T Ch 46 Sexuality NCLEX Review Questions

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? a) Menarche b) Menses c) Menopause d) Follicular phase

a) 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 male client informs the urology nurse that he is embarrassed because his wife rarely has time to reach sexual satisfaction, since he experiences an orgasm as soon as he enters the vagina. What is this condition best known as? a) Premature ejaculation b) Impotence c) Retarded ejaculation d) Erectile failure

a) Premature ejaculation Explanation: Premature ejaculation is a condition in which a man consistently reaches 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.

A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs? a) STIs are most prevalent among teenagers and young adults. b) The incidence of STIs is decreasing due to limited sex partners. c) STIs disproportionately affect people with a lower socioeconomic status and education. d) The signs and symptoms of an STI are obvious.

a) 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.

The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is: a) condoms. b) spermicides. c) a cervical cap. d) a diaphragm.

a) condoms. Explanation: Condoms provide effective (though imperfect) protection against STIs. Spermicides, diaphragms, and cervical caps do not provide effective protection against STIs.

Which patients would a nurse assess for menstrual cycle irregularities? Select all that apply. a. A patient who is breast-feeding b. A patient who is diagnosed with anorexia c. A patient who chooses to abstain from sexual intercourse d. A patient who has pelvic inflammatory disease e. A patient who is obsessed with exercising f. A patient who has a spinal cord injury

a, b, d, e. Causes of menstrual cycle irregularities include pregnancy or breast-feeding, eating disorders, extreme weight loss, excessive exercising, and pelvic inflammatory disease, as well as many other causes. Abstaining from sex and spinal cord injuries are not causes of menstrual irregularities.

A nurse is teaching parents about normal developmental aspects of sexuality in their children. Which statements from parents would warrant further teaching? Select all that apply. a. "When my 2-year-old son touches his genitals, I push his hand away and tell him 'No'." b. "I should wean my infant by 4 months and encourage him to use a sippy cup." c. "I should explain sexuality to my 9-year-old in a factual manner when she asks me questions about her body." d. "I should explain about body changes to my 11-year-old prior to them happening to alleviate her fears." e. "I should teach my 10-year-old about contraception and ways to avoid sexually transmitted diseases." f. "I should allow my teenager to establish her own beliefs and moral value system by not sharing my own beliefs."

a, b, e, f. Self-manipulation of genitals is normal behavior; parents should avoid telling a child this as "bad." Parents should avoid early weaning of infants to prevent oral deprivation. Parents should explain contraception and STIs to their adolescent children; it would be premature to do so for a 10-year-old. Parents should share their beliefs and moral system with their children. Parents should also give their children the desired information about sexuality in a clear, factual form and give them information about body changes before they experience them, to alleviate fears.

A nurse is performing sexual assessments of male patients in a long-term care facility. Which patients would the nurse flag as having an increased risk for erectile dysfunction? Select all that apply. a. A 72-year-old man with a history of diabetes b. A 78-year-old man who has a new partner c. A 75-year-old man who has Parkinson's disease d. An 80-year-old man who is an alcoholic e. An 85-year-old man who takes antihypertensive medication f. A 76-year-old man who smokes tobacco

a, d, e. Risk factors for erectile dysfunction include history of diabetes, spinal cord trauma, cardiovascular disease, surgical procedure, alcoholism, and use of antihypertensives, antidepressants, or illicit drugs. Having a new partner may be a risk factor for premature ejaculation, and a history of Parkinson's disease may predispose the patient to delayed ejaculation. Smoking is not a risk factor for impotence.

A school nurse is providing information for parents of teenagers regarding the human papillomavirus (HPV) and the recommended HPV vaccination. What teaching point would the nurse include? a. "HPV causes genital warts and cervical and other genital cancers." b. "HPV causes a single painless genital lesion and can lead to sterility." c. "50% of women between the ages of 14 and 19 are infected with HPV." d. "The HPV vaccination is only recommended for the female population."

a. HPV causes genital warts and cervical and other genital cancers. It manifests as pale, soft, papillary lesions found around the internal and external genitalia and perianal and rectal areas of the body. One in four young women between the ages of 14 and 19 is infected with at least one of the most common STIs, which include the human papillomavirus (HPV). The HPV vaccination is recommended for males and females.

