NSG 115 Sexuality, Reproduction, & STI
A patient has an induced abortion with suction curettage at an ambulatory surgical center. Which instructions will the nurse include when discharging the patient?
"Abstain from vaginal intercourse for 2 weeks."
A 49-year-old patient tells the nurse that she is postmenopausal but has recently had occasional spotting. Which initial response by the nurse is appropriate?
"Are you using prescription hormone replacement therapy?"
A patient has just been instructed in the treatment for a Chlamydia trachomatis vaginal infection. Which patient statement indicates that the nurse's teaching has been effective?
"Both my partner and I will need to be treated."
The nurse is obtaining the pertinent health history for a man who is being evaluated for infertility. Which question focuses on a possible cause of infertility?
"Do you use medications to improve muscle mass?"
A 22-year-old patient tells the nurse at the health clinic that he has recently had problems with erectile dysfunction. Which question should the nurse ask to assess for possible etiologic factors in this age group?
"Do you use recreational drugs or drink alcohol?"
A 19-year-old patient visits the health clinic for a routine checkup. Which question should the nurse ask to determine whether a Pap test is needed?
"Have you had sexual intercourse?"
A patient with urinary obstruction from benign prostatic hyperplasia (BPH) tells the nurse, "My symptoms are much worse this week." Which response by the nurse is appropriate?
"Have you taken any over-the-counter (OTC) medications recently?"
A nurse is working with a male patient being treated for erectile dysfunction. Which statement indicates that additional teaching is needed?
"I have a few drinks during the week when I go out after work."
A 70-yr-old patient who has had a transurethral resection of the prostate (TURP) for benign prostatic hyperplasia (BPH) is being discharged from the hospital today. Which patient statement indicates a need for a nurse to provide additional instruction?
"I should call the doctor if I have incontinence at home."
Which statement by the patient indicates that the nurse's teaching about treating vaginal candidiasis was effective?
"I should clean carefully after each urination and bowel movement."
After the nurse has taught a patient with a newly diagnosed sexually transmitted infection (STI) about expedited partner therapy, which patient statement indicates that the teaching has been effective?
"I will make sure that my partner takes all of the prescribed medications."
Which statement by a patient indicates that the nurse's teaching about management of primary genital herpes has been effective?
"I will take the oral acyclovir (Zovirax) every 8 hours for the next week."
A patient who is diagnosed with Chlamydia tells the nurse that she is very angry because her husband is her only sexual partner. Which response should the nurse make first?
"It is understandable that you feel angry about contracting an infection."
A female patient is diagnosed with Chlamydia during a routine pelvic examination. The nurse knows that teaching regarding the management of the condition has been effective when the patient says which of the following?
"My partner will need to take antibiotics at the same time I do."
When a 31-year-old male patient returns to the clinic for follow-up after treatment for gonococcal urethritis, a purulent urethral discharge is still present. When trying to determine the reason for the recurrent infection. Which question is most appropriate for the nurse to ask the patient?
"Were your sexual partners treated with antibiotics?"
A 47-year-old patient asks whether she is going into menopause if she has not had a menstrual period for 3 months. Which response by the nurse is appropriate?
"What was your menstrual pattern before your periods stopped?"
A 34-year-old patient who is discussing contraceptive options with the nurse says, "I want to have children but not for a few years." Which response by the nurse is accurate?
"Women often have more difficultly becoming pregnant after about age 35."
The following male patients recently arrived in the emergency department. Which one should the nurse assess first?
A 19-year-old patient who is reporting severe scrotal pain
The nurse in the women's health clinic has four patients who are waiting to be seen. Which patient should the nurse see first?
A 19-year-old patient with menorrhagia who has been using superabsorbent tampons and has fever with weakness
Several patients call the urology clinic requesting appointments with the health care provider as soon as possible. Which patient will the nurse schedule to be seen first?
A 22-year-old patient who has noticed a firm, nontender lump on his scrotum
Which patient will the nurse plan on teaching about the Gardasil-9 vaccine?
A 24-year-old female patient who has not been sexually active
The nurse in the outpatient clinic notes that the following patients have not received the human papillomavirus (HPV) vaccine. Which patients should the nurse plan to teach about benefits of the vaccine?
A 24-year-old male patient who has a history of genital warts A 20-year-old female patient who has had one male sexual partner A 20-year-old female patient who has a newly diagnosed Chlamydia infection
Which patient in the women's health clinic will the nurse expect to teach about an endometrial biopsy?
