Concept 19: Sexuality My Nursing Test Banks

Concept 19: Sexuality

Test Bank

MULTIPLE CHOICE

1. A 55-year-old male patient postmyocardial infarction (MI) queries the nurse caring for him whether he will be healthy enough for sexual activity after discharge from the hospital. The patient has been prescribed anti-hypertensives and beta-blockers. While health teaching, the nurse understands that the three phases of the four-stage model of the human sexual response cycle that are of concern for this patient include

a.

excitement, plateau, and orgasmic.

b.

plateau, orgasmic, and resolution.

c.

excitement, orgasmic, and resolution.

d.

arousal, excitement, and plateau.

ANS: A

During these three phases, heart rate, blood pressure, and respirations increase steadily, increasing stress to the heart muscle. This would be the period of greatest concern for a patient who has recently experienced an MI. The plateau and orgasmic phases may be of physiologic concern to this patient, but during the resolution phase, vital signs return to normal, and muscles relax. Arousal is not a phase in the four-stage model of the human sexual response cycle, although some researchers feel this should be added.

REF: 195 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

2. In order to fully assess the patient and plan appropriate care including health teaching regarding sexuality, it is important for the nurse working in either a primary care or hospital setting to be cognizant that some groups of patients will have an increased risk for problems related to the concept of sexual health. Which patient is most at risk for sexual abuse?

a.

A recently divorced 50-year-old woman

b.

A Hispanic teenage girl

c.

A 30-year-old African-American male

d.

An individual with intellectual or developmental disabilities

ANS: D

As more of these individuals move into mainstream society, it is important that sexual health is promoted, including teaching regarding sexual norms. Otherwise these individuals are likely victims of unhealthy sexual practices or sexual abuse. In todays society, the newly unpartnered are likely to begin dating and acquire one or more new sexual partners. This group is at significant risk for exposure to sexually transmitted infections and requires health teaching related to safer sexual practices. The Hispanic teenage girl is at increased risk for unintended teen pregnancy. Adolescent pregnancy puts an undue burden on the young woman during a crucial period of growth and development. Hispanic teens experience double the rate of pregnancy of Caucasian adolescents. Major health disparities continue to exist between African-Americans and their Caucasian counterpartsin particular a significantly increased risk for human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and other sexually transmitted diseases.

REF: 195 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

3. A thorough assessment of sexual health includes laboratory and other diagnostic procedures. Tests are ordered at the providers discretion based upon gender and lifestyle of the patient. A 37-year-old heterosexual African-American man has come for his annual health screening. Which test must the nurse ensure is ordered for this patient?

a.

Human papilloma virus (HPV)

b.

Prostate-specific antigen (PSA)

c.

HIV

d.

Venereal disease research laboratory (VDRL)

ANS: B

PSA testing is recommended annually for men at increased risk for prostate cancer. This includes men with a family history or those of African-American descent. HPV testing would likely be ordered for patients with genital warts. This might not be necessary for this patient. Tests for HIV should be ordered for patients that belong to high-risk populations, including men who have sex with men, and all pregnant women. All sexually active men and women should have a VDRL and rapid plasma reagin performed.

REF: 198 OBJ: NCLEX Client Needs Category: Physiological Integrity

4. Primary strategies are those that are implemented in order to avoid the development of disease. These strategies can be either population-based or individually-based. As a school nurse, you are developing a curriculum for a junior human sexuality class. In order to provide the most up-to-date information, you are aware that the single most effective primary prevention strategy for preventing sexually transmitted diseases is

a.

a vaccine to prevent HPV infection.

b.

HIV screening.

c.

education directed at high-risk behaviors.

d.

the male condom.

ANS: D

When used correctly, the male condom continues to be the single most effective method for preventing sexually transmitted diseases as well as being a very highly effective contraceptive agent. A significant primary prevention strategy is the recent introduction of a vaccine used to prevent cervical cancer and genital warts caused by HPV. One of two FDA-approved vaccines should be routinely administered to 11- and 12-year-old girls and can be given up to the age of 26. HIV screening is recommended for all sexually active teens by the Centers for Disease Control and Prevention. Screening for existing disease is a secondary prevention strategy. By educating teens towards behavior change related to high-risk behaviors, nurses may be able to reduce the risk for contracting sexually transmitted infections.