A nurse is counseling an older couple regarding sexuality. Which statement from the couple should the nurse address? a. "We're at the age when we should consider ceasing sexual activity." b. "We need more time for sexual stimulation than we used to." c. "If we are unable to have sex we can still have an intimate relationship." d. "If we change our position we can still have sex and be more comfortable."

a. Sexual activity need not be hindered by age, and couples who have been consistently sexually active throughout their lives may continue their intimate relationship for as long as they desire. Nurses should teach couples that adaptation to bodily changes is possible with use of comfortable positions for intercourse and increased time for stimulation as well as teach alternatives to coitus, such as caressing, hugging, and stroking, when coitus is impossible because of illness or disability.

A 17-year-old college student calls the emergency department (ED) and tells the nurse that she was raped by a professor. She wants to come to the ED, but only if the nurse can assure her that they will not call her parents. What should be the nurse's first priority? a. Getting the patient into a safe environment and mobilizing support for her b. Encouraging the student to disclose the name of the professor so that his predatory behavior will be stopped c. Convincing the student to be assessed for pregnancy, STIs, or other complications d. Convincing the student to tell her parents so that she can receive their support

a. While the remaining options may be indicated, the first priority is to ensure the safety of the woman and to get her the support she needs at this moment.

A patient tells the nurse that she would like to use a mechanical barrier for birth control. Which method might the nurse recommend? a. Diaphragm b. Oral contraceptive pills c. Depo-Provera d. Evra patch

a. While the remaining options may be indicated, the first priority is to ensure the safety of the woman and to get her the support she needs at this moment.

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? a) Vulvodynia b) Dyspareunia c) Vaginismus d) A sexually transmitted infection (STI)

b) Dyspareunia Explanation: Dyspareunia is painful intercourse. Vaginismus is characterized by difficult penetration rather than acute pain during intercourse, and vulvodynia is associated with pain that is not limited to intercourse. 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? a) Intense physical pleasure b) Feelings of relaxation and fulfillment c) Increased blood flow to the penis d) The ability to begin the excitement phase again

b) 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? a) Increasing age b) History of hypertension c) Past history of infection d) Lack of exercise

b) History of hypertension Explanation: Past history of infection and lack of exercise does not contribute to impotence. With advancing age the sexual function, libido, and potency decrease, but is not the primary reason for impotence. Vascular problems cause about half the cases of impotence in men older than 50 years.

A nurse is providing health checkups for patients in a clinic located in a predominately LGBT community. Which health disparities should the nurse keep in mind related to this population? Select all that apply. a. LGBT youth are four times more likely to attempt suicide. b. LGBT youth are more likely to be homeless. c. Lesbians are less likely to get preventive services for cancer. d. Lesbians and bisexual females are more likely to be underweight. e. Transgender people have a high prevalence of HIV and sexually transmitted infections. f. LGBT populations have the lowest rates of tobacco, alcohol, and other drug use in the country.

b, c, e. LGBT youth are more likely to be homeless. Lesbians are less likely to get preventive services for cancer. Transgender people have a high prevalence of HIV and sexually transmitted infections. LGBT youth are two to three times more likely to attempt suicide. Lesbians and bisexual females are more likely to be overweight or obese. LGBT populations have the highest rates of tobacco, alcohol, and other drug use in the country. These health issues are partly thought to be the effects of chronic stress resulting from stigmatization.

The mother of an 8-year-old boy tells the nurse that she is worried because she has found her son masturbating on occasion. She asks the nurse how she should "handle this problem." What would be the best response of the nurse to this mother's concern? a. "Children should be taught not to masturbate because most people believe self-stimulation is wrong." b. "Masturbation is a means of learning what a person prefers sexually, and overreacting to it can lead to the child thinking sex is bad or dirty." c. "There are serious health risks associated with frequent masturbation, and the practice should be discouraged in children." d. "Children who masturbate demonstrate sexual dysfunction and should be seen by a child psychologist."

b. Masturbation is a technique of sexual expression in which a person practices self-stimulation. It is a way for people to learn what they prefer during stimulation and what feels good. The reality is that people masturbate regardless of sex, age, or marital status. People might not masturbate because they feel guilty about it or believe self-stimulation is wrong. Masturbation is not "dirty" and will not lead to blindness or insanity. Negative overreaction by parents to a child's masturbating behavior can lead to a belief that the genitals and sex are bad and dirty.

