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A sexual history of a female client reveals that the client has a normal sex drive and reports of orgasm through means other than intercourse. The client also has a history of being raped several years ago. The client reports spasms of the perineal and outer vaginal muscles when vaginal intercourse is attempted. The nurse interprets these findings as suggesting which of the following?
- A. Priapism
- B. Dyspareunia
- C. Sexual aversion disorder
- D. Vaginismus
Correct Answer: D
Rationale: Vaginismus (D) involves involuntary vaginal muscle spasms preventing intercourse, often linked to trauma like rape. Priapism (A) is male-specific, dyspareunia (B) is pain during intercourse, and sexual aversion disorder (C) involves avoidance of sexual activity.
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A group of nursing students is reviewing information about sexual development. The students demonstrate understanding of the information when they describe biosexual identity as which of the following?
- A. Conviction of belonging to the male or female gender
- B. Outward expression of gender
- C. Sexual attraction to opposite, same, or both sexes
- D. Anatomic and physiologic state of being male or female
Correct Answer: D
Rationale: Biosexual identity refers to the anatomic and physiologic state of being male or female (D), based on biological characteristics like chromosomes and reproductive anatomy. Conviction of gender (A) is gender identity, outward expression (B) is gender role, and sexual attraction (C) is sexual orientation.
A client with premature ejaculation is prescribed sertraline as part of the treatment plan. The nurse explains the medication to the client, informing him that the effectiveness of the drug will most likely be evident in approximately which time frame?
- A. 5 to 7 days
- B. 1 to 2 weeks
- C. 3 to 4 weeks
- D. 6 to 8 weeks
Correct Answer: C
Rationale: Sertraline, an SSRI, typically takes 3 to 4 weeks (C) to achieve therapeutic effects for premature ejaculation by modulating serotonin levels. Shorter time frames (A, B) are too brief, and 6 to 8 weeks (D) is more typical for depression.
A nurse identifies the nursing diagnosis of Ineffective Sexuality Patterns based on which of the following?
- A. The sexual problem is causing dissatisfaction for the client.
- B. The client has experienced a change in sexual functioning.
- C. The client is feeling inadequacy related to the sexual problem.
- D. The client believes that sexual activity is unrewarding.
Correct Answer: B
Rationale: Ineffective Sexuality Patterns is diagnosed based on a change in sexual functioning (B), per nursing diagnosis criteria. Dissatisfaction (A), inadequacy (C), and unrewarding beliefs (D) may contribute but are not the defining criteria.
A client diagnosed with male orgasmic dysfunction is receiving desensitization as part of the treatment plan. The nurse understands that this treatment focuses on achieving which of the following?
- A. Decrease the pressure to perform
- B. Increase awareness of pleasurable sensations
- C. Eliminate spectatoring
- D. Decrease anxiety and fear
Correct Answer: B
Rationale: Desensitization in male orgasmic dysfunction focuses on increasing awareness of pleasurable sensations (B) to improve sexual response. Decreasing performance pressure (A), eliminating spectatoring (C), and reducing anxiety (D) are secondary benefits.
A client with erectile dysfunction who is prescribed sildenafil asks the nurse, When should I take the medication? Which response by the nurse would be most appropriate?
- A. You should take it every morning when you first get up.
- B. Take it about ½ to 2 hours before you have sexual activity.
- C. You need to take it about 5 minutes before you have intercourse.
- D. Take it at night before bedtime.
Correct Answer: B
Rationale: Sildenafil should be taken ½ to 2 hours before sexual activity (B) for optimal effect. Daily morning (A) or bedtime (D) dosing is incorrect, and 5 minutes (C) is too short for absorption.