Chapter 45

Question 1

A woman tells a nurse, “My husband wants to have sex when I have my period. Is that safe?” What is an appropriate
answer?
A) “No, the flow of blood could be slowed down.”
B) “No, it will tend to make your cramps worse.”
C) “Yes, but be sure to douche after sex.”
D) “Yes, there is no reason not to have sex then.”

Answer 1

D) “Yes, there is no reason not to have sex then.”

There is no scientific rationale to support abstinence from sexual activity during menses. Sexual activity during mens
may be more pleasurable and may reduce or relieve cramping.

Question 2

A male client age 15 years is experiencing nocturnal emissions. What nursing intervention would be appropriate for
client?
A) Ask the parents to consult with a specialist.
B) Tell the client to limit physical activity in the evening.
C) Ask the primary care provider to perform a physical examination.
D) No intervention is necessary as this is a normal phenomenon

Answer 2

D) No intervention is necessary as this is a normal phenomenon

Many males, particularly adolescent boys, may experience a phenomenon known as a nocturnal emission, or “wet
dream.” These ejaculatory episodes occur during sleep without physical stimulation. They are perfectly normal and do not represent any sort of deviation.

Question 3

In which of the phases of the sexual response cycle may secretions from Cowper’s glands appear at the glans of the penis?
A) Excitement
B) Plateau
C) Orgasm
D) Resolution

Answer 3

B) Plateau

In the male, secretions from Cowper’s glands may appear at the glans of the penis during the plateau phase.

Question 4

A male client tells the nurse that he does not understand why he feels the way he does when he is sexually excited. What would the nurse teach the client?
A) “I don’t know, but I will ask my boyfriend if he can describe his feelings to me.”
B) “The sexual response cycle includes excitement, plateau, orgasm, and resolution.”
C) “That is something that just happens and nobody knows why.”
D) “Isn’t sex wonderful? I think it has different parts to the experience.”

Answer 4

B) “The sexual response cycle includes excitement, plateau, orgasm, and resolution.”

The sexual response cycle is a total body response with many physiologic changes throughout the body. The cycle has four phases: excitement, plateau, orgasm, and resolution.

Question 5

A woman age 70 years tells the nurse that she is still sexually active. How would the nurse respond?
A) “You are too old for that kind of behavior.”
B) “Tell me what you enjoy the most.”
C) “You can be sexually active as long as you want to be.”
D) “There comes a time in life when this is no longer important.”

Answer 5

C) “You can be sexually active as long as you want to be.”

Sexual activity does not need to be hindered by age. Couples (or individuals) may continue intimate relationships for as long as they desire.

Question 6

A young woman has been diagnosed with human papilloma virus (HPV). As a result, she will be at increased risk for
which of the following?
A) Infertility
B) Genital warts
C) Vaginal bleeding
D) Cervical cancer

Answer 6

D) Cervical cancer

Infection with human papillomavirus (HPV), a sexually transmitted infection, increases a woman’s risk for cervical cancer.

Question 7

A nurse is educating a student nurse on how STIs affect the health of their clients. Which of the following statements
accurately describes an effect of an STI?
A) STIs are most common in young to middle adulthood populations.
B) The incidence of STIs is decreasing due to health promotion efforts.
C) Most of the time STIs cause no symptoms, especially in women.
D) Health problems caused by STIs are more severe and frequent in men

Answer 7

C) Most of the time STIs cause no symptoms, especially in women.

Most of the time, STIs cause no symptoms, particularly in women. STIs affect men and women of all backgrounds and
economic levels; they are most prevalent among teenagers and young adults. The incidence of STIs is rising, in part because in the last few decades, young people have become sexually active earlier yet are marrying later. Health
problems caused by STIs tend to be more severe and more frequent for women than for men, in part because the frequency of asymptomatic infection means that many women do not seek care until serious problems have developed.

Question 8

What term is used to describe painful intercourse?
A) Dyspareunia
B) Dysmenorrhea
C) Impotence
D) Vulvodynia

Answer 8

A) Dyspareunia

Dyspareunia is painful intercourse. Dysmenorrhea is pain with menstruation. Impotence is erectile failure. Vulvodynia is vulvar pain.