A 25-year-old patient who has a family history of hereditary nonpolyposis colorectal cancer
The nurse in the clinic notes elevated prostate-specific antigen (PSA) levels in the laboratory results of these patients. Which patient's elevated PSA result requires further evaluation?
A 48-year-old patient whose father died of metastatic prostate cancer
The nurse in a health care clinic receives requests for appointments from several patients. Which patient should be seen by the health care provider first?
A 58-year-old patient who has a painful erection that has lasted more than 6 hours
The nurse has just received change-of-shift report about the following four patients. Which patient should be assessed first?
A patient with a possible ectopic pregnancy who is reporting shoulder pain.
The nurse is obtaining a sexual history from an adolescent patient. Which finding has the greatest implication for this patient's care?
Patient has been intimate with more than one person in the last year.
A female patient comes to the clinic after missing one menstrual period. She lives in a house beneath electrical lines which is located near an oil field. She drinks two caffeinated beverages a day, is a daily beer drinker, and has not stopped eating sweets. She takes a multivitamin and exercises daily. She denies drug use. Which finding in the history has the greatest implication for this patient's plan of care?
Alcohol exposure should be avoided during pregnancy due to teratogenicity.
A 19-year-old patient has genital warts around her external genitalia and perianal area. She tells the nurse that she has not sought treatment until now because "the warts are so disgusting." Which patient problem is consistent with these data?
Disturbed body image
A 58-year-old patient with erectile dysfunction (ED) tells the nurse he is interested in using sildenafil (Viagra). Which action should the nurse take first?
Ask the patient about any prescription drugs he is taking.
A patient who has had blood drawn for an insurance screening has a positive Rapid Plasma Reagin (RPR) test. Which action should the nurse take first?
Ask the patient about past treatment for syphilis.
A 27-year-old patient who has testicular cancer is being admitted for a unilateral orchiectomy. The patient does not talk to his wife and speaks to the nurse only to answer the admission questions. Which action is appropriate for the nurse to take?
Ask the patient if he has any questions or concerns about the diagnosis and treatment.
An adult patient comes for a well-check up to the primary care provider's office. In completing the office admission form, the patient does not indicate gender on the form and seems somewhat agitated when provided the form back to the nurse. How should the nurse respond?
Ask the patient if you can assist with completing the form.
A patient reports anxiety, headaches with dizziness, and abdominal bloating occurring before her menstrual periods. Which action should the nurse take first?
Ask the patient to keep track of her symptoms in a diary for 3 months.
A patient brought to the emergency department reports being sexually assaulted. The patient is confused about where she is and she has a laceration above the right eye. Which action should the nurse take first?
Assess the patient's neurologic status.
Which actions can the nurse working in a women's health clinic delegate to experienced unlicensed assistive personnel (UAP)?
Assist the health care provider with performing a Pap test. Draw blood for CA-125 levels for a patient with ovarian cancer.
The nurse in the infertility clinic is explaining in vitro fertilization (IVF) to a couple. The woman tells the nurse that they cannot afford IVF on her husband's salary. The man replies that if his wife worked outside of the house, they would have enough money. Which patient problem should the nurse identify?
Difficulty coping
Which information about continuous bladder irrigation will the nurse teach to a patient who is being admitted for a transurethral resection of the prostate (TURP)?
Bladder irrigation prevents obstruction of the catheter after surgery.
What will the nurse plan to teach the patient who is incontinent of urine following a radical retropubic prostatectomy?
Do pelvic muscle exercises.
What information will the nurse plan to teach the patient scheduled for photovaporization of the prostate (PVP)?
Care of an indwelling urinary catheter.
The health care provider prescribes the following interventions for a patient with acute prostatitis caused by Escherichia coli. Which intervention should the nurse question?
Catheterize the patient as needed if symptoms of urinary retention develop.
Which information will the nurse include when teaching a patient who has developed a small vesicovaginal fistula 2 weeks into the postpartum period?
Change the perineal pad frequently to prevent perineal skin breakdown.
A patient who was recently diagnosed with benign prostatic hyperplasia (BPH) tells the nurse that he does not want to have a transurethral resection of the prostate (TURP) because it might affect his ability to have sexual intercourse. Which action should the nurse take?
Clarify that TURP does not commonly affect erection.
When caring for a 58-year-old patient with persistent menorrhagia, what should the nurse plan to monitor?
