Module: 19 Sexuality

A client asks for a prescription for tadalafil (Cialis). Given this information, what should the nurse ask the client prior to creating a plan of care? A) "Do you have diabetes mellitus?" B) "Are you comfortable taking this medication twice per day?" C) "Do you have any sexually transmitted infections?" D) "Do you use nitroglycerine?"

D) "Do you use nitroglycerine?" Explanation: Tadalafil (Cialis) should not be used by clients who are taking nitroglycerine and other nitrate-based drugs. Neither diabetes mellitus nor a sexually transmitted infection is a contraindication to the use of Cialis. Cialis should be taken no more than once per day, so there is no need to ask the client whether he is comfortable taking multiple doses in a 24-hour period.

The nurse is assessing a postmenopausal client. Which client statement indicates the need for further assessment by the nurse? A) "I use water-soluble lubricant to treat my vaginal dryness." B) "For some reason, I have more sexual desire than ever." C) "Sex certainly takes longer than it used to, but I'm getting used to that." D) "I am so glad that I don't need to worry about sex anymore."

D) "I am so glad that I don't need to worry about sex anymore." Explanation: The statement "I am so glad that I don't need to worry about sex anymore" merits further assessment by the nurse. This statement is unclear. Does it mean that the client is glad she doesn't have to engage in sex anymore, or does it mean she is happy that she no longer has to worry about getting pregnant? The other statements reflect normal changes associated with aging and healthy responses to those changes.

A community health nurse is educating a group of teenage girls about the prevention of dating violence. Which statement should the nurse include in teaching? A) "Studies suggest that males who monitor their partners' whereabouts are less likely to engage in violence than males who do not keep tabs on their partners." B) "Females can reduce their risk of becoming victims of violence by adopting a submissive role in the dating relationship." C) "Males who own weapons are no more likely to perpetrate dating violence than males who don't have access to weapons." D) "Males with a history of aggressive behavior are more likely to behave violently toward their partners."

D) "Males with a history of aggressive behavior are more likely to behave violently toward their partners." Explanation: Early warning signs that a male is at risk of perpetrating dating violence include jealous and possessive behaviors (such as monitoring a partner's whereabouts); ownership of weapons; and a history of aggressive behavior. Men who believe that women should be submissive are also more likely to engage in dating violence, even if their partners behave submissively. Encouraging women to act submissively thus not only places them at greater risk of violence, but erodes their sense of agency and self-worth.

The nurse is teaching a client about sexual activity during the pregnancy. Which of the client statements indicate that this teaching has been successful? A) "The elevated androgen levels that accompany pregnancy might reduce my desire for sex." B) "It's a good idea to avoid vaginal sex during the last few weeks of pregnancy, so I don't risk hurting the baby." C) "Sexual dysfunction is uncommon during pregnancy, although many women suffer from low desire during the postpartum period." D) "Pregnant women are most likely to experience sexual difficulties during the third trimester."

D) "Pregnant women are most likely to experience sexual difficulties during the third trimester." Explanation: Between 60% and 70% of women experience sexual dysfunction during pregnancy, and an even higher percentage report difficulties during the postpartum period. Sexual problems during pregnancy often fluctuate by trimester. The third trimester is the time when sexual difficulties are most common. Some of these difficulties are related to the decreased androgen levels of pregnancy, while others involve changes in body size and mechanics, self- esteem, and body image. Although some women fear that penetration will harm the fetus, this is rarely the case.

A 30-year-old client is concerned that he will become impotent after experiencing difficulty sustaining an erection during a recent sexual encounter. What is the nurse's best response to this client's concerns? A) "An occasional incident like this is normal and common." B) "Sexually transmitted infections may result in sexual problems in adults." C) "Erectile dysfunction is the correct term for inability to achieve or sustain an erection." D) "A medical diagnosis of erectile dysfunction is not made until a man has experienced erectile difficulties for a period of at least 3 months."

A) "An occasional incident like this is normal and common." Explanation: This client is concerned that he may become impotent. The correct answer at this point is to tell him that it is common and normal for men to experience occasional erectile difficulties. The other options are also true, but they do not serve to alleviate the client's concerns. If the client continues to have difficulties achieving or sustaining an erection, further investigation is warranted. Simply correcting the client's use of medical terminology does not address his concerns.

The nurse is providing education to sexual partners about the importance of treatment for a chlamydia infection. Which client statements indicate this teaching was effective? Select all that apply. A) "Chlamydia can cause inflammation of the tube that carries urine from the bladder to outside the body." B) "Severe vaginal itching can be a consequence of chlamydia." C) "Rashes commonly occur with this disease." D) "Chlamydia can spread to the uterus and fallopian tubes and result in infertility." E) "Chlamydia can result in pregnancy complications."

A) "Chlamydia can cause inflammation of the tube that carries urine from the bladder to outside the body." D) "Chlamydia can spread to the uterus and fallopian tubes and result in infertility." E) "Chlamydia can result in pregnancy complications." Explanation: In men, chlamydia is a major cause of nongonococcal urethritis. In women, chlamydia cervicitis can ascend and become pelvic inflammatory disease, or infection of the uterus, fallopian tubes, and sometimes ovaries. Pregnant women with an untreated chlamydia infection are at greater risk of developing complications such as miscarriage, premature birth, or stillbirth. Chlamydia does not cause vaginal itching or a rash.

A female client tells the nurse that she does not want to have children because there is a history of Down syndrome in her family. Which of the following statements should the nurse include in her response to this client? A) "Down syndrome is the most common genetic defect caused by an extra chromosome." B) "Babies born with Down syndrome do not live very long." C) "It is probably best to not give birth to a baby with birth defects." D) "Down syndrome only occurs in the babies of women who are over age 40."

A) "Down syndrome is the most common genetic defect caused by an extra chromosome." Explanation: Down syndrome is the most common trisomy abnormality seen in children. It is the product of the union of a normal egg or sperm with an egg or sperm that has an extra chromosome. This syndrome can occur at any time in a childbearing client of any age. Although children born with Down syndrome have a variety of physical ailments, advances in medical science have extended their life expectancy. The nurse should not provide an opinion about giving birth to a baby with birth defects.

A client wants to use the vaginal sponge as a method of contraception. Which statements indicate that the client needs further instruction about use of this method? Select all that apply. A) "I should never leave the sponge in for more than 6 hours." B) "I need to use a lubricant prior to insertion of the sponge." C) "I can insert the sponge up to 24 hours before having sex." D) "I need to add spermicidal cream to the sponge prior to having sex." E) "I need to moisten the sponge with water prior to use."

A) "I should never leave the sponge in for more than 6 hours." B) "I need to use a lubricant prior to insertion of the sponge." D) "I need to add spermicidal cream to the sponge prior to having sex." Explanation: A lubricant is not needed, because the sponge is moistened with water prior to insertion. Spermicidal cream is also unnecessary, because it is already in the sponge. To activate this spermicide, the vaginal sponge must be moistened thoroughly with water. After insertion, the sponge can remain in place for up to 24 hours.

A client who is experiencing menopause expresses an interest in using alternative and complementary therapies to manage her symptoms. Which initial response by the nurse is most appropriate? A) "What types of therapies are of interest to you?" B) "Those therapies seldom work." C) "Have you discussed this with your physician?" D) "Many women report success with these measures."

A) "What types of therapies are of interest to you?" Explanation: Alternative and complementary therapies are used by many women to manage the manifestations associated with menopause. Because the nurse has a responsibility to collect data from the client, the nurse will need to determine which of these therapies are of interest to the client. The success of such remedies varies by user and by therapy. It is inappropriate for the nurse to meet the client's request with negativity. Although clients who use alternative therapies should be asked to report these therapies to their physician, making such a request should not be the nurse's initial step in this scenario.

A 25-year-old client who is taking fluoxetine (Prozac) to treat depression reports decreased sexual desire since starting the medication. What can the nurse anticipate with regard to changes in the client's pharmacological regimen? A) Addition of bupropion to the client's drug regimen B) Immediate discontinuation of fluoxetine therapy C) Addition of flibanserin to the client's drug regimen D) Replacement of fluoxetine with paroxetine therapy

A) Addition of bupropion to the client's drug regimen Explanation: SSRI antidepressants, including both fluoxetine (Prozac) and paroxetine (Paxil), are frequently associated with a range of sexual side effects, including reduced desire. Abrupt discontinuation of these medications is not advisable because it can exacerbate a client's depression. Instead, providers may prescribe the atypical antidepressant bupropion (Wellbutrin) along with SSRI therapy, as bupropion can exert desire-increasing effects. Although flibanserin is the only FDA-approved medication specifically aimed at the treatment of low desire in women, it is rarely prescribed and would not be a provider's first treatment option in this scenario.

