Sexuality NCLEX

How should the nurse maintain client confidentiality and privacy related to sexual health?

• Provide privacy during assessment, history, and counseling.

• Respect client’s sexual decisions.

• Avoid discussing a client’s STI or sexual practices with anyone not involved in their care.

• Report STIs only to the local health department (not partner or family).

• Obtain written consent before STI testing.

What are key nursing actions when facing ethical dilemmas related to sexuality?

• Assess personal beliefs and biases.

• Acknowledge and validate client concerns.

• Encourage open communication about feelings and fears.

• Refer clients to appropriate counseling or community resources.

How should the nurse handle ethical and cultural issues impacting sexual care?

• Inform the care team about religious beliefs that prohibit contraception (e.g., Catholicism).

• Explore cultural and religious practices (e.g., circumcision, modesty rules, gender restrictions).

• Identify stress related to conflict between sexual identity and religion/culture.

What precautions are used when assessing clients with STIs?

• Perform hand hygiene before and after care.

• Use gloves when assessing genital lesions.

• Follow standard precautions.

• Educate clients on safe sex and risk factors for STIs.

What is the mode of transmission for most STIs?

Direct contact with infected mucous membranes, fluids, or lesions.

Which STIs are reportable to the health department?

• Syphilis

• Gonorrhea

• Chlamydia

What are key teaching points for STI infection control?

• Safe sex practices (abstinence, monogamy, condom use).

• Place clients with active lesions (e.g., syphilis) on contact precautions.

• Notify client that health department may contact them for follow-up.

What are examples of high-risk sexual behaviors?

• Unprotected sex with multiple partners.

• IV drug use or needle sharing.

• Sex under the influence of drugs/alcohol.

• Adolescent sexual activity.

• Intimate partner violence or sexual abuse.

Which population groups are at higher risk for STIs?

• LGBTQ+ youth

• Adolescents

• IV drug users

• Victims of sexual abuse

What may STIs in children indicate?

Possible sexual abuse (unless due to maternal transmission at birth)

What are the 5 Ps in a sexual health assessment?

• Partners – number, gender, type, risk factors

• Practices – type of sexual activity and protection used

• Prevention of pregnancy – contraceptive use

• Protection from STIs – abstinence, monogamy, condoms, etc.

• Past history of infection – prior STIs, herpes, gonorrhea, HPV, etc.

What should be included when educating about high-risk behaviors?

• Smoking cessation

• Safe sexual practices

• Needle exchange programs for IV drug users

• Screening for STIs at first prenatal visit

What should the nurse assess in relation to a client’s lifestyle and sexuality?

• Attitudes and perceptions about sexuality

• Desire for contraception or pregnancy

• Age, number of partners, and sexual practices

• Contraindications to contraception (e.g., smoking, health conditions)

What are expected outcomes for family planning education?

• Client demonstrates understanding of chosen method.

• Client chooses a safe and effective method suited to their lifestyle.

• Client can verbalize when and how to use contraception properly.

What teaching should be provided for safe sexuality and prevention?

• HPV vaccination at age 11–12.

• Encourage frequent STI screening for high-risk individuals.

• Provide information about menopause, impotence, and family planning.

What should the nurse assess before prescribing oral contraceptives?

• Age, smoking status, and compliance ability.

• Medical contraindications: DVT risk, hypertension, liver disease, breast cancer.

• Possible drug interactions (see below).

Which medications reduce oral contraceptive effectiveness?

• Anticonvulsants: barbiturates, phenytoin, carbamazepine, topiramate

• Antifungals: griseofulvin

• TB drugs: rifampin, rifabutin

• HIV protease inhibitors: nelfinavir, amprenavir

What are religious or spiritual influences that can affect sexual health?

• Spiritual distress from treatment conflicts

• Beliefs opposing contraception or abortion

• Restrictions on sexual behavior (e.g., abstinence until marriage)

How can nurses use therapeutic communication about sexuality?

• Use open-ended questions and nonjudgmental tone.

• Respect cultural and personal values.

• Use a professional interpreter when needed.

• Acknowledge and clarify client concerns.

• Provide privacy and adequate time to talk.

• Encourage clients to express fears or discomfort.

What medications are used to treat Chlamydia?

Azithromycin, erythromycin, or levofloxacin

What medications are used to treat Gonorrhea?

Ceftriaxone (single dose)

What medications are used to treat Syphilis?

• Penicillin G or erythromycin

• Tetracycline/doxycycline contraindicated in pregnancy

• Avoid sex until therapy is complete

What medications are used to treat HSV (Herpes Simplex Virus)?

Acyclovir, famciclovir, or valacyclovir

What topical treatments are used for HPV (genital warts)?

Podofilox 5% or Imiquimod 5% solution

What should be avoided during STI treatment?

• Sexual intercourse until treatment is complete

• Self-medication or stopping antibiotics early

What are the key nursing implications for pharmacologic therapy and sexuality?

• Review all medications for sexual side effects.

• Assess interactions that lower contraceptive effectiveness.

• Reinforce safe sex during treatment.

What lab and diagnostic tests are used for STI screening?

• Cultures for chlamydia and gonorrhea

• Serologic tests for syphilis

• Evaluate vital signs and changes related to infection (e.g., fever, hypotension).

What does an abnormal vital sign trend indicate during STI infection?

• Fever, hypotension, or tachycardia → possible sepsis or systemic infection

✅ KEY TAKEAWAYS (NCLEX FOCUS)

• Confidentiality: report only to local health department.

• 5 Ps: Partners, Practices, Prevention, Protection, Past infections.

• Reportable STIs: chlamydia, gonorrhea, syphilis.

• Contraceptive education: watch for drug interactions & contraindications.

• Therapeutic communication: open, private, nonjudgmental.

• STI meds: azithromycin (chlamydia), ceftriaxone (gonorrhea), penicillin G (syphilis).

• HPV prevention: vaccine at 11–12 years.

• HSV: acyclovir family drugs.

• Avoid sex until treatment complete.

• Standard precautions + hand hygiene always.