Chapter 27: Sexuality Nursing School Test Banks

Potter & Perry: Fundamentals of Nursing, 6th Edition

MULTIPLE CHOICE

1. The nurse is aware that sexuality is part of growth and development. The preschoolers interest in gender sexuality is characterized by an interest in:

a.

His or her genitalia

b.

Learning how and why his or her anatomy differs from that of other children

c.

Playing and developing friendships with children of the opposite sex

d.

Spending most of his or her time with the parent of the opposite sex 

ANS: a

a. 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.

b. This is not characteristic of the preschool child. Learning how and why his or her anatomy differs from that of other children would require a higher level of cognitive ability.

c. Children of this age group focus primarily on their parents and family, not on other children.

d. 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.

REF: Text Reference: p. 524

2. A female nurse is working with a male client. During the administration of medications, the male client acts out sexually to the female nurse who is caring for him. The nurse should:

a.

Have a male nurse assume care for this client

b.

Immediately report the incident to the clients physician

c.

Tell the client that his behavior is offensive and leave the room

d.

Review and define the professional relationship for the client

ANS: d

d. The nurse should convey a message of acceptance of the client, but not the inappropriate behavior. Reviewing and defining the professional relationship with the client can accomplish this.

a. Matching the gender of the health care worker with the gender of the client may be beneficial when dealing with assessment of sexual needs or sex education. However, in this instance, the client needs to be informed that inappropriate sexual behavior is unacceptable. To turn the clients care over to a male nurse would not resolve the problem and would convey a message of dislike and lack of acceptance of the client.

b. Reporting the incident immediately to the clients physician would not be the nurses best action. The client needs to be made aware of the problem to discontinue such behavior.

c. Telling the client his behavior is offensive and then leaving the room are not therapeutic. The client needs to be reminded of the professional relationship he shares with the nurse.

REF: Text Reference: p. 531

3. A client states that she is afraid that she and her husband will not be able to maintain a healthy sexual relationship now that they have a baby in the house. To assist these clients, it would be most helpful for the nurse to know:

a.

If they have similar parenting beliefs

b.

How long they have been married

c.

How comfortable they are in communicating their feelings to each other

d.

The level of knowledge they have regarding healthy sexual relationships

ANS: c

c. In response to identified concerns, the nurse may initiate discussion. This provides an open dialogue enabling the client to talk freely with the nurse to address the concerns.

a. To assist the clients in their situational change, the nurse must explore communication and sexual patterns of the couple. Having similar parenting beliefs will have less impact on their sexual relationship.

b. To assist the couple in adjusting to the change of becoming a family, the nurse should explore communication patterns of the couple. How long they have been married would be less significant.

d. The level of knowledge they have regarding healthy sexual relationships would not affect their sexual relationship as would their ability to discuss their feelings with one another.

REF: Text Reference: p. 539

4. On completion of an assessment of a client in the medical clinic, the nurse documents that the client has dyspareunia based on the clients experience of:

a.

Delay or absence or an orgasm

b.

Deficient or absent sexual desire

c.

Involuntary constriction of the vagina

d.

Recurrent genital pain during intercourse

ANS: d

d. Dyspareunia is recurrent or persistent genital pain in either a male or female before, during, or after sexual intercourse that is not associated with vaginismus or with lack of lubrication.

a. Orgasmic disorder is the recurrent delay in, or absence of, orgasm after normal sexual excitement.

b. Hypoactive sexual desire disorder is the persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity.

c. Vaginismus is an involuntary constriction of the outer one third of the vagina that prevents penile insertion and intercourse.

REF: Text Reference: p. 530

5. 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?

a.

My boyfriend is able to withdraw before to ejaculation, and that prevents me from getting pregnant.

b.

I take my temperature every morning, and when it goes down for at least 2 days, we have unprotected sex.

c.

We use foam before each time that we have sex, and I havent gotten pregnant yet.

d.

I use a diaphragm and contraceptive cream.

ANS: d

d. To be an effective contraceptive method, the diaphragm should be used with a contraceptive cream or jelly. The client is verbalizing understanding.

a. Any act of unprotected intercourse can result in pregnancy. This is not an effective contraceptive method.

b. Any act of unprotected intercourse can result in pregnancy. This statement does not demonstrate understanding of the basal body temperature method of contraception.

c. Using spermicidal foam alone is not recommended. The client should use a condom and foam to be more effective in preventing pregnancy.

REF: Text Reference: p. 526

6. A school nurse is responsible for teaching adolescents about sexually transmitted diseases (STDs). When discussing chlamydia, the nurse instructs the students that it is:

a.

A viral infection that cannot be cured

b.

Treated with a full course of antibiotics

c.

Contracted via blood-borne exchange

d.

Prevented with the use of a spermicidal

ANS: b

b. Diseases that are caused by bacteria and that can usually be cured with antibiotics include gonorrhea, chlamydia, syphilis, and pelvic inflammatory disease. All clients need to understand that antibiotics must be taken for the full course of treatment.

a. Chlamydia is caused by bacteria that can be treated, not a virus.

c. Sexually transmitted diseases, such as chlamydia, are transmitted from infected individuals to partners during intimate sexual contact. It is contracted not via blood-borne exchange, but rather through body fluids.

d. Chlamydia is not prevented with the use of a spermicidal.