During a health history, the nurse learns that a female client has been trying to conceive for 2 years and does not understand why she cannot become pregnant. Which risk factors for infertility should the nurse assess for in this client? Select all that apply. A) Amount of alcohol consumed each day B) Poor nutrition C) Amount of exercise D) Employment status E) History of sexually transmitted infections

A) Amount of alcohol consumed each day B) Poor nutrition C) Amount of exercise E) History of sexually transmitted infections Explanation: Risk factors for female infertility include excess alcohol consumption, poor diet, athletic training, or being infected with a sexually transmitted infection. Employment status is not a risk factor for female infertility.

A client with a history of breast cancer who is entering menopause is seeking information about how to manage hot flashes. Which of information should the nurse provide to the client? A) Soy may be useful in reducing hot flashes, but researchers are still gathering evidence. B) Hot flashes will continue until menopause is complete. C) Estrogen is the only reliable treatment for hot flashes. D) Black cohosh is effective in the management of hot flashes.

A) Soy may be useful in reducing hot flashes, but researchers are still gathering evidence. Explanation: Recent research suggests that soy is beneficial in reducing hot flashes during menopause; however, more evidence is needed before soy may be recommended as a treatment alternative. Estrogen is not the only reliable method of treatment for hot flashes, as estrogen/progestin combinations and SERMs have also proven useful in symptom reduction. Black cohosh has been found to be ineffective in managing hot flashes. Advising the client to wait until menopause is complete is inappropriate.

Which of the following statements is true with regard to sexually transmitted infections (STIs) and older adults? A) Because pregnancy is no longer a concern, older adults may not use condoms, thereby increasing their risk of STIs. B) Normal age-related changes to the body put older adults at reduced risk of contracting STIs. C) STIs are rare among older adults because of decreased levels of sexual activity among the members of this population. D) Healthcare providers should avoid discussing STIs with older clients unless these clients initiate the conversation.

A) Because pregnancy is no longer a concern, older adults may not use condoms, thereby increasing their risk of STIs. Explanation: Older adults are living longer, healthier lives and are engaging in sex more than in previous generations. Along with this increase in sexual activity comes an increase in STIs. Normal age-related changes to the body can put older adults at greater risk of infection. In addition, because pregnancy is no longer a concern, older adults may not use condoms or may use them inconsistently. Many older adults are hesitant to discuss sexual practices with their healthcare providers. Thus, providers play a key role in STI prevention by acknowledging that continuation of sexual activity is a normal part of aging, encouraging clients to talk about their sexual practice, dispelling myths about the risk of infection, and providing information that is relevant to older clients.

The nurse is assessing the sexual health of a 20-year-old female client. Which of the following findings should the nurse identify as risk factors for dysfunctional uterine bleeding? Select all that apply. A) High level of stress B) Weight gain of 20 pounds in 2 months C) Use of birth control pills for contraception D) History of peptic ulcer diseaseE) Limited intake of high-fat foods

A) High level of stress B) Weight gain of 20 pounds in 2 months C) Use of birth control pills for contraception Explanation: A number of factors may predispose a woman to dysfunctional uterine bleeding. These factors include stress, extreme weight changes, and use of hormonal birth control. Dysfunctional uterine bleeding is usually related to hormonal imbalances and not associated with peptic ulcer disease or low-fat diets.

________ is the absence of menstruation by age 14 without having undergone other changes associated with puberty or by age 15 with having undergone normal physical changes of puberty. A) Primary amenorrhea B) Oligomenorrhea C) Secondary amenorrhea D) Metrorrhagia

A) Primary amenorrhea Explanation: Primary amenorrhea is the absence of menstruation by age 14 without having undergone other changes associated with puberty or by age 15 with having undergone normal physical changes of puberty. Secondary amenorrhea occurs when a previously menstruating woman does not spot or bleed for a period of time that is three times that of her normal cycle length. Oligomenorrhea is light or infrequent menstruation and occurs when cycles are longer than 6-7 weeks. Metrorrhagia is bleeding of variable amount between menstrual periods.

The nurse is caring for a client with erectile dysfunction (ED). Which medication(s) should the nurse anticipate being prescribed for this client? Select all that apply. A) Sildenafil (Viagra) B) Methylphenidate (Ritalin) C) Vardenafil (Levitra) D) Buspirone (BuSpar) E) Tadalafil (Cialis)

A) Sildenafil (Viagra) C) Vardenafil (Levitra) E) Tadalafil (Cialis) Explanation: Sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) are all oral medications that act by facilitating relaxation of smooth muscle in the penis, thus allowing increased blood flow and erection. Buspirone (BuSpar) is an antianxiety agent and is not effective in the treatment of ED. Methylphenidate (Ritalin) is a mild central nervous system stimulant and is not effective for ED.

A nurse is evaluating the care provided to a client who is experiencing menopause. Which observation indicates that the client is successfully managing her menopausal symptoms? A) The client has lost 5 pounds in 4 months after starting an exercise program. B) The client reports consuming about 800 mg of calcium per day. C) The client has gained 8 pounds in 3 months despite regularly engaging in non-weight-bearing exercise. D) The client states that she is "doing fine" so there's no need for her to keep talking about menopause.

A) The client has lost 5 pounds in 4 months after starting an exercise program. Explanation: Successful outcomes for a client with menopause include demonstrating a positive sense of self as evidenced by stable weight, participation in a regular exercise program, and ability to manage stress; verbalizing feelings related to changes that have occurred; and describing strategies for maintaining health. Two particularly important health maintenance strategies are engaging in regular weight-bearing exercise and consuming at least 1200 mg of calcium per day, because both of these actions help prevent osteoporosis. Of the options given, only a weight loss of 5 pounds in 4 months after starting an exercise program is evidence of successful management of menopause. The other observations are not evidence of successful management of menopause.

A client who is postmenopausal confides in the nurse that she has been experiencing pain during intercourse. What should the nurse instruct the client to do? A) Use vaginal lubricants during intercourse. B) Avoid intercourse. C) Tolerate this problem because it is a normal part of aging. D) Decrease the frequency of intercourse to decrease the pain.

A) Use vaginal lubricants during intercourse. Explanation: It is not uncommon for postmenopausal females to report painful intercourse related to a decrease in vaginal lubrication. Vaginal lubricants can be very effective in reducing pain during intercourse. Although decreased vaginal lubrication is a normal change of aging, clients do not have to tolerate the associated discomfort. Avoiding sex and decreasing the frequency of intercourse would not resolve this client's problem. Furthermore, it would be stereotypical for the nurse to assume the client has a reduced desire for intercourse because she is postmenopausal.

During a health history, the nurse learns that a male client has a recent onset of erectile dysfunction (ED). Which assessment question is likely to elicit the most useful information about factors that may be contributing to the client's ED? A) "Does this occur often?" B) "For what diseases and disorders have you been treated?" C) "Are you on any medications?" D) "How does your partner feel about this problem?"

B) "For what diseases and disorders have you been treated?" Explanation: The client's health history can provide clues regarding the underlying cause of the erectile dysfunction (ED). The question "For what diseases and disorders have you been treated?" would most likely provide useful information as to possible causes for the recent onset of the disorder. Asking the client whether ED occurs often will not help identify the cause of the problem, nor will asking the client how his partner feels about the situation. Inquiring about the client's medication use would be useful; however, the inquiry should be phrased as an open-ended question and not a closed-ended question, as it is here.

A client with genital herpes asks the nurse how to manage pain when urinating and difficulty voiding. Which response by the nurse is correct? A) "Try to limit your fluid intake. That way, you won't have to void so often." B) "Pouring room-temperature water over your genitals may make it easier for you to start urinating." C) "Be sure to keep your genitals as dry as possible. Unnecessary exposure to water can worsen your infection and cause even greater pain upon urination." D) "Unfortunately, there's nothing you can do to eliminate your discomfort. It won't go away until your current herpes outbreak is over."