Question 9

An adolescent male tells the nurse that he is afraid his penis will be damaged because he masturbates every day. The nurse’s response is based on what knowledge?
A) Masturbation is not a normal activity.
B) Only adult men masturbate.
C) Masturbation may delay puberty.
D) Self-stimulation is a normal activity.

Answer 9

D) Self-stimulation is a normal activity.

Masturbation is a technique of sexual expression in which an individual practices self-stimulation. People masturbate regardless of age, sex, or marital status. It is a normal activity

Question 10

A heterosexual couple enjoys both anal and vaginal intercourse. What may result from these sexual activities?
A) Feelings of guilt and shame
B) Vaginal infections
C) Damage to the vagina
D) Penile infections

Answer 10

B) Vaginal infections

Once the penis is placed in the rectum, it should not be introduced into the vagina without thorough cleansing because microorganisms present in the rectum may cause vaginal infections.

Question 11

While answering questions posed by a nurse during a health history, a young woman says, “Before my period I get
headaches, am moody, and my breasts hurt.” What is the client experiencing?
A) Perimenopause
B) Menarche
C) PMS
D) Menses

Answer 11

C) PMS

Menstrual cycle–related distress, commonly called premenstrual (tension) syndrome (PMS), occurs in 50% to 90% of the female population. It is characterized by irritability, emotional tension, anxiety, mood changes, headache, breast tenderness, and water retention.

Question 12

What are the primary nursing considerations when assisting with, or conducting, a physical assessment of the genitalia?
A) Ensuring sterility of all equipment and supplies
B) Respecting the client’s privacy and modesty
C) Providing a means for cleansing the area
D) Leaving the room during the assessment

Answer 12

B) Respecting the client’s privacy and modesty

When assisting with, or conducting, a physical assessment of the genitalia, keep the client comfortable and respect his or
her privacy and modesty

Question 13

What is the most significant difficulty regarding sexuality faced by people taking medications for hypertension?
A) Medications result in increased desire for sex.
B) Medications change sexual functioning.
C) Clients experience a growth of body hair.
D) Clients experience increased body odors

Answer 13

B) Medications change sexual functioning.

The most significant difficulty a person with hypertension faces regarding sexuality is that the medication used to
control the disease frequently causes a change in sexual functioning. Impotence is a common response in men.

Question 14

What do most nursing interventions pertaining to sexuality involve?
A) Teaching to promote sexual health
B) Examinations to identify sexually transmitted infections
C) Advocacy for those with sexual dysfunctions
D) Maintaining confidentiality and privacy

Answer 14

A) Teaching to promote sexual health

Most nursing interventions pertaining to a client’s sexuality involve education to promote sexual health. Major goals of education are a change in knowledge, a change in client attitude, or a change in behavior

Question 15

A woman is using Depo-Provera as a method of birth control. What common side effect should the nurse explain to the client?
A) Constipation
B) Nausea
C) Irregular bleeding
D) Pregnancy

Answer 15

C) Irregular bleeding

Depo-Provera is a progestin-only hormonal birth control system. One injection can prevent pregnancy for 12 weeks and is 99.7% effective. Irregular bleeding is the most common side effect.

Question 16

A nurse is explaining the use of an IUD to a female client interested in obtaining contraception. Which of the following statements regarding the IUD is correct?
A) The intrauterine device (IUD) is an object that is placed by the client within the uterus to prevent implantation of a
fertilized ovum.
B) IUDs are small devices made of flexible plastic that provide irreversible birth control.
C) IUDs do not prevent fertilization of the egg.
D) IUDs seem to affect the way the sperm or egg moves.

Answer 16

D) IUDs seem to affect the way the sperm or egg moves.

IUDs seem to affect the way the sperm or egg moves. IUDs are small devices made of flexible plastic that provide reversible birth control. The intrauterine device (IUD) is an object that is placed by a physician or nurse practitioner within the uterus to prevent implantation of a fertilized ovum. IUDs usually prevent fertilization of the egg, but the precise mechanism by which it works is unknown.