REF: Text Reference: p. 527

7. The nurse is conducting a sexual history with a client who is scheduled for cardiac surgery. The client tells the nurse that he is nervous about resuming sexual activities. The nurse uses therapeutic communication with the client when responding:

a.

You can have sexual intercourse after your surgery, but there are serious risks.

b.

Your partner will be nervous about resuming sexual activities, but that is normal.

c.

Dont worry. In about 2 months you will be able to return to your normal sexual patterns.

d.

You are expressing a very normal concernperhaps we could discuss your feelings further.

ANS: d

d. Open communication and positive self-esteem are essential factors in effectively resolving concerns.

a. This statement may only worry the client more.

b. This statement does not focus on the client and therefore does not encourage the client to express his concerns.

c. Telling the client not to worry is nontherapeutic. At this point, not even knowing the outcome of the surgery, the nurse should not predict resumption of sexual activity for the client. Furthermore, this response does not encourage the client to communicate his feelings.

REF: Text Reference: p. 539

8. 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?

a.

So sexual intercourse will be more painful for my wife, and we should have sex less frequently?

b.

We have recently seen the need to begin using a lubricant. Thats because we make love less often.

c.

My orgasms seem to not last as long, but my husband and I are probably more satisfied now than when we were younger.

d.

Its natural not to have sex anymore. People our age shouldnt still have those feelings.

ANS: c

c. Orgasms may not last as long in the older adult as a result of aging. Older adults may feel more sexually satisfied because they no longer have to be concerned with contraception and are not experiencing the pressures of raising children and working.

a. Decreased levels of estrogen may lead to diminished vaginal lubrication and decreased vaginal elasticity, making intercourse more painful. The couple should not be advised to have sex less frequently, but rather to use a vaginal lubricant and allow more time for caressing.

b. The need to use a lubricant is not due to having sex less often, but is due to decreasing levels of estrogen in the woman.

d. This is not a true statement. Sexual feelings in older adulthood are normal. Sexuality and continued interest in sex throughout late life generally reflects life patterns.

REF: Text Reference: p. 525

9. The nurse has completed an assessment on an adult male client and finds that he has difficulty having an erection and has less interest in sex. The nurse notes that the client has recently been given 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:

a.

Client will avoid taking medication before intercourse

b.

Client will relate renewed interest in sex within 1 month

c.

Client will be seen by a sexual therapist immediately

d.

Client will seek out other activities or hobbies

ANS: b

b. An appropriate expected outcome for the nursing diagnosis of Sexual dysfunction related to side effects of antihypertensive would be Client will relate renewed interest in sex within 1 month. An appropriate goal would be Client will express satisfaction with sexual relationship with wife within 1 month.

a. The client should not avoid taking his antihypertensive medication before intercourse, but should be taught that other available blood pressure medications can maintain blood pressure control and do not negatively affect sexual function. He can then discuss this with his physician.

c. This is not an appropriate expected outcome. Seeing a sexual therapist immediately is not necessary and may only intensify his concern.

d. This is not an appropriate expected outcome. It does not address or resolve the problem.

REF: Text Reference: p. 536

10. A 58-year-old woman asks the nurse what she can do to promote healthy sexual relations. Based on the clients age, the nurse responds by saying:

a.

Continue what youve been doing. Nothing should have changed.

b.

I will refer you to a sexual therapist to assist you..

c.

Using a water-based lubricant may be helpful.

d.

Reducing the frequency of intercourse may help you.

ANS: c

c. The perimenopausal and menopausal woman may have diminished vaginal lubrication due to decreased levels of estrogen. Suggestions such as using vaginal lubrication and creating time for caressing and tenderness can help to ease adjustment to normal changes related to aging.

a. Some physical changes with aging may affect sexuality. The client should be educated on the expected changes and how best to address them.

b. If a nurse is uncomfortable discussing sexual issues with a client, then he or she should get another nurse who is comfortable to talk with the client. A sex therapist is not necessary in this situation. Sex therapists address more complex sexual issues.

d. This is not a true statement. Decreasing the frequency of intercourse would not promote healthy sexual relations.

REF: Text Reference: p. 525

11. In preparing a presentation on the prevention of sexual abuse, the nurse incorporates the following information:

a.

Intensity is generally increased during pregnancies

b.

Sexual abuse is found primarily in lower socioeconomic groups.

c.

Abusers fit into easily identified, classic profiles.

d.

Most of the incidents occur with strangers or unknown assailants.

ANS: a

a. Sexual abuse may begin, continue, or even intensify during pregnancy.

b. Sexual abuse crosses all gender, socioeconomic, age, and ethnic groups.

c. The abuser may not fit any classic description.

d. Most often sexual abuse is at the hands of a former intimate partner or family member.

REF: Text Reference: p. 529

12. To increase the tone and sensation of the pelvic floor for a female client, the nurse teaches:

a.

Sensate-focus exercises.

b.

Kegel exercises.

c.

Vaginal dilation.

d.

Stop/start techniques.

ANS: b

b. Kegel exercises increase the tone and sensation of the pelvic floor (pubococcygeus muscle) for the female client.

a. Sensate-focus exercises do not increase muscle tone.

c. Vaginal dilation will not increase the tone and sensation of the pelvic floor.

d. 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.

REF: Text Reference: p. 533

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