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The nurse is assessing a patient in the Sexual Health Clinic who has a positive Venereal Disease Research Laboratory (VDRL) test, but no chancre is noted. The nurse should plan to send the specimens for which of the following tests?
- A. Gram stain
- B. Cytological studies
- C. Rapid plasma reagin (RPR) agglutination
- D. Fluorescent treponemal antibody absorption (FTA-ABS)
Correct Answer: D
Rationale: Since false positives are common with VDRL and RPR testing, FTA-ABS testing is recommended to confirm a diagnosis of syphilis. Gram staining is used for other sexually transmitted infections (STIs) such as gonorrhea and chlamydia, and cytological studies are used to detect abnormal cells (such as neoplastic cells).
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A couple who has not been able to conceive is scheduled for a postcoital test for infertility. Which of the following information should the nurse provide to the couple in preparation for the test?
- A. Possible shoulder pain after the procedure
- B. Sedative medications used during the procedure
- C. Ways to determine the estimated time of ovulation
- D. How long to refrain from intercourse before the test
Correct Answer: C
Rationale: For the postcoital test, the couple should have intercourse at the estimated time of ovulation and then arrive for the test 2-8 hours after intercourse. The other instructions would be used for other types of fertility testing.
A male patient who is 53 years of age is scheduled for an annual physical exam. Which of the following information should the nurse include in the teaching plan?
- A. Increased risk for testicular cancer
- B. Possible changes in erectile function
- C. Normal decreases in testosterone level
- D. Annual digital rectal examination
Correct Answer: D
Rationale: A digital rectal examination is required for all men who have symptoms of prostate trouble, such as difficulty in initiating the flow and the urge to void frequently. This examination should be performed annually for all men 50 years of age or older. There is no indication that the other patient teaching topics are appropriate for this patient.
The nurse is assessing the sexual-reproductive functional health pattern for a patient. Which of the following questions is most useful in determining the patient's sexual orientation and risk factors?
- A. Do you have sex with men, women, or both?
- B. Which gender do you prefer to have sex with?
- C. What types of sexual activities do you prefer?
- D. Are you heterosexual, homosexual, or bisexual?
Correct Answer: A
Rationale: This question is the most simply stated and will increase the likelihood of obtaining the relevant information about sexual orientation and possible risk factors associated with sexual activity. A patient who prefers intercourse with women may also have intercourse at times with men. The types of sexual activities engaged in may not indicate sexual orientation. Many patients who have intercourse with both men and women do not identify themselves as homosexual or bisexual.
Which of the following questions should the nurse ask when assessing a patient who has a history of benign prostatic hyperplasia (BPH)?
- A. Have you noticed any unusual discharge from your penis?
- B. Has there been any change in your sex life in the last year?
- C. Do you find it hard to initiate your urinary stream?
- D. Have you been experiencing any difficulty in achieving an erection?
Correct Answer: C
Rationale: Enlargement of the prostate blocks the urethra, leading to urinary changes. Benign prostatic hyperplasia is a common problem of older men. It can alter normal urination, causing retention and difficulty in initiating the urinary stream. The other questions address possible problems with infection or sexual difficulties but would not be helpful in determining whether there were functional changes caused by BPH.
The nurse is assessing an older-adult male patient and the patient says that he does not respond to sexual stimulation the way he did when he was younger. Which of the following responses to the patient's comment is best?
- A. Many men need more sexual stimulation with aging.
- B. Interest in sex frequently decreases as men get older.
- C. Erectile dysfunction is a common problem with older men.
- D. Tell me more about how your sexual response has changed.
Correct Answer: D
Rationale: The initial response by the nurse should be further assessment of the problem. The other statements by the nurse are accurate but might not respond to the patient's concerns.