B) "Pouring room-temperature water over your genitals may make it easier for you to start urinating." Explanation: Clients with genital herpes who complain of dysuria and difficulty voiding can be taught to pour water over the genitals to start urination and dilute the urine. Drinking additional fluids also helps dilute the urine and reduce the burning sensation when voiding. The nurse might additionally suggest the use of sitz baths (with tepid water) for 15-30 minutes several times a day. The warm water is soothing and decreases pain from ulcers and an irritated urethral meatus. It facilitates wound healing and facilitates urination

A female client tells the nurse she would like to wait to start a family, even though her partner seems interested in having children in the near future. The client then asks the nurse what she should do. Which response from the nurse is best? A) "Maybe you should babysit a friend's child for a while to see whether you really want children." B) "You and your partner need to discuss the decision to start a family." C) "If you don't want to start a family, then you don't have to." D) "What would you do if you became pregnant now?"

B) "You and your partner need to discuss the decision to start a family." Explanation: Making the decision to have children is the first step a couple makes in the process of conception. Sometimes one individual wishes to have a child but the other does not. In these situations, open discussion is essential to reach a mutually acceptable decision. Telling the client that she does not need to start a family if she doesn't want to ignores the issue of the partner's desire for children. Asking what the client would do if she became pregnant now does not address the client's desire to wait to start a family. Suggesting the client babysit a friend's child would be a strategy to help a person decide if he or she wants to have a family, but it does not address the client and spouse's current issue.

The nurse is planning care for a client with gonorrhea who also has a history of prior sexually transmitted infections (STIs). What is the priority nursing action for this client? A) Instruction about the need to avoid all future sexual contact B) A plan for the client to contact sexual partners regarding the diagnosis C) Recommendation that the client increase fluids and rest D) Teaching regarding the importance of adequate nutrition

B) A plan for the client to contact sexual partners regarding the diagnosis Explanation: The client has gonorrhea and a history of sexually transmitted infections. The nurse should therefore encourage the client to develop a plan for contacting sexual partners regarding the diagnosis. Increasing fluids, rest, and nutrition are important, but not as important as contacting sexual partners to protect their health and limit the spread of disease. In addition, the nurse should instruct the client to avoid sexual contact until recovered from the current illness, but not necessarily to avoid all future sexual contact.

Why would a healthcare provider most likely recommend that a 37-year-old pregnant woman seek prenatal genetic testing? A) Because women over age 35 are at increased risk for gestational diabetes and other pregnancy complications B) Because babies born to women over age 35 are at increased risk for chromosomal abnormalities C) Because women over age 35 have a higher likelihood of giving birth to twins D) Because women over age 35 are more likely to give birth to male children

B) Because babies born to women over age 35 are at increased risk for chromosomal abnormalities Explanation: Genetic testing is recommended for women over age 35 because of the increased risk of giving birth to a child with chromosomal abnormalities. Although women over 35 are at increased risk for pregnancy complications, genetic screening does not reduce this risk. Similarly, while women over age 35 are more likely to have twins, the presence of multiple embryos or fetuses can be determined without the need for genetic testing. Finally, the likelihood of having a male or female child does not vary with maternal age.

The nurse is planning care to address pain in a client with genital herpes. Which intervention would most be appropriate for this plan of care? A) Do not submerge lesions in water. B) Clean lesions two or three times a day with warm water and soap. C) Dry lesions with a hair dryer turned to the hot setting. D) Wear tight cotton clothing.

B) Clean lesions two or three times a day with warm water and soap. Explanation: Measures to reduce the discomfort of herpes lesions include cleansing the lesions two or three times a day with warm water and mild soap. Lesions should be dried using a hair dryer turned to the cool setting, and it is important to wear loose cotton clothing that will not trap moisture. Tepid sitz baths are also useful in decreasing pain from ulcers and an irritated urethral meatus.

A client diagnosed with a sexually transmitted infection reports having "no idea" how the illness was contracted. Which nursing diagnosis would be appropriate for the client at this time? A) Anxiety B) Deficient Knowledge C) Ineffective Coping D) Sexual Dysfunction

B) Deficient Knowledge Explanation: The client's statement indicates deficient knowledge regarding the transmission of sexually transmitted infections. There is not enough information provided here to determine whether the diagnoses of sexual dysfunction, ineffective coping, and/or anxiety would also be appropriate for this client.

A client reports that he is having difficulty ejaculating during sexual activity, even though he is able to maintain an erection for 30-45 minutes. The client tells the nurse that this problem began about 6 months ago and has been a source of significant worry for both him and his partner. Based on this description, the client is most likely affected by which of the following conditions? A) Retrograde ejaculation B) Delayed ejaculation C) Erectile dysfunction D) Male hypoactive sexual desire disorder

B) Delayed ejaculation Explanation: Delayed ejaculation, once called male orgasmic disorder, involves extreme difficulty ejaculating, despite the ability to maintain an erection for long periods. Delayed ejaculation is a distinct disorder from retrograde ejaculation, in which ejaculation occurs but the fluid travels into the bladder instead of out through the urethra. Erectile dysfunction is an inability to attain or maintain an erection sufficient to permit mutually satisfactory sexual intercourse with a partner. Male hypoactive sexual desire disorder involves a deficiency in or absence of sexual fantasies and persistently low interest or a total lack of interest in sexual activity.

The nurse is caring for a young adult client who reports that she has painful periods. Which assessment findings suggest that this client is experiencing primary dysmenorrhea? Select all that apply. A) Bleeding between menstrual periods B) Headache C) Fatigue D) Diarrhea E) Scant menses

B) Headache C) Fatigue D) Diarrhea Explanation: Manifestations of primary dysmenorrhea include headache, diarrhea, fatigue, vomiting, breast tenderness, and pain radiating to the lower back and thighs. Scant menses is a symptom of hormone imbalance. Bleeding between menstrual periods is characteristic of metrorrhagia.

The nurse is conducting a history and physical assessment of a sexually active teenage client. Which findings should the nurse identify as consistent with genital herpes? Select all that apply. A) Low blood pressure B) Headache C) Fever D) Dysuria E) Vaginal discharge

B) Headache C) Fever D) Dysuria E) Vaginal discharge Explanation: Manifestations of genital herpes include flulike symptoms (e.g., headache, fever), dysuria, and vaginal discharge. Low blood pressure is not a manifestation of genital herpes.

A nurse is caring for a client who is perimenopausal who states that she has recently had frequent bacterial vaginal infections. Which reason for these infections should the nurse include in the response to the client? A) Decreased vaginal pH B) Increased vaginal pH C) Increased estrogen level D) Decreased vasomotor stability

B) Increased vaginal pH Explanation: During perimenopause, vaginal pH increases, predisposing the client to bacterial vaginal infections. Also during perimenopause, estrogen levels decrease, not increase. Although decreased vasomotor stability is characteristic of perimenopause, it leads to hot flashes, not vaginal bacterial infections.

What should the nurse include in the plan of care for a client experiencing erectile dysfunction due to a chronic health condition? Select all that apply. A) Information about herbal supplements that can help treat ED B) Information on prescription medications used in ED treatment C) Brief description of types of devices and surgeries available to help with ED D) Explanation of how to discontinue any prescribed medications that may be contributing to the client's ED E) Information on the exact cause of the client's ED

B) Information on prescription medications used in ED treatment C) Brief description of types of devices and surgeries available to help with ED Explanation: When planning care for a client with ED related to a chronic health condition, the nurse should include information on medications for treatment and types of devices and surgeries available to help with the disorder. Because an exact cause of the client's ED may be difficult to determine, this information would not be appropriate for the nurse to include in the plan of care. Discussing herbal supplements would also be inappropriate because none of these substances have been found to be effective in the treatment of ED. The nurse should not encourage the client to discontinue any medications that may be causing sexual side effects; rather, the nurse should advise the client to discuss these medications with his provider before stopping treatment or pursuing other medication options.

A college student is being treated for chlamydia. What should the nurse teach this student to decrease the risk of transmitting another sexually transmitted infection? A) Unprotected sex is acceptable if you know the partner well. B) Latex condoms should be used for all sexual activity. C) Birth control pills will help decrease the risk of pregnancy and STDs. D) Condoms should be used with petroleum jelly.

B) Latex condoms should be used for all sexual activity. Explanation: Latex condoms should be used for all sexual activity to decrease the risk of contracting and/or spreading a sexually transmitted infection. Although birth control pills can decrease the risk of pregnancy, they do not protect against the transmission of sexually transmitted infections. Petroleum jelly can damage a condom, defeating its purpose for safe sex. Unprotected sex should only be considered when both partners have been tested for STIs and the relationship is mutually monogamous.

