men older than 50 years. Use of medications to decrease blood pressure such as diuretics cause erectile dysfunction by decreasing the force of blood flow into the penis. With advancing age the sexual function, libido, and potency decrease, but is not the primary reason for impotence. Past history of infection and lack of exercise does not contribute to impotence.
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) Transdermal contraceptive patch Depo-Provera injection Use of the Norplant system
Insertion of a copper intrauterine device (IUD) Explanation: Emergency contraception is provided in two ways: increased doses of oral contractptive pills (usually within 72 hours) or insertion of a copper IUD within 5-7 days after unprotected intercourse. The other options are used for routine contraception.
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 Use of oral contraceptives in the past month Pregnancy related risk factors Hormone imbalance caused by pregnancy
Intrauterine device(IUD) placement within past 3 months Explanation: With intrauterine devices the clinician should be aware that adverse side effects peak at 3 months of use and reduce in frequency after that. The most common side effects include bleeding, depression, headache, acne, and weight changes. While some of the symptoms are found as side effects of oral contraceptive use and as signs of pregnancy the age of the client and cluster of symptoms should alert the nurse to assess for the presence of an IUD.
The nurse is preparing a talk on health issues in the LGBTQ population. Which statistic would the nurse include? Lesbians and bisexual females are more likely to be underweight or anorexic. LGBTQ populations have lower rates of tobacco, alcohol, and other drug use. LGBTQ youth are 2 to 3 times more likely to attempt suicide. Lesbians are more likely to get preventive services for cancer.
LGBTQ youth are 2 to 3 times more likely to attempt suicide. Explanation: Healthy People 2020 found that LGBTQ youth are 2 to 3 times more likely to attempt suicide. Lesbians and bisexual females are more likely to be overweight or obese. LGBTQ populations have higher rates of tobacco, alcohol, and other drug use than other populations. Lesbians are more likely to get preventive services for cancer.
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 larger penis allows for a more satisfying sexual experience. Nocturnal emissions indicate the existence of a sexual disorder. Nocturnal emissions are signs of a sexually transmitted infection. 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 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. Explanation: 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? Menses Menopause Menarche Follicular phase
Menarche Explanation: The first menstrual period, called menarche, is experienced at about 12 years of age. Menstruation is often referred to as a woman's "period" or "menses." Menopause is the cessation of a woman's menstrual activity. In the ovaries, in a typical 28-day cycle, the phase from day 4 to 14 is called the follicular phase.
A nurse is reading a journal article about the female sexual response cycle. Place the events of this cycle in the proper sequence from first to last that would demonstrate that the nurse has understood the information in the article. 1Nipple erection 2Clitoral retraction 3Involuntary contraction of genitals 4Feelings of relaxation
Nipple erection Clitoral retraction Involuntary contraction of genitals Feelings of relaxation Explanation: The sexual response cycle is manifested as follows: during the excitement phase, the woman's breasts swell and the nipples become erect and hard to the touch. During the plateau phase, the clitoris retracts and disappears under the clitoral hood. The orgasm phase in the female begins with a heightened feeling of physical pleasure, followed by overwhelming release and involuntary contractions of the genitals. The resolution phase is characterized by a return to normal body functioning present before the excitement phase. Feelings of relaxation, fatigue, and fulfillment are common.
During the menstrual cycle, when does ovulation typically take place? On day 14 On day 1 of a new cycle When sperm is present From days 15 to 28
On day 14 Explanation: Ovulation generally occurs on day 14 when the mature ovum ruptures from the follicle and the surface of the ovary and is swept into the fallopian tube. From day 15 to day 28, the phase in the ovaries is called the luteal phase. On day 1 of a new cycle begins the new menstrual cycle. Menstrual flow might occur every 21 to 35 days or the last two to seven days. Ovulation does not begin when sperm is present. If ovulation and sperm engage, then pregnancy occurs.
