Sexuality (40)

Question 1

Clients may be unlikely to introduce the topic of sex with health care providers for which reason?

1. ) They assume that health care providers know little about sexual functioning.
2. ) Most clients have few questions or problems.
3. ) Female clients prefer to discuss problems with female health care providers.
4. ) They are too embarrassed to introduce the topic of sex.

Answer 1

4.) They are too embarrassed to introduce the topic of sex.

Clients still may feel shame and discomfort regarding sexuality. Most people assume that providers have a great deal of information (option 1). Many clients have questions and concerns (option 2). Although talking with someone of the same gender may make it easier for some women, it is not a requirement for assessment and intervention (option 3).

Question 2

A nurse receives information that a client is transgender. Appropriate care is based on the knowledge that which of the following is most representative of this client?

1. ) Gonadal gender, internal organs, and external genitals are contradictory.
2. ) Sexual anatomy contradicts gender identity.
3. ) Sexual attraction is to individuals of both genders.
4. ) Gender identity is altered by acute psychosis.

Answer 2

2.) Sexual anatomy contradicts gender identity.

Transgender persons’ anatomic gender is not the same gender as they feel themselves to be. Option 1 is the definition of intersex. Option 3 is the definition of bisexuality. Gender identity is a lifelong belief and not altered by an acute condition (option 4).

Question 3

In conducting client teaching, the nurse bases content on knowing that which of the following is true regarding masturbation?

1. ) People who masturbate are psychologically disturbed.
2. ) Teenage masturbation interferes with academic achievement.
3. ) Most people do not masturbate past the teenage years.
4. ) Masturbation is a way people learn about their sexual response.

Answer 3

4.) Masturbation is a way people learn about their sexual response.

Masturbation is a normal activity for most people and assists with self-exploration of sexuality. There is no evidence that masturbation interferes with academic achievement (option 2). Individuals masturbate at all ages of life (option 3).

Question 4

A male client is beginning an antidepressant medication. Which of the following should be included in the teaching?

1. ) “Your partner will be pleased because your sexual functioning is going to improve.”
2. ) “You may find that your desire for sex will decrease while on this medication.”
3. ) “Retrograde ejaculation is a common problem when taking antidepressants.”
4. ) “Your skin will probably become supersensitive to touch, so you may need to change your activity during sex.”

Answer 4

2.) “You may find that your desire for sex will decrease while on this medication.”

Orgasmic response and sex drive are often inhibited by antidepressants. If the depression lifts, there may be an improvement but the focus in option 1 is on the partner rather than where it should be—on the client. Retrograde ejaculation is associated with removal of the prostate gland (option 3). Skin hypersensitivity is not a side effect of antidepressant medications (option 4).

Question 5

A client who had a hysterectomy 3 days ago, says to the nurse, “I no longer feel like a real woman.” What is the best response?

1. “Don’t worry about that. The feeling will probably go away.”
2. “You should talk to your doctor about how you feel.”
3. “I don’t blame you. I would feel like half a woman also.”
4. “I hear your concern. Tell me more about your feelings.”

Answer 5

4. “I hear your concern. Tell me more about your feelings.”

More information is needed before intervening. Also, the client needs the opportunity to express her feelings. Option 1 is an unprofessional response and false reassurance. The ANA Code of Ethics indicates that clients are entitled to a timely and appropriate response to their needs. Option 2 suggests postponing the discussion and that the primary care provider is the better person to deal with her concerns, which is untrue. Option 3 represents feeding into her negative self-concept and inappropriate self-disclosure.

Question 6

Because a client reports having dyspareunia, it is most appropri- ate to ask which question?

1. “Have you talked with your partner about this discomfort?”
2. “Have you had these spasms since you became sexually active?”
3. “Do you have pain before your period begins?”
4. “Do your breasts swell large enough to need a larger bra?”

Answer 6

1. “Have you talked with your partner about this discomfort?”

Dyspareunia is painful intercourse. Knowledge of the partner’s awareness will contribute to resolution. Involuntary vaginal spasms are called vaginismus (option 2). Painful menstruation is called dysmenorrhea (option 3). Breast swelling can occur during portions of the menstrual cycle but is unrelated to painful intercourse (option 4).

Question 7

Including at least some sexual health history questions would be most relevant for clients taking which category of drugs?

1. Anti-inflammatories (such as aspirin or ibuprofen)
2. Hypnotics (sleeping pills)
3. Antihypertensives (blood pressure medications)
4. Antihistamines (cold medications)

Answer 7

3. Antihypertensives (blood pressure medications)

Antihypertensive medications are known to affect sexual functioning in several different ways, so some focused history questions would be indicated. There is no evidence of a rela- tionship between sexual functioning and anti-inflammatories, hypnotics, or antihistamines (options 1, 2, and 4). However, the underlying condition that leads the client to take other medications could be important. Side effects of any medication could impact sexual interest or energy level, which reinforces the importance of including taking a sexual health history for all clients.

Question 8

A nurse informs a client who is 8 1/2 months pregnant that it is best to abstain from intercourse until after the birth of the baby. This communication is most representative of which component of the PLISSIT model?

1. Permission giving (P)
2. Limited information (LI)
3. Specific suggestions (SS)
4. Intensive therapy (IT)

Answer 8

2. Limited information (LI)

LI includes instructing clients regarding when sexual activity is safe or unsafe. P involves giving permission to be sexual beings and to discuss issues (option 1). SS includes specific suggestions that help clients promote optimal functioning (option 3). Intensive therapy (IT) requires special skills offered by a nurse specialist or sex therapist (option 4).

Question 9

A 75-year-old male client reports decreased frequency of sexual intercourse although he does not express dissatisfaction or difficulty. He seems a little embarrassed by the discussion but is engaged and asks some questions. An appropriate nursing diagnosis would be which of the following?

1. ) Sexual Dysfunction
2. ) Disturbed Body Image
3. ) Sedentary Lifestyle
4. ) Readiness for Enhanced Knowledge

Answer 9

4.) Readiness for Enhanced Knowledge

A change in sexual frequency is not abnormal but may suggest an opportunity for enhanced knowledge if he desires. It does not suggest pathology or disturbed body image (options 1 and 2). It would be incorrect to assume his lifestyle is sedentary merely be- cause the frequency of his sexual activity has decreased (option 3). Further assessment of the reason for the decrease in sexual activity is indicated.

Question 10

Which of the following outcomes may indicate the need for referral to a more highly skilled therapist?

1. ) The client verbalizes methods of modifying sexual activity according to physical limitations.
2. ) The client requests the phone number of a sex education support group.
3. ) Suggestions given by the nurse are ineffective in reaching the desired goals.
4. ) The client reports experimenting with new sexual activities.

Answer 10

3.) Suggestions given by the nurse are ineffective in reaching the desired goals.

The key term is ineffective. If the suggestions given by the nurse are ineffective in reaching the desired goals, the client may require intervention from someone with more specialized skills. Verbalizing constructive methods of modifying sexual activity are healthy responses and do not require a more skilled therapist (option 1). The generalist nurse can refer the client to education and support groups (option 2). Experimenting with new sexual activities is probably a healthy direction and does not suggest the need for referral (option 4).