Sexuality - Pottery and Perry Test Bank PDF

Preview

Summary

Pottery and Perry Test Bank ...

Description

Potter & Perry: Fundamentals of Nursing, 7th Edition Test Bank Chapter 28: Sexuality MULTIPLE CHOICE 1. The nurse is aware that sexuality is part of growth and development. The preschooler’s interest in gender sexuality is characterized by an interest in: 1. Exploring his or her own genitalia 2. Learning how and why his or her anatomy differs from other children 3. Playing and developing friendships with children of the opposite sex 4. Spending most of his or her time with the parent of the opposite sex ANS: 1 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. This is not characteristic of the preschool child. Learning how and why his or her anatomy differs from other children would require a higher level of cognitive ability. Children of this age-group primarily focus on their parents and family, not other children. 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. DIF: A REF: 427 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 2. While working with a male client and administering medications, the female nurse is approached sexually. The nurse should: 1. Have a male nurse assume care for this client 2. Immediately report the incident to the client’s physician 3. Tell the client that his behavior is offensive and leave the room 4. Review and define the limits of a professional relationship for the client ANS: 4

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-2

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. 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 client’s 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. Reporting the incident immediately to the client’s physician would not be the nurse’s best action. The client needs to be made aware of the problem in order to discontinue such behavior. Telling the client his behavior is offensive and then leaving the room is not therapeutic. The client needs to be reminded of the professional relationship he shares with the nurse. DIF: A OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 3. A client is concerned that she and her husband, now that they have a baby in the house, will be unable to maintain a healthy sexual relationship. To assist these clients, it would be most helpful for the nurse to know: 1. If they share parenting beliefs 2. How long they have been married 3. How comfortable they are in communicating their feelings to each other 4. The level of knowledge they have regarding healthy sexual relationships ANS: 3 In response to identified concerns, the nurse may initiate discussion. Knowing of the comfort level in communicating their feelings provides an open dialogue enabling the client to talk freely with the nurse to address the concerns. To assist the clients in their situational change, the nurse needs to explore communication and sexual patterns of the couple. Having similar parenting beliefs will have less impact on their sexual relationship. To assist the couple in adjusting to the change of becoming a family, the nurse needs to explore communication patterns of the couple. How long they have been married would be less significant. The level of knowledge they have regarding healthy sexual relationships would not be as impacting on their sexual relationship as would their ability to discuss their feelings with one another. DIF: A REF: 428 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 4. The nurse, after completion of an assessment in the medical clinic of a client, the nurse documents that the client has dyspareunia based on the client’s experience of: 1. Delay or absence of an orgasm 2. Deficient or absent sexual desire 3. Involuntary constriction of the vagina 4. Recurrent genital pain during intercourse

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-3

ANS: 4 Dyspareunia is recurrent or persistent genital pain in either a male or a female before, during, or after sexual intercourse that is not associated with vaginismus or with lack of lubrication. Orgasmic disorder is the recurrent delay in, or absence of, orgasm following normal sexual excitement. Hypoactive sexual desire disorder is the persistent or recurrent deficiency or absence of sexual fantasies and desire for sexual activity. Vaginismus is an involuntary constriction of the outer one third of the vagina that prevents penile insertion and intercourse. DIF: A REF: 432 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 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? 1. “My boyfriend is able to withdraw before ejaculation, and that prevents me from getting pregnant.” 2. “I take my temperature every morning; when it goes down for at least two days, we have unprotected sex.” 3. “We always use ‘foam’ before each time that we have sex and as you can see I haven’t gotten pregnant yet.” 4. “We have decided that I should have a diaphragm inserted and to use contraceptive cream with each intercourse.” ANS: 4 In order to be an effective contraceptive method, the diaphragm should be used with a contraceptive cream or jelly. The client is verbalizing understanding. Any act of unprotected intercourse can result in pregnancy. The boyfriend withdrawing prior to ejaculation is not an effective contraceptive method. Any act of unprotected intercourse can result in pregnancy. This statement is not demonstrating understanding of the basal body temperature method of contraception. Using spermicidal foam alone is not recommended. The client should use a condom and foam to be more effective in preventing pregnancy. DIF: A REF: 429 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 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: 1. A viral infection that cannot be cured 2. Treated with a full course of antibiotics 3. Contracted via blood-borne exchange 4. Prevented with the use of spermicidals ANS: 2

