Ch 46 Sexuality PrepU
A nurse is conducting a health history for a client at a local clinic. The client tells the nurse, "I feel like I am a man trapped in a woman's body." Which additional question will the nurse ask? "Are you having sex with men?" "Would you say you are gay?" "Tell me about the sex you are having with both genders." "Can you tell me what makes you feel that way?"
"Can you tell me what makes you feel that way?" Explanation: A transgender client is a person assigned a certain gender at birth who has the feelings of another gender. The person feels trapped within the body of the wrong gender. The nurse will use open-ended questions to uncover what makes the client feel that way. The nurse cannot assume the client is having sex with either or both sexes. Using closed-ended questions will not promote a discussion with the client about the individual's feelings.
In the female reproductive system, what corresponds with the male penis? Clitoris Mons pubis Skene glands Urethral meatus
Clitoris Explanation: The clitoris corresponds to the penis in the male in that both organs respond to stimulation that can result in orgasm.
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 clinic nurse is explaining the action of sildenafil (Viagra) to a client. The nurse should assess his medication regimen to determine if he is taking medications that are contraindicated with Viagra. Which of the following medications is contraindicated with Viagra? Amoxicillin Nitrates Diuretics MAO inhibitors
Nitrates Explanation: One concern with sildenafil is its potential to cause hypotension. It is contraindicated in men who take nitrates or use nitrate patches.
The nurse should inform a young female client that the barrier method providing the best protection against sexually transmitted infections (STIs) is: condoms. a diaphragm. a cervical cap. spermicides.
condoms. Explanation: Condoms provide effective (though imperfect) protection against STIs. Spermicides, diaphragms, and cervical caps do not provide effective protection against STIs.
A male client, recently diagnosed with diabetes, tells the nurse he is concerned about the effect the condition will have on his ability to participate in sexual activity. Which question by the nurse will be useful to initiate a conversation about the client's concern? "Have you discussed your fears with your partner?" "Who told you diabetes can interfere with sexual activity?" "Are you worried about erectile dysfunction being a problem?" "Can you tell me more about your worries regarding sexual activity?"
"Can you tell me more about your worries regarding sexual activity?" Explanation: Asking the client, "Can you tell me more about your worries with sexual activity?" is an open-ended question that allows the client to expand on his stated concern. Asking about the client's partner turns the focus to the partner and does not address the client's immediate concern. Asking the client who gave him this information is a close-ended question and turns the focus away from the client's concern. Erectile dysfunction, or impotence, is a great concern among men with type 2 diabetes; however, this is a close-ended question that does not allow the client to give further details.
A male client presents to the clinic with reports of erectile dysfunction. Which statement by the nurse will assist in identifying the potential cause of the erectile dysfunction? "Do you take any medications such as antihypertensives, antidepressants, or illicit drugs?" "What are you doing immediately prior to your sexual encounters?" "Have you had any discharge or pain with urination?" "Have you always had a hard time obtaining an erection?"
"Do you take any medications such as antihypertensives, antidepressants, or illicit drugs?" Explanation: Common causes of impotence (which may be physiologic or psychological) include various illnesses, treatments for these illnesses, and personal anxieties. Antihypertensive medication and antidepressant medications are a leading cause of impotence in male clients and it is possible to switch medications to help the client with this problem.
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 contraceptive method and does not prevent STIs.
A client presents to the office with concerns of low testosterone and feels it is due to a pituitary gland disorder based on what her read online. Which teaching would the nurse provide to educate this client on how testosterone is produced? "Gonads are the reproductive organs of the male and are responsible for the production of testosterone and spermatozoa." "The pituitary gland is not involved in the production of testosterone so this would not be cause for concern." "Injury to the testes can cause a reduction in testosterone that would only be noticeable through hair loss and weight gain." "Seminal fluid carries testosterone to the reproductive organs so a low level would prevent an inability to obtain an erection."
