Sexuality PrepU
A woman at an employee health fair informs the nurse that she has had vaginal bleeding for the past several days. She is postmenopausal and has not had a menstrual period for the past 4 years. What should the nurse instruct the woman to do? A) She should see her gynecologist or physician as soon as possible. B) She should use a birth control method, because she may be fertile with her next ovulation. C) She should disregard this bleeding episode, because it is probably normal. D) She should mention the bleeding episode to her physician at her next appointment.
A) She should see her gynecologist or physician as soon as possible. Postmenopausal bleeding, or bleeding 1 year after menses cease at menopause, must be investigated, as a malignant condition must be considered until proved otherwise. Chapter 56: Assessment and Management of Patients with Female Physiologic Processes - Page 1681
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? A) "Drink at least 6 to 8 glasses of water daily." B) "Practice your Kegel exercises several times each day." C) "Try using a water-soluble lubricant before intercourse." D) "Make sure you take your calcium supplement everyday."
C) "Try using a water-soluble lubricant before intercourse." 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. Chapter 56: Assessment and Management of Patients with Female Physiologic Processes - Page 1669
A nurse is working with a young woman who has been diagnosed with premenstrual syndrome (PMS) to develop a plan to alleviate her symptoms. Which of the following would be most appropriate to include in this plan? A) Engaging in a regular exercise program B) Planning work during the days of PMS C) Avoiding the intake of whole grains and fruits D) Decreasing water intake
A) Engaging in a regular exercise program Appropriate interventions include engaging in a regular exercise program, eating whole grains and fruits, planning work activities to accommodate the days client is less productive, and increasing water intake. Chapter 56: Assessment and Management of Patients with Female Physiologic Processes - Page 1666
The nurse is teaching a class of high school students about sexuality. After class the nurse is approached by Peggy, a 16-year-old female, who eventually discloses to the nurse that she has always had an inner sense that she was a male. The term for this is which of the following? A) Gender identity B) Biologic sex C) Sexual orientation D) Gender role behavior
A) Gender identity Gender identity is the inner sense a person has of being male or female. 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. Chapter 45: Sexuality - Page 1750
The nurse is caring for a 45-year-old female who discloses during the admission nursing history that she is no longer able to enjoy sexual relations with her husband because it causes too much pain in her vagina. The nurse includes which of the following nursing diagnoses in the patient's care plan related to this information? A) Sexual Dysfunction: Dyspareunia B) Altered Sexuality Patterns: Change in sexual expression C) Altered Sexuality Patterns: Change in positioning D) Altered Sexuality Patterns: Loss of desire
A) Sexual Dysfunction: Dyspareunia Sexual Dysfunction: Dyspareunia is the correct choice because "dyspareunia" means painful intercourse. Altered Sexuality Patterns: Change in sexual expression is more about not being able to do what is usual for a particular person or patient. The patient has no loss of desire, but cannot enjoy sex because of pain. The problem is not about positioning, but about vaginal pain with intercourse. Chapter 45: Sexuality - Page 1669-1670
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) transsexual. B) homosexual. C) bisexual. D) transvestite.
A) 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. Chapter 45: Sexuality - Page 1750
The nurse is assisting during a physical exam of a client. In regards to the genital exam, what steps does the nurse need to complete? Select all that apply. A) Use gloves during the exam. B) Use careful draping of the client. C) Provide privacy. D) Instruments should be kept cold.
A) Use gloves during the exam B) Use careful draping of the client C) Provide privacy Provide privacy and use careful draping. Instruments should be warm. Be sure to wear gloves during physical examination of a client's genitals. Chapter 45: Sexuality - Page 1767
During a routine sports physical examination, the nurse practitioner recommends HPV vaccination for an 11-year-old girl. Which statements by the client's mother demonstrates understanding of HPV vaccinations? A) "This vaccination is not indicated for my son, since boys cannot receive the HPV vaccine." B) "I will track follow-up appointments in my smartphone so she receives all three injections." C) "If my daughter is immunized against HPV, she can delay her first scheduled Pap test." D) "It's nice that she can take this vaccination intranasally, to avoid repeated injections."
B) "I will track follow-up appointments in my smartphone so she receives all three injections." The Centers for Disease Control and Prevention recommends routine vaccination of boys and girls 11-12 years of age, before they become sexually active. The vaccination is administered in three intramuscular doses, with the initial dose followed by a second dose in 2 months and a third dose 6 months after the first dose. Completion of all three doses of the vaccine is important for immunity to develop; it does not replace other strategies important in the prevention of HPV. Women still need recommended cervical cancer screening. Chapter 57: Management of Patients With Female Reproductive Disorders - Page 1692
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)
B) 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. Chapter 45: Sexuality - Page 1761
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: A) anal intercourse should be avoided. B) condoms are recommended for anal intercourse. C) lubricants should be avoided during anal intercourse. D) the rectal mucosa is thick and can withstand vigorous activity.
