Deck 41: Sexuality

Question 1

The parent of an 18-month-old is very concerned because the baby touches the genital area during diaper changes. How should the nurse respond to this concern?

A) Genital stimulation should not be occurring until the age of 2 1/2 or 3.
B) At 18 months, this touching is not a sexual experience.
C) Babies are sexual beings, but this activity should be discouraged.
D) Masturbation to orgasm is common and normal at this age.

Answer 1

At 18 months, this touching is not a sexual experience.

Question 2

The nurse is teaching a class on body development to a group of primary school girls. One of the girls asks about using tampons for sanitary protection during menstruation. What advice should the nurse include?

A) Super absorbent tampons should be used at night to protect from overflow accidents.
B) Tampons should be alternated with sanitary pads to help decrease infection.
C) Tampons should not be used until the menstrual cycle is well established, usually two to three years after the first period occurs.
D) Tampons should be changed at least every eight hours.

Answer 2

Tampons should be alternated with sanitary pads to help decrease infection.

Question 3

The 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 woman's lack of sexual desire has resulted in impotence in her husband.
B) If both partners share the same lack of desire, there is often not a problem.
C) This couple is experiencing sexual dysfunction.
D) This situation is so unnatural that some dysfunction is present.

Answer 3

If both partners share the same lack of desire, there is often not a problem.

Question 4

Gender dysphoria refers to a condition where a client has:

A) chromosomes and genitalia that are not consistent.
B) strong and persistent feelings of discomfort with one's gender.
C) a desire to express the feminine side of their personality.
D) difficulty maintaining erotic preferences.

Question 5

A female nurse walks into the hospital room of a 50-year-old male client, for the first time. The client is recuperating from knee surgery. The male client speaks little English and there are bed rails in place. The client has no pyjama bottoms on and he throws the sheet back to expose himself and then reaches out to grab the nurse. What should the nurse's immediate response be?

A) Advise the client: "I see you are not dressed. I will be back in 10 minutes and will help you get more comfortable but only when you have your clothes on".
B) Move out of the client's reach and then set about to assess the situation.
C) Seek a medical practitioner's order for interim physical restraint to prevent the client injuring himself and adhere to the ANMC National Competency Standards in this regard.
D) Leave the room immediately and report the incident to the clinical nurse consultant/unit coordinator.

Question 6

Which statement, made by a postmenopausal woman, would the nurse evaluate as indicating the need for further assessment?

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

Question 7

The female client has experienced recurrent candidiasis with intense vaginal itching and excoriation. After treatment the client is re-examined, 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) Treatment with a stronger oral antibiotic.
C) Examination and treatment of sexual partner.
D) Routine douches with a topical antibiotic solution.

Question 8

In discussion with adolescents, the nurse chooses to use the term "sexually transmitted infection" rather than "sexually transmitted disease". What is the rationale for this choice?

A) Sexually transmitted disease does not receive as much third-party reimbursement as does sexually transmitted infection.
B) These terms can be used interchangeably and there is no good rationale for using one over the other.
C) Infection is a much more precise term for the transmission that occurs.
D) The word disease may elicit guilt, shame, and fear in the client.

Question 9

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

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

Question 10

During a routine physical, an 11-year-old tells the nurse that many students in school are "doing it". How should the nurse respond to this statement?

A) Tell the client to talk with parents about sexual matters.
B) State that sexual activity is not appropriate at age 11.
C) Ask what "doing it" means to this client.
D) Stay silent and wait for the client to continue the discussion.

Question 11

A client who has been commenced on beta-blocker medication is asking about the effect it may have on his sexual function. The nurse tells him:

A) "This drug will enhance your sex drive."
B) "This drug can cause shrinking of your testicles."
C) "This drug can decrease your sexual desire."
D) "This drug has no impact on your sexual function."

Question 12

The nurse is developing strategies for the relief of menstrual cramping to teach a group of young women. What should be the focus of these strategies?

A) Minimisation of menstrual flow.
B) Avoidance of uterine contraction.
C) Decrease in oestrogen production.
D) Increase of blood flow to the uterine muscle.

Question 13

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) Extra cleaning supplies to remove thick external secretions.
B) Equipment for pre-examination douche.
C) Smaller than normal vaginal speculums.
D) Culture tubes to assess expected vaginal infection.

Question 14

During discussion of family, the client speaks about an adult son who is a practising homosexual. The client expresses concern about this son, stating: "I am so worried about him and 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) What constitutes normal sexual expression varies among cultures and religions.
C) Since alternative lifestyles are now so well accepted in society, this parent should not feel so much concern.
D) Sexual development is genetically determined and not affected by environment.