"Gonads are the reproductive organs of the male and are responsible for the production of testosterone and spermatozoa." Explanation: The testes are the male gonads, which are the reproductive glands that produce male cells (spermatozoa) and testosterone (male hormone). The pituitary gland is the master gland that is responsible for producing the follicle stimulating hormone (FSH) which triggers the production of testosterone so this could very well be a reason for low testosterone. Injury to the testes can be a possible reason for reduced testosterone levels, but this is unusual and is not limited to manifestation through hair loss and weight gain. Seminal fluid, also known as semen, is an organic fluid that may contain spermatozoa. It is secreted by the gonads; it does not transport testosterone.
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.
A nurse is collecting a sexual health history from an older adult woman who is postmenopausal. Which client statement requires further education by the nurse? "I have noticed I have less lubrication with sexual intercourse." "I have experienced orgasms that are longer than in the past." "I have had much more energy during the daytime hours." "I have noticed that intercourse is much easier than before."
"I have noticed I have less lubrication with sexual intercourse." Explanation: After menopause, certain physiologic changes result from decreasing amounts of estrogen. Women experience slower onset of and decreased amounts of lubrication, which could lead to painful intercourse. The clients comment about less lubrication should require follow-up to educate the client on the proper use of lubricants. Women may experience thinning of vaginal and vulvar tissues, genitourinary atrophy, and vasomotor symptoms that may disrupt daytime activities and sleep, resulting in heightened fatigue. The orgasmic phase may become shortened.
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 help reduce incidence of urinary tract infections." "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.
An adolescent 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 most accurate? "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 same-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.
While teaching sexual education to a group of high school students, the nurse talks about forms of birth control and when a woman can become pregnant. Which explanation by the nurse about the chance of the woman becoming pregnant is accurate? "It is not possible to become pregnant after surgical sterilization." "It is not possible to become pregnant if exclusively breastfeeding." "The withdrawal method is widely used because it is highly effective." "The intrauterine device is a highly effective and reversible contraceptive."
"The intrauterine device is a highly effective and reversible contraceptive." Explanation: The most highly effective and reversible methods of birth control are subdermal implants and two forms of intrauterine devices (IUDs). The most common contraception method worldwide is surgical sterilization. It is responsible for less than one pregnancy per 100 women in a year, but pregnancy is still a possibility. A highly effective but temporary method of contraception is that of the lactation amenorrhea method (LAM) when strict criteria are met (exclusively breastfeeding, no onset of menses, and less than 6 months postpartum). Those methods considered least effective with 18 or more pregnancies per 100 women in a year are all nonhormonal methods of contraception, including withdrawal. The only method guaranteed to prevent pregnancy is abstinence.
The parents of a 2-year-old are distraught because the discovered their child masturbating two occasions. How should the nurse best respond? "Your child is actively exploring gender identity." "It's important to be very gentle when discouraging this behavior." "Have you spoken to your care provider about this issue." "This is normal and expected developmental activity."
"This is normal and expected developmental activity." Explanation: Toddlers may engage in masturbation, and parents should be assured that this behavior is normal and healthy for development. There is no need to discourage the behavior or to make referrals. This behavior is not understood as an effort to explore gender identity.
A middle-aged male client is in the clinic for a routine blood pressure check. During the health history, the client mentions to the nurse about being concerned that the spouse is "unhappy with their love life." Which question is best for the nurse to ask? "What makes you think that? You seem so young and energetic." "You seem concerned about this. Has your spouse said anything?" "What makes you think your spouse is unhappy? What has happened?" "Can you talk openly with your spouse about your concerns?"
"What makes you think your spouse is unhappy? What has happened?" Explanation: It is often difficult for clients to discuss their sexuality. Any mention from the client should be discussed further to help discover if there are any early symptoms of a more serious condition such as undiagnosed cancer. It may also help uncover a situation which can be easily addressed such as erectile dysfunction. When the nurse uses therapeutic communication techniques (open-ended questions), the nurse demonstrates acceptance and concern for the client's perceived health need.