Question 17

A nurse is counseling a female victim of sexual assault. Which of the following statements accurately describes the
increased risks for this client?
A) The client is three times more likely to suffer from depression.
B) The client is 10 times more likely to suffer from post-traumatic stress disorder.
C) The client is 20 times more likely to abuse alcohol and 26 times more likely to abuse drugs.
D) The client is 20 times more likely to contemplate suicide

Answer 17

A) The client is three times more likely to suffer from depression.

Victims of sexual assault are 3 times more likely to suffer from depression, 6 times more likely to suffer from posttraumatic stress disorder, 13 times more likely to abuse alcohol, 26 times more likely to abuse drugs, and 4 times more likely to contemplate suicide.

Question 18

A nurse is responding to sexual harassment from a client at work. Which of the following is a recommended guideline for dealing with this behavior?
A) If confronted by management, deny any feelings about being harassed.
B) Do not confront the person harassing you in person.
C) Set and enforce limits to the behavior and maintain boundaries.
D) Document the incident but do not report it to the supervisor unless harassment continues

Answer 18

C) Set and enforce limits to the behavior and maintain boundaries.

The following assertive response is recommended and supports the nurse in maintaining his or her self-respect; it encourages the client to accept responsibility for his or her behavior. Be self-aware: Do not deny feelings about being
harassed. Confront: Provide feedback to the client in a nonthreatening way and clearly state what behavior is or is not acceptable. Set limits: Define clear and reasonable consequences that will be enforced if the behavior continues. Enforce
the stated limits: Maintain boundaries. Report: Document the incident and submit to the supervisor.

Question 19

A woman complains of pain with intercourse. What client medications should the nurse check for that contribute to
dyspareunia?
A) Antihistamines
B) Calcium supplements
C) Antibiotics
D) Antihypertensives

Answer 19

A) Antihistamines

Common causes of dyspareunia are organic problems, including inadequate lubrication at the vaginal opening or within
the vaginal walls. Medications that cause dyspareunia include antihistamines, certain tranquilizers, marijuana, and
alcohol.

Question 20

After instructing the male client on the performance of a testicular examination, the nurse instructs the client to perform the examination how often?
A) Monthly
B) Weekly
C) Bi-monthly
D) Bi-yearly

Answer 20

A) Monthly

The client should perform a testicular examination monthly.

Question 21

The client suffered a myocardial infarction (MI) and has shared with the nurse that he is reluctant to resume sexual activity. He is worried about having another MI. The nurse discusses various methods of sexual expression and points out that the most important body area for sexual arousal and stimulation is which of the following?
A) Breasts
B) Skin
C) Brain
D) Genitalia

Answer 21

C) Brain

The human body contains many erogenous zones, areas that when stimulated cause sexual arousal and desire. These include the genitalia, the skin, and the breasts, but the most important body area for sexual arousal and stimulation is the
brain

Question 22

The nurse is providing sexual education to a group of teenagers. One of the class members reports feeling sexually aroused when her boyfriend strokes her arms. The nurse points out that the human body has many erogenous zones, the largest being which of the following?
A) Skin
B) Brain
C) Genitalia
D) Breasts

Answer 22

A) Skin

The human body contains many erogenous zones, areas that when stimulated cause sexual arousal and desire. These include the genitalia, the brain, and the breasts, but the largest erogenous zone is the skin.

Question 23

The clinic nurse sees the client today and asks about his chief complaint. The client describes to the nurse his inability to attain an erection. Which of the following would be a priority for the nurse to assess? Choose all that apply.
A) Medication history
B) Specifics about sexual problem
C) Sleep history
D) Physical activity history
E) History of diabetes

Answer 23

A) Medication history
B) Specifics about sexual problem
E) History of diabetes

Assessment priorities for erectile dysfunction should include history of hypertension, current medications, diabetes, and
specifics about the erectile problem. Physical activity should not adversely affect ability to attain an erection. Unless the client is severely sleep deprived, this also should not affect erectile ability.

