Potter and Perry, Fundamentals Chapter 34 – Sexuality questions and answers, Exams of Nursing

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Potter and Perry, Fundamentals Chapter 34 – Sexuality questions and answers

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 a. "I know you feel invincible, but STIs and unwanted pregnancy are a real risk. Let's discuss what you think is the best method for protecting yourself." b. "Having sexual interaction with both males and females places you at higher risk for STIs. To protect yourself you need to decide which orientation you are." c. "Your current friends are leading you to make poor choices. You should find new friends to hang out with." d. "I think it's best to notify your parents. They know what's best for you and can help make sure you practice safe sex." - A 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? a. Continue to care for the patient, and limit conversation as much as possible. b. Refer the patient to a family planning center or health professional. c. Attempt to educate the patient about the consequences of abortion. d. Inform the patient that because of moral issues, another nurse will have to care for her. - B Which patient is most in need of a nurse's referral to adoption services? a. A patient considering abortion for an unwanted pregnancy b. An infertile couple religiously opposed to artificial insemination c. A woman who suffered miscarriage during her first pregnancy d. A couple who has been attempting conception for 3 months - B 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 a. "Don't worry. It's just a phase you will grow out of." b. "Those are abnormal impulses. You should seek therapy." c. "At your age, it is normal to be curious about both genders."

d. "Having questions about sexuality is normal. Have you noticed any changes in the way this makes you feel about yourself?" - C 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? a. Sexual dysfunction b. Ineffective coping c. Deficient knowledge about contraception d. Risk for self-directed violence - A 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? a. "Don't worry. This is normal for a child her age. She will grow out of it." b. "That is a natural part of development. Your child is exploring and becoming familiar with her body." c. "Most children have grown out of that phase by now. She might be developmentally delayed." d. "That is an abnormal behavior for a female child. I'm going to refer you to a specialist." - B 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? a. Spermicide b. Condom c. Diaphragm d. Oral contraceptive - B 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? a. Share an anecdote. b. Inform the patient that all encounters are confidential. c. Tell the patient that she must be honest about every sexual experience she has had. d. Ask the patient what concerns or fears she has related to the visit. - B 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 a. Do not acknowledge the importance of STI testing and treatment. b. Are hesitant to admit they contracted an STI. c. Have lifestyles that subject them to repeated exposure. d. Are uncomfortable discussing sexual health issues with a same-sex provider. - B 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

a. "I will no longer ovulate after menopause." b. "Orgasms are no longer achievable after menopause." c. "Hormones of sexual regulation such as estrogen decrease with age." d. "As men age, their ability to sexually perform may decrease." - B 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? a. Reassure the patient that lots of people resume sex the same week the ostomy is placed. b. Inform the patient about a support group for people with ostomies. c. Teach the patient about intimate activities that can be done to incorporate the ostomy. d. Discuss ways to adapt to new body image so the patient will be comfortable in resuming intimacy. - D 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 a. Is safe for children over the age of 5 and lasts 10 years. b. Is recommended only after a female becomes sexually active. c. Will prevent a female from ever getting cervical cancer. d. Requires a three-injection series to be fully effective. - D 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? a. Arrange a schedule with the patient to allow for intimacy at a time when the patient is well rested and able to participate in activity. b. Educate the patient about the dangers of strenuous activity in his condition. c. Ask the patient if it would be okay to have a monitor on in the room for his safety. d. Stress the importance of using barrier contraceptives to prevent infection because he is already susceptible. - A 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? a. "Avoiding alcohol use will enhance your sexual functioning." b. "You do not need to worry about getting a sexually transmitted infection at this point in your life." c. "You need to tell your partner how you feel about sex and any fears you may have." d. "Using pillows and taking pain medication if needed before having sexual intercourse often helps alleviate pain associated with intercourse and improves sexual functioning." - B A 12-year-old female patient complains that her periods are making her fat. Which response by the nurse is most therapeutic?

