FINAL FUNDAMENTALS EAQ MULTIPLE CHOICE QUESTIONS WITH CORRECT ANSWERS 2024 LATEST UPDATED, Exams of Business Taxation and Tax Management

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FINAL FUNDAMENTALS EAQ MULTIPLE

CHOICE QUESTIONS WITH CORRECT

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What are the chief factors that determine the self-concept of an individual? Select all that apply. 1 Age 2 Identity 3 Body image 4 Gender 5 Role performance - Solution 2,3, The way an individual identifies herself or himself, how the person perceives his or her body image, and the person's role performance determine the self-concept in the individual. Age and gender do affect the self-concept of a person, but they are not the main components mnemonic (IBR) ( Identity, Body image, and Role performance), make up a mnemonic, such as IBiRp, then a silly sentence using the sounds of IBiRp, such as, "I may burp [IBiRp], but I have a healthy self-concept!" How does the nurse ensure that he or she meets the goals related to self- concept alterations in an acute care setting? Select all that apply. 1 Plan for the patient's discharge to home. 2 Make referrals to other health care professionals. 3 Schedule routine follow-up appointments. 4 Renew prescriptions.

Schedule diagnostic tests periodically. - Solution 1,2, In an acute care setting in which the length of stay for the patient is short, the nurse should arrange for the patient's discharge to home, make appropriate referrals to other health care professionals, and schedule routine follow-up appointments to evaluate progress. Renewing prescriptions and scheduling diagnostic tests would help the patient's medical condition, not his or her self-concept. An adult woman is recovering from a mastectomy for breast cancer and is frequently tearful when left alone. On what should the nurse's approach be based? 1 Patients need support in dealing with the loss of a body part. 2 The patient's family should take the lead role in providing support. 3 The nurse should explain that breast tissue is not essential to life. 4 The patient should focus on the cure of the cancer rather than loss of the breast. - Solution 1 The nurse should encourage the patient to talk about the threats to body image, including the meaning of the loss, the reactions of others, and the ways in which the patient is grieving. Due to a shortage of staff, the nurse has been on duty for both morning and night shifts for the last 2 days. Which role performance is the nurse experiencing? 1 Role strain 2 Role conflict 3 Role overload 4 Role ambiguity - Solution 3 Every person undergoes numerous role changes throughout life. Role overload is not being able to meet the demands of work and carve out some personal time for family. Therefore, the nurse is experiencing role overload in this situation. Role strain is the expression of feelings of

frustration due to an illness or inadequate satisfaction. Role conflict occurs when a person has to assume two or more roles that are inconsistent and contradictory. Role ambiguity is unclear role expectations that create stress and confusion. Which statement made by a patient with cancer reflects positive thoughts about personal health? 1 "I will not get better soon." 2 "I am a burden to my family." 3 "I have the ability to get well quickly." 4 "I can't stand to look at myself anymore." - Solution 3 A person's belief about personal health helps the nurse to understand the patient's self-concept. The patient who feels he or she has the ability to get well reflects positive thoughts about personal health. A verbalization such as, "I will not get better soon," indicates that the patient is suffering from chronic illnesses. If the patient states that he or she is a burden to his or her family, it indicates negative perceptions about personal health. The patient who states, "I can't stand to look at myself anymore" is indicating that he or she does not have positive thoughts about personal health. A patient is scheduled for colon resection with colostomy in 2 days. The nurse finds the patient appearing anxious and asking, "How am I going to live with a bag on my belly for the rest of my life?" Which nursing actions address the patient's self-concept and altered body image? Select all that apply. 1 Showing the patient a colostomy bag and where it is fitted on the abdomen 2 Showing the patient a video about a healthy functioning body after a colostomy 3 Teaching the patient to do relaxation exercises to deal with anxiety 4 Informing the surgeon about the patient's stress and anxiety 5 Discussing the availability of support groups for patients with colostomies - Solution 2, 5

