Deck 45: Sexuality

Question 1

The nurse enters the room and finds the adult client masturbating.What action should the nurse take?

A)Tell the client that masturbation is harmful to sexual well-being
B)Say "excuse me" and leave the room
C)Request that the client stop so that care can be provided
D)Ask the client if there are any sexual concerns that should be discussed

Answer 1

Say "excuse me" and leave the room

Question 2

A 15-year-old female tells the nurse that she makes her boyfriend stop intercourse before she has an orgasm so she will not get pregnant.What should the nurse do first?

A)Inform her about sexually transmitted infections with unprotected sex
B)Explore any sexual myths the young woman might believe
C)Advise her that she can still get pregnant before an orgasm occurs
D)Advise that conception is unlikely as long as ejaculation happens outside the vagina

Answer 2

Advise her that she can still get pregnant before an orgasm occurs

Question 3

During discussion of family,the client speaks about an adult son who is a homosexual.The client expresses concern about his son,stating: "I am so worried about him.I know he is going to hell." What is the most important fact for the nurse to consider in formulating a response to this client's concern?

A)Normal sexuality is described as whatever behaviours give pleasure and satisfaction to those adults involved.
B)Since alternative lifestyles are now so well accepted in society,this parent should not feel so much concern.
C)What constitutes normal sexual expression varies among cultures and religions.
D)Sexual development is genetically determined and not affected by environment.

Answer 3

What constitutes normal sexual expression varies among cultures and religions.

Question 4

After client teaching on testicular self-exam,Mr.Williams is restating to the nurse the steps of the procedure.What facts stated by Mr.Williams indicate a need for clarification of information? (Select all that apply.)

A) Exam should be completed daily in the shower
B) Roll testicle between thumb and fingers
C) Check for lumps,thickening,or hardening
D) Palpate the epididymis on the bottom and front of the testicle
E) The epididymis should feel smooth as the testicle
F) Report any lumps to the health care provider

Question 5

The nurse uses the PLISSIT format in helping clients who have sexual dysfunction.Which action by the nurse best reflects the P section of this format?

A)Ask the physician for permission to discuss sexual topics with the client
B)Obtain informed consent from both the client and partner prior to providing them with sexual information
C)Acknowledge the client's spoken and unspoken sexual concerns when providing care
D)Arrange for peer counselling sessions for clients when appropriate

Question 6

The nurse uses the PLISSIT model in assisting clients who have sexual dysfunction.Which action by the nurse best reflects the IT section of this format?

A)Use information technology (the Internet)to obtain suggestions for the client
B)Use of informal therapeutic groups to assist the client and partner
C)Evaluate previous interventions and treatment
D)Recommend therapy with a qualified sex therapist

Question 7

A high school student tells the school nurse that during biology the class learned that alcohol is associated with erectile dysfunction.The student wonders why so many girls get pregnant during evenings when alcohol is consumed.The nurse plans a response based upon which concept?

A)Alcohol is a central nervous system depressant which affects judgment.
B)Erectile dysfunction only occurs after years of alcohol abuse.
C)Alcohol is a sexual stimulant.
D)Erectile dysfunction occurs only in men older than 50.

Question 8

The nurse uses the PLISSIT format in helping clients who have sexual dysfunction.Which action by the nurse best reflects the LI section of this format?

A)Limit information given to clients regarding adverse sexual side effects of treatments or medications
B)Give the client accurate but concise information in regard to any sexual questions that might be asked
C)Use slang terms to refer to sexual body parts because the client is not likely to know the proper terms
D)Review current research literature associated with the sexual concerns of the client and partner

Question 9

A 45-year-old client reports that she has no interest in sex and that she and her husband have not had intercourse in 16 years.How does the nurse interpret these assessment data?

A)The husband may be seeking sexual satisfaction outside the marriage.
B)The woman's lack of sexual desire has resulted in impotence in her husband.
C)If both partners share the same lack of desire,there is no problem.
D)This situation is so unnatural that some dysfunction is present.

Question 10

Mrs.Cape is a 56-year-old woman who had a right-sided mastectomy last year for breast cancer.She is currently cancer free,and is in the health clinic to speak with the nurse about her sexual relationship with her husband of 30 years.She tells the nurse that while she still has sexual desires,her body does not respond the same way it used to.She notes that she does not get the same level of excitement that she used to.In developing a plan of care,what nursing diagnosis is appropriate for Mrs.Cape?

A)Anxiety related to loss of sexual desire
B)Deficient knowledge
C)Disturbed body image
D)Ineffective sexuality pattern

Question 11

The daughters of an 80-year-old man who is aphasic after suffering a cerebrovascular accident express concern that their father is "always exposing and playing with himself and his catheter" while they are in the room.Upon assessment,the nurse finds the client pulling on and rubbing his penis.What is the nurse's priority action?

A)Tell the client to keep his hands away from his penis
B)Assess the client's penis for irritation from the catheter
C)Ask the client to keep his linens at waist level when he has visitors
D)Collaborate with the physician regarding medications to control this behaviour

Question 12

The nurse who is teaching a client about breast awareness describes inspection of the breasts before a mirror.Which findings should the nurse tell the client should be evaluated by a health care provider? (Select all that apply.)

A) puckering of the skin
B) scaling on a nipple
C) free movement of the breast over the chest wall
D) symmetry of the nipples
E) change in shape

Question 13

A nurse colleague is outraged that a grandchild's daycare centre is planning a class on sexuality for 3- and 4-year-olds.She is intending on speaking to the daycare about their plans.What key concept should be included in this conversation?