a. "Try to stop snacking on sweets when you get cravings, and replace them with healthy veggies instead." b. "Does the weight fluctuate throughout the month, getting worse around the time of your period?" c. "You are emotional around the time of your period; I promise no one notices this but you." d. "Those changes are normal with menstruation; try not to get upset about it." - B A patient asks the nurse what signs and symptoms are associated with chlamydia. How should the nurse respond? a. The first signs that chlamydia presents are frequency and burning upon urination. b. Symptoms of chlamydia usually affect only women. c. Small red blisters appear first and then multiply. d. Dementia results if chlamydia goes untreated too long. - A 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? a. Ask the patient what concerns she may have about the vaccination. b. Remind her that her mother knows best, and that she should respect her parents' wishes. c. Ask the patient how many sexual partners she has had in the past year. d. Promote the importance of the vaccine, and recommend that the patient get the vaccine as soon as possible. - A 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 a. Sexual dysfunction related to low self-esteem. b. Impaired circulation due to medication. c. Anxiety related to erectile dysfunction. d. Ineffective coping related to chronic illness. - B A 68-year-old female asks the nurse if a contraceptive is still necessary. What is the best response by the nurse? a. "A barrier such as a condom is recommended if you are unsure whether your sexual partners have been tested for STIs." b. "No, because you have gone through menopause and can no longer become pregnant." c. "Let's discuss this further, what is your current level of sexual activity?" d. "Yes, as long as using a barrier does not decrease sexual performance." - C The patient expresses his attraction to the nurse who is caring for him. The patient asks the nurse for her phone number. How should the nurse first attempt to handle the situation? a. Redefine the boundaries of professionalism. b. Give the patient her number, but ask that he call after work hours. c. Give the patient false information to appease him. d. Ask a coworker to take over care for this patient. - A

A patient expresses concern that her partner no longer finds her attractive and is considering having a three-way to spice up the relationship. Which response is the best option for the nurse in this situation? a. "Please help me understand how you are feeling about your relationship right now." b. "If your partner truly loves you, he doesn't need to have sex with another person." c. "Nonmonogamous sex is immoral; here is the number for the local church." d. "Have you considered the consequences of adding a third party to a sexual relationship?" - A An older couple expresses concern because they are easily fatigued during sexual intercourse and cannot reach climax. The nurse knows that older adults may have changes in sexual functioning. What strategies to increase sexual stamina could the nurse offer? (Select all that apply.) a. Avoid alcohol and tobacco. b. Encourage intimate touching, such as hugging and kissing. c. Eat well-balanced meals, and eliminate excess fats and sugars. d. Plan sexual activity around a time when the couple feels rested. e. Take pain medication before intercourse. f. Use extra lubrication to decrease discomfort. - A, C, D The nurse is providing education on sexually transmitted infections (STIs) to a group of adolescents. The nurse knows that further teaching is needed when one of the adolescents states: A. "A vaccine is available to reduce infection from certain types of human papillomavirus." B. "I should be screened for an STI after I am with a new partner." C. "I know I' m not infected if I don't have any symptoms such as discharge or sores." D. "A viral infection such as herpes or human papillomavirus cannot be treated with antibiotics." - C A 25-year-old patient is in the emergency department and states that she has had a cough and fever for the past 3 days. While performing a physical assessment, the nurse finds several bruises that are in various stages of healing and suspects that the patient possibly is a victim of sexual abuse. Which of the following is the nurse's first action? A. Refer the patient to a sexual counselor B. Tell the patient about the safe house for women C. Ask the patient to describe how she got the bruises D. Report the abuse immediately to the proper authorities - B A 26-year-old married woman recently discovered that she is pregnant and is at her first prenatal visit. While assessing the patient, the woman's health nurse practitioner discovers that she has purulent vaginal discharge. The patient states, "It burns when I urinate, and I seem to have to go to the bathroom frequently." Based on these symptoms, the nurse practitioner determines that further follow-up is needed because the patient: A. Should be tested for human immunodeficiency virus (HIV). B. May have a sexually transmitted infection (STI) such as chlamydia. C. Is experiencing normal signs of pregnancy. D. Needs education on proper perineal hygiene. - B A new graduate nurse is working in a rehabilitation center that specializes in the care of patients with spinal cord injuries (SCIs). The new graduate knows that sexual issues are common among patients with SCIs. Which of the following actions enhances the nurse's comfort in discussing sexual issues with the patients? (Select all that apply.) A. Clarifying personal values related to sexuality