For which of the following clients should the nurse make a referral due to the possibility of primary erectile dysfunction? A 79 year-old client who says he cannot maintain an erection like when he was a younger adult A 21 year-old client who discloses to the nurse that he has never been able to achieve an erection A 51 year-old client who is unable to achieve an erection since starting antihypertensive therapy A 40 year-old client with major depression who says that his libido is almost non-existent
A 21 year-old client who discloses to the nurse that he has never been able to achieve an erection Explanation: A person has primary ED if they have never been able to achieve an erection necessary for intercourse; secondary ED refers to a man who was once successful in attaining and maintaining erections but who has subsequently experienced difficulty. Of the four clients, only the 21 year-old possesses the characteristics of primary ED,
Which example best supports the nursing concern of sexual dysfunction because of dyspareunia? A client with a colostomy believes they cannot have a sexual relationship with their spouse because the spouse will be repulsed by the stoma. A 50-year-old client with a history of stroke is afraid to have sex with their spouse for fear that having sex will elevate their blood pressure. A 50-year-old client in the process of menopause has pain and burning during intercourse. A 39-year-old client with alcohol use disorder is no longer interested in having sex with their spouse.
A 50-year-old client 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 concern of sexual dysfunction, but because of dyspareunia.
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.
The Surgeon General's Call To Action To Promote Sexual Health and Responsible Sexual Behavior was released in 2001. The goal of this document was to achieve what? Decrease fear of alternative forms of sexual expression Reframe Americans' collective understanding of gender identity Enhance general health and wellness across the population Ensure the birth rate remains at or above the population replacement level
Enhance general health and wellness across the population 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. It did not focus on reproduction rates, gender identity or specific forms of sexual expression.
A male client has sought care because of difficulties in achieving and maintaining an erection. The nurse's education and interventions will focus on what phase of the sexual response in which the man is experiencing difficulty? Resolution phase Reproductive 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. Therefore, if a man cannot achieve an erection, the difficulty occurs in the excitement phase of the sexual response. Orgasmic and resolution phases normally follow this phase. There is no "reproductive" phase.
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.
The nurse prepares to assess a client who is presenting to the infertility clinic for her first appointment. What should the nurse include when obtaining data from the client? History of an untreated sexually transmitted infection (STI) Premenstrual symptoms Age at onset of menses Recent untreated urinary tract infection (UTI)
History of an untreated sexually transmitted infection (STI) Explanation: Health problems caused by STIs tend to be more severe and more frequent for women than for men, in part because the frequency of asymptomatic infection means that many women do not seek care until serious problems have developed. Some STIs can spread into the uterus (womb) and fallopian tubes to cause pelvic inflammatory disease (PID), which in turn is a major cause of both infertility and ectopic (tubal) pregnancy. The age at onset of menses is important to note for the client's overall health history however, it is not a cause of infertility. An untreated UTI will not lead to infertility. Premenstrual symptoms are not relevant in assessment of fertility.
The nurse is advising an adolescent male about sexual myths that have him concerned. Which client education accurately describe 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.
he 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.
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.
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 prepares to discuss emergency contraception with a client who reportedly had unprotected sex the day before. What information should be covered when counseling the client? Select All That Apply Over the counter availability for persons 16 years and older. The need to take oral contraceptives within 120 hours after intercourse. Oral contraceptives are up to 89% effective in preventing pregnancy. A copper intrauterine device (IUD) can be inserted five to seven days after sex. It is unlikely the client will become pregnant after one sexual encounter
The need to take oral contraceptives within 120 hours after intercourse. Oral contraceptives are up to 89% effective in preventing pregnancy. A copper intrauterine device (IUD) can be inserted five to seven days after sex. Explanation: Emergency contraception is provided in two ways: 1)Increased doses of specific oral contraceptive pills. Emergency 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. 2)Insertion of a copper IUD within 5 to 7 days after unprotected intercourse. Discussing the over the counter availability may or may not be appropriate depending on the age of the client. There is a strong likelihood that a client may become pregnant if ovulating during one sexual encounter.