Question 24

During a class for 5th- and 6th-grade girls about menstruation, one student comments that she has heard that girls smell bad during their menses. Other students chime in saying they have heard the same thing and ask how to prevent odors.
The nurse correctly answers with which of the following solutions?
A) Stay at home during heaviest flow
B) Use deodorizing pads and tampons
C) Utilize good hygiene and regular bathing
D) Change pads or tampons at least daily

Answer 24

C) Utilize good hygiene and regular bathing

Deodorized pads and tampons do little to minimize odor and can cause chemical irritation to the vulva and vagina. Good hygiene and regular bathing are much more effective during menses to prevent odor. Pads and tampons should be changed frequently to prevent odor and irritation from wetness, usually every few hours

Question 25

The nurse is caring for a female 29 years of age who is admitted with chronic pain secondary to rheumatoid arthritis. She
confides in the nurse that she would like to be able to have sex with her husband but it just hurts too much. The nurse’s
best response is which of the following?
A) After a time that sort of thing doesn’t matter.
B) Is your husband willing to forgo sex?
C) It may be time to put that behind you.
D) Modified positions may be possible

Answer 25

D) Modified positions may be possible

The desire for human warmth and contact does not cease because of pain. Altered or modified positions for coitusare sometimes necessary, and discussing these with clients can be an important part of implementing the nursing process. The nurse should not discourage the client from wanting to enjoy sex, but should explore ways to help her.

Question 26

A boy age 13 years visits the school nurse’s office and asks to speak privately with her. He looks very upset and
embarrassed and struggles to make eye contact with the nurse. After some stuttered stops and starts, he finally asks about masturbating and if the things he has heard about it are true. The nurse provides correct education and information
for the young man about masturbation by telling him which of the following? Choose all that apply.
A) It is a technique of self-stimulation
B) People do it regardless of age or gender
C) Masturbation can lead to blindness
D) Masturbation is not dirty or wrong
E) Masturbation can decrease intelligence

Answer 26

A) It is a technique of self-stimulation
B) People do it regardless of age or gender
D) Masturbation is not dirty or wrong

Masturbation is a technique of sexual expression in which an individual practices self-stimulation. It is a way for a
person to learn what he or she prefers during stimulation and what feels good. People masturbate regardless of sex, age,
or marital status. Masturbation is not dirty and will not lead to blindness or insanity.

Question 27

The nurse is caring for a female age 45 years who discloses during the admission nursing history that she is no longer
able to enjoy sex with her husband because it causes too much pain in her vagina. The nurse includes which of the following nursing diagnoses in the client’s care plan related to this information?
A) Sexual Dysfunction: Dyspareunia
B) Altered Sexuality Patterns: Change in sexual expression
C) Altered Sexuality Patterns: Loss of desire
D) Altered Sexuality Patterns: Change in positioning

Answer 27

A) Sexual Dysfunction: Dyspareunia

“Sexual Dysfunction: Dyspareunia” is the correct choice because “dyspareunia” means painful intercourse. “Altered
Sexuality Patterns: Change in sexual expression” is more about not being able to do what is usual for a particular person or client. The client has no loss of desire, but cannot enjoy sex because of pain. The problem is not about positioning,
but about vaginal pain with intercourse.

Question 28

A new client has come to the clinic wanting a method of birth control. The client asks about a diaphragm. What would the nurse teach this client about a diaphragm?
A) One size fits all females.
B) The diaphragm must be used during each episode of sexual activity.
C) A diaphragm’s effectiveness does not require spermicidal jelly.
D) The diaphragm may be removed an hour following intercourse.

Answer 28

B) The diaphragm must be used during each episode of sexual activity.

The diaphragm must be used during each episode of sexual activity. It must be left in six hours after intercourse and should be used with spermicidal jelly. There are different sizes of diaphragms, and the client needs to be fitted by the
health care practitioner.