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-4

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 need to be taken for the full course of treatment. Chlamydia is caused by bacteria that can be treated, not a virus. Sexually transmitted diseases, such as chlamydia, are transmitted from infected individuals to partners during intimate sexual contact. It is not contracted via blood-borne exchange, but rather through body fluids. Chlamydia is not prevented with the use of spermicidals. DIF: A REF: 430 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 7. A client is scheduled for cardiac surgery. The nurse is conducting a sexual history and is told that he is nervous about resuming sexual activities. The nurse uses therapeutic communication with the client when responding: 1. “You can have sexual intercourse after your surgery, but there are serious risks.” 2. “Your partner will be nervous about resuming sexual activities, but that is only normal.” 3. “Don’t worry. In about 2 months you will be able to return to your normal sexual patterns.” 4. “You are expressing a very normal concern, Perhaps we could discuss your feelings further.” ANS: 4 Open communication and positive self-esteem, such as explaining that their concern is very normal and offering to discuss further are essential factors in effectively resolving concerns. Telling the client that there are serious risks may only worry the client more. Stating that the client’s partner will be nervous about resuming sexual activities does not focus on the client and, therefore, does not encourage the client to express his concerns. 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. DIF: A REF: 427 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 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? 1. “So, sexual intercourse will be more painful for my wife, and we should have sex less frequently?” 2. “We have recently seen the need to begin using a lubricant. That’s because we make love less often.” 3. “My orgasms seem to not last as long, but my husband and I are probably more satisfied now than when we were younger.”

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-5

4. “I understand that it is natural not to have such an interest in sex anymore. People our age shouldn’t still have those feeling.” ANS: 3 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. 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. 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. Saying that people of a certain age shouldn’t still have sexual feelings is not a true statement. Sexual feelings in older adulthood are normal. Sexuality and continued interest in sex throughout late life generally reflect life patterns. DIF: A REF: 439 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 9. The nurse has completed an assessment on an adult male client and finds that he is having difficulty having an erection and has less interest in sex. The nurse notes that the client has recently started taking 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: 1. Client will avoid taking medication before intercourse 2. Client will relate renewed interest in sex within 1 month 3. Client will be interviewed by a sexual therapist immediately 4. Client will seek out other satisfying substitute activities or hobbies ANS: 2 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. The client should not avoid taking his antihypertensive medication before intercourse, but should be taught that there are other blood pressure medications available that can maintain blood pressure control and that do not negatively affect sexual function. He can then discuss this with his physician. Being interviewed by a therapist is not an appropriate expected outcome. Seeing a sexual therapist immediately is not necessary and may only intensify his concern. Seeking out substitute activities or hobbies is not an appropriate expected outcome. It does not address or resolve the problem. DIF: A REF: 434 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-6

10. A 58-year-old woman asks the nurse what she can do to promote healthy physical sexual relations. Based on the client’s age, the nurse responds by saying: 1. “Using a water-based lubricant may be helpful.” 2. “Reducing the frequency of intercourse may help you.” 3. “I will refer you to a sexual therapist to better assist you.” 4. “Continue what you’ve been doing. Nothing should have changed.” ANS: 1 The perimenopausal and menopausal woman may have diminished vaginal lubrication as a result of decreased levels of estrogen, thus using a water-based lubricant may help. Decreasing the frequency of intercourse would not promote healthy sexual relations. 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. There are some physical changes with aging that may affect sexuality. The client should be educated on the expected changes and how to best address them. DIF: A REF: 428 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 11. The nurse is putting together a presentation on the prevention of sexual abuse. She should incorporate which of the following? 1. Abusers fit into easily identified, classic profiles. 2. Intensity is generally increased during pregnancies. 3. Sexual abuse is found primarily in lower socioeconomic groups. 4. Most of the incidents occur with strangers or unknown assailants. ANS: 2 Sexual abuse may begin, continue, or even intensify during pregnancy. The abuser may not fit any classic description. Sexual abuse crosses all gender, socioeconomic, age, and ethnic groups. Most often sexual abuse is at the hands of a former intimate partner or family member. DIF: A REF: 432 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 12. To increase the tone and sensation of the pelvic floor for a female client, the nurse teaches: 1. Kegel exercises 2. Vaginal dilation 3. Stop-start techniques 4. Sensate focus exercises ANS: 1