The nurse 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 infant to discourage self-manipulation of genitals. The nurse teaches parents of a 4-year-old child that they may cause anxiety in the child by intolerance of inconsistency of sex-role behavior. The nurse warns parents of 2-year-old toddler 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 child 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 child from 4 to 6 years of age 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 infant 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.
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.
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.
A nurse reads a client's chart and sees that she may have dyspareunia. Which of the following would be priority assessments? Select all that apply. history of hormonal imbalance client's ability to use vaginal lubricants during sexual act physical assessment of internal and external genitalia use of certain medications such as antihypertensives history of neurologic disorders
history of hormonal imbalance client's ability to use vaginal lubricants during sexual act physical assessment of internal and external genitalia Explanation: Dyspareunia is painful intercourse. Assessment priorities for these clients include determining if the client has a history of hormonal imbalances, assessing the client's ability to use vaginal lubrication during the sexual act, and performing a physical assessment of internal and external genitalia. Assessing for the use of antihypertensive medication is important in the client with erectile dysfunction. History of neurologic disorders is associated with retarded ejaculation.
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 IUDs, the nurse 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. Although 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.
A nurse is teaching a sex education class to a group of adolescent girls. They ask the nurse about the sexual response cycle in females. Which physiologic response does the nurse tell them is only seen in girls/women? increase in heart rate nipples become hard and erect refractory period after orgasm loss of muscular control during orgasm causing twitching of the arms and legs
loss of muscular control during orgasm causing twitching of the arms and legs 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, women have a loss of muscular control, which causes spastic contractions and twitching of the arms and legs, and men experience involuntary spasmodic contractions only in the penis, epididymis, vas deferens, and rectum. 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 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.
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.
Which assessment question is most likely to yield 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.
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.
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.
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.
A female nurse is giving a complete bed bath to a young male client. The nurse notices the client has an erection. Which action will the nurse take? Continue bathing the client. Scold the client for feeling attraction. Stop bathing the client and state the nurse will return when the client stops reacting. Advise the client that the nurse will tell his parents.
Continue bathing the client. Explanation: An erection may occur in response to a full bladder, fantasy, or touch. Exposure of the male client by the nurse may cause an erection during a bed bath. An erection is a normal physiological response and not something the man can voluntarily control. It does not mean the client is attracted to the nurse. By continuing on with the bath the nurse creates a sense of normalcy. There is no need to tell the client's parents about this normal reaction.
Applying the Masters and Johnson description of sexual response, place the phases in the order in which they would occur from first to last. Plateau Excitement Orgasm Resolution
Excitement Plateau Orgasm Resolution Explanation: The classic sexual response cycle outlined by Masters and Johnson (1966) is linear in nature and has four phases: excitement, plateau, orgasm, and resolution
During the orgasmic phase of the female sexual response, the client may experience what phenomenon? 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.
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 contraceptive 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 school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs? STIs are most prevalent among adolescents 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 adolescents and young adults. Explanation: STIs are most prevalent among adolescents 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 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.
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.
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.
The nurse is providing education about sexuality to a group of college freshmen. Which terms(s) describe a client's sexual orientation? Select all that apply. heterosexual (straight) gender identity gay cross dresser lesbian transgender
heterosexual, gay, lesbian Explanation: Sexual orientation refers to the preferred gender of the partner of an individual, such as heterosexual (straight), gay, and lesbian. A transgender person is when a person of a certain biological gender expresses gender differs from what is associated with the gender assigned at birth. A cross dresser is an individual who dresses like someone of the opposite sex without this indicating how they view their biologic gender, as many crossdressers view themselves according to their biologic gender. Gender identity is the inner sense a person has of being male or female.
A nurse is counseling a couple who expressed that they are having difficulty conceiving. What could the nurse consider as a cause? Changing developmental stage Having sex during ovulation Masturbating "Petting" prior to intercourse
Changing developmental stage Explanation: Changing developmental stages, such as menopause, can interfere with a couple's normal sexual expression. Masturbation, and "petting" or simple stroking as part of foreplay do not affect a couple being able to conceive. Having sex during ovulation would increase the likelihood of the client becoming pregnant.