Providing the patient with a practical and realistic approach to the postoperative state, such as showing a video and discussing the availability of support groups for people with colostomies, may help the patient better prepare for the surgical outcome. Showing the bag and where it is fitted is an appropriate teaching activity but would likely have no effect on the patient's self-concept. Teaching the patient relaxation exercises would help reduce the patient's anxiety, but it is not likely to positively affect self- concept. It is part of the nurse's role to help prepare the patient psychologically for surgery; the problem should not be "handed off" to the surgeon without first attempting to address it. A patient diagnosed with major depressive disorder has long-term low self- esteem related to negative view of the self. Which action would be the most appropriate cognitive intervention by the nurse? 1 Promote active socialization with other patients. 2 Role-play to increase assertiveness skills. 3 Focus on identifying strengths and accomplishments. 4 Encourage journaling of underlying feelings. - Solution 3 Focusing on strengths and accomplishments to minimize the emphasis on failures assists the patient in altering distorted and negative thinking. The other interventions are important, but they are not designed to impact thoughts. Place the following people in order of highest expected levels of self- esteem to the lowest.

A mother of five children

A recently widowed elderly woman

The captain of the school soccer team

A high school prom queen and valedictorian

A 35-year-old male diagnosed with testicular cancer - Solution Self-esteem is what a person feels about himself or herself. A person's self-esteem is related to what he or she feels about self-worth. Self-esteem is both positively and negatively affected by several variables. A person who has achieved his or her desired goals, aspirations, and standards of behavior has a higher self-esteem.

4. A high school prom queen who was also valedictorian would likely have the highest level of self-esteem. 3. Self-esteem is also affected by team collaboration and recognition among peers and colleagues; hence, the captain of a soccer team would also have a high level of self-esteem.
5. A mother of five children would likely suffer from role overload and thus have a lower self-esteem than the teens.
6. A 35-year-old diagnosed with testicular cancer may suffer from an identity crisis and loss of self-worth, resulting in low self-esteem.
7. An elderly widow is likely to have the least sense of self-worth A 55-year-old male patient underwent a colostomy. Earlier he underwent coronary artery bypass graft (CABG) surgery. The nurse finds the patient depressed and weeping. The patient expresses that he is fed up with his poor health. He feels that he has become a burden on his family because he can't work now. The nurse finds that the patient's body language is suggestive of altered self-concept. Which behaviors suggest low self- esteem? Select all that apply. 1 Normal speech 2 Frequent crying 3 Hesitant speech 4 Avoidance of eye contact 5 Maintaining good eye contact - Solution 2,3, Behaviors that are suggestive of altered self-esteem include frequent crying, hesitant speech, avoiding eye contact, slumped posture, and an unkempt appearance. Normal speech and maintaining good eye contact are suggestive of a normal and positive self-esteem.

A single mother expresses that she feels inefficient because she is unable to balance her work and family roles. She takes care of her 5-year-old son without any support. She works as a store manager in a retail outlet. What are the role stressors that are responsible for her current state of mind? Select all that apply. 1 Sick role 2 Role conflict 3 Role ambiguity 4 Altered self-concept 5 Role overload - Solution 2, Role conflict occurs when a person has to perform two or more roles that are mutually exclusive. When an individual tries to assume many roles and responsibilities that are unmanageable, it can result in role overload. Role strain is a combination of role conflict and role ambiguity. Role ambiguity occurs when the expectations of a role are not very clear and the person is unsure of what he or she is expected to do (which is not apparent in this case). The sick role refers to the expectations of others and the society as to how the person should behave when he or she is sick. Altered self- concept is not a role stressor; it is the outcome of prolonged stress. A 30-year-old patient suffering from osteoarthritis is unable to move without using a splint and lives with her mother. The patient no longer has a job. The patient refuses to meet anyone and feels worthless. What factors are responsible for this change in self-concept? Select all that apply. 1 Chronic illness 2 Dependency on others 3 Physical impairment 4 Loss of job identity 5 Self-absorption - Solution 1,2,3,

