Deck 33: Sexual Health

Question 1

The nurse feels uncomfortable when preparing to assess a client's sexual health. Which of the following would be most important for a nurse to be able to do during the assessment?
1)Recognize and set aside personal biases or experiences related to sexuality.
2)Perform an accurate and comprehensive physical assessment.
3)Collect an accurate and comprehensive sexual history.
4)Acquire theoretical knowledge of sexual health concerns.

Answer 1

1

Question 2

The nurse is assessing a client in the pediatric office, when and the client's parent voices concern about the new neighbor who is a convicted sex offender. She asks for advice on how to protect her child. What is the nurse's best response?
1)"Keep the child indoors to prevent any contact with the sex offender."
2)"Discuss your concerns with the sex offender and neighbors."
3)"Teach your child to never let another person touch his or her private parts."
4)"Teach your child to avoid the house of the known sex offender."

Answer 2

3

Question 3

The nurse is evaluating the treatment plan for the client with erectile dysfunction (ED). Which statement made by the client indicates treatment was successful?
1)"I feel very good about the treatment; I am now comfortable with my sexual orientation."
2)"I am happy with the treatment as I can now maintain an erection through orgasm."
3)"Now I can communicate my sexual needs to my partner without embarrassment."
4)"I now know how to communicate my sexual desires with my partner."

Answer 3

2

Question 4

While admitting a young adult male into the family health clinic, the nurse asks about his occupation. The patient appears embarrassed and says, "You're going to think I'm lazy, but I stay home with our young children while my wife works." The nurse recognizes this patient is experiencing what type of conflict?
1)Sexual confusion
2)Gender role
3)Gender identity
4)Sexual orientation

Question 5

The nurse is conducting a case meeting of an older client in the Alzheimer's unit. The healthcare team is assembled to discuss the family's concerns. The older client has developed a close relationship with another client in the facility. It appears that the two have become intimate recently and the family voices concerns that the client is unable to make decisions regarding this intimate relationship. Which of the following would be an appropriate nursing intervention for this client?
1)Assess whether the client is able to consent to sexual intimacy.
2)Assess and transfer one of the clients to another unit.
3)Provide privacy for the clients to engage in sexual activities.
4)Bring in the other client's family members to discuss this fully.

Question 6

The nurse is discussing workplace issues with a 35-year-old client. The client tells the nurse that his boss requires him to massage her shoulders. His boss also rubs his legs, thighs, and genitals. He further states that he does not want to upset her because he needs the job. Which statement best applies to this situation?
1)The male is receiving sexual satisfaction from having his legs, thighs, and genitals massaged.
2)This is an example of quid pro quo sexual harassment and should be reported to a supervisor.
3)This is an example of a hostile work environment and sexual harassment and should be immediately reported to a supervisor.
4)This is not a situation of harassment because no sexual intercourse has occurred, and the client can refuse.

Question 7

The nurse is assessing a 16-year-old female client's knowledge of sexuality. Which of her statements indicates that she requires further teaching?
1)"I don't practice oral sex because it could lead to sexually transmitted infections (STIs)."
2)"I don't have sexual intercourse because I want to remain a virgin until marriage."
3)"My boyfriend and I are practicing abstinence by engaging in shared touching."
4)"My parents are lesbians, but it has not affected my sexual orientation."

Question 8

The emergency room nurse cares for a male patient experiencing an acute myocardial infarction. The patient is dressed in a bra, panties, and nightgown. Which of the following is the most accurate inference the nurse can make regarding the client's sexual expression?
1)The client is a transgender person.
2)The client is a cross-dresser.
3)The client is a homosexual person.
4)The client is a heterosexual person.

Question 9

The nurse is preparing education for the prepubescent female client on the menstrual cycle. Which of the following statements best explains the portion of the cycle when the ovum is released?
1)Fertilization
2)Follicular phase
3)Luteal phase
4)Menstrual phase

Question 10

A client confides to the nurse that he feels guilty because when he has intercourse with his girlfriend, he pretends that she is a certain female actress. What is the nurse's most appropriate response?
1)"This behavior is known as a minimal voyeuristic disorder and is perfectly normal."
2)"Perhaps we should discuss the problems in your relationship with your girlfriend?"
3)"Here is a referral to a sexual counselor to help work through your guilty feelings."
4)"Fantasy before or during sexual intercourse can add excitement to a relationship."

Question 11

The nurse is preparing to teach a group of adolescent male students about testicular self-exams. Which of the following would be an indication that the teaching was effective?
1)Monthly exams are necessary for early detection of lumps in the testicle.
2)Monthly exams for any changes in the testicle are a personal preference.
3)Monthly exams are not warranted if both testicles have not fully descended.
4)Monthly exams are not necessary once the male has become sexually active.