In what way does menometrorrhagia differ from menorrhagia? A) Menometrorrhagia involves excessive menstruation, whereas menorrhagia does not. B) Menometrorrhagia involves irregular menstruation, whereas menorrhagia does not .C) Menometrorrhagia involves prolonged menstruation, whereas menorrhagia does not. D) Menometrorrhagia involves the absence of menstruation, whereas menorrhagia does not.

B) Menometrorrhagia involves irregular menstruation, whereas menorrhagia does not Explanation: Menorrhagia is excessive or prolonged menstruation that occurs at regular intervals. Menometrorrhagia is irregular, excessive, prolonged menstruation. It is essentially a combination of the heavy bleeding of menorrhagia and the irregularity of metrorrhagia.

Which of the following statements is true regarding the etiology and pathophysiology of primary dysmenorrhea? A) Primary dysmenorrhea is caused by decreased levels of prostaglandins, which cause uterine contractions to increase in strength. B) Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during a woman's teens and twenties. C) Secondary dysmenorrhea is more common than primary dysmenorrhea. D) Causes of primary dysmenorrhea include endometriosis, tumors, cysts, pelvic adhesions, pelvic inflammatory disease, infections, cervical stenosis, uterine leiomyomas, and adenomyosis.

B) Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during a woman's teens and twenties. Explanation: Pain associated with menses, called dysmenorrhea, is one of the most common menstrual dysfunctions. Primary dysmenorrhea is common among women with normal menstrual function and is more common than secondary dysmenorrhea. Primary dysmenorrhea is caused by the release of prostaglandins that cause the contractions of the uterus needed to expel menstrual fluid and tissue. Primary dysmenorrhea begins within the first three or four menstrual periods after menarche and will occur with each ovulatory cycle during a woman's teens and twenties. Secondary dysmenorrhea is related to pathology or diseases that affect the uterus and pelvic area. Causes of secondary dysmenorrhea include endometriosis, tumors, cysts, pelvic adhesions, pelvic inflammatory disease, infections, cervical stenosis, uterine leiomyomas, and adenomyosis.

A female client is prescribed an androgen medication to treat an estrogen-sensitive type of breast cancer. What should the nurse instruct the client about this medication? Select all that apply. A) This medication is associated with an increased risk of multiple births. B) Secondary male sex characteristics may develop from use of this medication. C) Monitor your weight on a weekly basis when using this medication. D) When taking this medication, immediately report any calf pain or dyspnea to your healthcare provider. E) This medication must be taken with food.

B) Secondary male sex characteristics may develop from use of this medication. C) Monitor your weight on a weekly basis when using this medication. Explanation: Androgen hormone replacements may be used to treat estrogen-dependent cancers. The nurse should instruct female clients about the risk of developing secondary male sex characteristics when taking this type of medication. Androgen medications also affect body weight, so the nurse should instruct the client to monitor her weight on a weekly basis. Increased risk of multiple births is associated with female infertility medications, and increased risk of calf pain or dyspnea is associated with estrogen hormone replacement therapy. Also, androgen medications do not need to be taken with food.

A male client tells the nurse that he has no idea why his wife wants to stay married to him because he has not been able to "perform" sexually since his prostate surgery. Based on the client's statement, which nursing diagnosis would be most appropriate? A) Ineffective Coping B) Situational Low Self-Esteem C) Hormonal Imbalance D) Sexual Dysfunction

B) Situational Low Self-Esteem Explanation: This statement suggests that the client's inability to "perform" in sexual situations is causing him to question his self-worth. Situational Low Self-Esteem is therefore the most appropriate nursing diagnosis for the client at this time. A diagnosis of Sexual Dysfunction is associated with anxiety concerning the cause of the dysfunction, which is not the case for this client. The information given here is insufficient to determine whether the client is experiencing Ineffective Coping. Finally, Hormonal Imbalance is not a nursing diagnosis.

During an evaluation for infertility, a male client is asked to provide a sperm sample. What information from the client's health history could impact the quality and effectiveness of the client's sperm? Select all that apply. A) Activity level B) Smoking C) Use of over-the-counter analgesics D) Mumps after adolescence E) Number of siblings

B) Smoking C) Use of over-the-counter analgesics D) Mumps after adolescence Explanation: The quality and effectiveness of sperm is affected by smoking history, use of over-the-counter medications, and experiencing mumps after adolescence. Activity level and number of siblings are not criteria to evaluate the quality and effectiveness of a man's sperm.B) The quality and effectiveness of sperm is affected by smoking history, use of over-the-counter medications, and experiencing mumps after adolescence. Activity level and number of siblings are not criteria to evaluate the quality and effectiveness of a man's sperm.

Which of the following statements is true with regard to surgical menopause and oophorectomy? A) Natural conception is not an option for women who have undergone single oophorectomy. B) Surgical menopause may be successfully treated with hormone replacement therapy. C) Onset of surgical menopause is usually gradual. D) Oophorectomy is always accompanied by either hysterectomy or salpingectomy.

B) Surgical menopause may be successfully treated with hormone replacement therapy. Explanation: Oophorectomy may be done alone or may be combined with hysterectomy and/or salpingectomy. Unlike medical menopause, onset of surgical menopause is abrupt. Symptoms may be severe and may be treated with HRT. If oophorectomy involves one ovary, clients may still be able to conceive naturally; natural conception is not an option if oophorectomy involves both ovaries.

A nurse is gathering the health history of a client with erectile dysfunction (ED). Which finding(s) could indicate a possible cause for the client's ED? Select all that apply. A) Blood pressure of 118/68 mmHg B) Treatment for type 2 diabetes mellitus for 7 years C) Body mass index (BMI) of 24.5 D) Alcohol intake of 4 to 6 beers each day E) Engaging in moderate exercise twice a week

B) Treatment for type 2 diabetes mellitus for 7 years D) Alcohol intake of 4 to 6 beers each day Explanation: Risk factors for ED are numerous. They include advancing age, diseases such as heart disease and diabetes, trauma, and the use of prescription or illicit drugs. Excessive use of alcohol can also result in erectile dysfunction. Engaging in moderate exercise, a body mass index within normal limits, and normal blood pressure would not provide a possible cause for the client's recent experience with ED.

A female client complains of having a "strange discharge" from her vagina and "stinging" when voiding urine. Which diagnostic test(s) would be useful to aid in the diagnosis of this client's disorder? Select all that apply. A) Biopsy B) Urine culture C) Pregnancy test D) Serum hormone levels E) Papanicolaou test

B) Urine culture E) Papanicolaou test Explanation: The client is complaining of a strange discharge from her vagina, which may be indicative of infection. A Papanicolaou test would therefore be useful because it can diagnose certain types of infection. The client is also complaining of stinging with urination, so a urine culture would be helpful to rule out a urinary tract infection as the cause of the urinary pain. This client's symptoms are not associated with pregnancy, so a pregnancy test would not be useful. The remaining diagnostic tests listed here may or may not help diagnose this client's health problem.

Which of the following interventions should the nurse recommend to a client who is experiencing primary dysmenorrhea? Select all that apply. A) Increase caffeine intake. B) Use a heating pad. C) Try relaxation techniques. D) Engage in regular exercise. E) Avoid vitamin supplements.

B) Use a heating pad. C) Try relaxation techniques. D) Engage in regular exercise. Explanation: Regular aerobic activity helps decrease dysmenorrhea symptoms. Caffeine intake should be restricted to reduce irritability. Relaxation techniques may be useful because they promote the release of pain-relieving endorphins. Vitamin supplements should not be avoided and may be needed to help control symptoms. A heating pad can help reduce abdominal cramping and pain.

Which of the following terms describes involuntary tightening of the pelvic muscles that prevents penetration from occurring? A) Female orgasmic disorder B) Vaginismus C) Genito-pelvic pain/penetration disorder D) Dyspareunia

B) Vaginismus Explanation: In women, vaginismus is involuntary tightening of the pelvic muscles that prevents penetration from occurring. Although often associated with genito-pelvic pain/penetration disorder, it is not necessary for this diagnosis. Dyspareunia is pain experienced by a woman during vaginal penetration. Female orgasmic disorder is the persistent delay or absence of orgasm following a phase of normal sexual excitement.

