Question 1

A nurse works with many women who self-identify as lesbian or bisexual.What action by the nurse would best address this population's needs?

Accepted Answer

Lesbians and bisexuals are more likely to report poor physical or mental health compared with heterosexual women.Although the origins of this are not totally clear,one factor may relate to the homosexual/bisexual woman's hesitancy in seeking health care.Nurses can greatly assist with this by being nonjudgmental and by using language and questions that do not assume sexual orientation.Sexually transmitted infections do occur in this population,although woman-to-woman transmission is lower than man-to-woman transmission.Some lesbian women do seek to become pregnant and bear children; they should be apprised of all available options.Lesbian women have increased risks for breast,endometrial,and ovarian cancer.Although all options are feasible,the option that has the potential to have the greatest impact is the one related to neutral language,which can be perceived as welcoming and accepting.

Question 2

A nurse is working with a young couple whose contraceptive choice is latex condoms.What statement by either partner indicates the need for more teaching?

Accepted Answer

Nonoxynol-9 (N-9)spermicide is no longer recommended for use with condoms because of higher costs,shorter shelf life,and lack of additive benefit when compared to other spermicides.Also,N-9 can cause genital lesions and increases the woman's risk of acquiring HIV and other sexually transmitted infections,especially when the condoms are used often.The other statements are correct.Condoms should be stored in a cool place,which makes placing them in wallets or pants pockets an incorrect action.Men should be sure to use the correct size.Condoms should be discarded if they are past their expiration date.

Question 3

The nurse is teaching a group of women about hormonal emergency contraception.Which of the following is not a benefit of this type of contraception?

Accepted Answer

Emergency contraception pills have side effects that include nausea and vomiting,abdominal pain,breast tenderness,headache,and fatigue.The other statements about the "morning-after pill" are correct and are benefits of emergency contraception.

Question 4

Which of the following women would the nurse advise to use a back-up contraceptive in addition to their birth control pills?

Accepted Answer

The effectiveness of oral contraceptive pills (birth control pills [BCPs])can be decreased by several medications,including rifampin (Rifadin),isoniazid (Tubizid),barbiturates,and griseofulvin (Fulvicin-U/F).Other drugs that can decrease BCP effectiveness include acetaminophen (Tylenol),anticoagulants,and some anticonvulsants.The patient being treated for tuberculosis would most likely be taking either (or both)rifampin and isoniazid.The other patients would not have a decreased effectiveness of their BCPs due to medications,unless the diabetic patient had the disease for more than 20 years or has vascular complications.

Question 5

The clinic nurse is counseling a woman who had a Nexplanon rod implanted.The nurse reminds her that she will need an appointment to replace this birth control method in what time frame?

Accepted Answer

Nexplanon is a subdermal contraceptive that must be removed and replaced every 3 years if continued contraception is desired.The single-rod implant,which is inserted on the inner side of the woman's upper arm,contains etonogestrel,which is a progestin.

Question 6

A nurse is working with a patient who has the nursing diagnosis of altered sexuality patterns.What action by the nurse takes priority?

Accepted Answer

All options are important nursing actions,but without a trusting relationship,women (and men!)may be hesitant to share information.

Question 7

A student nurse is giving a patient an intramuscular Depo-Provera injection.Which action by the student would cause the instructor to intervene?

Accepted Answer

The injection site should not be massaged,as this action can decrease the effectiveness of the medication.The other actions are correct.

Question 8

A 24-year-old lactating woman asks about contraceptive options.The family planning clinic nurse recommends an oral contraceptive formulated with which ingredients?

Accepted Answer

Low-dose progestin-only contraceptive pills are often referred to as the "mini-pill" because they contain no estrogen.The mini-pill may be used during breastfeeding because it does not interfere with milk production.

Question 9

The nurse working in a family practice clinic assesses women for sexual dysfunction.Which woman would the nurse assess as having a sexual dysfunction?

Accepted Answer

Sexual dysfunction is defined as any sexual situation that causes personal distress for the woman herself.If the woman is comfortable with the situation,there is no dysfunction.Dysfunction can occur in the physical,emotional,or relationship aspect of sexuality.The woman who complains of lack of arousal has a dysfunction even though she still is sexually active.The other women do not manifest complaints or personal distress about their situations.

Question 10

The nurse is assessing a sexually active heterosexual woman who does not use birth control.The nurse explains that the chance of becoming pregnant with each act of unprotected intercourse is what percentage?

Accepted Answer

The probability of becoming pregnant with each act of unprotected intercourse is approximately 15-20%.