B. Role playing discussion of sexual concerns with another nurse C. Attending a conference to enhance knowledge about sexuality D. Avoiding a discussion of sexual concerns until after completing new nurse orientation - A, B, C The nurse is gathering a sexual history from a 68-year-old man in a nursing home. It is important for the nurse to keep in mind that: A. Older adults are usually not part of a sexual minority group. B. Older adults sometimes do not reveal intimate details. C. Older men and women lose their interest in sex. D. Older adults in nursing homes do not usually participate in sexual activity. - B Certain cultural groups in the United States are disproportionately affected by diseases such as human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS). The nurse understands that this is most likely caused by: (Select all that apply.) A. Expectations about behavior by men or women in the culture. B. Higher percentages of lesbian, gay, bisexual, or transgender individuals in the culture. C. Genetic predisposition to the disease in the culture D. Communication patterns and language practiced by the culture. - A, D Since the majority of sexually transmitted infections (STIs) have few if any symptoms, it is important for the nurse to: A. Encourage regular screenings in all sexually active individuals. B. Provide information about contraception options. C. Administer prescribed antibiotics for human papillomavirus (HPV) or genital herpes outbreaks. D. Ask all patients if they are experiencing any symptoms. - A Establishing trust and encouraging disclosure about sexuality are often facilitated if the nurse begins by asking the patient: A. How often he or she has sexual intercourse. B. To disrobe in preparation for the physical assessment. C. For permission to discuss sexual issues. D. For specific examples of sexual practices and problems. - C A 15-year-old girl states that she is having unprotected intercourse with her boyfriend. She asks for more information about birth control methods. The nurse informs the patient that: (Select all that apply.) A. Condoms or diaphragms must be used with each sexual encounter. B. Hormonal methods offer little protection against sexually transmitted infections (STIs). C. Barrier methods offer some protection against STIs. D. Sterilization is an effective option that she should consider. - B, C The nurse reviews the health history of a 24-year-old woman who indicates that she has had three new sexual partners since her previous examination 2 years ago. The nurse discusses the need for sexually transmitted infection (STI) screening with the patient even though she denies symptoms or discomfort. The nurse realizes that the most serious complication from untreated STIs in females is: A. Genital discharge and dyspareunia. B. Painful menstrual cycles. C. Infertility and pelvic inflammatory disease.

D. Genital warts. - C The nurse is providing education about condom use at a community clinic for older adults. Which of following statements demonstrates that the adults understand correct use of condoms? (Select all that apply.) A. "I can use any kind of lubricant such as lotions or baby oil." B. "Before using the condom, I should check the package for damage or expiration." C. "I need to use a condom to help reduce the risk of sexually transmitted infections." D. "A good place to store condoms is in the bathroom so they don't dry out." - B, C Which of the following represents a nonjudgmental approach when gathering a sexual health history? A. How do you and your wife/husband feel about intimacy? B. Do you have sex with men, women, or both? C. Are you heterosexual or homosexual? D. What is your sexual orientation? - B A 54-year-old male patient who is being seen for an annual physical tells the nurse that he is having difficulty sustaining an erection. The nurse reviews his health history and notes no current health problems except medical treatment for depression. The nurse understands that: A. A personal issue such as this is best addressed by the male physician during the examination. B. Erectile dysfunction affects most men over the age of 50. C. The patient needs to be screened for sexually transmitted infections (STIs). D. Antidepressant medication may be affecting his sexual functioning. - D 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. The nurse knows that the information is understood when one of the women states that: A. It's normal for me to take longer to reach an orgasm. B. I might experience chest pain or shortness of breath during intercourse. C. It's normal for me to lose interest in sexual relationships. D. I won't need to be concerned about contraception or sexually transmitted infections because of my age. - A A school nurse is completing a health history on an adolescent female and notices several body piercings and tattoos. The student tells the nurse that she is planning to get more tattoos and piercings over the summer break. The nurse tells the student piercing and tattoos can: A. Prevent you from being involved in contact sports. B. Only create health problems if they are located in the nipples or genital area. C. Increase your risk for infection at the site and in the body. D. Be a safe and important way of establishing your personality. - C Which statement about sexual response in older adults is correct? A. The resolution phase is slower. B. The orgasm phase is prolonged. C. The refractory phase is more rapid. D. Both genders experience a reduced availability of sex hormones. - D The only 100% effective method to avoid contracting a disease through sex is:

A. Abstinence B. Using condoms C. Avoiding sex with partners at risk D. Knowing the sexual partner's health history - A Pill, intrauterine device, condoms, diaphragm, tubal ligation, vasectomy: A. Contraceptive options B. Middle adulthood C. Older adulthood D. Adolescents E. School-age children F. Sexuality - A Which is not a primary route for human immunodeficiency virus (HIV) transmission? A. Contaminated IV needles B. Urinary Tract infections C. Anal intercourse D. Vaginal intercourse E. Oral-genital sex F. Blood transfusions - B Which is not a commonly diagnosed STI? A. Syphilis B. Gonorrhea C. Chlamydia D. Osteoporosis E. Trichomoniasis F. HPV G. Herpes Simplex - D dyspareunia - - painful intercourse PLISSIT Assessment of Sexuality - Permission to discuss sexuality issues Limited Information related to sexual health problems being experienced Specific Suggestions - only when the nurse is clear about the problem Intensive Therapy - referral to professional with advance training if necessary