During a vaginal examination, a woman's cervix and vaginal fornices are found to have a bluish cast to them. This finding suggests that the client A) is experiencing menopause. B) may be pregnant. C) has a pelvic infection. D) is likely anemic.

B) may be pregnant. Explanation: A bluish color to the cervix and vaginal fornices may be a sign of pregnancy. A pale cervix would be suggestive of anemia. In some women, menopause may cause the vaginal mucosa to become pale and dry, but it would not result in bluish coloration. Similarly, pelvic infection is unlikely to cause the cervix or vaginal mucosa to take on a bluish tint.

The nurse is working with a client who experiences severe premenstrual syndrome. Which of the following interventions should the nurse suggest to assist the client in coping with this disorder? A) "Take frequent rest periods." B) "Consider drinking 4 ounces of wine each day." C) "Be sure to exercise and use relaxation techniques on a regular basis." D) "Avoid contraception during menstruation when engaging in sexual intercourse."

C) "Be sure to exercise and use relaxation techniques on a regular basis." Explanation: Interventions to promote effective coping in a client with severe premenstrual syndrome include encouraging exercise and use of relaxation techniques. Alcohol intake should be avoided, so the client should not be encouraged to have 4 ounces of wine each day. The client should be instructed to use contraception if engaging in sexual intercourse during menstruation because ovulation and pregnancy can occur. Frequent rest periods would be beneficial for a client with dysfunctional uterine bleeding but not a client with premenstrual syndrome.

A young adolescent client is concerned about experiencing severe cramps with menstruation. She tells the nurse, "I don't like the pain, and I'm also worried the cramps mean there is something wrong with me." How should the nurse respond to this client? A) "Menstrual cramping is not normal but is something that can be treated." B) "You have cramps because you started your periods too early." C) "Cramps are common in young women who just started having their periods, but they can be managed and often become less severe over time." D) "You need to see a gynecologist for a pelvic examination."

C) "Cramps are common in young women who just started having their periods, but they can be managed and often become less severe over time." Explanation: Primary dysmenorrhea occurs without specific pelvic pathology and is most often seen in girls who have just begun menstruating, usually becoming less severe after a woman's mid-20s. The client is an early adolescent, so she is in the normal age range to start having periods. Cramps are common in this age range, so the client does not need to see a gynecologist for a pelvic examination. However, the client would benefit from teaching about how to reduce and manage her menstrual pain.

The nurse is instructing a client about the medication sildenafil (Viagra). Which statement on the part of the client indicates that this teaching has been effective? A) "Viagra should be taken with food." B) "I can take Viagra at the same time I take my daily alpha-adrenergic blocker." C) "I can take only one pill in a 24-hour period." D) "Viagra works by decreasing blood flow to the penis."

C) "I can take only one pill in a 24-hour period." Explanation: Sildenafil (Viagra) acts by facilitating relaxation of smooth muscle in the penis, thus allowing increased blood flow. This drug should be taken no more than once per day, should not be used by men who are taking nitrate-based drugs or alpha-adrenergic blockers, and does not need to be taken with food.

A nurse is caring for a client in menopause. When discussing hormone replacement therapy (HRT) with the client, the nurse should include which of the following statements? A) "Most healthy, recently menopausal women should not use HRT for relief of hot flashes and vaginal dryness." B) "HRT is the least effective treatment of menopausal hot flashes and vaginal dryness." C) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal estrogen is preferred." D) "The risk of blood clots in the legs or lungs is further increased by using transdermal patches, gels, or sprays."

C) "If vaginal dryness and painful intercourse are the only symptoms, then low-dose vaginal estrogen is preferred." Explanation: If vaginal dryness and dyspareunia (painful intercourse) are the only symptoms of menopause, then low-dose vaginal estrogen is preferred. Most healthy, recently menopausal women may use HRT for relief of hot flashes and vaginal dryness. Risks for blood clots in the legs and lungs are increased with HRT, but occurrence is rare in women ages 50-59. The risk is further lowered by using low-dose estrogen pills or transdermal patches, gels, or sprays.

A nurse educator is teaching a group of student nurses about problems of infertility and genetic inheritance of disease. Which statement made by a student nurse indicates that teaching has been effective? A) "A person's genotype is the observable expression of his or her traits." B) "The total genetic makeup of an individual is referred to as the phenotype." C) "In an autosomal recessive inherited disorder, the individual must have two abnormal genes to be affected." D) "An individual is said to have an autosomal dominant inherited disorder if the disease trait is homozygous."

C) "In an autosomal recessive inherited disorder, the individual must have two abnormal genes to be affected." Explanation: In an autosomal recessive inherited disorder, the individual must have two abnormal genes to be affected. A person's phenotype is the observable expression of his or her traits, and the person's genotype is his or her total genetic makeup. An individual is said to have an autosomal dominant inherited disorder if the disease trait is heterozygous—that is, the abnormal gene overshadows the normal gene of the pair to produce the trait.

A client who gave birth 10 weeks ago via cesarean section tells the nurse that she is having difficulty resuming sexual relations with her husband. She reports both reduced desire for sex and pain upon penetration. What is the nurse's best response to this client? A) "Are you breastfeeding? If so, switching to formula will help resolve these issues." B) "Most women don't report these sorts of problems unless they've delivered vaginally." C) "These problems are common during the postpartum period and usually resolve with time." D) "Based on the symptoms you're reporting, I'm concerned you might be experiencing a postpartum mood disorder."

C) "These problems are common during the postpartum period and usually resolve with time." Explanation: Both reduced desire and sexual pain are common during the postpartum period, regardless of whether a woman gave birth vaginally or via cesarean section. Typically, these problems resolve within several months. Although the hormonal changes associated with breastfeeding may contribute to sexual difficulties, women should be encouraged to continue breastfeeding for the health of their infant. In addition, even though clients with postpartum mood disorders are at increased risk for sexual dysfunction, such dysfunction is not necessarily indicative of a postpartum mood disorder.

The nurse is teaching a client with infertility about the medication clomiphene (Clomid). Which statement on the part of the client indicates that this teaching has been effective? A) "This medication increases the amount of gonadotropin-releasing hormone." B) "This medication leads to increased levels of follicle-stimulating hormone." C) "This medication stimulates the secretion of luteinizing hormone." D) "This medication increases my estrogen levels so that I can ovulate."

C) "This medication stimulates the secretion of luteinizing hormone." Explanation: Clomiphene (Clomid) stimulates the secretion of luteinizing hormone (LH), resulting in the maturation of more ovarian follicles than would normally occur. Clomiphene (Clomid) does not increase estrogen levels, nor does it stimulate secretion of FSH or gonadotropin-releasing hormone.

A nurse is caring for a client who wants more information about fertility awareness-based contraceptive methods. Which statement made by the nurse provides the client with correct information? A) "For women, the fertility window occurs between days 19 and 26 of the menstrual cycle." B) "The calendar rhythm method is based on the assumption that ovulation tends to occur about 7 days before the start of a woman's next menstrual period." C) "To use the calendar rhythm method, a woman must record her menstrual cycles for 6 months to identify the shortest and longest cycles." D) "The calendar method is the most reliable fertility awareness-based method of contraception."

C) "To use the calendar rhythm method, a woman must record her menstrual cycles for 6 months to identify the shortest and longest cycles." Explanation: Fertility awareness-based methods, also known as natural family planning, are based on an understanding of the changes that occur throughout a woman's ovulatory cycle. For women, the fertility window occurs between days 8 and 19 of 26- to 32-day cycles. The calendar rhythm method, also called the standard days method, is based on the assumption that ovulation tends to occur about 14 days before the start of a woman's next menstrual period. To use this method, the woman must record her menstrual cycles for 6 months to identify the shortest and longest cycles. The calendar method is the least reliable of the fertility awareness methods.

A public health nurse is educating a group of adults about the incidence and prevalence of sexually transmitted infections (STIs). Which statement should be included? A) "Males have higher rates of gonorrhea and chlamydia, whereas women have higher rates of syphilis." B) "Men are disproportionately affected by STIs as compared to women and infants." C) "Women often experience few early manifestations of infection, which causes them to delay diagnosis and treatment." D) "The incidence of STIs is highest among young Caucasian females."

C) "Women often experience few early manifestations of infection, which causes them to delay diagnosis and treatment." Explanation: Women often experience few early manifestations of sexually transmitted infection, which can lead to delays in diagnosis and treatment. Women have higher rates of gonorrhea, whereas men have higher rates of chlamydia and syphilis. Women and infants are disproportionately affected by STIs as compared to men.

