Question 1

The primary care pediatric nurse practitioner is performing a well child examination on a 3-year-old. The child's parent reports that the child has recently begun masturbating. What will the nurse practitioner counsel this parent?

A) To allow the behavior whenever it occurs, since it is normal
B) To discuss sexuality with the child
C) To explore whether the child is being abused
D) To teach the child about privacy and hand hygiene

D

Accepted Answer

Masturbation is a common behavior in young children and is considered normal in most cases. The primary care pediatric nurse practitioner should counsel the parent to teach the child about privacy and hand hygiene to ensure that the behavior happens in an appropriate setting and with good hygiene practices. Exploring whether the child is being abused may be necessary in some cases but would not be the first step in counseling the parent. Discussing sexuality with a three-year-old is not developmentally appropriate.

Question 2

During a well child examination of a 6-year-old girl, the primary care pediatric nurse practitioner notes that the child becomes embarrassed and resists taking off her underwear for the exam. What should the nurse practitioner infer from this observation?

A) The child has been sexually molested.
B) The child is feeling violated by the examiner.
C) The parent is exhibiting regressive behavior.
D) This is a normal reaction in a child of this age.

D

Accepted Answer

It is normal for a child of this age to feel uncomfortable with undressing in front of strangers. This may be due to modesty, shyness, or simple unfamiliarity with the situation. It is important for the nurse practitioner to acknowledge and respect the child's discomfort, and to explain the reasons for the exam in a way that the child can understand. It is also important to involve the child in the exam process and provide reassurance throughout. However, it is not appropriate to jump to conclusions or infer that the child has been sexually molested without further evidence or investigation.

Question 3

During a well child examination, a 15-year-old female tells the primary care pediatric nurse practitioner that some of her friends have begun having sex. She has a boyfriend but denies engaging in sex with him. What will the nurse practitioner do initially?

A) Ask her for her definitions of "sex."
B) Discuss the risks of sexually transmitted diseases.
C) Find out if she is considering sexual relations.
D) Give her information about contraception.

A

Accepted Answer

Initially, it's important to understand the teenager's perspective and definition of "sex" to ensure that any advice or information provided is relevant and addresses the teenager's actual situation or questions. Different individuals may have varying understandings of what constitutes sexual activity, and clarifying this can guide the healthcare provider in offering appropriate guidance and support.

Question 4

The primary care pediatric nurse practitioner is providing anticipatory guidance to the parent of a school-age boy. The parent expresses concerns that the child prefers to play with dolls, is worried that the child will be a homosexual, and asks what can be done to prevent this from happening. What will the nurse practitioner tell this parent?

A) Homosexual identity formation cannot be predicted by early childhood behavior.
B) Masculinizing boys from an early age helps to determine heterosexual orientation.
C) Sexual orientation identification begins late in adolescence and not in childhood.
D) The development of sexual orientation is generally a multifaceted process.

Accepted Answer

The answer of The primary care pediatric nurse practitioner is...

Question 5

The primary care pediatric nurse practitioner is performing a well child exam on an 8-year-old girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient?

A) A discussion about the risks of pregnancy and sexually transmitted diseases
B) Information about sexual maturity and menstrual periods
C) Material about the human papillomavirus vaccine
D) Sexual orientation and the nature of sexual relationships

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Accepted Answer

The nurse practitioner should emphasize the importance of discussing and supporting healthy sexuality for young individuals with Down syndrome. It may be important to use appropriate materials and strategies to ensure that the information is provided in a way that is understandable to the child. Additionally, discussing puberty and menstruation with a female patient and her parents is important to prepare for the physiological changes that will occur. Suppressing periods with contraceptives is not recommended unless there is a specific medical reason to do so, and focusing solely on periods and not sexuality may deprive the child of important information and support.

Question 6

The mother of a 3-month-old male infant tells the primary care pediatric nurse practitioner that she occasionally notices he has a penile erection just after nursing. What will the nurse practitioner tell the mother?

A) Infants should be prevented from masturbating.
B) The infant is conscious of the pleasure associated with nursing.
C) This is a form of infantile priapism.
D) This is a normal, reflexive behavior at this age.

Accepted Answer

Penile erection in male infants, particularly after nursing or during diaper changes, is a normal reflexive behavior and does not indicate any conscious thought or awareness of sexual pleasure. It is a common and normal occurrence in both boys and girls due to the immature nervous system and hormonal fluctuations during infancy. It should not be a cause for concern to parents or caregivers. Option A is incorrect as infants do not have the developmental capacity to engage in conscious masturbation. Option B is incorrect as infants do not experience sexual pleasure at this age. Option C is incorrect as infantile priapism is a rare medical condition that is not related to normal reflexive erections in infants.

Question 7

The primary care pediatric nurse practitioner is performing a well child exam on an 8-year-old girl and notes the presence of breast buds. What will the nurse practitioner include when initiating anticipatory guidance for this patient?

A) A discussion about the risks of pregnancy and sexually transmitted diseases
B) Information about sexual maturity and menstrual periods
C) Material about the human papillomavirus vaccine
D) Sexual orientation and the nature of sexual relationships

Accepted Answer

Breast bud development is a normal part of female puberty, which typically begins between the ages of 8 and 13. Anticipatory guidance should include information about sexual maturity and menstrual periods, as well as proper breast care and support. Discussions about pregnancy, sexual orientation, and sexual relationships are not typically appropriate for an 8-year-old patient. Information about the human papillomavirus vaccine may be discussed if the patient has not yet received it, but it is not directly related to breast bud development.

Question 8

The parent of an 8-year-old child tells the primary care pediatric nurse practitioner that the child has begun to ask questions about why a schoolmate has "2 daddies" and wonders how to talk to the child about this. What will the nurse practitioner recommend?

A) Beginning a discussion about different types of sexual relationships and same-sex partners
B) Discussing the issue with the child in terms of the parent's religious values and norms
C) Explaining that not all families are the same and what is most important is that they love and care for their children
D) Telling the child that some adult relationships are complicated and will be understood when the child is older

Accepted Answer

Explaining that not all families are the same and what is most important is that they love and care for their children is the most appropriate response. This approach acknowledges diversity in family structures and emphasizes that love and care are the most important aspects of any family, regardless of its composition. A discussion about different types of sexual relationships and same-sex partners may not be appropriate at this age and may be better suited for an older child or adolescent. Discussing the issue in terms of the parent's religious values and norms may not be helpful in promoting acceptance of diversity. Telling the child that some relationships are complicated and will be understood when the child is older is dismissive and does not provide any useful information.

Deck 21: Sexuality, Sex and Gender Identity