A)At this age,education regarding sexuality should come from parents.
B)Children are sexual beings from before birth.
C)Understanding the body and sexuality are a part of growth and development.
D)Sexual activity is beginning at earlier ages.

Question 14

The parents of a 17-month-old boy are very concerned because the baby touches his genital area during diaper changes.What information should the nurse share with the parents?

A)At his age,this touching is not a sexual experience.
B)Masturbation to orgasm is common and normal at this age.
C)Genital stimulation should not be occurring until the age of 2 1/2 or 3.
D)Babies are sexual beings,but this activity should be discouraged.

Question 15

A female client has experienced recurrent candidiasis with intense vaginal itching and excoriation.After treatment,the client is reexamined,and the nurse practitioner finds presence of a white,cheesy discharge.What recommendation is necessary?

A)Referral to a surgeon for excision of infected tissue
B)Examination and treatment of sexual partner
C)Treatment with a stronger oral antibiotic
D)Routine douches with a topical antibiotic solution

Question 16

Ms.Jenner is a community health nurse teaching sexual health to teenagers in the local high school.Which of the following conversations heard in the hallway following her lesson indicates the need for follow-up teaching?

A)Sexually transmitted infections are on the rise in Canada.
B)Preventing pregnancies will prevent sexually transmitted infections.
C)Teen pregnancies are actually decreasing in Canada.
D)Sexually transmitted infections can cause infertility.

Question 17

The nurse uses the PLISSIT model in assisting clients who have sexual dysfunction.Which action by the nurse best reflects the SS section of this format?

A)Use the nurse's knowledge about how disease affects sexuality to offer specific suggestions to the client
B)Focus interventions on explaining the somatic sexual difficulties and their treatment
C)Offer the client a list of expected sexual side effects of drugs or treatments
D)Identify any concerns the client has regarding attraction to the same sex

Question 18

A recently married couple is trying to conceive a child.The husband is a college athlete and his coach forbids sexual activity for 2 days prior to a game because it weakens the individual.The wife asks the nurse if abstinence before the game is necessary.What is the best response?

A)As long as intercourse is not involved,there is no reason to avoid sexual activity.
B)Some residual physical weakness is common for up to 18 hours after sex.
C)This is a common myth among athletes,but there is no basis in fact.
D)Sexual activity before intense physical exercise increases stamina and endurance.

Question 19

The nurse is preparing for pelvic physical examination of a woman who has been medically diagnosed with vaginismus.What equipment should the nurse obtain for this examination?

A)Culture swabs to assess expected vaginal infection
B)Gloves and a vaginal suppository
C)Smaller than normal vaginal speculums
D)Equipment for pre-examination douche

Question 20

Which statement,made by a postmenopausal woman may indicate the need for further assessment by the nurse?

A)"For some reason,I have more sexual desire than ever."
B)"I use water-soluble lubricant to treat my vaginal dryness."
C)"I am so glad that I don't need to worry about sex anymore."
D)"Sex certainly takes longer than it used to,but I'm getting used to that."

Question 21

A man and woman at the nursing home have become very attached and want to have intimate sexual relations.Which nursing action would be most appropriate?

A)State that this is not allowed in the facility
B)Tell them they will have to leave
C)Provide them with uninterrupted time alone
D)Tell them they will need permission from their physician

Question 22

Mr.Edwards is seeing his health care provider regarding erectile dysfunction.He is intending on asking specifically about the use of Viagra.Which of the following medications that Mr.Edwards currently takes may preclude the use of Viagra?

A)Nitroglycerin
B)Levothyroxin
C)Lasix
D)Lanoxin

Question 23

What information should the nurse offer a heterosexual couple who have expressed interest in trying anal intercourse?

A)The condom should not be lubricated because it may tear.
B)Condom use is unnecessary because one cannot become pregnant as a result of anal intercourse.
C)Condom use should not be used for subsequent vaginal intercourse.
D)Condom use will cause rectal tissue to tear and become infected.

Question 24

Ms.Bowman is scheduled for a mitral valve replacement tomorrow,and has been admitted for her presurgical assessments.Which of the following is an appropriate initial question to include in her health history?

A)Has your illness altered your usual sexual experiences?
B)Do your sexual experiences include men and or women?
C)What are your partner's concerns about your future sexual functioning?
D)How has your illness affected how you see yourself as a sexual being?

Question 25

Which of the following reflects the P phase of the PLISSIT model of intervention?

A)Giving an accurate but concise explanation of what is normal
B)Using specialized knowledge to suggest specific therapeutic interventions
C)Acknowledging the client's sexual concerns
D)Referring the client to a clinical nurse-specialist or sex therapist

Question 26

A client was a victim of sexual incest as a child.Now,when she attempts to have intercourse,her vaginal muscles contract,preventing penile penetration.What is this condition called?

A)Impotence
B)Vaginismus
C)Vestibulitis
D)Orgasmic dysfunction

Question 27

Which of the following is a term that reflects the outward expression of one's sense of sexuality or of what is perceived as appropriate with regard to one's sexuality?

A)Sex
B)Gender
C)Sexuality
D)Sexual health

Question 28

During sexual encounter,both partners can experience diminished sensory awareness.In which of the following phases of the sexual response cycle is this a common finding?

A)Resolution
B)Desire
C)Orgasmic
D)Excitement