Question 11

A nurse in an emergency pregnancy clinic is evaluating women for the IUD method of emergency contraception.Which woman would not be considered a good candidate for this method of emergency contraception?

Accepted Answer

Women who are at high risk of sexually transmitted infections or pelvic infections should not use this form of emergency contraception.This includes women who have been raped.The other women would be appropriate candidates for emergency IUD contraception.

Question 12

A nurse is assessing a patient who complains of an inability to achieve orgasm.The patient was recently started on several new medications.Which one would the nurse evaluate as possibly contributing to this problem?

Accepted Answer

Selective serotonin reuptake inhibitors such as sertraline can cause anorgasmia.Beta blockers (atenolol)can cause decreased libido.Clonidine can lead to decreased libido.Thyroid replacement hormones can cause menstrual irregularities with excessive doses.

Question 13

A teenage girl wishes to obtain birth control and is interested in a diaphragm.What advice does the nurse provide?

Accepted Answer

Because the diaphragm requires planning ahead,it may not be the best choice for adolescents because of their frequent "forgetfulness" and because it interferes with spontaneity and requires correct use with every act of intercourse.All barrier methods are fairly inexpensive.A diaphragm is easy to use for many women,after they learn to use it correctly.The effectiveness of a properly used diaphragm is about 84%,making it not the best choice for someone who would consider an unplanned pregnancy a disaster.This also makes it less appealing for teens.

Question 14

A nurse is working with a young woman planning to become sexually active.She has the nursing diagnosis of knowledge deficit related to contraceptive choices.Which action by the patient would indicate that a priority goal has been met?

Accepted Answer

A woman often seeks contraception with a predetermined method in mind,which may or may not be the best "fit" for her lifestyle.Nurses should be able to explain the entire range of choices and help the woman find the method that will work best for her.Once the method is chosen,it is important to know how to use it properly and what the potential side effects are; however,this is not directly correlated to a knowledge deficit related to choices.The woman should be willing and able to explain the method to her partner once one is chosen.

Question 15

A woman is interested in the transdermal contraceptive patch.She is 5'5" tall and weighs 200 lb (90.9 kg).What information should the nurse provide this patient as a priority?

Accepted Answer

All answers are correct; however,because this woman is obese,the nurse needs to tell her that women weighing over 198 lb should not use the patch.This is because of concerns that excessive adipose tissue may be associated with inconsistent levels of hormonal absorption.

Question 16

A woman is being started on oral contraceptive pills.Which screening assessments should the nurse perform or assist with?

Accepted Answer

The only routine screening needed before initiating oral contraceptive pills is blood pressure,unless the woman has other symptoms that need investigation.

Question 17

A woman who was recently fitted for a diaphragm is in the clinic for a follow-up visit.Which statement by the patient indicates that teaching was effective?

Accepted Answer

The diaphragm should be left in place for 6 hours after intercourse.If intercourse occurs again before 6 hours have passed,the diaphragm must be left in place for 6 hours after the last act of intercourse.Diaphragms should not be used during a woman's menstrual period.Oil-based lubricants such as baby oil can deteriorate the latex.The diaphragm should be replaced every 2 years.

Question 18

The reproductive health nurse counsels a 17-year-old woman who is interested in initiating contraception.Which of the following would be a short-term positive outcome of the visit?

Accepted Answer

Short-term outcomes include the patient's ability to voice an understanding about the selected contraceptive method,voice an understanding of all information necessary to provide informed consent,and voice a comfort level with the use of the contraceptive method selected.Intermediate and long-term goals include the patient's correct and consistent use of the selected contraceptive method,denial of adverse side effects,continued satisfaction with the selected contraceptive method,and consistent use of the contraceptive method and avoidance of pregnancy for the following year.

Question 19

A patient has been taught about her Depo-Provera contraceptive injection.Which statement by the patient indicates that education has not been effective?

Accepted Answer

On average,ovulation begins within 10 months of discontinuing this medication,so women who are planning a pregnancy within the next year should probably use a different method of contraception.The other statements are correct.Due to possible decrease in bone density,weight-bearing exercise and calcium supplementation are important.Exercise will offset the possible weight gain also associated with this medication.Depo-Provera usually causes light or absent menstrual periods.

Question 20

A patient has been taught about the vaginal contraceptive ring.Which statement by the patient indicates that further teaching is needed?

Accepted Answer

If the vaginal ring comes out,it can be washed with lukewarm water and reinserted.If it is out of the vagina for more than 3 hours,the woman will need a back-up method of contraception for the next 7 days.Her incorrect statement indicates she needs more teaching.The other statements about the vaginal contraceptive ring are correct.

Quiz 6: Human Sexuality and Fertility