A 45-year-old female client tells the nurse that she has not had any interest in sex for about 8 months. During this time, she has also had difficulty with arousal. Which response by the nurse is best? A) "Don't worry; all women go through periods where they are uninterested in sex." B) "It sounds like you might be experiencing female sexual interest/arousal disorder, although your symptoms need to be present for 12 full months before this diagnosis applies." C) "You are not alone. Lack of interest and arousal is the most common sexual problem reported by female clients." D) "A lack of interest in sex is a normal consequence of the aging process, and it often begins around the time a woman enters menopause."

C) "You are not alone. Lack of interest and arousal is the most common sexual problem reported by female clients." Explanation: Although some declines in desire and arousal are normal with age, a total or near-total lack of interest in sex is not typical and is likely indicative of a larger problem. A diagnosis of female sexual interest/arousal disorder may be appropriate when a woman experiences decreased or absent sexual thoughts, interest in sexual activity, mental or physical feelings of arousal, and/or pleasurable sensation during sexual activity at least 75% of the time for a period of 6 months or more. Female sexual interest/arousal disorder is the most common female sexual dysfunction.

A female client tells the nurse she is having difficulty with sexual relations because of a recent weight gain. When planning this client's care, the nurse should prioritize interventions related to which of the following areas? A) Sexual self-concept B) Gender identity C) Body image D) Gender-role behavior

C) Body image Explanation: An individual's body image is constantly changing. How people feel about their bodies is related to sexuality, and people who have a poor body image may respond negatively to sexual arousal. This is what the client is experiencing. Sexual self-concept determines the gender and kinds of individuals to whom the person is attracted; the individual's values about when, where, how, and with whom he or she expresses his or her sexuality; and the individual's ability to freely choose sexual partners. Gender identity refers to an individual's self-image as a male, female, or transgender person. Gender-role behavior is the outward expression of an individual's sense of maleness or femaleness, as well as the expression of what is perceived as gender- appropriate behavior.

A client is prescribed an oral contraceptive that contains estrogen and progesterone. What information should the nurse include when educating the client about this contraceptive? Select all that apply. A) The estrogen portion of the contraceptive may cause an increase in appetite and subsequent weight gain. B) The progesterone portion of the contraceptive may cause headaches and nausea. C) Breast tenderness may occur when taking oral contraceptives that contain estrogen. D) Taking an oral contraceptive that contains progesterone can lead to an increase in blood pressure. E) Acne and oily skin are common side effects of the progesterone component in combined oral contraceptives.

C) Breast tenderness may occur when taking oral contraceptives that contain estrogen. E) Acne and oily skin are common side effects of the progesterone component in combined oral contraceptives. Explanation: There are a variety of possible side effects when taking oral contraceptives that contain both estrogen and progesterone. The estrogen component of these contraceptives may cause headaches, nausea, breast tenderness, and an increase in blood pressure. The progesterone portion may cause acne, oily skin, an increase in appetite, and weight gain.

A client is experiencing dysuria, urinary frequency, and vaginal discharge. For which sexually transmitted infection(s) should the nurse prepare the client for testing? Select all that apply. A) Syphilis B) HIV C) Chlamydia D) Human papillomavirus (HPV) E) Gonorrhea

C) Chlamydia E) Gonorrhea Explanation: Chlamydia and gonorrhea are both bacterial infections that invade the same target organs, including the cervix and male urethra, and create the manifestations of dysuria, urinary frequency, and discharge. The other sexually transmitted infections listed here target other organs and/or create other manifestations.

A female client asks what causes the symptoms of menopause. On which hormonal function should the nurse focus when responding to this client's question? A) Increased estradiol levels B) Increased progesterone levels C) Decreased estrogen levels D) Increased luteinizing hormone levels

C) Decreased estrogen levels Explanation: As ovarian function decreases, the production of estrogen decreases, and estradiol is replaced by estrone as the major ovarian estrogen. Estrone is produced in small amounts and has only about one-tenth the biological activity of estradiol. With decreased ovarian function, production of progesterone is also markedly reduced. Although levels of luteinizing hormone increase, they are not the primary cause of the symptoms of menopause.

A client who is approaching menopause is interested in oral hormone replacement therapy (HRT) to manage her symptoms. Which of the following points should the nurse include in this client's teaching plans? A) HRT decreases a woman's risk for deep vein thrombosis. B) HRT helps protect women against stroke and congestive heart failure. C) HRT is often useful for women who are at increased risk for osteoporosis. D) HRT is associated with a reduced incidence of breast cancer and pulmonary embolism.

C) HRT is often useful for women who are at increased risk for osteoporosis. Explanation: Although HRT was once thought to exert cardioprotective effects, several large studies suggest it may actually increase a woman's likelihood of stroke and congestive heart failure. HRT is also associated with increased incidence of deep vein thrombosis, breast cancer, and pulmonary embolism. On the positive side, administration of estrogen has been shown to reduce a woman's risk of developing osteoporosis.

Which of the following statements is true with regard to women's sexual health during the postpartum period? A) The lactational amenorrhea method is the most reliable form of contraception during the postpartum period, but only if a woman is breastfeeding exclusively. B) Condoms and spermicides should not be used for contraception in the immediate postpartum period, because they increase a woman's risk for uterine infection. C) Hormonal contraceptives can affect the quantity and quality of breast milk and increase the risk for deep vein thrombosis (DVT) if used in the first month after giving birth. D) Women who use diaphragms as their primary means of contraception should be refitted for these devices no more than 6 weeks after giving birth.

C) Hormonal contraceptives can affect the quantity and quality of breast milk and increase the risk for deep vein thrombosis (DVT) if used in the first month after giving birth. Explanation: Clients who are breastfeeding exclusively may choose the lactational amenorrhea method (LAM). However, the effectiveness of LAM varies greatly, so women who use this method should be encouraged to consider a secondary method of contraception. Condoms and spermicides are an excellent and safe option in the immediate postpartum period. Hormonal contraceptives may be inappropriate because they can affect the quantity and quality of breast milk and increase the risk for DVT if used in the first month after giving birth. Diaphragms should not be used until at least 6 weeks postpartum, at which time the woman will need to be refitted for a new device.

A nurse is preparing to teach a group of young women about strategies for the relief of menstrual cramping. What should be the focus of these strategies? A) Minimizing menstrual flow B) Avoiding uterine contraction C) Increasing blood flow to the uterine muscle D) Decreasing estrogen production

C) Increasing blood flow to the uterine muscle Explanation: Menstrual cramping is a result of muscle ischemia that occurs when the client experiences powerful uterine contractions. Increasing blood flow to the uterine muscle through rest, certain exercises, application of heat to the abdomen, and presence of milder uterine contractions (such as those associated with orgasm) can decrease pain and cramping. There is no connection between pain and the actual amount of menstrual flow. Estrogen production should follow normal patterns and should not be altered.

________ is a form of sex therapy that involves several stages of guided touching in which clients and their partners are encouraged to explore each other's bodies. A) Progressive desensitization B) Integrated therapy C) Sensate focus D) Directed masturbation

C) Sensate focus Explanation: Sensate focus is a type of sex therapy that involves several stages of guided touching. With this method, clients and their partners are encouraged to explore each other's bodies, beginning with areas other than the breasts and genitals, then gradually incorporating these areas as they progress to full intercourse. Directed masturbation is a similar technique, although it is used by clients who do not wish to have a partner participate in the therapeutic process. Integrated sex therapy is a method that involves whatever combination of medical, behavioral, and cognitive techniques the provider(s) determine will be most beneficial to a client's particular problem. Finally, progressive desensitization is not a type of sex therapy.

A premenopausal client tells the nurse that she is not looking forward to menopause because it means her life is over. When the nurse asks what she means by this statement, the client says, "I can't imagine that anyone will have much use for an old woman who can't have children anymore." Based on this statement, which nursing diagnosis would most likely be appropriate for the client at this time? A) Ineffective Sexuality Pattern B) Deficient Knowledge C) Situational Low Self-Esteem D) Disturbed Body Image

C) Situational Low Self-Esteem Explanation: The client believes that once she reaches menopause, her life is over. The most appropriate nursing diagnosis for the client at this time would be Situational Low Self-Esteem, because it seems that the client feels that she will no longer have value once she enters menopause; this, in turn, suggests the client has inadequate coping skills to aid with the aging process. There is no information in the client's statement to support the diagnosis of Ineffective Sexuality Pattern. Similarly, based on this statement alone, the client may or may not have deficient knowledge or a disturbed body image.