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.
How would the nurse respond to a female client who says, "I do not think I have ever experienced an orgasm. Is that normal? "Women with a normal sexual response may experience definite orgasm." "Women with a normal sexual response may experience multiple orgasms." "A normal sexual response for women may be excitement, a plateau, then orgasm." "A normal sexual response for women may include multiple plateaus without an orgasm as a result."
"A normal sexual response for women may include multiple plateaus without an orgasm as a result." Explanation: Although studies have found only one response pattern in men, studies found variability in the patterns of sexual response among women. An intimacy-based circular model emphasized the multifactorial nature of the female sexual response, which encompasses emotional intimacy, sexual stimuli, psychological factors, and relationship satisfaction. Some women experience a plateau phase with several peaks without actually experiencing orgasm. Others experience a definite orgasm; still others experience multiple orgasms.
A nurse is conducting a health history on a 45-year-old client. The nurse is preparing to address the client's sexual history. Which statement by the nurse would be most appropriate at this time? "I am going to ask you some questions about your sexual health." "I need to determine if you are at risk for sexually transmitted infections." "Are you sexually active?" "Do you engage in safer sexual behaviors?"
"I am going to ask you some questions about your sexual health." Explanation: Because of the sensitivity of the questions involved with a sexual history, it is helpful to start this section of the interview with a transitional statement, such as, "I am going to ask you some questions about your sexual health." This question focuses the client on the topic and demonstrates the nurse's comfort with the topic. The statement regarding the need to determine if the client is at risk of sexually transmitted infections may frighten the client and does not allow for good communication regarding this sensitive topic. The statements about the client being sexually active or engaging in safer sexual behaviors indicate assumptions on the part of the nurse and are judgmental.
A nurse is conducting a healthy living workshop with a group of female college students. Which information will the nurse include in the teaching plan about condoms? Condoms can protect the client from pregnancy. Condoms are used only for penises. Condoms can be rinsed and reused. Condoms are necessary when you are having sex with multiple partners.
Condoms can protect the client from pregnancy. Explanation: Condoms should be used during every sexual encounter to provide significant (but imperfect) protection against both pregnancy and sexually transmitted infections. Condoms are worn by male and female partners. Condoms are 98% effective in preventing pregnancy. Each individual will determine which method of contraception is the best method to personally use. Condoms should never be reused.
A nurse is explaining premenstrual syndrome to a female client. The client demonstrates understands when stating what may occur in the premenstrual phase? Water loss Blurred vision Headache Calmness
Headache Explanation: Premenstruation is characterized by the appearance of one or more of the following symptoms several days before the onset of menstruation: (1) emotional symptoms such as depression, irritability, anxiety, changes in sleep habits, changes in sexual desire, poor concentration, crying, anger, and social withdrawal; and (2) physical symptoms such as appetite changes, breast tenderness, bloating and weight gain, aches and pains, swelling, acne, gastrointestinal issues, and fatigue. Blurred vision may be an ominous sign that is unrelated to premenstrual syndrome.
The nurse is preparing a talk on health issues in the lesbian, gay, bisexual, transgender, queer or questioning (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 more likely to attempt suicide. Lesbians are more likely to get preventive services for cancer.
LGBTQ youth are more likely to attempt suicide. Explanation: Healthy People 2030 found that LGBTQ youth are 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 less likely to get preventive services for cancer.
A client presents to the clinic seeking the safest contraceptive method to use. The nurse reviews the client's health history and notes that the client is 26 years old, married with no children, and a smoker. Based on the client's history the nurse identifies which methods are the most appropriate for this client? (Select All That Apply) Oral Contraceptives Norplant System Implanon Depo-Provera Transdermal Contraceptive Patch
Norplant System Implanon Depo-Provera Explanation: According to the client's history she is a smoker. Smoking increases the risks associated with oral contraceptives. The transdermal contraceptive patch has the same contraindications as oral contraceptives. All of the other options are not contraindicated based on the client's history.
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.