The factors that influence the self-concept of a person are chronic illness, dependency on others, and physical impairments. Loss of job identity also leads to alteration of self-concept and role performance. Self-absorption is the seventh stage of Erickson's psychosocial theory of development. Self- absorption may be a result of an inability to accept the changes in appearance and physical endurance. Accepting the changes due to the aging process leads to generativity. The nurse is assigned to care for a patient who has low self-esteem after undergoing a right leg amputation. The goal for the patient is that the patient's self-esteem will improve in 2 weeks. What are the expected outcomes to achieve the goal? Select all that apply. 1 The patient will have difficulty in making eye contact. 2 The patient will verbalize acceptance of the prosthetic leg. 3 The patient will become less depressed. 4 The patient will interact in a social setting. 5 The patient will talk about his or her feelings. - Solution 2,4,5, Expected outcomes for a patient with low self-esteem include nonverbal behaviors that indicate positive self-esteem. The expected outcomes include the patient verbalizing acceptance of the use of the prosthetic leg, having social interactions, and making eye contact. The patient will talk about his or her feelings. Ambiguous outcomes such as "become less depressed" don't provide the patient with small, manageable goals. The nurse is interviewing a 15-year-old female patient and finds that the patient has an altered body image. Which factors can affect body image in this patient? Select all that apply. 1 Cognitive and physical growth 2 Cultural and societal attitudes 3 Role performance 4 Fulfillment of role expectations 5

Achievement of identity - Solution 1, An altered body image can lead to a negative self-concept. Cognitive and physical growth during adolescence and aging can affect the body image. The hormonal changes during adolescence and puberty affect the way one perceives oneself. The cultural and societal attitudes and values may also affect body image. Some cultures consider aging to be a normal growth process, whereas other cultures are more youth oriented. Role performance and fulfillment of role expectations do not affect body image but have an impact on self-concept. Achievement of identity does not affect body image. A 20-year-old patient is diagnosed with an eating disorder. Which nursing intervention would be best to address self-esteem? 1 Offer independent decision-making opportunities. 2 Review previously successful coping strategies. 3 Provide a quiet environment with minimal stimuli. 4 Support a dependent role throughout treatment. - Solution 1 Offering opportunities for decision making promotes a sense of control, which is essential for promoting independence and enhancing self-esteem. Reviewing successful coping strategies is a priority intervention for patients who cannot cope. Providing a quiet environment and supporting a dependent role throughout treatment won't address self-esteem. The nurse is examining a patient who just had a spontaneous abortion. What observations suggest to the nurse that the patient has good self- esteem post incident and is coping well? Select all that apply. 1 The patient's husband stays by her side and holds her hand. 2 The patient seems depressed but is asking the health care provider about conceiving again. 3 The patient does not want to conceive another child. 4 The patient does not talk to anybody about the incident. 5

The patient asks the health care provider about permanent contraception methods. - Solution 1,2, The fact that the patient's spouse is supportive helps her cope with the stress and loss of self-esteem. Healthy social support from family and loved ones has a very positive effect on a person's self-esteem. The patient's willingness and ability to make decisions about conceiving again show that the patient has a good self-esteem level. A patient who does not want to conceive another child may be depressed and fears that she could face the situation again. If the patient does not talk to anybody about the incident, she may not want to face the emotions related to the incident. Asking the health care provider about permanent contraceptive methods indicates that the patient does not want to go through the process of childbirth again. This behavior may indicate that the patient has low self-esteem and is not coping well. Following a bilateral mastectomy, a 50-year-old patient refuses to eat, discourages visitors, and pays little attention to her appearance. One morning the nurse enters the room to see the patient with her hair combed and makeup applied. Which statement is the best response from the nurse? 1 "What's the special occasion?" 2 "You must be feeling better today." 3 "This is the first time I have seen you look this good." 4 "I see that you've combed your hair and put on makeup." - Solution 4 When the nurse uses a matter-of-fact approach and acknowledges a change in the patient's behavior or appearance, it allows the patient to establish its meaning. The nurse is teaching the proper technique for using an inhaler to a 12- year-old patient who suffers from asthma; the nurse is also teaching exercises to improve the breathing process. What should the nurse focus on to avoid development of an altered self-concept? Select all that apply. 1 Awareness of limitations 2 Awareness of strengths 3

