Kozier & Erb’s Fundamentals of Nursing, 10/E
Chapter 40
Question 1
Type: MCSA
A client speaks about an adult son who is a practicing homosexual and expresses concern by stating: “I am so
worried about him and I know he is going to hell.” What is the most important fact for the nurse to consider in
formulating a response to this client’s concern?
1. Normal sexuality is described as whatever behaviors give pleasure and satisfaction to those adults involved.
2. Because alternative lifestyles are now so well accepted in society, this parent should not feel so much concern.
3. What constitutes normal sexual expression varies among cultures and religions.
4. Sexual development is genetically determined and not affected by environment.
Question 2
Type: MCSA
The parent of a 20-month-old is very concerned because the baby touches the genital area during diaper changes.
How should the nurse respond to this concern?
1. At 20 months this touching is not a sexual experience.
2. Masturbation to orgasm is common and normal at this age.
3. Genital stimulation should not be occurring until the age of 2 1/2 or 3.
4. Babies are sexual beings, but this activity should be discouraged.
Question 3
Type: MCSA
The nurse is teaching a class on body development to a group of middle school girls. One of the girls asks about
using tampons for sanitary protection during menstruation. What advice should the nurse include?
1. Tampons should not be used until the menstrual cycle is well established, usually 2 to 3 years after the first
period occurs.
2. Superabsorbent tampons should be used at night to protect from overflow accidents.
3. Tampons should be alternated with sanitary pads to help decrease risk for infection.
4. Tampons should be changed at least every 8 hours.
Question 4
Type: MCSA
The nurse is developing strategies for the relief of menstrual cramping to teach a group of young clients. What
should be the focus of these strategies?
1. Increase of blood flow to the uterine muscle
2. Avoidance of uterine contraction
3. Minimization of menstrual flow
4. Decrease in estrogen production
Question 5
Type: MCSA
During a routine physical, an 11-year-old tells the nurse that many students in school are “doing it.” How should
the nurse respond to this statement?
1. Tell the client to talk with parents about sexual matters.
2. Ask what “doing it” means to this client.
3. State that sexual activity is not appropriate at age 11.
4. Stay silent and wait for the client to continue the discussion.
Question 6
Type: MCSA
A young adult single mother of a second-grade child has to make a decision regarding the teacher her child will
have in third grade and asks the nurse for advice. All other variables being equal, which choice is best?
1. A woman with 35 years of teaching experience
2. A man who is 40 years old
3. A newly graduated 22-year-old man
4. A 30-year-old woman
Question 7
Type: MCSA
Which statement made by a postmenopausal client should the nurse evaluate as indicating the need for further
assessment?
1. “For some reason, I have more sexual desire than ever.”
2. “I use water-soluble lubricant to treat my vaginal dryness.”
3. “I am so glad that I don’t need to worry about sex anymore.”
4. “Sex certainly takes longer than it used to, but I’m getting used to that.”
Question 8
Type: MCSA
A research article the nurse is reading discusses the prevalence of androgyny in persons 20 to 30 years old. What
should the nurse keep in mind when caring for clients who are androgynous?
1. They do not limit behaviors to one gender over the other.
2. They are attracted to people of the same gender.
3. They often repress their sexual feelings.
4. They hold rigid stereotyped gender role expectations.
Question 9
Type: MCSA
A client experienced female circumcision as a puberty ritual while living in Africa as a child. For which health
problem should the nurse monitor the client as an adult?
1. Early menopause
2. Increased menstrual flow
3. Chronic urinary tract infection
4. Tendency for postpartum hemorrhage
Question 10
Type: MCSA
The 45-year-old client reports that she has no interest in sex and that she and her husband have not had intercourse
in 16 years. How should the nurse interpret this assessment data?
1. This couple is experiencing sexual dysfunction.
2. The woman’s lack of sexual desire has resulted in impotence in her husband.
3. If both partners share the same lack of desire, there is often not a problem.
4. This situation is so unnatural that some dysfunction is present.
Question 11
Type: MCSA
A client is concerned because he was unable to achieve an erection during his last sexual encounter with his wife.
He tells the nurse that he has worried about becoming impotent because he had a sexually transmitted infection as
a young adult. What is the nurse’s best response to this client’s concerns?
1. Sexually transmitted infections may result in sexual problems in adults.
2. Erectile dysfunction is the correct term for the inability to achieve or sustain an erection.
3. An occasional incident like this is normal and common and there is no reason to be concerned.
4. The medical diagnosis of erectile dysfunction is not made until the man has erection difficulties in 25% or more
of his interactions.