Question 15

The mother of a 5-year-old tells the nurse that her daughter has always been closer to her than to her husband. The mother expresses concern that, over the last two months, the little girl wants to spend all of her time with her father instead of with the mother. The nurse recognises that this behaviour:

A) may indicate sexual abuse by the father and should be further investigated.
B) is a normal expectation of a preschooler developing sexuality.
C) can be a sign of precocious puberty and should be monitored.
D) indicates that the girl is over-identifying with the male gender.

Question 16

The secondary school student tells the community 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) Erectile dysfunction only occurs after years of alcohol abuse.
B) Erectile dysfunction occurs only in men older than 50.
C) Alcohol is a sexual stimulant.
D) Alcohol is a central nervous system depressant which affects judgment.

Question 17

A research article the nurse is reading discusses the prevalence of androgyny in persons 20 to 30 years old. The nurse understands which of the following about androgynous persons?

A) They often repress their sexual feelings.
B) They hold rigid stereotyped gender role expectations.
C) They are attracted to people of the same gender.
D) They do not limit behaviours to one gender over the other.

Question 18

Which of the following is not a characteristic of sexual health?

A) Ability to decide one's sexual values and beliefs.
B) Ability to make free reproductive choices.
C) Ability to access sexual health care.
D) Ability to coerce sexual partners.

Question 19

The client experienced female circumcision as a puberty ritual while living in Africa as a child. What condition should the nurse monitor the client for as an adult?

A) Chronic urinary tract infection.
B) Increased menstrual flow.
C) Tendency for postpartum haemorrhage.
D) Early menopause.

Question 20

The nurse enters the room of a bed-ridden young adult client who is recovering from a motor bike accident where he sustained multiple fractures. The client is finishing washing himself with a basin of water, in bed, and the nurse finds the client masturbating. What action should the nurse take?

A) Interrupt the act and ask the client if there are any sexual concerns that should be discussed.
B) Tell the client that masturbation is harmful to sexual wellbeing.
C) Request that the client stop so that care can be provided.
D) Say "excuse me" and leave the room.

Question 21

The daughters of an 80-year-old man who is aphasic after suffering a cerebrovascular accident (stroke) 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) Collaborate with the physician regarding medications to control this behaviour.
B) Assess the client's penis for irritation from the catheter.
C) Tell the client to keep his hands away from his penis.
D) Ask the client to keep his linens at waist level when he has visitors.

Question 22

There is disagreement among the nursing unit staff regarding how much sexual history should be included in adult admission history and physical assessments. What standard is generally the most applicable?

A) Sexual assessment should be done by the physician and not repeated by the nurse.
B) Sexual information should be pursued only if the client's chief complaint indicates possible sexual dysfunction.
C) A complete sexual history must be included in the admission history and physical assessments.
D) The amount of sexual information taken will vary on a case-by-case basis.

Question 23

A client who has recently had a heart attack asks the nurse when he will be able to resume sexual activity. The nurse responds:

A) "No problem, you can start as soon as you get home."
B) "You may not feel like having sex again."
C) "When you can climb a flight of stairs without having chest pain."
D) "Most people can resume intercourse in six months."

Question 24

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

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

Question 25

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

A) Use the technique of informal therapeutic groups to assist the client and partner.
B) Use information technology such as the internet to obtain guidance suggestions for the client.
C) Recommend intensive therapy with a qualified sex therapist.
D) Evaluate previous interventions and treatment for success.

Question 26

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) Document precertification for benefits from the client's insurance company regarding sexual teaching.
B) Obtain signed informed consent from both the client and the spouse or partner prior to providing them with sexual information.
C) Acknowledge the client's spoken and unspoken sexual concerns when providing care.
D) Ask the physician for permission to discuss sexual topics with the client.

Question 27

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) Give the client accurate but concise information in regard to any sexual questions that might be asked.
B) Start information using slang terms to refer to sexual body parts because the client is not likely to know the proper terms.
C) Review current research literature associated with the sexual concerns of the client and partner.
D) In order to avoid causing anxiety, limit the amount of information given to clients regarding adverse sexual side effects of treatments or medications.

Question 28

The nurse who is teaching a client breast self-examination describes inspection of the breasts before a mirror. Which findings should the nurse tell the client should be evaluated by a health care provider?

A) Puckering of the skin.
B) Flattening of the breast from the side view.
C) Free movement of the breast over the chest wall.
D) Symmetry of the nipples.
E) Change in shape.

Question 29

A nurse colleague is outraged that a grandchild's day-care centre is planning a class on sexuality for 3- and 4-year-olds. Discussion of this plan should include what concept?

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

Question 30

What self-examination schedules should the nurse teach a class of young adult men and women?

A) Monthly breast self-exams for women.
B) Annual breast self-exams for men.
C) Weekly testicular self-exams for men.
D) Monthly testicular self-exams for men.
E) Annual vulvar self-exams for women