Reassessment of life goals 4 Acceptance of changes in physical endurance 5 Providing reinforcement for mastery of a new skill 00:00: Question Answer Confidence Buttons - Solution 1,2,4,5, Awareness of the limitations and strengths helps the child to strengthen self-concept. Providing reinforcement for mastering a new skill also helps to strengthen the self-concept that the child has developed. The nurse is helping the patient to accept the changes in physical endurance. Learning alternative techniques to deal with the asthma will help in developing a new self-concept. A 12-year-old is unlikely to have a set of goals in life. Thus, reassessment of goals is not usually required at this age. The nurse is teaching a group of young adults about the normal changes in role performance associated with maturation. What are the common stressors related to role performance in this stage of life? Select all that apply. 1 Societal attitudes 2 Dependency on others 3 Transition from school to work setting 4 Physical, emotional, or cognitive deficits preventing role assumption 5 Death of a loved one - Solution 3,4, Role performance is the way in which individuals perceive their abilities to carry out significant roles (e.g., parent, supervisor, or close friend). Normal changes associated with maturation result in changes in role performance. The common stressors include transition from school to work setting, and the physical, emotional, or cognitive deficits preventing role assumption. The death of a loved one creates an emotional deficit that may prevent a person from assuming his or her roles. Societal attitudes and dependency on others are related to identity. The nurse is outlining a plan of care for a 9-year-old patient. What primary developmental task for this patient should the nurse consider?

Communication of likes and dislikes 2 Mastery of new skill 3 Acceptance of body changes 4 Distinguishing self from environment - Solution 2 Based on Erikson's theory of development, during the ages of 6 to 12 years, the primary developmental task is to increase self-esteem. This is achieved through mastery of new skills such as reading, math, music, and sports. Communication of likes and dislikes is exhibited between 3 and 6 years of life. During the ages of 12 to 20 years, body changes and maturation are accepted. Between the ages of 1 and 3 years, the person distinguishes the self from the environment. A 50-year-old female patient is admitted to the hospital for surgical management of breast cancer. The patient is now at home after a successful operation. During a home visit, the patient breaks down and expresses that she is overburdened with responsibilities. She takes care of her 8-month-old granddaughter as well as her 80-year-old mother who has Alzheimer's disease. What stressors is the patient facing? Select all that apply. 1 Sick role 2 Role performance 3 Role conflict 4 Role overload 5 Role ambiguit - Solution 3, Role conflict results when a person has to handle two different responsibilities that are mutually exclusive. Role overload is having more roles and responsibilities than one can handle. The sick role refers to the expectations of others when a person is sick. Role performance is the way in which a person perceives his or her ability to carry out significant roles. Role ambiguity involves unclear role expectations.

A 50-year-old female patient is admitted to the hospital for surgical management of breast cancer. On the second postoperative day, the nurse finds the patient crying. She tells the nurse that she had agreed to take care of her 8-month-old granddaughter, but knows she will be unable to do so. The patient also expresses concern about her looks and that she feels worthless. Identify the stressor that influenced the patient's self-esteem. 1 Pain 2 Job loss 3 Mastectomy 4 Repeated failures - Solution 3 Mastectomy is a surgical procedure for removal of affected breast tissues. Mastectomy has a negative effect on the physical appearance of a female and may be unacceptable to many women. This can be a major factor in lowering their self-esteem. Chronic illness and the idea of depending on others also lower self-esteem. In this case, there is no mention of pain, job loss, or repeated failure, which may also reduce self-esteem. The nurse determines that a patient is experiencing repeated failures, having conflicts, with others, and is more dependent on his or her parents. Which component of self-concept is affected in the patient? 1 Identity 2 Self-esteem 3 Body image 4 Role performance - Solution 1 Identity is defined as an internal sense of individuality, wholeness, and consistency of a person in different situations. The experiences of repeated failures, conflicts with others, and dependency on parents disturb the internal sense of individuality and consistency of an individual. Therefore, identity is affected in the patient.

Self-esteem is an individual's overall feeling of self-worth or the emotional appraisal of self. Body image is the physical appearance, structure, and function of the person. The individual has significant roles throughout life. Failure in meeting role expectations results in deficits. The nurse asks the patient, "How do you feel about yourself?" What is the nurse assessing? 1 Identity 2 Self-esteem 3 Body image 4 Role performance - Solution 2 Self-esteem is how a person feels about himself or herself. Asking open- ended questions about self-esteem is important during the nursing assessment. The nurse cares for a family of four, offering routine medical care throughout the year. Which member of the family does the nurse expect to exhibit the highest levels of self-esteem? 1 The 42-year-old father 2 The 8-year-old boy 3 The 15-year-old girl 4 The 71-year-old grandmother - Solution 2 Low self-esteem is a risk factor for health problems, so the nurse would monitor this in a family that he or she sees often. Self-esteem is highest in childhood. When a person reaches adolescence, self-esteem levels decline. Self-esteem then gradually rises during adulthood and again declines slightly in old age. The pattern may vary slightly in individuals but seems unaffected by gender, socioeconomic status, and ethnicity. The 8-