A female client has recently had surgery for cervical cancer and asks the nurse about other ways she can have sex with her husband. Which of the following statements by the nurse is most accurate? a) "Fellatio is stimulation of the female genitals." b) "Anal intercourse is not practiced by heterosexuals." c) "Stimulation of the genitals by the mouth and tongue may be used to reach orgasm." d) "Complete abstinence would satisfy your sexual needs."

c) "Stimulation of the genitals by the mouth and tongue may be used to reach orgasm." Explanation: Stimulation of the genitals by the mouth and tongue may be used as a way to reach orgasm. Abstinence is not having sex and would not meet the couple's needs. Anal intercourse, commonly practiced by gay men, is also used by heterosexual couples. Fellatio is stimulation of the male genitals; cunnilingus is stimulation of the female genitals.

While teaching sex education to a group of high school students, the nurse talks about forms of birth control. Which of the following could the nurse say is 100% effective if practiced correctly and consistently? a) Oral contraceptives b) Withdrawal prior to ejaculation c) Abstinence d) Condoms

c) Abstinence Explanation: Abstinence is not having sex. It is the most effective form of birth control, preventing pregnancy 100% of the time when practiced consistently. Oral contraceptives are hormonal preparations that may contain combinations of the hormones estrogen and progestin or progestin alone to prevent pregnancy. OC if not taken the same time everyday are not 100% effective in preventing pregnancy. Condoms provides protection from sexually transmitted infections and pregnancy but not as effective as abstinence. Withdrawl does not prevent pregnancy as sperm can be in the lubricant from the sexual stimulation from the male penis.

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

c) Antihypertensive medication Explanation: Antihypertensives are among the drugs implicated in sexual dysfunction. Antibiotics, bronchodilators, and NSAIDs do not typically have this effect.

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? a) Resolution phase b) Excitement phase c) Plateau phase d) Orgasm

c) 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.

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? a) Fetishism. b) Environmental harassment. c) Quid pro quo harassment. d) Hostile environment harassment.

c) 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.

Which of the following statements best describes the relationship between biologic sex and gender identity? a) Biologic sex is genetically determined but gender identity is chosen during adolescence. b) Biologic sex and gender identity are both modifiable by surgery and medical interventions. c) Sex is chromosomally determined, while gender is a psychosocial construct. d) Biologic sex and gender identity are considered synonymous in nursing practice.

c) 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.

Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina? a) Herpes simplex 2 b) Herpes simplex 1 c) Trichomoniasis d) Nonspecific vaginitis

c) 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 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) desire to wear the clothes of the opposite sex c) inner sense of being male or female d) preferred gender of the partner of an individual

c) inner sense of being male or female Explanation: 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.

An 18-year-old presents at a women's health care clinic seeking oral contraceptives for the first time. She tells the nurse that she wants to have sex with her boyfriend, but doesn't know what to expect. Which statement by the nurse is not accurate? a. "Vaginal intercourse is most commonly performed in the missionary position." b. "The side-by-side position achieves better clitoral stimulation than the missionary position." c. "Achieving simultaneous orgasms is the goal of vaginal intercourse." d. "The period after coitus is just as significant as the events leading up to it."

c. Simultaneous orgasms, or both people attaining orgasm at the same moment, are difficult to achieve, and a preoccupation with attaining simultaneous orgasms might disrupt the ultimate intimacy and satisfaction possible during coitus. The most common position in Western cultures is the "missionary position," in which the woman lies horizontally underneath the man. Clitoral stimulation is difficult to achieve in the missionary position. Lying side by side, female on top, and rear entry are some examples of coital positions that enable clitoral stimulation. The period after coitus is just as significant as the events leading up to it.