Question 29

The nursing instructor is talking with the junior nursing class about male reproductive issues. The instructor tells the
students that the causes of erectile dysfunction include which of the following? Select all that apply.
A) Alcoholism
B) Spinal cord trauma
C) Tadalafil
D) Phosphodiesterase-5 inhibitors
E) Diabetes

Answer 29

A) Alcoholism
B) Spinal cord trauma
E) Diabetes

Causes include cardiovascular disease, endocrine disease (diabetes, pituitary tumors, testosterone deficiency, hyperthyroidism, and hypothyroidism), alcoholism, chronic renal failure, genitourinary conditions (radical pelvic
surgery), hematologic conditions (Hodgkin lymphoma, leukemia), neurologic disorders (neuropathies, parkinsonism,
spinal cord injury, multiple sclerosis), trauma to the pelvic or genital area, alcohol, smoking, medications, and drug
abuse. Phosphodiesterase-5 inhibitors, which include Tadalafil, are used to treat erectile dysfunction; they don’t cause it.

Question 30

The nurse is conducting a class on human sexual response. The participants have understood the education when they
identify that, during the excitement phase of the sexual response, the man may experience what?
A) Nipple erection
B) Hypotension
C) Bradycardia
D) Decreased blood flow to genitals

Answer 30

A) Nipple erection

Some of the physiologic changes include an increase in heart rate and blood pressure, and the appearance of a pink to
red flush to the skin. The first obvious sign of arousal in the man is an erection of the penis caused by increased pelvic congestion of blood. The scrotum noticeably elevates, thickens, and enlarges. The skin of the penis and scrotum turns a
deep reddish-purple in response to congestion and arousal. Male nipples may also harden and become erect.

Question 31

Which of the following questions or statements would be most useful for the nurse to make when eliciting information about a client’s sexual history?
A) “We need to talk about this.”
B) Why did you have unprotected sex?
C) “How would you describe the problem?
D) I need to know sex partners’ numbers.”

Answer 31

C) “How would you describe the problem?

A helpful way to elicit information about a client’s sexual history is to ask, How would you describe the problem?

Question 32

The nurse conducting a class on human sexuality includes which of the following about gender identity?
A) It is opposite of biologic gender.
B) It may be the same as or different from biologic gender.
C) It is determined by male (XY) or female (XX) chromosomes.
D) It is determined by physical characteristics.

Answer 32

B) It may be the same as or different from biologic gender.

Gender sex denotes chromosomal sexual development. Gender identity is the inner sense one has of being male or
female, which may be the same or different from biologic gender.

Question 33

When conducting a class on sexuality with teenagers, the nurse includes that sexuality is which of the following?
A) External appearance of one’s genitalia as male or female
B) Male or female internal organ structure and function
C) How one experiences maleness or femaleness physically, emotionally, and mentally
D) The pleasure experienced during sexual activity

Answer 33

C) How one experiences maleness or femaleness physically, emotionally, and mentally

A critical component of human identity and well-being, sexuality involves how a person exhibits and experiences maleness or femaleness physically, emotionally, and mentally. Sexuality is defined not only by a person’s genitalia and
hormones, but also by attitudes and feelings.

Question 34

Parents of an infant express concern because the infant is touching his genitals. What should the nurse teach the parents?
A) Self-manipulation of genitals is normal behavior in an infant.
B) Have the child wear clothes that prohibit touching.
C) If this bad behavior continues, seek counseling.
D) Make him have time out every time it happens.

Answer 34

A) Self-manipulation of genitals is normal behavior in an infant.

Infants touch their genitals. This is normal behavior for a toddler. Punishment of genital fondling may lead to guilt and shame regarding sexual behavior later in life.

Question 35

Which of the following occurs in the male during the resolution phase of the sexual response cycle?
A) The penis becomes erect due to increased pelvic congestion of blood.
B) Involuntary spasmodic contractions occur in the penis.
C) The male orgasm occurs usually with ejaculation of semen from the penis.
D) The male experiences a period during which he is incapable of sexual response

Answer 35

D) The male experiences a period during which he is incapable of sexual response