Prep U Fundamentals of Nursing CH 45

How would the nurse respond to a female client who says, "I do not think I have ever experienced an orgasm. Is that normal?

"A normal sexual response for women may include multiple plateaus without an orgasm as a result."

A male client presents to the clinic with reports of erectile dysfunction. Which statement by the nurse will assist in identifying the potential cause of the erectile dysfunction?

"Do you take any medications such as antihypertensives, antidepressants, or illicit drugs?"

A middle-aged male client is in the clinic for a routine blood pressure check. During the health history he mentions to the nurse that he is concerned that his wife is "unhappy with their love life." Which of the following question is best for the nurse to ask?

"What makes you think she is unhappy? What has happened?"

The nurse is teaching a male adolescent how to use a condom. Which teaching points would the nurse include? Select all that apply.

- "Immediately after ejaculation remove the condom and discard it." - "If the condom does not have a nipple receptacle, leave a small space at the end for semen to collect." - "Use a condom with every act of intercourse."

A nurse is conducting a healthy living workshop with a group of female college students. Which information will the nurse include in the teaching plan about condoms?

Condoms can protect the client from pregnancy.

A female nurse is giving a complete bed bath to a young male client. The nurse notices the client has an erection. Which action will the nurse take?

Continue bathing the client.

The nurse prepares to assess a client who is presenting to the infertility clinic for her first appointment. What should the nurse include when obtaining data from the client?

History of an untreated sexually transmitted infection (STI)

The community health nurse is aware that many factors influence a client's decision for contraception. Which of the following is the most likely reason a client would select permanent contraception?

The choice not to start a family.

An infant is identified as intersex at birth. Which education provided by the nurse is accurate?

Your child has variations in the reproductive anatomy.

The nurse recommends a barrier method of contraception for a client who is concerned about the side effects of hormonal contraception. Which method might the nurse suggest?

Cervical cap

The nurse is teaching a class of high school students about sexuality. After class the nurse is approached by Peggy, a 16-year-old female, who eventually discloses to the nurse that she has always had an inner sense that she was a male. The term for this is which of the following?

Gender identity

During the menstrual cycle, when does ovulation typically take place?

On day 14

A 19-year-old client scheduled for a vaginal exam is visibly upset and cancels the appointment when learning the clinic provider is a man. Which factor should the nurse prioritize when assisting this client?

Taught to avoid exposing herself to strangers

The nurse is conducting an interview with a client who has a sexual concern. To obtain accurate and complete information from the client, which method will the nurse use to create a comfortable environment to encourage communication?

The nurse should demonstrate ease.

Which is true regarding the female sexual response?

The plateau phase involves full elevation of the uterus and the cervix.

During the orgasmic phase of the sexual response, the woman may experience:

hypertension.

The nurse observes that a client shows signs of depression and often is found crying quietly in her room. Based on what the nurse is aware about violence against women what does the nurse suspect may have occurred with this client?

the patient is a victim of date rape

A nurse practitioner is teaching the student about sexual health and is evaluating the student's knowledge of sexual identity. The practitioner knows that the student understands when the student says which of the following?

"Gender role behavior is the behavior a person conveys about being male or female."

A 16-year-old girl tells the nurse that her friend has genital warts and asks the nurse how to make sure that she does not get them. Which of the following should the nurse recommend?

"Get the human papillomavirus vaccine."

The nurse is providing education about barrier contraceptives. Which statement by the client indicates a need for further education?

"I can leave my diaphragm in for up to 48 hours."

A gerontology nurse is discussing sexual dysfunction with an older adult male client. The nurse determines that the education has been effective when the client states:

"Malnutrition may cause impotence."

A teenage female client tells the nurse that she is having intercourse with her boyfriend. The client asks the nurse about methods to prevent pregnancy. Which statement by the nurse would be most accurate?

"Many unintended pregnancies result from the use of less effective methods of contraception."

A nurse reads in a client's chart that he or she has gender dysphoria. The nurse determines that the client understands the diagnosis when making what statement?

"People whose biologic sex at birth is contrary to the gender they identify with have gender dysphoria."

Which response will the nurse provide to a 13-year-old female client who says to the nurse, "My parents said masturbation is wrong. Is that true?"

"Tell me more about what you know of masturbation."

While teaching sexual education to a group of high school students, the nurse talks about forms of birth control and when a woman can become pregnant. Which explanation by the nurse about the chance of the woman becoming pregnant is accurate?

