Question 1

A mother brings her 10-year-old daughter into a clinic and inquires about getting her a human papillomavirus (HPV)vaccine that day.What information does the nurse give the mother?
A)The HPV vaccine is safe for children over the age of 9.
B)The HPV vaccine is recommended only after a girl or woman becomes sexually active.
C)The HPV vaccine will prevent a girl or woman from ever getting cervical cancer.
D)The HPV vaccine is not currently available for 10-year-old girls.

Accepted Answer

The HPV vaccine is effective against the four most common types of HPV that can cause cervical cancer.The recommendation is that girls and women between the ages of 9 and 26 be offered this vaccine;it is important that the vaccine be given before the initiation of sexual activity.The vaccine is most effective if administered before sexual activity or exposure.

Question 2

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.

Accepted Answer

Urinary problems and abnormal discharge are often the first signs of chlamydia.Both men and women can experience these symptoms,although it is known as the "silent STI" because symptoms may not manifest for some time after the disease is contracted.Small red blisters are associated with genital warts and herpes.Chlamydia does not cause dementia.

Question 3

When conducting an education session on the use of contraceptives,the nurse informs the group that which method has the lowest initial rate of effectiveness?
A)Use of a male condom.
B)Tubal ligation.
C)Use of a female condom.
D)Use of a vaginal contraceptive ring.

Accepted Answer

Of the answer choices,the female condom has the lowest rate of effectiveness,beginning at 79%.The initial rate of effectiveness of the male condom is 86%.The initial rate of effectiveness of a tubal ligation 99.5%.The initial rate of effectiveness of the vaginal contraceptive ring is 98%.

Question 4

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.With which statement can the nurse establish a trusting relationship with the patient?
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.Tell me about your sexual experience."

Accepted Answer

Young adults have questions about sexuality.The patient will feel most comfortable discussing his sexual concerns further if the nurse establishes that it is normal to ask questions about sexuality.The nurse can then discuss in greater detail.Although it is normal for young adults to be curious about sexuality,the nurse should use caution in giving advice on taking sexual action.The nurse should promote safe sex practices.Telling the patient not to worry dismisses his concern.Telling the patient that he is abnormal might offend the patient and prevent him from establishing an open relationship.Asking the patient about his sexual experience is also inappropriate in this situation and is not likely to assist in building a trusting relationship with the patient.

Question 5

What is an example of a quality in the critical thinking model for sexuality assessment?
A)Displaying curiosity.
B)Applying an ethic of care.
C)Accepting the sexual orientation of the patient.
D)Determining the patient's sexual concerns.

Accepted Answer

One of the three qualities in the critical thinking model for sexuality assessment is displaying curiosity.The other two qualities are displaying integrity and taking risks if necessary.Applying an ethic of care is an example of a standard in the model.Accepting a patient's sexual orientation and determining the patient's sexual concerns are examples of knowledge in the model.

Question 6

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 makes which statement?
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."

Accepted Answer

Orgasms are achievable at any age.Estrogen levels do decrease,and this may impede sexual desire.The nurse should ask the patient whether she has any questions on action that will assist in healthy sexual patterns.The other statements indicate that the patient does have an understanding of age-related changes.

Question 7

An adolescent female student who is sexually active visits the office of the school nurse.The nurse knows that teaching has been effective when the student states which of the following?
A)"My boyfriend is able to withdraw before ejaculation,and that prevents me from getting pregnant."
B)"I take my temperature every morning,and when it goes down for at least two days,we have unprotected sex."
C)"We use 'foam' before each time we have sex,and I haven't gotten pregnant yet."
D)"We use a condom with a water-based lubricant."

Accepted Answer

As a more effective contraceptive method,the water-based lubricant reduces the risk of the condom's breaking.The patient is verbalizing understanding.Any act of unprotected intercourse can result in pregnancy.Withdrawal is not an effective contraceptive method;any act of unprotected intercourse can result in pregnancy.The statement "I take my temperature every morning,and when it goes down for at least two days,we have unprotected sex" also does not demonstrate understanding of the basal body temperature method of contraception.Using spermicidal foam alone is not recommended.The patient should use a condom and foam to be more effective in preventing pregnancy.

Question 8

A patient admits that he knew for several months that he had an STI but did not report it.Why did he behave this way?
A)Many patients with STIs do not acknowledge the importance of STI testing and treatment.
B)Many patients with STIs are hesitant to admit they contracted an STI.
C)Many patients with STIs have lifestyles that subject them to repeated exposure.
D)Many patients with STIs are uncomfortable discussing sexual health issues with a same-sex health care provider.