A nurse is assessing a patient who is visiting her gynecologist. The patient tells the nurse that she has been having a vaginal discharge that "smells bad and is green and foamy." She also complains of burning upon urination and dyspareunia. What sexually transmitted infection would the nurse suspect? a. Human papillomavirus (HPV) b. Syphilis c. Trichomoniasis d. Herpes simplex virus

c. Trichomoniasis causes a foul-smelling vaginal discharge that is thin, foamy, and green in color, and also causes itching of the vulva and vagina, burning on urination, and dyspareunia. HPV causes a profuse watery vaginal discharge, dyspareunia, intense pruritus, and vulvar irritation. Syphilis causes a single painless genital lesion 10 days to 3 months after exposure and generalized skin rash, enlarged lymph nodes, and fever that may appear 2 to 4 weeks after appearance of primary lesion and may last for several years. Herpes presents as single or multiple painful vesicles that rupture and form ulcer-like lesions, which form scabs as they heal.

A patient tells the nurse counselor that he can only get sexual pleasure by looking at the body of a person other than his wife from a distance. How would the nurse document this data? a. Masochism b. Pedophilia c. Voyeurism d. Sadism

c. Voyeurism is the achievement of sexual arousal by looking at the body of someone other than a person's own sexual partner. Masochism refers to gaining sexual pleasure from the humiliation of being abused. Pedophilia is a term used to describe the practice of adults gaining sexual fulfillment by performing sexual acts with children. Sadism refers to the practice of gaining sexual pleasure while inflicting abuse on another person.

Which assessment question is most likely to yield clinically meaningful data about a female client's sexual identity? a) "Are you satisfied with the quality of your relationships right now?" b) "Do you find that your health allows you to enjoy a meaningful sex life?" c) "Have you ever had any sexually transmitted infections in the past?" d) "How do you feel about yourself as a woman?"

d) "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. 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.

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? a) "Use talcom powder on the tampon prior to insertion," b) "The tampon should be changed hourly." c) "Tampons are dangerous, and you should not be using them." d) "The tampon should be changed frequently."

d) "The tampon should be changed frequently." Explanation: To 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.

After receiving information on various forms of birth control, a young couple decides to use a barrier method because they would like to try and conceive in a year or two. Which barrier method uses a rubber barrier to hold spermicide against the cervix? a) A cervical cap b) A condom c) A vaginal sponge d) A diaphragmc

d) A diaphragmc Explanation: A diaphragm is a dome-shaped device made from latex rubber that mechanically prevents semen from coming in contact with the cervix, and it holds a spermicidal jelly in place against the cervix. A condom rolls over an erect penis and collects the semen after ejaculation. A cervical cap is placed over the cervix and may be left in place for up to 3 days. A vaginal sponge contains spermicide and is a reservoir to hold the semen.

A nurse is caring for a 55-year-old male on an orthopedic unit. When the nurse hands the client his morning medication, he grabs her breast and squeezes it. How should the nurse best respond to this situation? a) Ask another nurse to switch assignments and care for this patient b) Withhold the client's pain medication c) Seek legal advice to bring charges against the client d) Assertively tell the client that this behavior is not acceptable

d) Assertively tell the client that this behavior is not acceptable Explanation: Squeezing the nurse's breast can be viewed as a type of sexual harassment by the client. An assertive response by the nurse is recommended as it supports the nurse in maintaining his or her self-respect and encourages the client to accept responsibility for his behavior. Inappropriate sexual behavior by a client may cause the nurse to inappropriately respond with either passive avoidance (switching assignments) or aggressive retaliation (withholding pain medication). Legal advice would only be an option if all efforts to stop the behavior were unsuccessful.

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? a) Biologic sex b) Sexual orientation c) Gender role behavior d) Bisexual

d) 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 nurse is conducting a healthy-living workshop with a group of female college students. Which method of contraception should the nurse recommend as a means of preventing both pregnancy and sexually transmitted infections? a) Intrauterine devices (IUD) b) Coitus interruptus c) Oral contraceptives d) Condoms

d) Condoms Explanation: Condoms provide significant (but imperfect) protection against both pregnancy and STIs. Coitus interruptus, also known as the rejected sexual intercourse, withdrawal or pull-out method, is a method of birth control in which a man, during sexual intercourse, withdraws his penis from a woman's vagina prior to orgasm (and ejaculation) and then directs his ejaculate (semen) away from the vagina in an effort to prevent pregnancy. Semen which is lubrication for the penis can contain sperm and STIs. Oral contraceptives prevent pregnacy but not STIs. IUDs provide no protection against STIs but prevent pregnancy.