year-old boy is in the childhood stage and thus is expected to show the highest levels of self-esteem in the family. The father will have high self- esteem but it may not be as high as in the child. The girl, an adolescent, will generally have a low level of self-esteem. The grandmother is elderly and thus is expected to have a lower level of self-esteem. The only details given in all the choices are age and gender. Because there are two female and two male patients, gender could not be the determining factor because this is a single-answer question. Therefore, it must be age. Thinking in general terms about self-esteem and various ages (a child, an adolescent, a parent, and a grandparent) gives you the answer. A patient has a large facial scar after the removal of a tumor of the buccal mucosa. The patient is extremely depressed due to this facial disfiguration. Which nursing actions would be helpful in motivating the patient? Select all that apply. 1 Allow a negative natural reaction to show when seeing the patient. 2 Examine the scar and assuring the patient that it is healing well. 3 Tell the patient about a good plastic surgeon who can improve the appearance of the scar. 4 Avoid looking at the patient. 5 State that the scar does not look as bad as anticipated. - Solution 2,3,5, When dealing with a patient with a disturbed body image, the nurse should be aware that both verbal and nonverbal communication might affect the patient and family. The nurse should encourage the patient with positive expressions, such as telling him or her that the scar is healing well and that it can be further improved by a plastic surgeon. The nurse may reinforce that the patient's condition is better than originally anticipated, which creates a positive feeling in the patient and family. The nurse should be careful to control facial expressions and never exhibit disgust or discomfort, even if that is a natural reaction to the patient's condition. Showing negative reactions to the patient may further lower the self-esteem of the patient. By not looking directly at the patient, the nurse may create a feeling of nonacceptance in a patient with low self-esteem.

What statements made by the patient indicate that the patient's self- concept is improving following treatment? Select all that apply. 1 "I am pretty comfortable with my crutches." 2 "It is easier to administer insulin than I had imagined." 3 "The prosthesis hurts; I cannot endure it." 4 "Physical therapy is going well. I'm going to be on my feet soon." 5 "I don't find the social gathering very interesting." - Solution 1,2, Acceptance of the use of assistive devices and understanding teaching, such as how to administer insulin, suggest good progress. Positive attitudes toward returning to previous levels of functioning also indicate good progress. Not wanting to put additional efforts into rehabilitation and not wanting to socialize indicate negative self-concept. In assessing a patient for self-concept and self-esteem, on what components should the nurse focus? Select all that apply. 1 Identity 2 Body image 3 Role performance 4 Physical condition 5 Medical condition - Solution 1,2, When assessing a patient's self-esteem, the nurse should focus on assessing individual components such as identity, body image, and role performance. This helps the nurse determine which factor is affecting the self-concept. The physical and medical conditions are not components of self-concept. How can the nurse increase a patient's self-awareness? Select all that apply. 1 Help the patient define his or her problems clearly.

Allow the patient to openly explore thoughts and feelings. 3 Reframe the patient's thoughts and feelings in a more positive way. 4 Have family members assume more responsibility during times of stress. 5 Arrange for the patient to work with an occupational therapist. - Solution 1,2, Helping a patient define his or her problems, allowing the patient to explore his or her feelings, and reframing the patient's thoughts and feelings in a more positive way are techniques designed to promote self-awareness and a positive self-concept. Having a family member assume more responsibility does not help a patient achieve self-awareness; instead it is important to encourage a patient to assume more self-responsibility. What are the familial factors that contribute to the development of high self- esteem? Select all that apply. 1 Parental support 2 Social support 3 Authoritarian parenting style 4 Peer relations 5 Positive communication - Solution 1,2, Parental support and monitoring play a vital role in developing high self- esteem. Social support and acceptance are other important factors. Positive communication in the family helps foster the self-esteem of an individual. An authoritarian parenting style is characterized by strict rules, harsh punishments, and little warmth towards the child. This style of parenting fosters a negative self-concept. Influences of peer relations do not come under the family domain. Which question should the nurse ask a patient with low self-esteem in order to assess the nature of the problem? 1 "What do you like about your appearance?"