B) 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. Chapter 45: Sexuality - Page 1752
A nurse is preparing a presentation about cervical cancer for a local woman's group. Which of the following would the nurse include as a possible risk factor for the development of cervical cancer? A) Never having been pregnant B) Infection with humanpapilloma virus (HPV) C) Sexual activity beginning at a later age D) Having a single sexual partner
B) Infection with humanpapilloma virus (HPV) Risk factors for the development of cervical cancer include genital infections caused by the humanpapilloma virus (HPV), sexual activity at an early age, multiple sexual partners or intercourse with a high-risk male. Never having been pregnant is a risk factor for endometrial cancer. Chapter 57: Management of Patients With Female Reproductive Disorders - Page 1706
A client with erectile dysfunction is prescribed sildenafil (Viagra). Which of the following would the nurse include in the teaching plan for this client? A) "Your blood glucose level might increase when you take this drug." B) "The effects of this medication usually last for up to 48 hours." C) "You may experience headache and some flushing with this drug." D) "You need to take this medication throughout the day to be effective."
C) "You may experience headache and some flushing with this drug." Sildenafil (Viagra) may cause headache, flushing, dyspepsia, diarrhea, nasal congestion, and lightheadedness. It is taken 30 minutes to 4 hours before sexual activity. It can be taken more than once a day, but doing so will not increase its effect. It should be taken only when the client wants to have intercourse, to a maximal dose of 100 mg/24 hours. The drug may cause low blood glucose levels and abnormal liver function tests. Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders - Page
A client with challenging menopausal symptoms has discussed treatment options with the physician and now has some questions for the nurse. The client asks, "What are the potential risks of hormone replacement therapy?" What is the best answer? A) heart disease B) stroke (CVA) C) All options are correct. D) breast cancer
C) All options are correct In using hormonal replacement therapy, the risks of breast cancer and the seriousness of future myocardial infarction and stroke may outweigh the potential benefit of alleviating symptoms associated with menopause. The Women's Health Initiative study revealed an increase in breast cancer, blood clots, stroke, and heart disease in postmenopausal women taking HRT. Chapter 57: Management of Patients With Female Reproductive Disorders - Page 1683
A man 50 years of age has a long history of diabetes, which is poorly controlled. What does diabetes greatly increase the man's risk of experiencing? A) Sexually transmitted infections B) Retarded ejaculation C) Erectile dysfunction D) Premature ejaculation
C) Erectile dysfunction Diabetes is a significant risk factor for erectile dysfunction. The constant elevation of blood sugar in diabetes affect the vascular contraction of the male. Retarded or premature ejaculation is less likely, since these problems do not have a vascular etiology. Diabetes does not create an appreciably increased risk of developing STIs, though persons with diabetes do have an increased susceptibility to infections of all kinds. Chapter 45: Sexuality - Page 1761
The nurse conducting a community health promotion class on sexualty includes that a person's biologic sex is determined by: A) preferred gender for sexual partners. B) sense of being male or female. C) external and internal genitalia. D) act of sexual intercourse.
C) External and internal genitalia 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 identity is the inner sense a person has of being male or female. Sexual orientation refers to the preferred gender of the partner of an individual. The act of sexual intercourse is with the preferred sex. Chapter 45: Sexuality - Page 1659
Which of the following is a term used to describe excessive menstrual bleeding? A) Amenorrhea B) Metrorrhagia C) Menorrhagia D) Dysmenorrhea
C) Menorrhagia Menorrhagia is excessive menstrual bleeding. Amenorrhea is the absence of menses. Dysmenorrhea is painful menses. Metrorrhagia is excessive and prolonged menstrual bleeding. Chapter 57: Management of Patients With Female Reproductive Disorders - Page 1703
The nurse should inform a young female client that the barrier method providing the bestprotection against sexually transmitted infections (STIs) is: A) a diaphragm. B) a cervical cap. C) spermicides. D) condoms.
D) Condoms Condoms provide effective (though imperfect) protection against STIs. Spermicides, diaphragms, and cervical caps do not provide effective protection against STIs. Chapter 45: Sexuality - Page 1752
A nurse is reviewing the history of a client who is experiencing difficulty sustaining an erection. Which of the following might the nurse suspect as a possible contributing factor? A) Sinus infections B) Asthma C) Lower back pain D) Hypertension
D) Hypertension Hypertension may be a contributing factor because some types of antihypertensive agents can reduce a male's ability to achieve or sustain an erection. A history of lower back pain, sinus infections, or asthma is unrelated to erectile dysfunction. Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders - Page 1756
The nurse is providing education regarding sexually transmitted diseases. Which statement regarding herpes virus 2 (herpes genitalis) is accurate? A) The virus is very difficult to kill. B) Transmission of the virus requires sexual contact. C) Usually, the virus is killed at room temperature by drying. D) In pregnant women with active herpes, babies delivered vaginally may become infected with the virus.
D) In pregnant women with active herpes, babies delivered vaginally may become infected with the virus. A cesarean birth may be performed if the virus recurs near the time of delivery. Asexual transmission by contact with wet surfaces or self-transmission (i.e., touching a cold sore and then touching the genital area) can occur. Transmission is possible even when the carrier does not have symptoms. Chapter 57: Management of Patients With Female Reproductive Disorders - Page 1692
During a physical examination, the nurse inspects the external genitalia of a male client. Which of the following would the nurse identify as an abnormality? A) Absence of urethral discharge B) Prepuce covering the glans penis C) Slightly pendulous scrotum D) Skin lesions
D) Skin lesions During a physical examination, the nurse inspects the external genitalia, looking for abnormalities such as skin lesions and urethral discharge. Prepuce covering the glans penis is a normal finding in an uncircumcised male. The scrotum is normally pendulous, and with increasing age, it becomes more pendulous. Chapter 59: Assessment and Management of Patients with Male Reproductive Disorders - Page 1785
