ATI PN COMPREHENSIVE EXIT EXAM

1. A parent asks about the human papillomavirus (HPV) vaccine. Which information will the nurse include in the teaching session? a. It is recommended for girls 6 to 9 years old. b. It is recommended for females ages 11 to 26. c. It is recommended that booster injections be given. d. It is recommended to receive four required injections. ANS: B The vaccine is safe for girls as young as 9 years old and is recommended for females ages 11 to 26 if they have not already completed the three required injections. Booster doses currently are not recommended. The vaccine is most effective if administered before sexual activity or exposure. 2. A nursing student is providing education to a group of older adults who are in an independent living retirement village. Which statement made by the nursing student requires the nurse to intervene? a. “Avoiding alcohol use will enhance your sexual functioning.” “You need to tell your partner how you feel about sex and any fears b. you may have.” “You do not need to worry about getting a sexually transmitted c. infection at this point in your life.” “Using pillows and taking pain medication if needed before having sexual intercourse often help alleviate pain and improve sexual d. functioning.” ANS: C Research indicates many older adults are more sexuality active than previously thought and engage in high-risk sexual encounters, resulting in a steady increase HIV and STI rates over the past 12 years. Therefore, the nurse needs to intervene when the student tells the older adults that they are not at risk for developing an STI. Avoiding the use of alcohol; using pillows; taking pain medications before having intercourse if needed; and communicating thoughts, fears, and feelings about sex all enhance sexual functioning. 3. A nurse is interviewing a woman who uses a diaphragm. Which information from the patient will require the nurse to follow up? a. “I have lost 12 pounds on this diet.” b. “I use the diaphragm to prevent pregnancy.” c. “I use a contraceptive cream with my diaphragm.” d. “I know this provides a barrier over the cervical opening.” ANS: A The woman needs to be refitted after a significant change in weight (10-pound gain or loss) or pregnancy. The diaphragm is a round, rubber dome that has a flexible spring around the edge. It is used with a contraceptive cream or jelly and is inserted in the vagina so it provides a contraceptive barrier over the cervical opening. 4. A nurse is conducting a sexual assessment. Which question is appropriate for the nurse to ask? a. Have you noticed any changes in the way you feel about yourself? b. What is your favorite sex position with men and with women? c. Do you think your partner is attractive? d. Why do you like men over women? ANS: A Asking about any changes in the way you feel about yourself is an appropriate question to ask during a sexual assessment. Asking about favorite sex position with men and/or women is inappropriate and invasive. The assessment needs to focus on the patient, not the partner. Asking “why” questions is nontherapeutic and is judgmental in this scenario. 5. A 15-year-old patient is concerned because her mother wants her to receive the human papillomavirus (HPV) vaccination, but the patient is unsure if she wants it. Which response by the nurse is most therapeutic? a. Ask the patient what concerns she may have about the vaccination. b. Inquire about how many sexual partners she has had in the past year. Remind her that her mother knows best and that she should respect her c. parents’ wishes. Promote the importance of the vaccine, and recommend that the d. patient get the vaccine as soon as possible. ANS: A The nurse should encourage health promotion behaviors but first must consider the autonomy of the patient and assess the patient for more data. The nurse should value the input of the patient in making a decision and assess what the patient is thinking to address any concerns the patient may have. The HPV vaccine is a preventative treatment; whether or not the patient is sexually active (asking about how many sexual partners) does not matter in this case. The nurse should not make assumptions about a patient’s home life (mother knows best); instead, the nurse should ask questions while establishing a therapeutic relationship. Recommending the patient get the vaccine as soon as possible is in violation of the patient’s rights. 6. A nurse is reviewing a patient’s history. Which priority finding will alert the nurse to assess the patient for possible sexual dysfunction? a. Takes vacations out of the country Takes antianxiety medication b. Takes exercise classes c. Takes afternoon naps ANS: B Medications that can affect sexual functioning include antihypertensive, antipsychotics, antidepressants, and antianxiety. Taking vacations out of the country, exercise classes, and afternoon naps are not as priority for sexual functioning as medications. 7. A nurse is assessing a child for sexual abuse. Which assessment findings will the nurse expect? a. Physical aggression and sleep disturbances b. Many peers and no drug usage c. Panic attacks and anorexia d. Anxiety and depression ANS: A Behavioral signs of sexual abuse in a child include physical aggression, sleep disturbance, poor peer relationships, and substance abuse. Panic attacks, anorexia, anxiety, and depression are behavioral signs for adults. 8. The nurse is teaching a patient how to use a condom. Which instructions will the nurse provide? a. Store in a warm lit space. b. Use massage oils for lubrication. c. Rinse and reuse the condom if needed. d. Hold onto the condom when pulling out. ANS: D Teach patients to pull out right after ejaculating and to hold onto the condom when pulling out. Store condoms in a cool, dry place away from sunlight. Instruct patient to never reuse a condom or use a damaged condom. Instruct patient to only use water-based lubricants (e.g., K-Y jelly) to prevent the condom from breaking; do not use petroleum jelly, massage oils, body lotions, or cooking oil.