"Can you remember a time when you felt good about yourself?" 3 "What impact does your self-esteem have on your relationships?" 4 "When did you start thinking or feeling differently about yourself?" - Solution 1 During the assessment process, the nurse asks open-ended, focused, and specific questions in order to determine accurate data. The nurse asks the patient about the perception of his or her own appearance to understand the nature of the problem. The nurse asks about the times the patient has felt good about himself or herself in order to determine which area is important for patient care. To determine the effects of low self-esteem on a patient, the nurse asks about the impact of relationships on the patient's self-esteem. To assess the onset and duration of symptoms, the nurse asks when the patient began to feel differently. A middle-aged patient is diagnosed with erectile dysfunction. Which associated conditions might the nurse find in the patient? Select all that apply. 1 Diabetes 2 Hypertension 3 Anorexia 4 Hyperlipidemia 5 Hyperthyroidism - Solution 1,2, Diabetes mellitus, hypertension, and hyperlipidemia are risk factors associated with erectile dysfunction. Obesity, not anorexia, is a risk factor for erectile dysfunction. Hypothyroidism, not hyperthyroidism, is associated with erectile dysfunction. Which is the most commonly reported bacterial sexually transmitted infection (STI) in the United States? 1 Syphilis 2

Gonorrhea 3 Genital herpes 4 Chlamydia - Solution 4 Syphilis, gonorrhea, genital herpes, and chlamydial infections are all commonly reported; however, infection with Chlamydia organisms is the most common bacterial sexually transmitted infection (STI) in the United States. Other STIs include syphilis, gonorrhea, and genital herpes. Syphilis is caused by Treponema pallidum. Gonorrhea is caused by Neisseria gonorrhoeae. Genital herpes is caused by herpes simplex virus. A male patient approaches the nurse for advice on permanent methods of contraception. What should the nurse suggest to the patient? 1 Tubal ligation 2 Vasectomy 3 Subdermal implants 4 Transdermal skin patches - Solution 2 Vasectomy is a permanent method of contraception in males. In the procedure, the vas deferens, which carries the sperm away from the testicles, is cut and tied. Tubal ligation is a surgical procedure done in females that involves cutting the fallopian tube. Subdermal implants and transdermal skin patches are hormonal methods for temporary contraception. The nurse is assessing a couple who have been unable to conceive a child for some time. Which questions should the nurse ask the couple to determine whether they should be diagnosed as infertile? Select all that apply. 1 "What is the duration of having unprotected sex?" 2 "Do you experience a sense of failure?" 3 "Do you feel that your body is defective?" 4

"Do you enjoy having sexual intercourse?" 5 "Do you live in a city or suburban area?" - Solution 1,2, Patients are diagnosed as infertile if they are unable to conceive after having 1 year of unprotected sexual intercourse. The patients may experience a feeling of failure and may even think that their bodies are defective. Infertility does not depend on seeking pleasure from sexual intercourse and enjoying the activity. The location of a residence does not affect fertility. What is the primary contraceptive action of an intrauterine device (IUD)? 1 It prevents ovulation. 2 It acts as a physical barrier. 3 It prevents fertilization. 4 It kills sperm cells. - Solution 3 The primary action of an intrauterine device (IUD) is to prevent fertilization of the ovum. It has no effect on ovulation, does not act as a physical barrier, and has no effect on the sperm. Hormonal contraception (use of oral contraceptive pills) prevents ovulation. Condoms and diaphragms act as physical barriers to contraception. Spermicidal products, such as spermicidal creams and jellies, kill sperm cells. A 50-year-old male reports he is experiencing issues related to his sexual performance. His blood levels are normal except for a high glucose level. His semen analysis is within normal limits. Which disorder is likely responsible for his condition? 1 Hypoactive sexual desire 2 Erectile dysfunction 3 Dyspareunia 4 Infertility - Solution 2 High blood sugar often leads to sexual dysfunction. Erectile dysfunction is a type of sexual dysfunction in which the person cannot have or sustain an