A female client informs the nurse that her husband is concerned about her sexual response. The client reports that during stimulation her husband has noticed her clitoris disappears, and he wonders if she is enjoying the experience despite her positive responses to his stimulation. The nurse explains that building excitement and the retraction of the clitoris are normal characteristics of which stage of the sexual response cycle? Plateau phase Excitement phase Orgasm Resolution phase
Plateau phase Explanation: During the plateau phase, the intensity of excitement increases but not enough to cause orgasm. The female clitoris retracts and disappears under the clitoral hood. This phase may last for 15 to 20 minutes. The excitement phase is initiated by erotic stimulation and arousal, and physiologic changes begin. Orgasm defines the climax and sexual explosion of the tension that has been building during the preceding phases. The resolution phase is the return to normal body function.
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 An acute urinary tract infection (UTI) Complications from an untreated sexually transmitted infection (STI) A diagnosis of interstitial cystitis
Possible complications from female genital mutilation (FGM) requiring further physical assessment Explanation: 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.
Which statements describe sexual dysfunction in males or females? Select all that apply. Premature ejaculation is a condition in which a man consistently reaches ejaculation or orgasm before or soon after entering the vagina. Retarded ejaculation refers to the man's inability to ejaculate into the vagina or delayed intravaginal ejaculation. Vaginismus is painful intercourse. Dyspareunia is a condition in which the vaginal opening closes tightly and prevents penile penetration. Vulvodynia is a chronic vulvar discomfort or pain characterized by burning, stinging, irritation, or rawness of the female genitalia that interferes with sexual activity. Inhibited sexual desire refers to the inability of a woman to reach orgasm.
Premature ejaculation is a condition in which a man consistently reaches ejaculation or orgasm before or soon after entering the vagina. Retarded ejaculation refers to the man's inability to ejaculate into the vagina or delayed intravaginal ejaculation. Vaginismus is painful intercourse. Vulvodynia is a chronic vulvar discomfort or pain characterized by burning, stinging, irritation, or rawness of the female genitalia that interferes with sexual activity. Explanation: Sexual dysfunction in males includes premature ejaculation (which is usually not caused by a physical problem), and retarded ejaculation (ejaculatory incompetence; has similar causes as impotence). Vulvodynia (unknown cause or treatment) is a female sexual dysfunction. Vaginismus is a condition in which the vaginal opening closes tightly, causing severe pain with penetration or making penetration impossible. Dyspareunia is painful intercourse. Inhibited sexual desire consists of an inhibition in sexual arousal so that congestion and vaginal lubrication are absent or minimal.
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. Fetishism. Environmental harassment. Hostile environment harassment.
Quid pro quo harassment. Explanation: Quid pro quo means that something is given or withheld in exchange for something else. It generally occurs when a person in a position of authority offers either direct or indirect reward or punishment based on the granting of sexual favors. Environmental harassment and hostile environment harassment are identical situations and occur when workplace behaviors of a sexual nature create a hostile, intimidating environment that interferes with a person's work performance. Fetishism is sexual arousal with the aid of an inanimate object not generally associated with sexual activity.
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 incidence of STIs is decreasing due to limited sex partners. 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 of age. 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. Not all signs and symptoms of STI's are obvious such as HIV/AIDS.
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. Biologic sex and gender identity are both modifiable by surgery and medical interventions. Biologic sex is genetically determined but gender identity is chosen during adolescence. Biologic sex and gender identity are considered synonymous in nursing practice.
Sex is chromosomally determined, while gender is a psychosocial construct. Explanation: 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. As such, biologic sex is amenable to medical interventions, but surgery and hormone therapy will not change an individual's inner sense of being male or female. Gender identity is not commonly thought to be chosen or objectively selected during adolescence.
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? Transvestite Sexual orientation Gender role behavior Transsexual
Sexual orientation Explanation: 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. Gender role behavior is the behavior a person conveys about being male or female. A transsexual is a person of a certain biologic gender who has the feelings of the opposite sex.
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. To reduce the risk of sexually transmitted diseases. The desire to have multiple sex partners. Religious beliefs which prevent reproduction.
The choice not to start a family. Explanation: 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.
Traditionally, the male sexual response is thought to be broken up into three phases. Which occurrence is part of the plateau phase? A rapid erection of the penis occurs. The circumference of the penis thickens at the coronal ridge and a few drops of fluid appear at the urethral meatus. A decrease in vasocongestion occurs. The spermatic cords shorten, causing a partial elevation of both testes.
