Deck 28: Sexuality

Question 1

The nurse is aware that sexuality is part of growth and development.The preschooler's interest in gender sexuality is characterized by an interest in:
1) Exploring his or her own genitalia
2) Learning how and why his or her anatomy differs from other children
3) Playing and developing friendships with children of the opposite sex
4) Spending most of his or her time with the parent of the opposite sex

Answer 1

1
The first step of gender identity development occurs as the child becomes aware of the differences of the sexes and perceives that he or she is male or female.This is characterized by an interest in his or her genitalia.This is not characteristic of the preschool child.Learning how and why his or her anatomy differs from other children would require a higher level of cognitive ability.Children of this age-group primarily focus on their parents and family,not other children.According to Freud,the preschool child identifies with the parent of the same sex and develops a complementary relationship with the parent of the opposite sex.The preschool child does not spend most of his or her time with the parent of the opposite sex.

Question 2

Which of the following statements made by a client concerning birth control requires immediate correction by the nurse?
1) "My partner is responsible for our birth control;he uses a condom."
2) "I've gained some weight so I should have my diaphragm refitted."
3) "My husband is reluctant to have a vasectomy since it is permanent."
4) "I prefer the cervical cap since I can leave it in for a longer period of time."

Answer 2

1
Barrier methods include over-the-counter spermicidal products and condoms.Spermicidal products (e.g. ,creams,jellies,foams,and sponges)are put into the vagina before intercourse to create a spermicidal barrier between the uterus and ejaculated sperm.A condom is a thin rubber sheath that fits over the penis to prevent entrance of sperm into the vagina.Vaginal spermicides and condoms are most effective when instructions are carefully followed;their combined use is more effective in preventing pregnancy than the use of either one alone.While a vasectomy may be reversed,it is very difficult and results cannot be guaranteed.The remaining options are correct.

Question 3

To increase the tone and sensation of the pelvic floor for a female client,the nurse teaches:
1) Kegel exercises
2) Vaginal dilation
3) Stop-start techniques
4) Sensate focus exercises

Answer 3

1
Kegel exercises increase the tone and sensation of the pelvic floor (pubococcygeus muscle)for the female client.Vaginal dilation will not increase the tone and sensation of the pelvic floor.Stopping urination may help identify proper muscle contraction,but once the muscle is identified,Kegel exercises should not be repeated during urination.Stopping urination midstream may create a backflow of urine into the bladder,predisposing a person to infection.Sensate focus exercises do not increase muscle tone.

Question 4

The nurse has completed an assessment on an adult male client and finds that he is having difficulty having an erection and has less interest in sex.The nurse notes that the client has recently started taking an antihypertensive medication.A nursing diagnosis of sexual dysfunction related to side effects of antihypertensive is identified by the nurse.An appropriate outcome for this client is:
1) Client will avoid taking medication before intercourse
2) Client will relate renewed interest in sex within 1 month
3) Client will be interviewed by a sexual therapist immediately
4) Client will seek out other satisfying substitute activities or hobbies

Question 5

The middle adult couple is most likely to experience a change in their sexual intimacy when:
1) The changes of normal aging occur
2) One or both retire from the work force
3) Chronic illness affects sexual performance
4) The children no longer reside full time in the home

Question 6

The nurse is discussing various sexual issues with a group of military personnel who have experienced spinal cord injuries.Which of the following statements best addresses the issue of alternative methods of personal sexual gratification?
1) "People do whatever works best for them and their partner."
2) "You don't need anyone else to approve how you engage in sex."
3) "Sex practices are private and need only to be discussed with your sexual partner."
4) "Any form of stimulation that is mutually agreed upon and satisfying is acceptable sexual practice."

Question 7

Sexual experimentation is common among adolescents and should primarily be:
1) Discouraged
2) Encouraged
3) Accepted as normal adolescent behavior
4) Viewed as a means of determining sexual orientation

Question 8

The nurse is discussing the physical changes that occur during puberty with a group of 11- to 12-year-olds.The most therapeutic statement the nurse could make directed toward minimizing their anxiety would be:
1) "You'll be fine.Everyone survives puberty."
2) "Don't worry because everyone goes through the changes."
3) "Don't be afraid to talk about the changes with an adult;we all know about puberty."
4) "Puberty is a normal stage of development.Remember,it's simply a part of growing up."

Question 9

While working with a male client and administering medications,the female nurse is approached sexually.The nurse should:
1) Have a male nurse assume care for this client
2) Immediately report the incident to the client's physician
3) Tell the client that his behavior is offensive and leave the room
4) Review and define the limits of a professional relationship for the client

Question 10

The nurse is teaching sexuality to a group of senior adults.Which of the following comments by a participant reflects that he or she has an understanding of the changes in sexuality that occur with aging?
1) "So,sexual intercourse will be more painful for my wife,and we should have sex less frequently?"
2) "We have recently seen the need to begin using a lubricant.That's because we make love less often."
3) "My orgasms seem to not last as long,but my husband and I are probably more satisfied now than when we were younger."
4) "I understand that it is natural not to have such an interest in sex anymore.People our age shouldn't still have those feeling."

Question 11

The nurse,after completion of an assessment in the medical clinic of a client,the nurse documents that the client has dyspareunia based on the client's experience of:
1) Delay or absence of an orgasm
2) Deficient or absent sexual desire
3) Involuntary constriction of the vagina
4) Recurrent genital pain during intercourse

Question 12

Which of the following statements best educates the client regarding the transmission of sexually transmitted diseases (STDs)?
1) "Always have protected sex,and you will be safe."
2) "Be careful to avoid coming into contact with a partner's semen or vaginal secretions."
3) "STDs are spread from person to person by coming into contact with their sperm or vaginal secretions."
4) "STDs can be transmitted through any open sore that comes into contact with a partner's semen or vaginal secretions."