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-7

Kegel exercises increase the tone and sensation of the pelvic floor (pubococcygeus muscle) for the female client. Vaginal dilation will not increase the tone and sensation of the pelvic floor. 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. Sensate focus exercises do not increase muscle tone. DIF: A REF: 428 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 13. The nurse is discussing the physical changes that occur during puberty with a group of 11- to 12-year-olds. The most therapeutic statement the nurse could make directed toward minimizing their anxiety would be: 1. “You’ll be fine. Everyone survives puberty.” 2. “Don’t worry because everyone goes through the changes.” 3. “Don’t be afraid to talk about the changes with an adult; we all know about puberty.” 4. “Puberty is a normal stage of development. Remember, it’s simply a part of growing up.” ANS: 3 School-age children generally have questions regarding the physical and emotional aspects of sex. They need accurate information from home and school about changes in their bodies and emotions during this period and what to expect as they move into puberty. Knowledge about normal emotional and physical changes associated with puberty will decrease anxiety as these changes begin to happen. It is of little value to tell the child that all will be fine since that tends to send a message that you are minimizing their concerns and so is a barrier to communication. Keeping the responses short and in terms the child will understand is best. DIF: C REF: 427 OBJ: Analysis TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 14. Teenagers tend to engage in risky sexual behavior primarily because they: 1. Feel invincible 2. Lack factual information 3. Emulate poor social models 4. Possess immature decision-making skills ANS: 1 Adolescents tend to think they are invincible and do not expect ‘bad things’ to happen to them. While the other options can be factors in some teens’ decisions to engage in unprotected sex, the age-group generally lacks the insight that they are not invincible and that they will suffer the consequences of poor decision making.

Mosby items and derived items © 2009, 2005 by Mosby, Inc., an affiliate of Elsevier Inc.

Test Bank

28-8

DIF: A REF: 427 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 15. Sexual experimentation is common among adolescents and should primarily be: 1. Discouraged 2. Encouraged 3. Accepted as normal adolescent behavior 4. Viewed as a means of determining sexual orientation ANS: 4 Adolescence is often a time when individuals explore their primary sexual orientation. Although the behavior should not be discouraged or encouraged, in order to avoid undo stress on the adolescent, the experimentation should be viewed as an acceptable way to determine sexual orientation. DIF: A REF: 428 OBJ: Comprehension TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 16. The nurse is discussing various sexual issues with a group of military personnel who have experienced spinal cord injuries. Which of the following statements best addresses the issue of alternative methods of personal sexual gratification? 1. “People do whatever works best for them and their partner.” 2. “You don’t need anyone else to approve how you engage in sex.” 3. “Sex practices are private and need only to be discussed with your sexual partner.” 4. “Any form of stimulation that is mutually agreed upon and satisfying is acceptable sexual practice.” ANS: 4 As sexually active adults develop intimate relationships, they learn techniques of stimulation that are satisfying to both themselves and their sexual partners. Some adults need permission or affirmation that alternative ways of sexual expression other than penile-vaginal intercourse are normal. While the other options prove acceptance, they are not as sensitive in their wording or address the issue as completely. DIF: C REF: 440 OBJ: Analysis TOP: Nursing Process: Evaluation MSC: NCLEX® test plan designation: Safe, Effective Care Environment 17. The middle adult couple is most likely to experience a change in their sexual intimacy when: 1. The changes of normal aging occur 2. On...