Accepted Answer

Many patients feel guilt,embarrassment,and anxiety about contracting an STI;this can cause them to defer care until the problem becomes severe.Although knowledge about the severity of STIs may be insufficient,this should not deter seeking care.Regardless of lifestyle,STIs should be treated immediately to prevent further transmission.The role of the health care provider is to establish a trusting relationship.A person may be open to discussing health promotion behaviours but may still be hesitant to discuss STIs.

Question 9

While teaching adolescents about chlamydia,what does the school nurse tell the group?
A)Chlamydia is a viral infection that cannot be cured.
B)Chlamydia can be treated with a full course of antibiotics.
C)Chlamydia can be contracted via bloodborne exchange.
D)Chlamydia can be prevented with the use of a spermicide.

Accepted Answer

Chlamydia is the most common of all bacterial STIs and is treated with an antibiotic.Chlamydia is caused by bacteria,not by a virus,and can be treated with an antibiotic.STIs such as chlamydia are transmitted from infected individuals to partners during intimate sexual contact.STIs are contracted not via bloodborne exchange but rather through body fluids.Chlamydia is not prevented with the use of a spermicide.

Question 10

A 68-year-old female asks the nurse if using 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."

Accepted Answer

The nurse should first assess the patient's risk for contracting an STI.If the patient has been in a monogamous relationship,and both parties are STI free,there is no need for a barrier.However,even though a patient has gone through menopause,there is still risk for an STI.The best way for a nurse to be sensitive to a patient's needs is to find out more about the patient.Discussing sexual performance in relation to using a barrier method does not answer the patient's question.

Question 11

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.

Accepted Answer

Antidepressants have adverse effects on sexual desire and response.The nurse should be sure to educate the patient on the potential for these side effects and how to correct for them (e.g. ,using lubricant to ease discomfort).The patient has taken steps toward effective coping by seeking therapy.The patient has not expressed a reason for the nurse to be concerned about contraceptives.The nurse should always assess for concerns about violence in a patient's life.Although some antidepressants have been related to self-directed violence,this patient states that she is feeling happy.

Question 12

A patient 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 patients,what should the nurse know?
A)Whether they have similar parenting beliefs.
B)How long they have been married.
C)That effective communication about sexuality requires a nondiscriminatory attitude.
D)The level of knowledge the patients have regarding healthy sexual relationships.

Accepted Answer

In response to identified concerns,the nurse may initiate discussion.Effective communication about sexuality requires caring,sensitivity,tact,compassion,the use of appropriate language,and a nondiscriminatory attitude.It is important not to have preconceived notions about the patients' sexual identity or activity.Having similar parenting beliefs will have less effect on their sexual relationship than the use of effective communication;to assist the patients in adjusting to the change of becoming a family,the nurse should explore their communication patterns.How long they have been married would be less significant.The level of knowledge the patients have regarding healthy sexual relationships would not affect their sexual relationship as much as their ability to discuss their feelings with one another.

Question 13

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 centre or health care 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.

Accepted Answer

The nurse must be aware of personal beliefs and values and is not required to participate in counselling or procedures that compromise those values.However,the patient is entitled to nonjudgemental care and should be referred to someone who can create a trusting environment.The nurse should not care for a patient if the quality of care could be jeopardized.The nurse should not attempt to project personal values onto a patient.The nurse also should not create tension by informing the patient that she does not have the same morals;this could cause the patient to feel guilty or defensive when receiving care from any health care professional.

Question 14

A nursing student is providing education to a group of older persons who are in an independent living retirement village.Which of the following statements made by the nursing student should prompt 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."

Accepted Answer

Any person who has sexual intercourse can develop an STI at any age.People with multiple sex partners are at greater risk.Therefore,the instructor needs to intervene when the student tells the older persons that they are not at risk for developing a STI.Sexual functioning is enhanced by avoiding the use of alcohol;using pillows;taking pain medications before intercourse if needed;and communicating thoughts,fears,and feelings about sex.

Question 15

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 she believes her partner must have cheated on her.Which response by the nurse is most effective in establishing an open rapport with a patient?
A)Sharing an anecdote.
B)Informing the patient that all discussions with the nurse are confidential.
C)Telling the patient that she must be honest about every sexual experience she has had.
D)Asking the patient what concerns or fears she has related to the visit.