Question 12
Type: MCSA
The nurse is preparing for pelvic physical examination of a woman who has been medically diagnosed with
vaginismus. What equipment should the nurse obtain for this examination?
1. Culture tubes to assess expected vaginal infection
2. Extra cleaning supplies to remove thick external secretions
3. Smaller-than-normal vaginal speculums
4. Equipment for preexamination douche
Question 13
Type: MCSA
There is disagreement among the nursing unit staff regarding how much sexual history should be included in adult
admission assessments. What standard is generally the most applicable?
1. A complete sexual history must be included in the admission history and physicals.
2. Sexual information should be pursued only if the client’s chief complaint indicates possible sexual dysfunction.
3. Sexual assessment should be done by the physician and not repeated by the nurse.
4. The amount of sexual information taken will vary on a case-by-case basis.
Question 14
Type: MCSA
The mother of a 5-year-old tells the nurse that her daughter has always been closer to her than to her husband. The
mother expresses concern that, over the last 2 months, the little girl wants to spend all of her time with her father
instead of with the mother. The nurse recognizes that this behavior
1. may indicate sexual abuse by the father and should be further investigated.
2. is a normal expectation of a preschooler developing sexuality.
3. indicates that the girl is overidentifying with the male gender.
4. can be a sign of precocious puberty and should be monitored.
Question 15
Type: MCSA
A recently married couple is trying to conceive a child. The husband is a collegiate athlete and his coach forbids
sexual activity for 2 days prior to a game. The wife asks the nurse if abstinence before the game is necessary.
What is the best response?
1. As long as intercourse is not involved, there is no reason to avoid sexual activity.
2. Some residual physical weakness is common for up to 18 hours after sex.
3. This is a common myth among athletes, but there is no basis in fact.
4. In fact, sexual activity before intense physical exercise increases stamina and endurance.
Question 16
Type: MCSA
The 15-year-old female tells the nurse that she makes her boyfriend stop intercourse before she has an orgasm so
she will not get pregnant. What teaching is necessary for this client?
1. Even though she doesn’t get pregnant, she might still get a sexually transmitted infection.
2. Intercourse until orgasm may actually reduce conception because the vaginal contractions help to expel sperm.
3. Conceiving is not related to whether or not the female partner experiences an orgasm.
4. As long as her boyfriend does not ejaculate in her vagina, conception is unlikely.
Question 17
Type: MCSA
The high school student tells the school nurse that during biology the class learned that alcohol is associated with
erectile dysfunction. The student wonders why so many girls get pregnant during evenings when alcohol is
consumed. The nurse should plan a response based upon which concept?
1. Alcohol is a central nervous system depressant that affects judgment.
2. Erectile dysfunction only occurs after years of alcohol abuse.
3. Alcohol is a sexual stimulant.
4. Erectile dysfunction occurs only in men older than 50.
Question 18
Type: MCSA
The female client has experienced recurrent candidiasis with intense vaginal itching and excoriation. After
treatment the client is reexamined, and the nurse practitioner finds presence of a white, cheesy discharge. What
recommendation is necessary?
1. Referral to a surgeon for excision of infected tissue
2. Examination and treatment of sexual partner
3. Treatment with a stronger oral antibiotic
4. Routine douches with a topical antibiotic solution
Question 19
Type: MCSA
The nurse enters the room and finds the adult client masturbating. What action should the nurse take?
1. Tell the client that masturbation is harmful to sexual well-being.
2. Say “excuse me” and leave the room.
3. Request that the client stop so that care can be provided.
4. Ask the client if there are any sexual concerns that should be discussed.
Question 20
Type: MCSA
A nurse colleague learns that a grandchild’s day-care center is planning a class on sexuality for 3- and 4-year-olds.
Discussion of this plan should include what concept?
1. At this age, education regarding sexuality should come from parents.
2. Children are sexual beings from before birth.
3. Understanding the body and sexuality are a part of growth and development.
4. Sexual activity is beginning at earlier and earlier ages.
Question 21
Type: MCSA
In discussion with teenagers, the nurse chooses to use the term sexually transmitted infection rather than sexually
transmitted disease. What is the rationale for this choice?
1. Infection is a much more precise term for the transmission that occurs.
2. The word disease may elicit guilt, shame, and fear in the client.
3. Sexually transmitted disease does not receive as much third-party reimbursement as does sexually transmitted
infection.
4. These terms can be used interchangeably and there is no good rationale for using one over the other.