Question 13

A client is concerned that she and her husband,now that they have a baby in the house,will be unable to maintain a healthy sexual relationship.To assist these clients,it would be most helpful for the nurse to know:
1) If they share parenting beliefs
2) How long they have been married
3) How comfortable they are in communicating their feelings to each other
4) The level of knowledge they have regarding healthy sexual relationships

Question 14

A school nurse is responsible for teaching adolescents about sexually transmitted diseases (STDs).When discussing chlamydia,the nurse instructs the students that it is:
1) A viral infection that cannot be cured
2) Treated with a full course of antibiotics
3) Contracted via blood-borne exchange
4) Prevented with the use of spermicidals

Question 15

A client is scheduled for cardiac surgery.The nurse is conducting a sexual history and is told that he is nervous about resuming sexual activities.The nurse uses therapeutic communication with the client when responding:
1) "You can have sexual intercourse after your surgery,but there are serious risks."
2) "Your partner will be nervous about resuming sexual activities,but that is only normal."
3) "Don't worry.In about 2 months you will be able to return to your normal sexual patterns."
4) "You are expressing a very normal concern,Perhaps we could discuss your feelings further."

Question 16

An adolescent female student,who is sexually active,visits the office of the school nurse.Which of the following statements best reflects her understanding of the effective use of contraception devices?
1) "My boyfriend is able to withdraw before ejaculation,and that prevents me from getting pregnant."
2) "I take my temperature every morning;when it goes down for at least two days,we have unprotected sex."
3) "We always use 'foam' before each time that we have sex and as you can see I haven't gotten pregnant yet."
4) "We have decided that I should have a diaphragm inserted and to use contraceptive cream with each intercourse."

Question 17

The nurse is putting together a presentation on the prevention of sexual abuse.She should incorporate which of the following?
1) Abusers fit into easily identified,classic profiles.
2) Intensity is generally increased during pregnancies.
3) Sexual abuse is found primarily in lower socioeconomic groups.
4) Most of the incidents occur with strangers or unknown assailants.

Question 18

A 58-year-old woman asks the nurse what she can do to promote healthy physical sexual relations.Based on the client's age,the nurse responds by saying:
1) "Using a water-based lubricant may be helpful."
2) "Reducing the frequency of intercourse may help you."
3) "I will refer you to a sexual therapist to better assist you."
4) "Continue what you've been doing.Nothing should have changed."

Question 19

Teenagers tend to engage in risky sexual behavior primarily because they:
1) Feel invincible
2) Lack factual information
3) Emulate poor social models
4) Possess immature decision-making skills

Question 20

The nurse knows that studies of sexuality in older adults have shown:
1) To be inconsistent in their overall findings
2) That this population is reluctant to discuss their sexual practices
3) That there is a decline of sexual interest and behavior among older adults
4) That older adults retain an interest in sexual function and are sexually active

Question 21

Which of the following interview questions asked by the nurse is best directed at assessing a common symptom of chlamydia?
1) "Do you have any sores on your genitals (privates)?"
2) "Remember that a fever can be a sign of this sexually transmitted disease (STD)."
3) "Have you been experiencing any problems with urinating (making your water)?"
4) "If you notice a red rash on your perineal area (between your legs)notify your doctor."

Question 22

The nurse is interviewing a client who is concerned about the possibility of contracting the human immunodeficiency virus (HIV)from unprotected sex with a known IV drug user.The nurse knows that if the client is infected:
1) The client's life expectancy is 3 to 5 years
2) There are no effective treatment modalities
3) Symptoms of the disease will be assessable within the first month post exposure
4) Blood work will confirm the diagnosis 6 weeks to 3 months after the initial exposure

Question 23

The nurse realizes that a woman who has experienced a voluntary abortion will be most likely to experience a sense of:
1) Loss and sadness
2) Remorse and regret
3) Relief and confidence
4) Peace and contentment

Question 24

The nurse knows that when a society or culture supports sexual abstinence outside of marriage,it avoids providing sex education to its children because it is believed that to do so would:
1) Erode traditional family values
2) Promote premarital sexual activity
3) Be too emotionally traumatic for both parent and child
4) Put the child at an increased risk for disease and pregnancy

Question 25

Which of the following statements best reflects the nurse's understanding regarding strong personal feelings against voluntary abortions?
1) "It would be difficult,but I would try to care for the client in a professional manner."
2) "I chose not to work in areas that would require me to deal with the issue of abortion."
3) "I will need to separate my personal values in a manner so as to not appear to be judgmental."
4) "I would just ask another registered nurse to care for the client who is recovering from an abortion."

Question 26

The most common reason for clients with sexually transmitted diseases (STDs)to remain untreated is:
1) Embarrassment and guilt
2) Inability to access health care services
3) Lack of knowledge concerning signs and symptoms
4) Insufficient respect for the seriousness of the disease

Question 27

The nurse is counseling a woman who has multiple sexual partners and has recently been diagnosed with the human papillomavirus (HPV).The importance of regularly scheduled Pap smears is discussed primarily because:
1) This woman has a high risk for cervical cancer
2) Her sexual practices also put her at risk for HIV
3) This woman's age puts her at risk for uterine cancer
4) Regular screening results in improved client outcomes