The circumference of the penis thickens at the coronal ridge and a few drops of fluid appear at the urethral meatus. Explanation: During the plateau phase, the circumference of the penis thickens at the coronal ridge. The size of the testes also increase by 50% 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 an 18-month old to discourage self-manipulation of genitals. 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. The nurse warns parents of 2-year-old that toilet training should be initiated immediately to prevent compulsive behaviors later on. The nurse states that same-sex preference for relationships in the school-age child may be related to heterosexual or homosexual tendencies.
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. Explanation: The process of human development affects the psychosocial, emotional, and biologic aspects of life, which in turn affect a person's sexuality. The 4 to 6 year-old becomes increasingly aware of the sexual self, demonstrated by enjoyment in exploring body parts of self and playmates, and engaging in masturbation. Parents may cause anxiety in the child by intolerance of inconsistency of sex-role behavior. The nurse should teach the parents of an 18-month old to not discourage self-manipulation of genitals. Parents should allow toddlers to designate their own readiness for toilet training because strict measures may lead to compulsive behaviors later. Same-sex preference for relationships is not related to heterosexual or homosexual tendencies in the school-age child.
A patient calls the clinic and tells the nurse they have a foamy, greenish, and itchy vaginal discharge. The patient asks the nurse what the significance of this discharge is. What is the best response by the nurse? Drainage is physiologic and normal. The patient may have trichomoniasis. Drainage is caused by vaginal dryness. The patient may have chlamydia.
The patient may have trichomoniasis. Explanation: Mucus or white discharge from the vagina is physiologic and normal. Drainage caused by Candida is curd-like and white, while infection with trichomonas is often foamy and green in color. Vaginal dryness causes scant and mucoid drainage that may be blood-tinged. Many people with Chlamydia are asymptomatic without discharge.
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, while she is happily married, she feels like a man inside. Cathleen describes this as feeling "trapped" inside her female body. The term for this behavior is which of the following? Transvestite Bisexual Gender role behavior Transsexual
Transsexual Explanation: A transsexual is a person of a certain biologic gender who has the feelings of the opposite sex. A bisexual is a person who finds pleasure with both opposite-sex and same-sex partners. A transvestite is an individual who desires to take on the role or wear the clothes of the opposite sex. Gender role behavior is the behavior a person conveys about being male or female.
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? Acquired immunodeficiency syndrome (AIDS) Chlamydia trachomatis Trichomonas vaginalis Neisseria gonorrhoeae
Trichomonas vaginalis Explanation: Trichomonas vaginalis is characterized by foul-smelling vaginal discharge that is thin, foamy, and green in color; itching of vulva and vagina; and burning on urination. Fatigue, diarrhea, weight loss, enlarged lymph nodes, fever, anorexia, and night sweats are common with AIDS. Vaginal discharge, burning on urination, urinary frequency, dysuria, and urethral soreness is common with Chlamydia trachomatis. Neisseria gonorrhoeae may be symptom free, or may present in males with purulent penile discharge, dysuria, and frequency of urination; women typically present with dysuria, abnormal menses, vaginal discharge, or pelvic inflammatory disease.
Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina? Nonspecific vaginitis Herpes simplex 1 Herpes simplex 2 Trichomoniasis
Trichomoniasis Explanation: Trichomoniasis is characterized by thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina; it is often asymptomatic in males. Nonspecific vaginitis is characterized by foul-smelling, thin, grayish-white vaginal discharge. Herpes simplex virus type 1 and 2 are characterized by lesions.
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 Dyspareunia Orgasmic dysfunction Celibacy
Vaginismus Explanation: 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.
During the orgasmic phase of the sexual response, the woman may experience: vaginal relaxation. bradycardia. hypoventilation. hypertension.
hypertension. Explanation: The orgasm in the woman produces contractions, and the woman experiences an increased respiratory rate, heart rate, and blood pressure.
When the mother of a 2-year-old tells the pediatric nurse that the child masturbates, the nurse informs the mother that the child: may have an identity crisis. should have a physical examination. needs family counseling. is exhibiting normal behavior.
is exhibiting normal behavior. Explanation: Toddlers may engage in masturbation, and parents should be assured that this behavior is normal and healthy for development.