Complete blood count (CBC)
What topic should the nurse plan to discuss with a patient who has been diagnosed with stage 0 cervical cancer?
Conization
The nurse is reviewing concepts related to physiological responses that occur during sexual acts. Which statements should the nurse identify as not being accurate?
Dopamine secretion acts as an inhibitory transmitter.
The nurse is caring for a patient with pelvic inflammatory disease (PID) requiring hospitalization. Which nursing intervention will be included in the plan of care?
Elevate the head of the bed at least 30 degrees.
What action will the nurse take when caring for a patient who has a radium implant for treatment of cervical cancer?
Encourage the patient to discuss any concerns by telephone.
A 56-year-old patient is concerned about having a moderate amount of vaginal bleeding after 5 years of menopause. What topic should the nurse plan to discuss with this patient?
Endometrial biopsy
A female infertility patient is found to be hypoestrogenic at the preconceptual clinic visit. She asks the nurse why she has never been able to get pregnant. Which is the best nursing response?
Estrogen deficiency prevents the ovum from reaching the uterus and may be a factor in infertility.
Which nonhormonal therapies will the nurse suggest for a healthy perimenopausal woman who prefers not to use hormone therapy (HRT)?
Exercise several times a week. Take black cohosh supplements. Increase intake of dietary soy products. Have a daily calcium intake of 1500 mg.
A nurse working with a family whose child recently told them that he identifies with the LGBTQ community asks the nurse to explain how this happened considering the fact that the child was raised as a male and played with appropriate toys. What is the best nursing response to the family's concerns?
Explain that sexual orientation changes can occur over time.
A patient who was admitted to the emergency department with severe abdominal pain is diagnosed with an ectopic pregnancy. The patient begins to cry and asks the nurse to leave her alone to grieve. Which action should the nurse take next?
Explain the reason for taking vital signs every 15 to 30 minutes.
What potential cause of infection will the nurse consider in the plan of care for a patient immediately after a perineal radical prostatectomy?
Fecal wound contamination
What side effect of leuprolide (Lupron) should the nurse plan to discuss with a patient who has cancer of the prostate?
Flushing
What will the nurse will ask the patient about to determine the severity of benign prostatic hyperplasia (BPH) symptoms?
Force of urinary stream
A patient is considering the use of combined estrogen-progesterone hormone replacement therapy (HRT) during menopause. Which information will the nurse include during their discussion?
HRT decreases osteoporosis risk and increases the risk for cardiovascular disease and breast cancer.
What information should the nurse include when performing discharge teaching for a patient after a vasectomy?
He should continue to use other methods of birth control for 6 weeks.
A 39-year-old patient with a history of IV drug use is seen at a community clinic. The patient reports difficulty walking, stating, "I don't know where my feet are." Diagnostic screening reveals positive rapid plasma reagin (RPR) and fluorescent treponemal antibody absorption (FTA-Abs) test results. Based on the patient history, what will the nurse assess?
Heart sounds Mental state for judgmental and orientation Skin and mucous membranes for gummas
The health care provider prescribes finasteride (Proscar) for a patient who has benign prostatic hyperplasia (BPH). What information should the nurse provide when teaching the patient about the drug?
His interest in sexual activity may decrease while he is taking the medication.
A patient tells the nurse that she would like a prescription for oral contraceptives to control her premenstrual dysphoric disorder (PMDD) symptoms. Which patient information that contraindicates oral contraceptives should be communicated to the health care provider?
History of migraine headaches
What topic should the nurse plan to teach a female patient who has genital warts?
Importance of regular Pap tests
The nurse at the family planning clinic conducts a male history for infertility evaluation. Which finding has the greatest implication for this patient's care?
Impotence due to alcohol ingestion
A patient who has benign prostatic hyperplasia (BPH) with urinary retention is admitted to the hospital with elevated blood urea nitrogen (BUN) and creatinine. Which prescribed therapy should the nurse implement first?
Insert a urinary retention cathter.
Which information will the nurse teach a patient who has chronic prostatitis?
Intercourse or masturbation will help relieve symptoms.
A patient is diagnosed with primary syphilis during her eighth week of pregnancy. What information should the nurse discuss with the patient?
Intramuscular injection of penicillin
A patient with endometriosis asks why she is being treated with a contraceptive. What information should the nurse explain about this therapy?
It suppresses the menstrual cycle by mimicking pregnancy.
A patient in the emergency department reports that she has been sexually assaulted. Which action by the nurse will help to maintain the medicolegal chain of evidence?
