Question 1

The nurse is aware that sexuality is part of growth and development.The preschooler's interest in gender sexuality is characterized by an interest in:

Accepted Answer

The first step of gender identity development occurs as the child becomes aware of the differences of the sexes and perceives that he or she is male or female.This is characterized by an interest in his or her genitalia.This is not characteristic of the preschool child.Learning how and why his or her anatomy differs from other children would require a higher level of cognitive ability.Children of this age-group primarily focus on their parents and family,not other children.According to Freud,the preschool child identifies with the parent of the same sex and develops a complementary relationship with the parent of the opposite sex.The preschool child does not spend most of his or her time with the parent of the opposite sex.

Question 2

Which of the following statements made by a client concerning birth control requires immediate correction by the nurse?

Accepted Answer

Barrier methods include over-the-counter spermicidal products and condoms.Spermicidal products (e.g. ,creams,jellies,foams,and sponges)are put into the vagina before intercourse to create a spermicidal barrier between the uterus and ejaculated sperm.A condom is a thin rubber sheath that fits over the penis to prevent entrance of sperm into the vagina.Vaginal spermicides and condoms are most effective when instructions are carefully followed;their combined use is more effective in preventing pregnancy than the use of either one alone.While a vasectomy may be reversed,it is very difficult and results cannot be guaranteed.The remaining options are correct.

Question 3

To increase the tone and sensation of the pelvic floor for a female client,the nurse teaches:

Accepted Answer

Kegel exercises increase the tone and sensation of the pelvic floor (pubococcygeus muscle)for the female client.Vaginal dilation will not increase the tone and sensation of the pelvic floor.Stopping urination may help identify proper muscle contraction,but once the muscle is identified,Kegel exercises should not be repeated during urination.Stopping urination midstream may create a backflow of urine into the bladder,predisposing a person to infection.Sensate focus exercises do not increase muscle tone.

Question 4

The nurse has completed an assessment on an adult male client and finds that he is having difficulty having an erection and has less interest in sex.The nurse notes that the client has recently started taking an antihypertensive medication.A nursing diagnosis of sexual dysfunction related to side effects of antihypertensive is identified by the nurse.An appropriate outcome for this client is:

Accepted Answer

An appropriate expected outcome for the nursing diagnosis of sexual dysfunction related to side effects of antihypertensive would be client will relate renewed interest in sex within 1 month.An appropriate goal would be client will express satisfaction with sexual relationship with wife within 1 month.The client should not avoid taking his antihypertensive medication before intercourse,but should be taught that there are other blood pressure medications available that can maintain blood pressure control and that do not negatively affect sexual function.He can then discuss this with his physician.Being interviewed by a therapist is not an appropriate expected outcome.Seeing a sexual therapist immediately is not necessary and may only intensify his concern.Seeking out substitute activities or hobbies is not an appropriate expected outcome.It does not address or resolve the problem.

Question 5

The middle adult couple is most likely to experience a change in their sexual intimacy when:

Accepted Answer

Children leaving home usually creates a change in intimate relationships.This results in either a time of renewed intimacy between partners or a time when formerly intimate partners realize that they no longer care for each other or have common interests.While changes of aging and chronic illness can affect performance and retirement usually requires an adjustment in expectations and attitudes,these options do not appear to have the same degree of impact on intimacy as does the "empty nest."

Question 6

The nurse is discussing various sexual issues with a group of military personnel who have experienced spinal cord injuries.Which of the following statements best addresses the issue of alternative methods of personal sexual gratification?

Accepted Answer

As sexually active adults develop intimate relationships,they learn techniques of stimulation that are satisfying to both themselves and their sexual partners.Some adults need permission or affirmation that alternative ways of sexual expression other than penile-vaginal intercourse are normal.While the other options prove acceptance,they are not as sensitive in their wording or address the issue as completely.