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: decrease fear of sexual expression. enhance prevention with free care. promote general health and wellness. stop sexual promiscuity in the country.
promote general health and wellness. Explanation: The Surgeon General's Call to Action To Promote Sexual Health and Responsible Sexual Behavior, was released by the U.S. Office of the Surgeon General. Approaching sexuality issues from a public health perspective, this document emphasizes the challenges to promoting responsible sexual behavior with the goal of promoting general health and wellness in our society.
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? "Women who have multiple orgasms are promiscuous." "A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." "The larger the penis, the greater the potential for achieving orgasm." "The ability to achieve orgasm is the only indicator of a person's sexual responsiveness."
"A mature sexual relationship does not require a man and woman to achieve simultaneous orgasm." Explanation: 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.
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 concerning, because the child is too young to think about sex." "This is a normal behavior for this age group, because 5-year-olds are increasingly aware of self." "You need to be sure that you tell your child that touching is dirty." "Inform the child that it is bad to touch oneself in the private areas."
"This is a normal behavior for this age group, because 5-year-olds are increasingly aware of self." Explanation: The parents should be made aware that this is a normal developmental stage and the child is developing a sense of self. Parents may cause anxiety in the child by intolerance of inconsistency of sex-role behavior. Negative overreaction by parents to child's masturbating behavior can lead to a belief that the genitals and sex are bad and dirty.
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 Use of the BETTER model Voyeurism Masturbation
Use of Kegel exercises Explanation: Some women who practice Kegel exercises, which promote good vaginal tone, have found their sexual satisfaction is improved. The BETTER model is a tool used in conducting sexual assessments. Voyeurism and masturbation are techniques of self-stimulation that would not involve the client's partner.
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 HPV Pap smear Wet preparation
VDRL Explanation: VDRL is a blood test done to detect syphilis in males and females. HPV is a test done to detect the human papilloma virus. Pap smear is performed on females to evaluate for changes in the cervix. A wet preparation is a sample of vaginal secretions done to detect Candida, Gardnerella and Trichomonas.
When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is: refractory phase. obligatory phase. excitement phase. orgasmic phase.
excitement phase. Explanation: The excitement phase is characterized by rapid erection of the penis with tensing and thickening of the scrotal skin and elevation of the scrotal sac.
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 onlyseen in females? increase in heart rate nipples become hard and erect refractory period after orgasm loss of muscular control during orgasm causing spastic contractions
loss of muscular control during orgasm causing spastic contractions Explanation: During the excitement phase, some of the physiologic changes common in both men and women include an increased heart rate and blood pressure. Male and female nipples become hard and erect. In the orgasm phase, females have a loss of muscular control, which causes spastic contractions and twitching of the arms and legs. In the resolution phase, men experience a period during which the body does not respond to continued sexual stimulation, called the refractory period.
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 past history of an STI multiple vaginal births The client is in the first trimester of pregnancy.
past history of a rape Explanation: 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.
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: sexual identity problems. primary impotence. secondary impotence. ejaculatory dysfunction.
primary impotence. Explanation: 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: ask her husband to be present during the examination. seek a female health care provider to perform the examination. tell her to refuse to have the examination based on beliefs. have the pelvic examination with another woman present.
seek a female health care provider to perform the examination. Explanation: 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.
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 oral-genital contact is safe with use of a barrier method use of public restrooms increases the risk of contracting HIV avoid multiple partners to reduce the risk of being infected
skin-to-skin contact can spread herpes and genital warts Explanation: Some STIs spread through oral-genital sex, anal sex, or even intimate skin-to-skin contact without actual penetration (genital warts and herpes can be spread this way). Therefore, only avoiding all types of intimate genital contact can prevent these STIs. The use of a barrier method reduces the risk of STIs but should not be conveyed as "safe." HIV is contracted through direct contact with infected bodily secretions not through the use of public restrooms. While reducing sexual partners does reduce the risk of infection it only takes one exposure to contract a STI. The concept that should be conveyed is the risk that any skin-to-skin contact can spread herpes and genital warts.
The term that is used to describe the female client who states that she's a man trapped in a women's body is: bisexual. homosexual. heterosexual. transsexual.
transsexual. Explanation: A transsexual woman views herself as a man trapped in woman's body. Some people are heterosexual, attracted sexually to members of the opposite gender. Others are bisexual, attracted to both men and women sexually. Others are homosexual, attracted sexually to members of the same gender.