"The intrauterine device is a highly effective and reversible contraceptive."

The nurse assessing an adolescent's need for further information regarding sexual health should ask which question?

"What questions or concerns do you have about your sexual health?"

The nurse is preparing a presentation on contraceptive methods. Which methods are designated highly effective? Select all that apply.

- Injectable medroxyprogesterone - Subdermal implants - IUDs

The nurse is advising an adolescent male about sexual myths that have him concerned. Which statements describe accurate client education regarding these concerns? Select all that apply.

- No male or female should feel pressured into sexual activity at any age. - Masturbation or self-stimulation is a natural and healthy outlet for sexual urges. - Nocturnal emissions are normal in men of all ages.

The nurse knows that there are three basic charting methods in predicting ovulation in order to prevent pregnancy. (Select All That Apply)

- Temperature method - Calendar method - Cervical mucus method

Applying the American Psychiatric Association description of sexual response, place the phases in the order in which they would occur from first to last.

1. Appetitive 2. Excitement 3. Orgasm 4. Resolution

The nurse is preparing to counsel a couple on their sexual relationship. The nurse prepares for the session by reviewing the sexual response cycle. The nurse recalls the order of the four phases of the cycle. Place the phases in correct order as they occur. Use all options.

1. Excitement 2. Plateau 3. Orgasm 4. Resolution

A woman age 49 years has sought care from her primary care provider because of "intimacy problems." Upon questioning, the woman reveals that she is experiencing sexual desire, but that intercourse causes her significant pain. In the absence of sexual activity, the woman states that she does not have any significant vaginal discomfort. What would the clinician recognize that this client is most likely experiencing?

Dyspareunia

A man 68 years of age comes to the clinic complaining that he is having difficulty obtaining an erection. When reviewing the client's history, what might the nurse note that contributes to impotence?

History of hypertension

The forensic nurse is caring for a client who was raped four days ago. Which of the following could the nurse teach the client is an effective contraceptive?

Insertion of a copper intrauterine device (IUD)

A client comes to the women's clinic and reports to the nurse that she is having a foul-smelling, thin, grayish-white vaginal discharge. What testing will the nurse prepare the client for?

Nonspecific vaginitis

During hospitalization for a suicide attempt, the client informs the nurse that she does not want to return to work because her boss expects sexual favors each week before he gives her a paycheck. The client informs the nurse that she needs the job but is embarrassed that she performs these favors. The nurse informs the client that this is illegal behavior and is called what?

Quid pro quo harassment.

A school nurse is providing a class on sexually transmitted infections (STIs). Which statement is correct regarding STIs?

STIs are most prevalent among teenagers and young adults.

Which of the following statements best describes the relationship between biologic sex and gender identity?

Sex is chromosomally determined, while gender is a psychosocial construct.

The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by Cathleen, a 54-year-old female, who eventually discloses to the nurse that she is having a sexual affair with a female partner. The term for an individual's preference for a partner of a particular gender is which of the following?

Sexual orientation

A client is trying to be understanding; however, the client is getting frustrated by the spouse's lack of sexual response. Which factor should the nurse explore to help this physiologically healthy couple create reasonable goals to improve their situation?

Spouse's lack of self-esteem

Traditionally, the male sexual response is thought to be broken up into three phases. Which occurrence is part of the plateau phase?

The circumference of the penis thickens at the coronal ridge and a few drops of fluid appear at the urethral meatus.

The nurse caring for clients in a physician's office takes into consideration developmental stage when assessing sexuality. Which is an example of a developmentally appropriate intervention?

The nurse teaches parents of a 4-year-old that they may cause anxiety in the child by intolerance of inconsistency of sex-role behavior.

A patient calls the clinic and tells the nurse they have a foamy, greenish, and itchy vaginal discharge. The patient asks the nurse what the significance of this discharge is. What is the best response by the nurse?

The patient may have trichomoniasis.

A female client tells the nurse that vaginal intercourse with her partner is not as exciting as it used to be. Which of the following could the nurse teach her?

Use of Kegel exercises

The nurse is assessing the sexual health of a female client age 20 years. During the interview, the client says, "I feel that my vaginal opening constricts whenever I am about to have intercourse. I seem to have no control over it." What would the nurse use when documenting the client's report?