Question 12

A 19-year-old client asks if he is normal because he has always viewed himself as a female, although he has acted like a male to please his parents. The nurse should provide the client with education on which concept?
1)Bisexual
2)Intersex
3)Transgender
4)Transvestite

Question 13

The nurse has completed teaching a group of adolescents about (STIs). Which of the following statements made by one of the adolescents would indicate that the teaching has been effective?
1)"A healthcare provider can tell whether you have an STI by asking if you have any symptoms."
2)"The healthcare provider can diagnose most STIs with a surgical biopsy or blood draw."
3)"A healthcare provider can tell whether you have an STI by getting a detailed sexual history."
4)"The healthcare provider can swab the genitals to diagnose whether a person has an STI."

Question 14

The nurse is providing presurgical care to a patient scheduled for a total abdominal hysterectomy as treatment for cancer. The patient says, "I won't be a woman after surgery." The nurse recognizes that the patient connects having a uterus with which aspect of sexuality?
1)Eroticism
2)Intimacy
3)Reproduction
4)Role and identity

Question 15

The nurse is assessing the older adult client when he states that although he can achieve an erection, he is unable to achieve an orgasm. The nurse recognizes that the client may be having difficulty completing which of the following phases of sexual arousal?
1)Desire
2)Excitement
3)Plateau
4)Resolution

Question 16

The mental health nurse has assessed a male client who has repeatedly made sexual comments and advances toward other clients. The nurse recognizes these behaviors as which possible mental health disorder?
1)Anxiety disorder
2)Bipolar disorder
3)Depressive disorder
4)Paranoid schizophrenia

Question 17

The nurse is assessing a middle-aged client's compliance with his medications. The client states that he has stopped all medications because he could not "perform sexually." Which of the following medications do NOT negatively influence his sexual activity?
1)Beta blocker antihypertensive medication
2)Allergy and antihistamine medications
3)First-generation antimicrobials
4)Antipsychotics and antidepressants

Question 18

The nurse assesses a client's medical history in a gynecology office prior to admission. As the nurse prepares the client for a female examination, the client confides about a form of cultural practice that she has been subjected to that is illegal in the United States. What is the name of that form of cultural practice?
1)Genitalia piercing
2)Hysterectomy
3)Female circumcision
4)Transgender surgery

Question 19

The nurse is developing a plan of care for a female client who expresses loss of interest in sexual intimacy with her husband following a total hysterectomy several months ago. The client states "I just don't have the energy to be intimate; besides I don't feel like a woman anymore because I cannot have children." What nursing diagnosis would be most appropriate for this patient?
1)Activity Intolerance and Fatigue
2)Disturbed Body Image
3)Ineffective Sexuality Patterns
4)Sexual Dysfunction

Question 20

During an initial assessment of the client's sexual orientation, the nurse may utilize the PLISSIT model. What is the first step of this model?
1)Provide information about sexual orientation and common alterations.
2)Plan time to discuss concerns with the client in a private, comfortable setting.
3)Permit the client to speak openly by communicating an open, accepting attitude.
4)Provide referrals to the client so the client can identify resources to assist him in the future.

Question 21

The nurse is interviewing a client in the family practice clinic who has been diagnosed with pelvic inflammatory disease (PID). The client states that she uses several methods to stay clean "down there," such as occasional condom use by the partner, twice-weekly douches, and taking daily bubble baths instead of showers. Which of the following practices may have increased her likelihood of this infection?
1)Wearing cotton underwear
2)Inconsistent condom use by the partner
3)Daily bubble baths
4)Twice-weekly douches

Question 22

The nurse is providing teaching to a group of prepubescent students regarding some common myths about sexuality and body functions. Which statement by the students is an indication that teaching was effective?
1)"I don't to worry about birth control or STIs during my first time."
2)"Condoms are the most effective birth control and the only way I can be sure I won't get pregnant."
3)"I only have to worry about being infected with an STI if I see a sore or have pain."
4)"Enjoyable sexual relationships or reaching orgasm simultaneously do not indicate the quality of the relationship."

Question 23

The nurse has finished teaching a class for adolescents and young adults on sexually transmitted infections (STIs) and safe sexual practices. The nurse determines that the teaching has been effective when class participants make which statements? Select all that apply.
1)"It is important for me to avoid STIs, so I will get a prescription for birth control pills."
2)"I cannot contract an STI if we only perform oral sex on one another."
3)"I should see my provider to be tested if I experience burning on urination."
4)"If I contract an STI, it isn't my fault because I had sex with only one person."
5)"I need to have a discussion with my sexual partner about our past sexual histories."