The nurse is assessing a client who presents with an open sore on his penis. Which question by the nurse best elicits additional data related to this finding? A) "Do you think you have a disease?" B) "Have you had sexual intercourse recently?" C) "Are you promiscuous?" D) "When did you initially notice this open area?"

D) "When did you initially notice this open area?" Explanation: It is important that the nurse record the onset of the open area. The remaining questions are all closed and will not elicit much information, although determining the date of the last episode of sexual intercourse might be indicated later if a disease is diagnosed. Asking the client about promiscuity is judgmental.

A client tells the nurse she plans to use oral contraceptives for birth control. Given this information, which client behavior would cause the nurse the most concern? A) The client has several sexual partners. B) The client is being treated for bipolar disorder. C) The client smokes a pack of cigarettes each day. D) The client drinks two glasses of wine per day.

C) The client smokes a pack of cigarettes each day. Explanation: Smoking while taking oral contraceptives increases the client's risk of developing a thrombolytic disorder. Drinking two glasses of wine a day is not a contraindication to the use of oral contraceptives, nor is being treated for bipolar disorder. Having several sexual partners does not preclude the use of oral contraceptives, but the client should be advised that oral contraceptives do not provide protection against sexually transmitted infections so use of a barrier method is also recommended.

Which of the following clients would be described as experiencing premature ovarian failure? A) A 29-year-old woman who is receiving chemotherapy that damages her ovaries B) A 43-year-old woman who has irregular periods as a result of ovarian dysfunction C) A 35-year-old woman who recently underwent an oophorectomy D) A 32-year-old woman who does not ovulate because of an abnormally low number of ovarian follicles

D) A 32-year-old woman who does not ovulate because of an abnormally low number of ovarian follicles Explanation: Premature ovarian failure (POF), also known as premature menopause, occurs in women under the age of 40 who do not ovulate each month because of a low number of follicles or ovarian dysfunction. Because of her age, the 43-year-old woman would not be considered to have POF. Similarly, the client undergoing chemotherapy would be experiencing medical menopause, while the client with an oophorectomy would be experiencing surgical menopause.

Which of the following actions on the part of the nurse is most appropriate when treating an 8-year-old client who is exhibiting the symptoms of a sexually transmitted infection (STI)? A) Immediately perform a detailed examination and collect relevant specimens B) Assume that the child acquired the infection during the perinatal period C) Initiate presumptive treatment of the STI as soon as possible D) Anticipate the need to follow mandatory reporting guidelines

D) Anticipate the need to follow mandatory reporting guidelines Explanation: In some cases, STIs in young children may be the result of perinatally acquired infections that can persist for 2 to 3 years; however, the general rule is to consider infection evidence of abuse. STI testing should be conducted prior to initiating treatment of children exhibiting STI symptoms in order obtain a reliable diagnosis. It is essential to examine and collect specimens from children in a manner that minimizes trauma to them; thus, examination and collection should be conducted by a clinician with specific experience in the area of child sexual abuse. Because STIs in children are often a result of sexual abuse, and also because public health authorities require the reporting of certain STIs, the nurse should anticipate the need to follow mandatory reporting guidelines.

A postmenopausal client says to the nurse, "I've lost interest in sex over the past few months, but that's normal for women my age." Based on the client's statement, which nursing diagnosis would be most appropriate? A) Situational Low Self-Esteem B) Readiness for Enhanced Communication C) Readiness for Enhanced Relationship D) Deficient Knowledge

D) Deficient Knowledge Explanation: Although some declines in desire and arousal are normal with age, a total or near-total lack of interest in sex is not typical and is likely indicative of a larger problem. Because the client seems unaware of this fact, a diagnosis of Deficient Knowledge is most likely appropriate. Nothing in the client's statement suggests that she suffers from situational low self- esteem or is having difficulty communicating with her spouse or the healthcare team. Furthermore, nothing in the client's statement indicates that relationship issues are a factor in this situation.

An older adult client tells the nurse that he still has erections and wants to have sex with his wife, but she does not have the same interest in sexual activity as he does. What should the nurse do to assist this client? A) Explain that women lose interest in sex as part of the aging process. B) Suggest that the client wait a while and his urge to have sex will pass. C) Ask what the client has been doing to fulfill himself sexually. D) Encourage the client to ask his wife to discuss her lack of interest in sexual activity with her healthcare provider.

D) Encourage the client to ask his wife to discuss her lack of interest in sexual activity with her healthcare provider. Explanation: Lack of interest in sex is not a normal part of the aging process and suggests that the client's wife is experiencing sexual dysfunction. Thus, the nurse's most appropriate course of action would be to encourage the client to ask his wife to discuss the lack of interest with her healthcare provider as a starting point. The other choices are inappropriate and should not be provided to the client.

The nurse is planning care for a client with female orgasmic disorder. Which of the following elements would least likely be included in the client's plan of care? A) Referral to a sex therapist B) Information on the use of vibrators and other mechanical aids C) Teaching on how to perform pelvic floor exercises D) Instruction on how to obtain and use vaginal dilators

D) Instruction on how to obtain and use vaginal dilators Explanation: A variety of treatment options may be useful for women affected by female orgasmic disorder, including sex therapy; use of vibrators and other mechanical aids; and instruction regarding exercises that strengthen the pelvic floor. Vaginal dilators are used in the treatment of genito-pelvic pain/penetration disorder, not female orgasmic disorder.

The nurse instructs a client on ways to reduce premenstrual difficulty. Which statement on the part of the client indicates that the instruction was beneficial? A) The client states the need to increase dietary sugar intake to promote energy. B) The client states that guided imagery does not help with premenstrual symptoms. C) The client states the need to increase intake of simple carbohydrates.' D) The client states that reducing caffeine intake will help.

D) The client states that reducing caffeine intake will help. Explanation: The client stating that a reduction in caffeine intake will help reduce premenstrual difficulty is evidence that the instruction was beneficial. The other client statements all indicate the need for additional instruction, because guided imagery can be used to reduce stress and promote relaxation and intake of simple carbohydrates and sugars should be reduced.

Which of the following statements is true with regard to human sexuality? A) The term "intersex" is used to describe individuals whose gender identity and/or gender expression differs from the gender they were assigned at birth. B) Members of the medical and psychological professions believe that all transgender individuals are affected by gender dysphoria. C) Today, the terms "transgender" and "transsexual" are typically used interchangeably. D) Transgender individuals are at increased risk for violence, discrimination, poverty, and limited access to healthcare.

D) Transgender individuals are at increased risk for violence, discrimination, poverty, and limited access to healthcare. Explanation: Intersex individuals are people who have contradictions among their chromosomal gender, gonadal gender, internal sex organs, and external genital appearance, whereas transgender individuals are people whose gender identity and/or expression differs from the gender they were assigned at birth. In the past, transgender individuals were often referred to as transsexual, although use of this term is now usually limited to people who have changed or seek to change their sexual anatomy through medical interventions. Some-but not all-transgender individuals are affected by a condition called gender dysphoria, which involves strong and persistent feelings of discomfort with one's assigned gender. Regardless of terminology and diagnoses, all transgender individuals are at increased risk for violence, discrimination, poverty, and limited access to healthcare.

Why is type 2 diabetes associated with an increased risk of sexual dysfunction in older adults? A) Type 2 diabetes causes a decrease in sex hormone levels that may lead to diminished sexual function. B) Type 2 diabetes contributes to arthritis and other joint problems that can make sexual activity difficult. C) Type 2 diabetes brings about changes in cellular metabolism that may result in atrophy of the male and female reproductive organs. D) Type 2 diabetes leads to vascular and nerve damage that may negatively affect sexual function.

D) Type 2 diabetes leads to vascular and nerve damage that may negatively affect sexual function. Explanation: Type 2 diabetes can cause both vascular damage and nerve damage that negatively affect sexual arousal and orgasm. Although decreased sex hormone levels, arthritis, and joint pain can contribute to sexual dysfunction in older adults, these conditions are not related to type 2 diabetes. Furthermore, type 2 diabetes does not contribute to atrophy of the reproductive organs.