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) Premature ejaculation d) Erectile dysfunction

d) Erectile dysfunction Explanation: 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.

During the menstrual cycle, when does ovulation typically take place? a) When sperm is present b) From days 15 to 28 c) On day 1 of a new cycle d) On day 14

d) 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.

The school nurse is visited by the parents of a girl age 9 years who express concern about the child's preference for same-sex friendships. The parents reveal that they are worried that this may be an early manifestation of homosexuality. The best response by the nurse is which of the following? a) Ask if the child is masturbating. b) Ask if menarche has occurred yet. c) This is cause for concern. d) Same-sex friendships are normal for this age.

d) Same-sex friendships are normal for this age. Explanation: The school-age child (6 to 10 years old) normally shows a tendency toward same-sex friendships. This is no cause for concern. Masturbation and menarche have nothing to do with school-age children having same-sex friendships.

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) Dyspareunia b) Orgasmic dysfunction c) Celibacy d) Vaginismus

d) 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 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) the rectal mucosa is thick and can withstand vigorous activity. b) lubricants should be avoided during anal intercourse. c) anal intercourse should be avoided. d) condoms are recommended for anal intercourse.

d) condoms are recommended for anal intercourse. Explanation: 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.

When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is: a) refractory phase. b) obligatory phase. c) orgasmic phase. d) excitement phase.

d) 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.

Which assessment question would be most appropriate for a patient who is experiencing dyspareunia? a. "Do you currently have a new partner?" b. "Have you been diagnosed with a neurologic disorder?" c. "Do you take antihypertensive medication?" d. "Do you use antihistamines?"

d. Factors contributing to dyspareunia include diabetes; hormonal imbalances; vaginal, cervical, or rectal disorders; antihistamine, alcohol, tranquilizer, or illicit drug use; and cosmetic or chemical irritants to genitals.

A school nurse is providing sex education classes for adolescents. Which statement by the nurse accurately describes normal sexual functioning? a. "Each person is born with a certain amount of sexual drive, which can be depleted in later years." b. "If you want to be a great athlete, sexual abstinence is necessary when you are training." c. "If you have a nocturnal emission (wet dream), it is an indicator of a sexual disorder." d. "It is natural for a woman to have as strong a desire for sex and enjoy it as much as a man."

d. Physiologic studies indicate that, in some respects, the woman's sex drive is not only as strong but may be even stronger than that of the man. The more consistently sexually active a person is, the longer the activity continues into the later years of life. Physiologically, the achievement of orgasm is rarely more demanding than most activities encountered in daily life; there is no scientific evidence that sex "weakens" a person. Erotic dreams that culminate in orgasms are normal common physiologic phenomena in at least 85% of men.

A nurse is teaching patients about contraception methods. Which statement by a patient indicates a need for further teaching? a. "Depo-Provera is not effective against sexually transmitted infections, but contraceptive protection is immediate if I get the injection on the first day of my period." b. "The hormonal ring contraceptive, NuvaRing, protects against pregnancy by suppressing ovulation, thickening cervical mucus, and preventing the fertilized egg from implanting in the uterus." c. "Abstinence is an effective method of contraception and may be used as a periodic or continuous strategy to prevent pregnancy and STIs." d. "Withdrawal is an effective method of birth control as well as an effective method of reducing the spread of sexually transmitted infections."

d. Withdrawal offers no protection against sexually transmitted infections. An injection of DMPA in the buttock or arm can prevent pregnancy for 12 weeks and is 99.7% effective. Protection is immediate if the injection is given on the first day of the woman's period. The NuvaRing works by inhibiting ovulation in much the same way as oral contraceptives. Used appropriately, the vaginal ring is 99.3% effective in protecting against pregnancy. Abstinence is the most effective form of birth control, preventing pregnancy 100% of the time when practiced consistently. Abstinence also prevents the transmission of STIs 100% of the time when practiced appropriately and consistently.