Question 24

The nurse is providing care to the menopausal client in the women's health clinic. The client states she is tired all the time, and has frequent hot flashes, and then she asks about the advantages of hormone replacement therapy (HRT). Which of the following are advantages of hormone replacement therapy? Select all that apply.
1)HRT is the most effective treatment to relieve symptoms of menopause, such as hot flashes and sleep disturbances.
2)HRT decreases the risk of heart and vascular disease, such as arteriosclerosis and myocardial infarctions.
3)HRT often prevents loss of bone density (osteoporosis) and leads to fewer hip fractures.
4)HRT prevents blood clots and certain cancers, such as breast, ovarian, and colorectal cancers.
5)HRT decreases the likelihood of cerebral vascular accidents and dementia.

Question 25

A 2-year-old boy has come to the well-child clinic with his mother for a checkup. When the nurse asks his mother whether she has any concerns, the mother expresses concern that her son often touches his genitals. She says, "I have tried sitting him in a chair, smacking his hand, and telling him no, but he continues to do this. I just don't know how to make him stop." Which of the following would be the nurse's most appropriate responses to address the mother's concerns? Select all that apply.
1)"Give him a little time. The first two years of a child's life are a time for them to explore their bodies. He'll grow out of it."
2)"How often do you punish him by giving him a time-out or by using physical discipline?"
3)"Physical punishment, such as smacking his hand, is not the best way to modify a child's behavior."
4)"It isn't unusual for him to fondle his genitals, as this is part of his exploration of his body."
5)"Perhaps he needs something to do. Have you tried distracting him with new toys and other activities?"

Question 26

The nurse is providing care to the client who was sexually assaulted. What is the nurse's best approach for collecting information surrounding the event? Select all that apply.
1)Use a calm, reassuring voice when asking questions of the client.
2)Ask only close family members to describe events related to the incident.
3)Provide privacy by asking questions behind a closed curtain.
4)Document the details using the patient's own words.
5)Refer the client to the sexual assault support group immediately.

Question 27

The patient tells the nurse, "My partner and I never have intercourse when I have my period because I read that it is dangerous." What statement by the nurse is most appropriate?
1)"You can protect the bed linens by placing protective padding under the buttocks."
2)"Reaching orgasm during your period can help to relieve menstrual cramps."
3)"The blood is from the uterus, not the vagina, so intercourse will not harm the vagina."
4)"The increased blood flow to the pelvis will make sex more pleasurable for you."

Question 28

A physician frequently approaches a nurse and complements her on her appearance including making inappropriate comments about the nurse's body shape. What is the most appropriate initial action of the nurse?
1)Inform the nursing supervisor of the physician's behavior.
2)Call the medical board to report the physician's behavior.
3)Document the physician's behavior and report concern to the chief of staff.
4)Inform the physician the behavior is inappropriate and unwelcome.

Question 29

What are common reasons that a victim of domestic abuse might not report an incident of sexual assault? Select all that apply.
1)Fear that the significant other would be angry if the client reported it and repeat the assault
2)Belief that it was the client's behavior that caused the significant other to "lose their temper"
3)Idea that the legal system couldn't prosecute the significant other for the assault
4)Desire to have the incident behind the client, as if it never happened in the first place
5)Financial independence of the client from the significant other

Question 30

The nurse is assessing an older female client in the clinic, when the client states that she is having issues with sexual intercourse due to lubrication. The nurse begins to use the PLISSIT model as the guideline for counseling for sexual problems. Which of the following are examples of the components of the PLISSIT model? Select all that apply.
1)"Some women experience decreased vaginal lubrication after menopause. Tell me how well you have been lubricating."
2)"Should your sexual partner be in the room to further discuss this issue and find some methods to help you?"
3)"Some women experience decreased vaginal lubrication because of decreased hormone levels. "
4)"Some women have found that using a water-soluble lubricant prior to sexual intercourse to be helpful."
5)"I will send this information onto your gynecologist for you to further discuss possible treatments."

Question 31

The nurse is providing preoperative screening for the older adult male client who is scheduled for prostate surgery due to cancer. The client states that he knows that his girlfriend will leave him now because the surgery will ruin his sex life. What statement by the nurse would be most appropriate?
1)"I am so sorry to hear that. A close sexual relationship is so important."
2)"It is possible to have a close, intimate relationship without intercourse."
3)"Let's talk a little more about the ways in which your sex life has been ruined."
4)"You might want to try one of the medications available to treat erectile dysfunction."

Question 32

Which of the following are considered sexual response cycle disorders? Select all that apply.
1)Arousal disorder
2)Dysmenorrhea
3)Orgasmic disorder
4)Low libido
5)Retrograde ejaculation