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 nurse is preparing a presentation for a local senior group about sexuality and sexual behaviors in older adults. Which of the following would the nurse need to address? Select all that apply.
- A. Decreased vaginal lubrication
- B. Decreased amount of sperm
- C. Enhanced clitoral response
- D. Thickening of vaginal mucosa
- E. Increased ejaculation time
Correct Answer: A,B,E
Rationale: Aging causes decreased vaginal lubrication (A), reduced sperm production (B), and increased ejaculation time (E). Clitoral response (C) typically decreases, and vaginal mucosa thins (D), not thickens, with age.
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.
When describing the events associated with the determination of sex of a fetus, which of the following would the nurse most likely include in the discussion?
- A. Genes on the Y chromosome
- B. Formation of ovaries
- C. Rising testosterone levels
- D. Neurochemical inhibition
Correct Answer: A
Rationale: Genes on the Y chromosome (A), particularly the SRY gene, initiate male sex determination by triggering testicular development. Ovary formation (B) and testosterone rise (C) are outcomes, not primary events, and neurochemical inhibition (D) is not relevant.
A client has been admitted to the inpatient psychiatric facility as part of a court-ordered program. The client was arrested numerous times over the past several months for exposing his genitals and masturbating in public in front of an elementary school. The nurse interprets this behavior as reflecting which of the following?
- A. Frotteurism
- B. Exhibitionism
- C. Sexual masochism
- D. Voyeurism
Correct Answer: B
Rationale: Exhibitionism (B) involves exposing genitals in public for sexual gratification, matching the client?s behavior. Frotteurism (A) involves non-consensual touching, masochism (C) involves self-inflicted pain, and voyeurism (D) involves observing others.
A nurse is reviewing the medical record of a client with a sexual dysfunction. Which of the following if noted in the client?s history would the nurse identify as a possible contributing factor? Select all that apply.
- A. Antihypertensive therapy
- B. Diabetes
- C. Peptic ulcer disease
- D. Appendectomy at age 15 years
- E. Occasional alcohol use
Correct Answer: A,B,E
Rationale: Antihypertensives (A), diabetes (B), and alcohol use (E) can contribute to sexual dysfunction by affecting vascular, neurological, or hormonal function. Peptic ulcer disease (C) and a distant appendectomy (D) are unlikely contributors.
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