A menopausal client is concerned that intercourse with her spouse has become increasingly painful. What should the nurse explain about the changes in this client's body after menopause? A) Cervical mucus is thicker. B) Estrogen levels increase. C) Sexual desire diminishes. D) Vaginal lubrication decreases.

D) Vaginal lubrication decreases. Explanation: Older women remain capable of multiple orgasms and may, in fact, experience an increase in sexual desire after menopause. However, vaginal lubrication and elasticity decrease with menopause and the accompanying decline in estrogen, and this can lead to painful intercourse. The client's concerns are not related to cervical mucus.

A nurse is caring for a 15-year-old who in the past 6 months has had multiple male and female sexual partners. The nurse knows that the therapeutic statement that would be most effective is: a. "I know you feel invincible, but STIs and unwanted pregnancy are a real risk. Let's discuss what you think is the best method for protecting yourself." b. "Having sexual interaction with both males and females places you at higher risk for STIs. To protect yourself you need to decide which orientation you are." c. "Your current friends are leading you to make poor choices. You should find new friends to hang out with." d. "I think it's best to notify your parents. They know what's best for you and can help make sure you practice safe sex."

a. "I know you feel invincible, but STIs and unwanted pregnancy are a real risk. Let's discuss what you think is the best method for protecting yourself." Most young adults feel invincible, and for this reason they participate in risky behaviors. The nurse should acknowledge this feeling to the patient and offer education and alternatives, while giving the patient the autonomy to make his own decisions. The nurse should not force the patient to make a choice of orientation and should not pass judgment on a patient's sexual orientation or social network; this would make the patient feel defensive and would eliminate the trust in the relationship. Involving parents is not the first line of action; parents should be notified only if the child is in a life or death situation.

A woman is considered to be in menopause after she has missed how many menstrual cycles? a. 12 b. 6 c. 9 d. 3

a. 12 Menopause begins at that point when the client as had the last menstrual cycle and no other cycle begins for one year. The client should have no menstrual cycles for one year in order to be considered in menopause.

When completing an assessment, the nurse would focus on sexual dysfunction with a patient prescribed which medication? a. Antihypertensive b. Non-steroidal anti-inflammatory c. Bronchodilators d. Antibiotic

a. Antihypertensive Antihypertensives can cause sexual dysfunction and all the other medications do not.

The nurse is planning to teach a teenage client about sexuality. What should the nurse do first? a. Establish a relationship with the teenage client b. Provide written information about sexually transmitted infections c. Inform the teenager about the dangers of pregnancy d. Advise the teenager to maintain sexual abstinence until marriage

a. Establish a relationship with the teenage client The first step in effective communication is to establish a relationship.

A client comes to the outpatient department complaining of vaginal discharge, dysuria, and genital irritation. Suspecting a sexually transmitted disease (STD), the healthcare provider orders diagnostic tests of the vaginal discharge. Which STD must be reported to the public health department? a. Gonorrhea b. Human papillomavirus infection c. Chlamydia d. Genital herpes

a. Gonorrhea Gonorrhea must be reported to the public health department. Public health control of gonorrhea depends upon suitable antimicrobial therapy and control of the infection to others in the community.

A client requests a prescription for oral contraceptives from the nurse. Before phoning the provider to ask for a prescription, the nurse reviews the client's health history to determine if oral contraceptives are appropriate for this client. The nurse determines oral contraceptives are contraindicated. Which one of these found in the client's history would make oral contraceptives contraindicated? a. Had a thrombotic stroke at age 35 years b. Blood pressure 108/72 mm Hg c. Has a history of renal stones d. Apical heart rate 68 beats per minute

a. Had a thrombotic stroke at age 35 years Oral contraceptives can cause thrombotic strokes. If the client is a smoker the risk increases substantially. Vitals signs are within normal limits. Renal stones are not related to oral contraceptives.

What is the most serious adverse effect of menopause? Select all that apply. a. Osteoporosis b. Heart disease c. Hot flashes d. Swelling

a. Osteoporosis b. Heart disease Bones thin when ovaries stop producing estrogen. Cholesterol levels can rise, which threatens heart health.

When teaching an adolescent, female client about barrier protection during sexual intercourse, the nurse should explain that which one of these is the best protection: a. Spermicides b. Condom c. Cervical cap d. Diaphragm

b. Condom Condoms provide the best protection out of the selections, although not 100% effective.

The nurse is assessing a male client diagnosed with gonorrhea. Which symptom most likely prompted the client to seek medical attention? a. Pain red papules in the genital area b. Foul smelling discharge from the penis c. Rash on the cheeks of the face d. Warts in the genital area

b. Foul smelling discharge from the penis Symptoms of gonorrhea in men include purulent, foul-smelling drainage from the penis and painful urination. The most common clinical manifestations of gonococcal disease in males include penile purulent discharge, dysuria, and testicular discomfort. Although many females, more than 50%, will not manifest symptoms of their gonococcal infections, most males, more than 90%, will manifest symptoms. Rashes are a sign of syphilis, warts are a sign of papillomavirus and papules are a sign of genital herpes.

A 24-year old female client has just been diagnosed with condyloma acuminata (genital warts). What information is appropriate to tell this client? a. The potential for transmission to her sexual partner will be eliminated if condoms are used every time they have sexual intercourse. b. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. c. The most common treatment is metronidazole (Flagyl), which should eradicate the problem within 7 to 10 days. d. The human papillomavirus (HPV), which causes condyloma acuminata, can't be transmitted during oral sex

b. This condition puts her at a higher risk for cervical cancer; therefore, she should have a Papanicolaou (Pap) smear annually. Women with condylomata acuminata are at risk for cancer of the cervix and vulva. Yearly Pap smears are very important for early detection.

A female client is having pain midway between each menstrual cycle. Which subjective finding supports the possibility of middle cycle pain? a. Experiences pain during intercourse b. Has pain when the menstrual cycle starts c. Has sharp pain, lasting 1-3 days, scant amount of bleeding d. Experience profuse vaginal bleeding

c. Has sharp pain, lasting 1-3 days, scant amount of bleeding Knowledge-Mittelschmerz or middle pain occurs between the menstrual cycle when ovulation occurs. The pain is sharp, lasts for 1-3 days and there is a small amount of bleeding.

When obtaining a health history with a menopausal woman, which information should a nurse recognize as a contraindication for hormone replacement therapy? a. Has feelings of dizziness b. Experiences hot flashes c. History of stroke d. Experiences night sweats

c. History of stroke Hormone Replacement Therapy is associated with an increased risk of ischemic stroke and subarachnoid hemorrhage during the first year after initiation.

The nurse is preparing a patient for gender reassignment surgery. The patient states: "I should have been born a man." Which sexual orientation is the patient demonstrating? a. Bisexual b. Heterosexual c. Transsexual d. Homosexual

c. Transsexual Transsexual has the feelings of the opposite sex but is born in the body of the wrong sex. Some transsexuals have surgery to align their feelings and biology. Bisexual=same sex and opposite sex partner. Homosexual=same sex partners and Heterosexual=different sex partners.

Which of these is a health problem that can be caused by Sexually Transmitted Infections in women? a. Pelvic inflammatory disease (PID) b. Ectopic pregnancy c. Higher risk for cervical cancer d. All of the above

d. All of the above Health problems caused by STIs tend to be more serious and happen more often in women than in men. This is because women are more likely to get HIV, gonorrhea, and chlamydia. They also may not know they are infected until serious problems have developed. PID occurs when STIs spread into the uterus and fallopian tubes. PID can cause infertility and ectopic pregnancy. The human papillomavirus (HPV) infection, which causes genital warts, can cause cervical cancer and other cancers of the reproductive system. A pregnant woman with an STD can pass the disease on to her baby. Some of these illnesses can cause permanent disabilities or death.

Gonorrhea is treated with antibiotics. What problem has occurred recently in treatment? a. People have developed an allergic reaction to certain antibiotics b. All of the above c. Antibiotics have been in short supply d. The bacteria that cause gonorrhea have become resistant to certain antibiotics

d. The bacteria that cause gonorrhea have become resistant to certain antibiotics The CDC recommends only one class of antibiotics to treat gonorrhea—the cephalosporins. The most common symptom of gonorrhea is a discharge from the vagina or penis and painful or difficult urination. Women with gonorrhea can develop PID, ectopic pregnancy, and infertility. Overall, STIs that are caused by bacteria are becoming resistant to antibiotics.