erection. Hypoactive sexual desire disorder is a disorder in which the person has no or very low sexual desire. Dyspareunia is the occurrence of pain during intercourse, which can be the result of decreased levels of estrogen in perimenopausal women. Infertility is the inability to conceive after 1 year of unprotected intercourse. Which question represents a nonjudgmental approach when gathering a sexual health history? 1 "How do you and your wife/husband feel about intimacy?" 2 "Do you have sex with men, women, or both?" 3 "Are you heterosexual or homosexual?" 4 "What is your sexual orientation?" - Solution 2 A nonjudgmental attitude facilitates trust and open communication between the nurse and patient. Using terms such as partner versus wife or husband allows patients to identify their sexual preference. The terms gay, lesbian, bisexual, or transgender are preferred over the terms heterosexual or homosexual and are more specific in reference to sexual practices. The nurse at a community health center is teaching a group of menopausal women about normal changes in the female sexual response that occur with aging. Which statement by one of the women indicates that the information is understood? 1 "It's normal for me to take longer to reach an orgasm." 2 "I might experience chest pain or shortness of breath during intercourse." 3 "It's normal for me to lose interest in sexual relationships." 4 "I won't need to be concerned about contraception or sexually transmitted infections because of my age." - Solution 1 Normal changes in the female sexual response include a decrease in sex hormone levels, decrease in vaginal lubrication, longer time to reach orgasm, and longer refractory times. Many factors such as chronic illness, medications, stress, or loss of partner can influence the older adult's sexual activity. Older adults may not be comfortable using barrier methods such as

condoms and therefore are at increased risk for sexually transmitted infections. A couple is diagnosed as positive for the human immunodeficiency virus (HIV). Which information should the nurse include when educating this couple about HIV? 1 They should not engage in sexual intercourse. 2 Their children will also be HIV positive. 3 Their duration of survival would increase with treatment. 4 They can be cured by highly active antiretroviral therapy (HAART). - Solution 3 Individuals infected with human immunodeficiency virus (HIV) can survive for about 10 years if left untreated. Because they are already infected, they may have sexual intercourse with each other. Their children are at risk, but not all children born to HIV mothers test positive for HIV. Highly active antiretroviral therapy (HAART) greatly increases the longevity of infected individuals but does not cure the disease. How can a nurse establish trust and encourage patient disclosure about sexuality? 1 Ask how often the patient has sexual intercourse. 2 Ask the patient to disrobe in preparation for the physical assessment. 3 Request permission to discuss sexual issues. 4 Request specific examples of sexual practices and problems. - Solution 3 According to the PLISSIT assessment of sexuality, the nurse should first ask for permission to discuss sexual issues with the patient, followed by open-ended questions to determine the patient's concerns. The nurse is teaching a patient how to use a condom. Which statement by the nurse about using a condom is appropriate? Select all that apply. 1 The air should be squeezed out of the condom. 2

The condom should be applied when the penis is hard. 3 The condom should be unrolled to the base of the penis. 4 The condom should be pulled out during ejaculation. 5 Massage oils should be used for lubrication. - Solution 1,2,3 The air in the condom should be squeezed out. It should be put on as soon as the penis becomes hard and before making any contact with vagina, anus, or mouth. It should be unrolled to the base of the penis to prevent any leakage. The condom should be pulled out after ejaculation and not during ejaculation; pulling it out during ejaculation may cause the semen to pass into the partner. Only water-based lubricants should be used with a condom. Massage oils should not be used, because they may contribute to the condom breaking. A patient has opted for a diaphragm as a mode of contraception. Which advice should the nurse provide to the patient? Select all that apply. 1 It should be used along with an intrauterine device (IUD). 2 It should be used along with condoms. 3 It should be refitted after pregnancy. 4 It should be used with a contraceptive cream. 5 It should be refitted after a significant change in weight. - Solution 3,4,5 The nurse is reviewing the sexual and physical examination data of a patient diagnosed with sexual dysfunction. Which signs and symptoms might the nurse anticipate finding in the assessment data? Select all that apply. 1 Dyspareunia 2 Erectile dysfunction 3 Uncontrolled hypertension 4 Depression and guilt

