Question 1

Which statement made by a patient shows a correct understanding of human sexuality?

Accepted Answer

Sexually,men and women in good health can function effectively throughout the life span.The other answers are sexual myths that the nurse should address.

Question 2

Which classification of drugs has the greatest potential for causing sexual dysfunction?

Accepted Answer

Antihypertensive medications,antihistamines,anticholinergics,chemotherapeutic agents,and antiseizure drugs can cause reduced sexual desire and/or orgasmic disorders in both men and women.The other drug classes listed are not known for these types of effects.

Question 3

A couple come to the clinic for treatment of sexual dysfunction.A therapist obtains a detailed sexual history and decides to employ the Masters and Johnson model of therapy.The nurse expects that treatment planning will include:

Accepted Answer

Masters and Johnson believe that attitudes and ignorance are responsible for most sexual dysfunction.Their therapeutic model emphasizes education about sexual function,alleviation of performance anxiety,and an increase in warm,comfortable feelings between partners.There is no attempt to employ the uncovering used in psychoanalytical treatment.

Question 4

Which nursing diagnosis could be applied to both a patient who is upset that she has developed vaginismus associated with fear of pregnancy as well as a patient with diabetes who is concerned that he cannot attain an erection?

Accepted Answer

Sexual dysfunction is a state in which an individual expresses concern about his or her sexuality.This diagnosis would be equally applicable to either of the patients described above.

Question 5

A nurse requests that a patient assignment be changed,saying,"I learned in school that homosexuality is not an illness and I want to be therapeutic,but every time I see my patient with a same-sex partner,I think it's a sickness!" The nurse is experiencing which stage of the self-awareness process?

Accepted Answer

Cognitive dissonance arises when two opposing beliefs exist at the same time.

Question 6

A patient is seeking help after being diagnosed with hypertension.A nurse plans to include questions about sexual health in the assessment.Which question would be most effective to introduce this topic?

Accepted Answer

This open-ended question is more sensitive than the other answers and is worded so as to make the patient more comfortable in answering,encouraging the patient to share information.

Question 7

A nurse assesses a patient who reports that she is unable to have intercourse because of involuntary contractions at the vaginal opening.The nurse can correctly assess this as:

Accepted Answer

Vaginismus is defined as recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with coitus.

Question 8

What is the rationale for seeking information about the effects of prescribed medications on a patient's sexual function?

Accepted Answer

A nursing history should include questions about sexual health.The side effects of several groups of drugs include impotence or delayed ejaculation in men and diminished responsiveness in women.

Question 9

A person states,"I feel as though I'm really a woman trapped in this male body." This type of statement is characteristically expressed by someone who is a:

Accepted Answer

A transsexual is a person who is anatomically a male or female but who expresses strong conviction that he or she has the mind and feelings of the opposite gender.

Question 10

A nurse caring for an attractive patient of similar age and background begins fantasizing about having a social and sexual relationship with the patient.The most effective means of dealing with these feelings is to:

Accepted Answer

Sexual attraction and fantasy are part of the human experience.Nurses are not immune.Nurses,however,must recognize and deal appropriately with the feelings or risk interference with the quality of care.The feelings should not be denied,nor should they be tested or shared with the patient.It is the nurse's responsibility to preserve professional boundaries.Consultation is a constructive way of dealing with the situation.

Question 11

A patient is hospitalized for an acute episode of schizophrenia.A nurse finds the patient in the lounge nude and telling everyone,"I am the body beautiful." The most appropriate intervention for the nurse would be to:

Accepted Answer

The sexual expression of patients with psychiatric illness may be inappropriate and,at times,intrusive.The patient may not be able to understand or control sexual thoughts or impulses.Nursing intervention should protect the patient from the consequences of poor judgment whenever possible and should be achieved in a neutral,nonjudgmental manner.

Question 12

When a patient tells a nurse,"I think I'm impotent," which response by the nurse would be most therapeutic?

Accepted Answer

Validating terminology is a vital first step.After the nurse understands the patient's complaint,further assessment can take place.

Question 13

What factor is most important during evaluation of effectiveness of sexual counseling or intervention?

Accepted Answer

Evaluation factors include patient sense of well-being,functioning ability,and satisfaction with treatment.

Question 14

The best expected outcome for a patient with maladaptive sexual response is,"The patient will

Accepted Answer

An expected outcome is a broad statement relating to resolution of maladaptive sexual response.The remaining options are more circumscribed and are considered short-term goals.

Question 15

A nurse shares with a mentor,"When my patient brought up the subject of resuming sexual relations after surgery,I felt flustered.While I realized I wasn't letting the patient express concerns,I couldn't stop monopolizing the conversation." The nurse describes experiencing the stage of the self-awareness process called:

Accepted Answer

In the stage of anxiety,the nurse may exhibit behaviors that hinder the discussion of sexual issues,such as talking too much,failing to listen,and being preoccupied with facts rather than feelings.

Question 16

A nurse consults with local elementary and secondary school teachers about implementing strategies to reinforce the concept of "say no to unwanted sexual advances." The most helpful method the nurse can suggest is:

Accepted Answer

Understanding that one should say "no" is much simpler than saying "no" when under pressure.A sex education program must give students tools with which to make appropriate decisions and the behavioral skills necessary to implement the decisions.Role playing assertive ways of saying "no" is the most effective behaviorally focused intervention listed.

Question 17

Parents are upset after learning that their child is homosexual.They ask the nurse,"What causes homosexuality; was it something we did?" The nurse responds best when stating:

Accepted Answer

Giving a direct answer is appropriate because the patient is seeking information.To mention a possible genetic origin may cause the parent to needlessly feel responsible.Saying that homosexuality is a normal expression of sexual behavior denies the parent's right to be distressed.Suggesting that the patient is concerned for self may be considered challenging.

Question 18

A patient hospitalized for depression will be discharged tomorrow.The patient asks a nurse,"Could the two of us meet for coffee away from the hospital sometime?" The most therapeutic response by the nurse would be:

Accepted Answer

Termination is a time for evaluating progress and bidding farewell.Patients who view their nurses in a positive fashion are often reluctant to terminate and seek to continue the relationship on a social basis after discharge.Helping the patient clarify the therapeutic aspect of the nursing role is appropriate.

Question 19

A patient with a new colostomy tells a nurse,"This surgery is the end of my sex life." This statement should lead the nurse to take the initial step of:

Accepted Answer

Exploration of fears and feelings should be the initial intervention after the patient's statement of concern.Each of the other interventions might be appropriate at a later time.

Question 20

A patient being treated for cellulitis tells a nurse,"I feel like you and I should get romantic tonight.What do you say to closing the door and crawling into bed with me?" The nurse should respond by saying:

Accepted Answer

When patients behave seductively toward nurses,it is appropriate to set limits firmly and matter-of-factly.

Quiz 25: Sexual Responses and Sexual Disorders