Accepted Answer

If effective open communication is to be established with the patient,the patient must know that she can trust her health care provider.By telling the patient that all discussions with the nurse are confidential,the nurse establishes trust.After establishing that trust,the nurse can further build the relationship by asking the patient open questions about her fear.Forcing the patient to confide by sharing every sexual encounter may hinder the development of a trusting relationship.

Question 16

When responding to an adolescent girl's inquiry related to emergency contraception,the nurse tells her that the most effective method is which of the following?
A)Levonorgestrel for emergency contraception (LNG-EC).
B)Ulipristal acetate for emergency contraception (UPA-EC).
C)Hormonal intrauterine device.
D)Copper intrauterine device.

Accepted Answer

The most effective method of emergency contraception is the use of a copper intrauterine device,which can be inserted and is effective within 7 days after unprotected intercourse.Hormonal intrauterine devices are not used as emergency contraception.Both LNG-EC and UPA-EC are used as emergency contraception but are not as effective as the copper intrauterine device.

Question 17

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.

Accepted Answer

Adoption is ideal for someone with infertility,especially if infertility treatments are unavailable owing to religious or financial constraints.A patient who wishes to have an elective abortion may be educated about all the possibilities,but the nurse should approach the patient in a nonjudgemental manner and should accept the patient's decision.When a patient has recently miscarried,the nurse should assess the patient's feelings about the loss and should address any concerns the patient may have about fertility.Infertility is the inability to conceive after 1 year of unprotected intercourse;therefore,talking about adoption after one miscarriage or after only 3 months of attempting conception would be too soon.

Question 18

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 which therapeutic statement would be most effective?
A)"I know you feel invincible,but STIs [sexually transmitted infections] 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 practise safe sex."

Accepted Answer

Most teenagers feel invincible,and for this reason,some participate in risky behaviours.The nurse should acknowledge this feeling to the patient and offer education and alternatives,while giving the patient the autonomy to make his or her own decisions.The nurse should not force the patient to make a choice of orientation and should not pass judgement on a patient's sexual orientation or social network;this would make the patient feel defensive and would eliminate the trust in the relationship.Involving parents is not the first line of action;parents should be notified only if the child is in a life-or-death situation.

Question 19

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.

Accepted Answer

Condoms are both a contraceptive and a barrier against STIs and human immunodeficiency virus (HIV)infection;proper use greatly reduces the risk of infection.Spermicides,diaphragms,and oral contraceptives all protect against pregnancy;however,they do not prevent bodily fluids from coming in contact with the patient during sexual intercourse.

Question 20

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.

Accepted Answer

The nurse should address the patient's need to be comfortable with his own body image;once this is done,the patient can resume sexual activity.Reassuring the patient that others manage to have sexual intercourse with an ostomy may help to decrease anxiety but may have the unintended effect of making the patient feel as though he is abnormal because he has not yet resumed sexual activity.Support groups may be helpful for the patient,but this is not the most effective intervention a nurse can provide.The patient should be discouraged from manipulating the ostomy during sexual activity;this can cause infection,trauma,or prolapse to the stoma.

Quiz 27: Sexuality

A mother brings her 10-year-old daughter into a clinic and inquires about getting her a human papillomavirus (HPV) vaccine that day.What information does the nurse give the mother?

A patient asks the nurse what signs and symptoms are associated with chlamydia.How should the nurse respond?

When conducting an education session on the use of contraceptives,the nurse informs the group that which method has the lowest initial rate of effectiveness?

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.With which statement can the nurse establish a trusting relationship with the patient?

What is an example of a quality in the critical thinking model for sexuality assessment?

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 makes which statement?

An adolescent female student who is sexually active visits the office of the school nurse.The nurse knows that teaching has been effective when the student states which of the following?

A patient admits that he knew for several months that he had an STI but did not report it.Why did he behave this way?

While teaching adolescents about chlamydia,what does the school nurse tell the group?

A 68-year-old female asks the nurse if using a contraceptive is still necessary.What is the best response by the nurse?

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 patient 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 patients,what should the nurse know?

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 nursing student is providing education to a group of older persons who are in an independent living retirement village.Which of the following statements made by the nursing student should prompt the nursing professor to intervene?

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 she believes her partner must have cheated on her.Which response by the nurse is most effective in establishing an open rapport with a patient?

When responding to an adolescent girl's inquiry related to emergency contraception,the nurse tells her that the most effective method is which of the following?

Which patient is most in need of a nurse's referral to adoption services?

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 which therapeutic statement would be most effective?

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?