Question 1

Which patient is most in need of a nurse's referral to adoption services?

Accepted Answer

Adoption is ideal for someone with infertility,especially if infertility treatments are unavailable owing to religious or financial constraints.A patient who wishes to have an elective abortion may be educated about all the possibilities,but the nurse should approach the patient in a nonjudgmental manner and should accept the patient's decision.When a patient has recently miscarried,the nurse should assess the patient's feelings about the loss and should address any concerns the patient may have about fertility.Infertility is the inability to conceive after 1 year of unprotected intercourse; therefore,talking about adoption after one miscarriage or after only 3 months of attempting conception would be too soon.

Question 2

A 12-year-old female patient complains that her periods are making her fat.Which response by the nurse is most therapeutic?

Accepted Answer

The nurse should first assess what type of weight gain the patient is concerned about.From there,the nurse can make recommendations on how to modify daily lifestyles.The nurse should not assume that the patient is eating too many sweets.It is inappropriate to dismiss a patient's concerns by telling her that she is being too emotional,or that no one else sees her problem.This would negatively affect the nurse-patient interaction.

Question 3

The nurse is caring for a patient who recently had unprotected sex with a partner who has HIV.The nurse informs the patient

Accepted Answer

Highly active retroviral therapy increases the survival time of a person with HIV or AIDS.HIV antibodies will not show up in blood work for 6 weeks to 3 months.The infection stage of HIV lasts for about a month after the virus is contracted; during that time,the patient may experience flulike symptoms.A support group may be beneficial for a patient who contracts HIV; however,it is unknown whether the patient has contracted HIV,and antiretroviral therapy has helped people live beyond the 10 years expected if HIV goes untreated.

Question 4

A patient asks the nurse what signs and symptoms are associated with chlamydia.How should the nurse respond?

Accepted Answer

Urinary problems and abnormal discharge are often the first signs of chlamydia.Both men and women can experience these symptoms,although it is known as the silent STI because symptoms may not present for a length of time after the disease is contracted.Small red blisters are associated with genital warts and herpes.Chlamydia does not cause dementia.

Question 5

A 68-year-old female asks the nurse if a contraceptive is still necessary.What is the best response by the nurse?

Accepted Answer

The nurse should first assess the patient's risk for contracting an STI.If the patient has been in a monogamous relationship,and both parties are STI free,there is no need for a barrier.However,even though a patient has gone through menopause,there is still risk for an STI.The best way for a nurse to be sensitive to a patient's needs is to find out more about the patient.Discussing sexual performance in relation to using a barrier method does not answer the patient's question.

Question 6

A nurse is caring for a 15-year-old who in the past 6 months has had multiple male and female sexual partners.The nurse knows that the therapeutic statement that would be most effective is

Accepted Answer

Most young adults feel invincible,and for this reason they participate in risky behaviors.The nurse should acknowledge this feeling to the patient and offer education and alternatives,while giving the patient the autonomy to make his own decisions.The nurse should not force the patient to make a choice of orientation and should not pass judgment on a patient's sexual orientation or social network; this would make the patient feel defensive and would eliminate the trust in the relationship.Involving parents is not the first line of action; parents should be notified only if the child is in a life or death situation.

Question 7

An 18-year-old male patient informs the nurse that he isn't sure if he is homosexual because he is attracted to both genders.The nurse establishes a trusting relationship patient by saying

Accepted Answer

Young adults have questions about sexuality.The patient will feel most comfortable discussing his sexual concerns further if the nurse establishes that it is normal to ask questions about sexuality.The nurse can then discuss in greater detail.Although it is normal for young adults to be curious about sexuality,the nurse should use caution in giving advice on taking sexual action.The nurse should promote safe sex practices.Telling the patient not to worry dismisses his concern.Telling the patient that he is abnormal might offend the patient and prevent him from establishing an open relationship.

Question 8

A patient who had an ostomy placed 1 month ago states that he is feeling depressed and does not want to participate in sexual activities anymore because he is afraid that his partner is not physically attracted to him.Which nursing intervention will be most effective in helping this patient resume sexual activity?

Accepted Answer

The nurse should address the patient's need to be comfortable with his own body image; once this is done,the patient can resume sexual activity.Reassuring the patient that others manage to have sexual intercourse with an ostomy may help to decrease anxiety but may have the unintended effect of making the patient feel as though he is abnormal because he has not yet resumed sexual activity.Support groups may be helpful for the patient,but this is not the most effective intervention a nurse can provide.The patient should be discouraged from using the ostomy as an orifice for sexual activity; this can cause infection,trauma,or prolapse to the stoma.

Question 9

The nurse is leading a seminar about menopause and age-related changes.The nurse knows that a patient does not fully understand the changes of aging when the patient says

Accepted Answer

Orgasms are achievable at any age; however,estrogen levels decrease,and this may impede sexual desire.The nurse should ask the patient if she has any questions on action that will assist in healthy sexual patterns.All other statements indicate that the patient does have an understanding of age-related changes.

Question 10

A woman who has been in a monogamous relationship for the past 6 months presents to clinic with herpes on her labia.The patient is distraught because her partner must have cheated on her.Which response by the nurse is most effective in establishing an open rapport with a patient?

Accepted Answer

If open communication is to be established with the patient,the patient must know that she can trust her health care provider.By telling the patient that all encounters are confidential,the nurse establishes trust.After establishing that trust,the nurse can ask the patient open questions about her fear to further build a relationship.Forcing the patient to confide by sharing every sexual encounter may hinder a trusting relationship.