REF: 199 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

5. Symptoms of sexual dysfunction and altered body image often coexist with prolapse of the female reproductive organs. Nursing care requires a great deal of sensitivity, because many women are embarrassed by their condition. Your patient is a 44-year-old married woman who is complaining of painful intercourse and incontinence. Clinical evaluation reveals that the patient has a cystocele. Which treatment option is most appropriate for this patient?

a.

Pelvic floor training

b.

Vaginal pessaries

c.

Surgical correction

d.

Lifestyle changes

ANS: C

Depending on the cause, a cystocele can be readily corrected by surgery. Pelvic muscle floor training (Kegel exercises) will most definitely help with symptoms of urinary incontinence. This alone is not adequate treatment for this patient. Vaginal pessaries are an excellent treatment modality for uterine prolapse. Lifestyle changes such as weight loss, avoiding constipation, and reducing high-impact exercise, such as running, will all help the patient with pelvic organ prolapse. Although these modalities will provide relief, they will not correct the cystocele without surgical intervention.

REF: 198 OBJ: NCLEX Client Needs Category: Physiological Integrity

6. Preventing infection remains the most effective way of reducing the adverse consequences of sexually transmitted infections, in particular those that are not readily curable. Nurses are often able to reassure the patient enough to open dialog regarding possible exposure, testing, and treatment options. When assessing high-risk behaviors, which question specifically identifies a blood-related risk?

a.

Have you ever received donor semen, eggs, or transplanted tissue?

b.

Have you ever exchanged sex for drugs, money, or shelter?

c.

How do you protect yourself from HIV and sexually transmitted infections?

d.

Have you ever injected drugs using shared equipment?

ANS: A

Receipt of any donated organ, tissue, semen, or eggs is considered a blood-related risk. Other blood-related risks include blood transfusion, sex with a person with hemophilia, or sharing equipment for tattoos and body piercing. The exchange of sex for money, drugs, or shelter is considered a drug userelated risk. Other drug userelated risks include having sex with a person who uses or shares, and having sex while stoned, high, or drunk so that you cannot remember the details. By using male condoms, female condoms, or other barriers, patient can protect themselves against sexual risk. Other high-risk behaviors in this category include: having sex against ones will, failing to use protection, having sex with a partner who is bisexual or gay, having anal intercourse, and sexual activity with an increased number of partners. Sharing equipment to inject street drugs or steroids is a drug userelated risk.

REF: 198 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

MULTIPLE RESPONSE

1. Sexual dysfunction is a negative consequence of human sexuality manifested by any disturbance to the psycho-physiologic changes that occur during the sexual response cycle. Which statements related to sexual dysfunction are correct? (Select all that apply.)

a.

Biological factors play a more significant role than psychologic factors.

b.

Sexual dysfunction is more prevalent among men than women.

c.

The best predictor of sexual health is emotional well-being.

d.

The patient with sexual dysfunction is at risk for anxiety and depression.

e.

Sexual dysfunction remains uncommon.

ANS: C, D

The best predictor of sexual health is emotional well-being rather than the impairment of the physical aspects of sexual arousal and function. Nurses must remain cognizant that sexual dysfunction, regardless of the cause, is likely to result in a number of negative consequences including anxiety, stress, and depression. Although sexual arousal may be diminished by biological factors such as illness and hormone levels, psychologic factors such as anxiety, mood disorders, or stress play a more significant role in sexual health. Sexual dysfunction is more common in women, with 40 to 45% of women reporting symptoms as opposed to 20 to 30% of men. It appears that sexual dysfunction is very common among the general population, with rates varying from 20 to 50%.

REF: 197 OBJ: NCLEX Client Needs Category: Health Promotion and Maintenance

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