Foul-smelling genitals - Solution 1,2,3,4 Sexual dysfunction is the inability to accomplish sexual desires. It can be due to many reasons. Dyspareunia is pain occurring with sexual intercourse that may lead to decreased sexual desire. Erectile dysfunction that prevents erection required for satisfactory copulation may also lead to decreased desire. Sexual dysfunction may also be related to various psychological factors, including anxiety, depression, and guilt. Uncontrolled hypertension is a risk factor for sexual dysfunction. Foul-smelling genitals call into question cleanliness or suggest the presence of infection. After teaching a group of young adults about contraception, the nurse concludes that there is a need for further teaching. Which statement made by a young adult supports the nurse's conclusion? 1 "A vasectomy is a contraceptive method that is permanent." 2 "A condom is the most effective barrier method for contraception." 3 "I consult a health care provider before starting hormonal contraceptive therapy." 4 "I prefer to use a combined method of birth control to reduce the risk of sexually transmitted infections (STIs)." - Solution 4 Contraception, also known as birth control, is the method or device used to prevent pregnancy. The nurse teaches about contraception to people who are sexually active in order to provide higher protection against a number of diseases. However, methods that are effective for contraception do not always reduce the risk of sexually transmitted infection (STIs). Therefore, the nurse should correct the statement about using a combined method of contraception to reduce the risk of STIs. A vasectomy or male sterilization is a permanent contraceptive surgical method. A condom is the most effective barrier method. A condom is a thin rubber sheath that fits over the penis to prevent the entrance of sperm into the vagina. The use of hormonal contraception requires a primary health care provider's prescription. Therefore, the young adult will consult a health care provider before beginning a suitable therapy. While caring for a pregnant patient who is in the first trimester of pregnancy, the nurse discusses sexual activity during pregnancy with the

patient. During which trimester are pregnant women most likely to experience increased libido? 1 First trimester 2 Second trimester 3 Third trimester 4 It is unaffected during preg - Solution 2 During the second trimester of pregnancy, patients are most likely to experience an increased libido due to an increased blood supply to the pelvic area to nourish the placenta. In the first trimester, there is usually a decrease in libido due to nausea and vomiting. In the third trimester, a comfortable position for sex is difficult. Therefore, sexual desire is usually not equal during all trimesters of pregnancy. Which nursing action takes priority when working with a patient who opts for an abortion? 1 Explain that abortion means killing a life. 2 Clarify the nurse's own personal values. 3 Convince the patient that abortion is a crime. 4 Criticize the patient for the decision. - Solution 2 Before nurses can be helpful to patients opting for an abortion, they must be aware of and comfortable with their own feelings and values. The nurse should not provide wrong and biased information to the patient to influence the decision. As a corollary, nurses must be comfortable with the idea that patients have a right to their own values. Nurses must also avoid criticism and censure. Which evidence-based factors should the nurse consider when caring for a homosexual patient population? Select all that apply. 1 They belong to a sexual minority. 2 They do not readily seek preventive care.

They are comfortable revealing their sexual orientation. 4 They are concerned about discrimination. 5 They are more prone to getting sexually transmitted diseases. - Solution 1,2,4 Homosexual patients belong to a sexual minority group often described as lesbian, gay, bisexual, or transgendered (LGBT). Current evidence indicates that homosexual patients have reduced access to health care and do not readily seek preventive care (Lim et al., 2014; Williamson, 2010). They also may limit their own access to health care in fear of discrimination. Although there have been many social advancements, the sexual minority group is still not yet well accepted, so many of them are not comfortable revealing their sexual orientation. Although the US Centers for Disease Control and Prevention determined in recent studies that sexually transmitted disease (STD) incidence is rising among men who have sex with men, this is not the case for lesbians. In general, STDs can occur in any sexually active person regardless of the population to which they belong. A couple wishes to prevent conception using natural contraceptive methods based on the menstrual cycle. Which factors indicate the fertile period? Select all that apply. 1 Rhythm of the menstrual cycle 2 Cervical mucus 3 Urinary frequency 4 Breast tenderness 5 Basal body temperature - Solution 1,2,5 The factors that indicate the fertile period of the menstrual cycle are the regularity of the menstrual cycle, consistency of the cervical mucus, and changes in basal body temperature. The regularity of the menstrual cycle can be affected by many factors, including illness and emotional stressors. Cervical mucus changes in color and consistency throughout the menstrual