Question 7

Sexual experimentation is common among adolescents and should primarily be:

Accepted Answer

Adolescence is often a time when individuals explore their primary sexual orientation.Although the behavior should not be discouraged or encouraged,in order to avoid undo stress on the adolescent,the experimentation should be viewed as an acceptable way to determine sexual orientation.

Question 8

The nurse is discussing the physical changes that occur during puberty with a group of 11- to 12-year-olds.The most therapeutic statement the nurse could make directed toward minimizing their anxiety would be:

Accepted Answer

School-age children generally have questions regarding the physical and emotional aspects of sex.They need accurate information from home and school about changes in their bodies and emotions during this period and what to expect as they move into puberty.Knowledge about normal emotional and physical changes associated with puberty will decrease anxiety as these changes begin to happen.It is of little value to tell the child that all will be fine since that tends to send a message that you are minimizing their concerns and so is a barrier to communication.Keeping the responses short and in terms the child will understand is best.

Question 9

While working with a male client and administering medications,the female nurse is approached sexually.The nurse should:

Accepted Answer

The nurse should convey a message of acceptance of the client,but not the inappropriate behavior.Reviewing and defining the professional relationship with the client can accomplish this.Matching the gender of the health care worker with the gender of the client may be beneficial when dealing with assessment of sexual needs or sex education.However,in this instance,the client needs to be informed that inappropriate sexual behavior is unacceptable.To turn the client's care over to a male nurse would not resolve the problem,and would convey a message of dislike and lack of acceptance of the client.Reporting the incident immediately to the client's physician would not be the nurse's best action.The client needs to be made aware of the problem in order to discontinue such behavior.Telling the client his behavior is offensive and then leaving the room is not therapeutic.The client needs to be reminded of the professional relationship he shares with the nurse.

Question 10

The nurse is teaching sexuality to a group of senior adults.Which of the following comments by a participant reflects that he or she has an understanding of the changes in sexuality that occur with aging?

Accepted Answer

Orgasms may not last as long in the older adult as a result of aging.Older adults may feel more sexually satisfied because they no longer have to be concerned with contraception and are not experiencing the pressures of raising children and working.Decreased levels of estrogen may lead to diminished vaginal lubrication and decreased vaginal elasticity,making intercourse more painful.The couple should not be advised to have sex less frequently,but rather to use a vaginal lubricant and allow more time for caressing.The need to use a lubricant is not due to having sex less often,but is due to decreasing levels of estrogen in the woman.Saying that people of a certain age shouldn't still have sexual feelings is not a true statement.Sexual feelings in older adulthood are normal.Sexuality and continued interest in sex throughout late life generally reflect life patterns.

Question 11

The nurse,after completion of an assessment in the medical clinic of a client,the nurse documents that the client has dyspareunia based on the client's experience of:

Accepted Answer

Dyspareunia is recurrent or persistent genital pain in either a male or a female before,during,or after sexual intercourse that is not associated with vaginismus or with lack of lubrication.Orgasmic disorder is the recurrent delay in,or absence of,orgasm following normal sexual excitement.Hypoactive sexual desire disorder is the persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity.Vaginismus is an involuntary constriction of the outer one third of the vagina that prevents penile insertion and intercourse.

Question 12

Which of the following statements best educates the client regarding the transmission of sexually transmitted diseases (STDs)?

Accepted Answer

Any contact with another person's body fluids or an open lesion on the skin,anus,or genitalia can transmit an STD.The remaining options do not provide complete information of the possible means of transmitting STDs.

Question 13

A client is concerned that she and her husband,now that they have a baby in the house,will be unable to maintain a healthy sexual relationship.To assist these clients,it would be most helpful for the nurse to know:

Accepted Answer

In response to identified concerns,the nurse may initiate discussion.Knowing of the comfort level in communicating their feelings provides an open dialogue enabling the client to talk freely with the nurse to address the concerns.To assist the clients in their situational change,the nurse needs to explore communication and sexual patterns of the couple.Having similar parenting beliefs will have less impact on their sexual relationship.To assist the couple in adjusting to the change of becoming a family,the nurse needs to explore communication patterns of the couple.How long they have been married would be less significant.The level of knowledge they have regarding healthy sexual relationships would not be as impacting on their sexual relationship as would their ability to discuss their feelings with one another.