Vaginismus

The nurse is providing education about sexuality to a group of college freshman. One of the terms he discusses is gender identity. Which of the following describes gender identity?

inner sense of being male or female

The nurse should instruct an Islamic female client who is reluctant to undergo pelvic examination from an assigned male health care provider to:

seek a female health care provider to perform the examination.

A female client presents with a report of pain and burning in the area of the vulva during intercourse. How will the nurse document the clients report of symptoms?

vulvodynia

A nurse is conducting a health history on a 45-year-old client. The nurse is preparing to address the client's sexual history. Which statement by the nurse would be most appropriate at this time?

"I am going to ask you some questions about your sexual health."

The nurse has provided information to a client about oral contraceptives. Which statement by the client would indicate a need for further education?

"Some oral contraceptives protect against STIs."

What is associated with the resolution phase of the male sexual response cycle?

Feelings of relaxation and fulfillment

The nurse is caring for a client diagnosed with vaginismus. When reviewing the client's history, what would the nurse would expect to find?

past history of a rape

When a 19-year-old male client tells the nurse that he has never been able to achieve an erection, the nurse recognizes that the client is experiencing:

primary impotence.

The Surgeon General's Call To Action To Promote Sexual Health and Responsible Sexual Behaviorwas released in 2001. The goal of this document is to:

promote general health and wellness.

The nurse is speaking to a client regarding his sexual history. The client states, "I was born with a penis but I should have had a vagina." The nurse would document the client's gender identity as:

transsexual.

A client presents to the office with concerns of low testosterone and feels it is due to a pituitary gland disorder. Which teaching would the nurse provide to educate this client on how testosterone is produced?

"Gonads are the reproductive organs of the male and are responsible for the production of testosterone and spermatozoa."

The school nurse is educating a group of 5th and 6th grade girls on menstruation. One girl asks if there is a name for having her first menstrual period. The nurse replies with which of the following terms?

Menarche

A male client comes to the clinic because he thinks that he has syphilis. Which test would the nurse expect the client to have done?

VDRL

The nurse is preparing to provide education to a group of high school students on sexually transmitted infection (STI) prevention. The nurse knows that this age group often uses oral-genital stimulation as a way to prevent pregnancy. Which concept should the nurse make sure to convey to the group?

skin-to-skin contact can spread herpes and genital warts

A nurse is collecting a sexual health history from an older adult woman who is postmenopausal. Which client statement requires further education by the nurse?

"I have noticed I have less lubrication with sexual intercourse."

The nurse is working in the emergency department when a male client states, "I have been exposed to gonorrhea from a sexual partner and I think I have it." What symptoms should the nurse assess in this client that correlate with the client's suspicions of infection? Select all that apply.

- Purulent penile discharge - Difficulty urinating - Increased frequency of urination

The clinic nurse is explaining the action of sildenafil (Viagra) to a client. The nurse should assess his medication regimen to determine if he is taking medications that are contraindicated with Viagra. Which of the following medications is contraindicated with Viagra?

Nitrates

The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by John, a 22-year-old male, who eventually discloses to the nurse that, while he enjoys having sex with his girlfriend, he also has experienced pleasurable sex with males. The term for this behavior is which of the following?

Bisexual

A nurse is counseling a couple who expressed that they are having difficulty conceiving. What could the nurse consider as a cause?

Changing developmental stage

In the female reproductive system, what corresponds with the male penis?

Clitoris

Documentation from nurse: reports generalized reticular rash, swollen lymph node in neck and arm pits, hair falling out, feels tired all the time. The nurse is conducting an assessment on a 42-year-old female client. The client admits to having unprotected sex with multiple individuals over the years. Based on the data collected during the assessment, which disorder should the nurse suspect this client has?

Syphilis

The nurse is teaching a class about sexuality at a public health clinic. After class the nurse is approached by Cathleen, a 54-year-old female, who eventually discloses to the nurse that, while she is happily married, she feels like a man inside. Cathleen describes this as feeling "trapped" inside her female body. The term for this behavior is which of the following?

Transsexual

A client visits a community clinic reporting a foul-smelling vaginal discharge that is thin, foamy, and green in color; itching of vulva and vagina; and burning on urination. Which STI would the nurse suspect?

Trichomonas vaginalis

Which sexually transmitted infection has the following characteristics: thin, foamy, greenish vaginal discharge that causes itching of the vulva and vagina?

Trichomoniasis

When a man cannot achieve an erection, the phase of the sexual response in which the man is experiencing difficulty is:

excitement phase.