Labeling all specimens and other materials obtained from the patient
Which nursing assessment finding in a patient who recently started taking hormone replacement therapy (HRT) requires discussion with the health care provider about a possible change in therapy?
Left calf swelling
A patient who has been sexually assaulted expresses that she wants to prevent pregnancy. What treatment option should the nurse in the emergency department plan to discuss with the patient?
Levonorgestrel (Plan-B One-Step)
After a transurethral resection of the prostate (TURP), a 64-year-old patient with continuous bladder irrigation complains of painful bladder spasms. The nurse observes clots in the urine. Which action should the nurse take first?
Manually instill and then withdraw 50 mL of saline into the catheter.
What is most important for the nurse to teach a patient recently diagnosed with polycystic ovary syndrome?
Methods to maintain a healthy weight.
Which infection reported in the health history of a female patient will the nurse identify as a risk factor for infertility?
Neisseria gonorrhoeae
A nursery nurse performed the first physical assessment of the newborn observes that there is no clear identification of genitalia as being either female or male. How should the nurse identify this newborn?
Observation of intersex
A 22-year-old patient tells the nurse that she has not had a menstrual period for the past 3 months. Which action is most important for the nurse to take?
Obtain a urine specimen for a pregnancy test.
A patient in the sexually transmitted infection (STI) clinic tells the nurse that she is concerned she may have been exposed to gonorrhea. How will the nurse plan to determine whether the patient has gonorrhea?
Obtain secretions for a nucleic acid amplification test (NAAT).
A female college student is planning to become sexually active. She is considering birth control options and desires a method in which ovulation will be prevented. To prevent ovulation while reaching 99% effectiveness in preventing pregnancy, which option should be given the strongest consideration?
Oral contraceptive pills
A young patient who is trying to become pregnant asks the nurse how to determine when she is most likely to conceive. What information should the nurse provide?
Ovulation prediction kit can provide accurate information about ovulation.
What should the nurse plan to teach a 67-year-old patient who has been diagnosed with orchitis?
Pain management
A healthy 24-year-old patient who has been vaccinated against human papillomavirus (HPV) has a normal Pap test result. Which information will the nurse include in patient teaching when calling the patient with the results of the Pap test?
Pap testing is recommended every 3 years for women your age.
A patient undergoes an anterior and posterior (A&P) colporrhaphy for repair of a cystocele and rectocele. Which nursing action will be included in the postoperative care plan?
Perform urinary catheter care.
What topic should the nurse plan to teach a 26-year-old patient who has been treated for pelvic inflammatory disease?
Potential complication of infertility
The emergency department nursing assessment of a pregnant female at 35 weeks gestation reveals back pain, blood pressure 150/92, and leaking of clear fluid from the vagina. Which complication of pregnancy does the nurse suspect?
Premature rupture of membranes
A 45-year-old female patient, gravida 3 para 3, presents with complaints of decreased desire to engage in sexual activity with her husband as it is becoming more painful. What physical assessment data should the nurse focus on?
Prepare for a vaginal exam
A 53-year-old patient is scheduled for an annual physical examination. What diagnostic test will the nurse will plan to explain to the patient?
Prostate-specific antigen (PSA)
A patient with gonorrhea is treated with a single IM does of ceftriaxone and is given a prescription for azithromycin 1000 mg x 1 dose. What rationale should the nurse provide to the patient for this combination?
Provides coverage for possible chlamydia infection.
Which topic will the nurse include in the preoperative teaching for a patient admitted for an abdominal hysterectomy?
Purpose of ambulation and leg exercises
A male patient who has a profuse, purulent urethral discharge with painful urination is seen at the clinic. Which information should the nurse obtain as a basis for planning focused care?
Recent sexual contacts
When caring for a patient with continues bladder irrigation after having transurethral resection of the prostate, which action could the nurse delegate to unlicensed assistive personnel (UAP)?
Report any patient reports of pain or spasms to the nurse.
A patient with pelvic inflammatory disease (PID) is being treated with oral antibiotics as an outpatient. Which instruction will be included in patient teaching?
Return for a follow-up appointment in 2 to 3 days.
A 31-year-old patient who has been diagnosed with human papillomavirus (HPV) infection gives a health history that includes smoking tobacco, taking oral contraceptives, and having been treated twice for vaginal candidiasis. Which topic will the nurse include in patient teaching?