Question 14

A school nurse is responsible for teaching adolescents about sexually transmitted diseases (STDs).When discussing chlamydia,the nurse instructs the students that it is:

Accepted Answer

Diseases that are caused by bacteria and that can usually be cured with antibiotics include gonorrhea,chlamydia,syphilis,and pelvic inflammatory disease.All clients need to understand that antibiotics need to be taken for the full course of treatment.Chlamydia is caused by bacteria that can be treated,not a virus.Sexually transmitted diseases,such as chlamydia,are transmitted from infected individuals to partners during intimate sexual contact.It is not contracted via blood-borne exchange,but rather through body fluids.Chlamydia is not prevented with the use of spermicidals.

Question 15

A client is scheduled for cardiac surgery.The nurse is conducting a sexual history and is told that he is nervous about resuming sexual activities.The nurse uses therapeutic communication with the client when responding:

Accepted Answer

Open communication and positive self-esteem,such as explaining that their concern is very normal and offering to discuss further are essential factors in effectively resolving concerns.Telling the client that there are serious risks may only worry the client more.Stating that the client's partner will be nervous about resuming sexual activities does not focus on the client and,therefore,does not encourage the client to express his concerns.Telling the client not to worry is nontherapeutic.At this point,not even knowing the outcome of the surgery,the nurse should not predict resumption of sexual activity for the client.Furthermore,this response does not encourage the client to communicate his feelings.

Question 16

An adolescent female student,who is sexually active,visits the office of the school nurse.Which of the following statements best reflects her understanding of the effective use of contraception devices?

Accepted Answer

In order to be an effective contraceptive method,the diaphragm should be used with a contraceptive cream or jelly.The client is verbalizing understanding.Any act of unprotected intercourse can result in pregnancy.The boyfriend withdrawing prior to ejaculation is not an effective contraceptive method.Any act of unprotected intercourse can result in pregnancy.This statement is not demonstrating understanding of the basal body temperature method of contraception.Using spermicidal foam alone is not recommended.The client should use a condom and foam to be more effective in preventing pregnancy.

Question 17

The nurse is putting together a presentation on the prevention of sexual abuse.She should incorporate which of the following?

Accepted Answer

Sexual abuse may begin,continue,or even intensify during pregnancy.The abuser may not fit any classic description.Sexual abuse crosses all gender,socioeconomic,age,and ethnic groups.Most often sexual abuse is at the hands of a former intimate partner or family member.

Question 18

A 58-year-old woman asks the nurse what she can do to promote healthy physical sexual relations.Based on the client's age,the nurse responds by saying:

Accepted Answer

The perimenopausal and menopausal woman may have diminished vaginal lubrication as a result of decreased levels of estrogen,thus using a water-based lubricant may help.Decreasing the frequency of intercourse would not promote healthy sexual relations.If a nurse is uncomfortable discussing sexual issues with a client,then he or she should get another nurse who is comfortable to talk with the client.A sex therapist is not necessary in this situation.Sex therapists address more complex sexual issues.There are some physical changes with aging that may affect sexuality.The client should be educated on the expected changes and how to best address them.

Question 19

Teenagers tend to engage in risky sexual behavior primarily because they:

Accepted Answer

Adolescents tend to think they are invincible and do not expect 'bad things' to happen to them.While the other options can be factors in some teens' decisions to engage in unprotected sex,the age-group generally lacks the insight that they are not invincible and that they will suffer the consequences of poor decision making.

Question 20

The nurse knows that studies of sexuality in older adults have shown:

Accepted Answer

Studies of sexuality in older adults are limited and inconsistent in their findings.Many studies suggest that older adults retain an interest in sexual function and are sexually active while other studies conclude that there is a decline of sexual interest and behavior among older adults.

Quiz 28: Sexuality