Question 11

A patient has been hospitalized from a motor vehicle accident for the past month.The nurse notices that the patient has been becoming withdrawn and asks the patient if something is upsetting him.The patient confides to the nurse that he wants to have sex with his spouse but is afraid to in a hospital.How should the nurse proceed?

Accepted Answer

Maintaining intimacy during hospitalization is important for many patients.Arranging a time when the patient is well rested is ideal for any physical activity.Educating the patient about the dangers can be construed as discouraging; instead,the nurse should make a plan with the patient to avoid dangers.Monitoring the patient during intimacy is an invasion of privacy.Barrier contraceptives are not indicated for a patient just because he is hospitalized.

Question 12

A patient admits that he knew for several months that he had an STI but did not report it.The nurse knows that this is because many people with STIs

Accepted Answer

Many patients feel guilt,embarrassment,and anxiety about contracting an STI; this can cause them to defer care until the problem becomes severe.Although knowledge about the severity of STIs may be insufficient,this should not deter seeking care.Regardless of lifestyle,STIs should be treated immediately to prevent further transmission.The role of the health care provider is to establish a trusting relationship.A person may be open to discussing health promotion behaviors but may still be hesitant to discuss STIs.

Question 13

A nursing student is providing education to a group of older adults who are in an independent living retirement village.Which of the following statements made by the nursing student requires the nursing professor to intervene?

Accepted Answer

Any person who has sexual intercourse can develop a sexually transmitted infection (STI)at any age.People with multiple sex partners are at greater risk.Therefore,the instructor needs to intervene when the student tells the older adults that they are not at risk for developing a STI.Avoiding the use of alcohol; using pillows; taking pain medications before having intercourse if needed; and communicating thoughts,fears,and feelings about sex all enhance sexual functioning.

Question 14

A nurse is caring for a patient who expresses a desire to have an elective abortion.The nurse's religious and ethical values are strongly opposed.How should the nurse best handle the situation?

Accepted Answer

The nurse must be aware of personal beliefs and values and is not required to participate in counseling or procedures that compromise those values.However,the patient is entitled to nonjudgmental care and should be referred to someone who can create a trusting environment.The nurse should not care for a patient if the quality of care could be jeopardized.The nurse should not attempt to push personal values onto a patient.The nurse also should not create tension by informing the patient that she does not have the same morals; this could cause the patient to feel guilty or defensive when receiving care from any health care professional.

Question 15

A nurse is caring for a 35-year-old female patient who recently started taking antidepressants after repeated attempts at fertility treatment.The patient tells the nurse,"I feel happier,but my sex drive is gone." Which nursing diagnosis has the highest priority?

Accepted Answer

Antidepressants have adverse effects on sexual desire and response.The nurse should be sure to educate the patient on the potential for these side effects and how to correct for them,for example,using lubricant to ease discomfort.The patient has taken steps toward effective coping by seeking therapy.The patient has not expressed a reason for the nurse to be concerned about contraceptives.The nurse should always assess for concerns about violence in a patient's life.Although some antidepressants have been related to self-directed violence,this patient states that she is feeling happy.

Question 16

A patient who has had several sexual partners in the past month expresses a desire to use a contraceptive.Which contraceptive method should the nurse recommend?

Accepted Answer

Condoms are both a contraceptive and a barrier against STIs and HIV; proper use will greatly reduce the risk.Spermicides,diaphragms,and oral contraceptives all protect against pregnancy; however,they are not a barrier and do not prevent bodily fluids from coming in contact with the patient during sexual intercourse.

Question 17

A male patient with diabetes who is taking medication for erectile dysfunction is experiencing pain and discomfort related to the side effect of priapism.The nurse knows that this patient is at greatest risk for

Accepted Answer

The most immediate concern for a patient with priapism,a condition caused by lack of circulation to the penis,is that this can cause further health complications.Anxiety,sexual dysfunction,and ineffective coping are all also valid nursing diagnoses but are not a priority for this patient.The diagnosis that causes the most harm to the patient should be addressed first.

Question 18

A mother brings her 12-year-old daughter into a clinic and inquires about getting her an HPV vaccine that day.The nurse informs the mother that the HPV vaccine

Accepted Answer

The HPV vaccine is effective against the four most common types of HPV that can cause cervical cancer.Three injections are required,and booster doses currently are not recommended.It is safe for females older than 9 years of age and is intended for females from 13 to 26 years of age.The vaccine is most effective if administered before sexual activity or exposure.

Question 19

A 15-year-old patient is concerned because her mother wants her to receive the HPV vaccination,but the patient is unsure if she wants it.Which response by the nurse is most therapeutic?

Accepted Answer

The nurse should encourage health promotion behaviors but first must consider the autonomy of the patient.The nurse would want to value the input of the patient in making a decision and to address any concerns the patient may have.The HPV vaccine is a preventative treatment,whether or not the patient is sexually active.The nurse should not make assumptions about a patient's home life; instead,the nurse should ask questions while establishing a therapeutic relationship.

Question 20

A mother brings her 4-year-old daughter to clinic.She states that she is upset because she has caught her child masturbating.Which response by the nurse is best for calming the mother?

Accepted Answer

Embarrassment about sexuality often stems from lack of understanding about what is normal behavior.The best way to alleviate that anxiety is to explain why the behavior occurs.Telling the parent that a child will grow out of it can create more anxiety because the parent will be wondering when the behavior should stop.Sexual development is a continual process that begins in infancy and continues into young adulthood.Both male and females must establish gender identity,and self-exploration is normal for both genders.

Quiz 82: Sexuality