Risk factors for cervical cancer
A patient tells the nurse that he decided to seek treatment for erectile dysfunction (ED) because his partner "is losing patience with the situation." Which patient concern should be the focus of the nurse's follow-up questions?
Role performance
A patient who has been diagnosed with a stage 2 prostate cancer chooses the option of active surveillance. What should the nurse plan to do?
Schedule the patient for annual prostate-specific antigen testing.
A obstetric multipara with triplets is placed on bed rest at 24 weeks' gestation. Her perinatologist is managing intrauterine growth restriction with serial ultrasounds. This prescribed treatment is an example of which type of care?
Secondary prevention
Which topics will the nurse include when preparing to teach a patient with recurrent genital herpes simplex?
Sitz baths may be used to relieve discomfort caused by the lesions. Recurrent genital herpes episodes usually are shorter than the first episode. The virus can infect sexual partners even when you do not have symptoms.
The nurse is admitting a prenatal patient for diagnostic testing. While eliciting the psychosocial history, the nurse learns the patient smokes a pack of cigarettes daily, drinks a cup of cappuccino with breakfast, has smoked marijuana in the remote past, and is a social drinker. Which action should the nurse first take?
Strongly advise immediate tobacco cessation
A patient has been diagnosed with primary dysmenorrhea. How will the nurse suggest that the patient manage discomfort?
Take nonsteroidal anti-inflammatory drugs (NSAIDs) when her period starts.
A 32-year-old patient has oral contraceptives prescribed for endometriosis. What instruction should the nurse give this patient?
Take the medication every day for the next 9 months.
A patient requests a prescription for birth control pills to control severe abdominal cramping and headaches during her menstrual periods. Which action should the nurse take first?
Take the patient's personal and family health history.
Which action should the nurse take when a 35-year-old patient whose repeat cervical Pap test was abnormal?
Teach the patient about colposcopy.
Which information will the nurse plan to include when teaching a young adult who has a family history of testicular cancer about testicular self-examination?
Testicular self-examination should be done in a warm room?
A 20-year-old female patient who is being seen in the family medicine clinic for an annual physical examination reports being sexually active. What topic should the nurse plan to teach the patient?
Testing for Chlamydia infection
Which action by the unlicensed assistive personnel (UAP) who are assisting with the care of male patients with reproductive problems indicates that the nurse should provide more teaching?
The UAP leave the foreskin pulled back after cleaning the glans of a patient who has a retention catheter.
A patient is scheduled for an induced abortion using instillation of hypertonic saline solution. Which information will the nurse plan to discuss with the patient before the procedure?
The expulsion of the fetus may take 1 to 2 days.
Which assessment information collected by the nurse may present a contraindication to a testosterone replacement therapy (TRT)
The patient has had a gradual decrease in the force of his urinary stream.
A 50-year-old patient is diagnosed with uterine bleeding caused by a leiomyoma. Which information will the nurse include in the patient teaching plan?
The symptoms may decrease after the patient undergoes menopause.
What test will the nurse plan to explain to a 61-year-old patient who has an enlarged prostate detected by digital rectal examination (DRE) and an elevated prostate-specific antigen (PSA) level?
Transrectal ultrasonography (TRUS)
What health history information should the nurse obtain from the patient who has possible testicular cancer?
Undescended testicicles
A patient is on the surgical unit after a total abdominal hysterectomy. Which findings requires contacting the health care provider?
Urine output of 125 mL in the first 8 hours after surgery
A patient who has a large cystocele was admitted 10 hours ago but has not yet voided. If the patient reports no urge to void, which action should the nurse take first?
Use an ultrasound scanner to check for urinary retention.
What should the nurse assess for when performing a focused examination to determine possible causes of infertility?
Varicocele
A patient admitted with chest pain is found to have positive rapid plasma reagin (RPR) and fluorescent treponemal antibody absorption (FTA-Abs) tests, rashes on the palms and the soles of the feet, and moist papules in the anal and vulvar area. Which action will the nurse include in the plan of care?
Wear gloves for patient contact.
A male patient who has been diagnosed with gonococcal urethritis tells the nurse he had recent sexual contact with a woman but says she did not appear to have any disease. What information should the nurse explain to the patient?
Women may not be aware they have gonorrhea because they often do not have symptoms of infection.
A 58-year-old patient is on the medical-surgical unit after undergoing a radical vulvectomy for vulvar carcinoma. What is the greatest risk to patient at this time?
Wound infection
