question

A loving couple should pay special attention to touching because 1. sensual touching is an important basis for intimacy. 2. skin senses are very related to hypothalamic activity. 3. the sex flush occurs on the skin. 4. touching is a way to induce sexual arousal.

answer

1. sensual touching is an important basis for intimacy.

question

Denise enjoys placing a condom on her partner, Darryl, as part of foreplay. Darryl is uncomfortable about this. As they talk about this sensitive issue, there are several silences. Such silences 1. indicate serious problems in the relationship. 2. suggest that both partners are ignorant of their own values and limits. 3. can be calming and a sign of intimacy. 4. are a sign of unequal commitment.

answer

3. can be calming and a sign of intimacy

question

A difficult conversation about intimate sexual issues is a little easier to have if 1. both partners are feeling equally upset about the issue. 2. it is structured around traditional gender roles of authority and submission. 3. both partners are very committed to the relationship. 4. one partner possesses more sexual knowledge than does the other.

answer

3. both partners are very committed to the relationship.

question

Ruth becomes very aroused when she can initiate sexual activity with her boyfriend. However, she is fearful that this violates a strong societal norm, so she feels controlled and resentful. Ruth's behavior is an example of 1. confusing sex and romantic attachments. 2. modeling her sexuality after external standards. 3. not allowing herself to be vulnerable. 4. remaining at a dread/anger impasse.

answer

2. modeling her sexuality after external standards.

question

Harriet tells her younger brother, Michael, "There are just some things about men's sexuality that I just don't know and can't explain to you. Wouldn't it help if you spoke to your friend Jim? He seems very knowledgeable." If Michael is unwilling to do this, it is most likely because 1. men usually don't know how to listen to each other. 2. being vulnerable with a male friend would place Michael in a "one-down" position. 3. Michael sees only close relatives as appropriate for discussing sensitive issues. 4. Michael believes that only women can help men with their sexual problems.

answer

2. being vulnerable with a male friend would place Michael in a "one-down" position.

question

What misconception do many people have about long-term relationships? 1. Romantic love is a pure and idealistic love. 2. Individuals expect that intense feelings of love and sexual passion will last. 3. People who create the opportunity for sex don't really love each other. 4. Love ultimately becomes a way of controlling another person

answer

2. Individuals expect that intense feelings of love and sexual passion will last.

question

One all-too-common "game" that gets in the way of real communication is 1. confronting difficult problems directly. 2. pushing for resolution of a conflict prematurely. 3. basing opinions on little or no solid information. 4. acknowledging one's vulnerability to criticism.

answer

2. pushing for resolution of a conflict prematurely.

question

Pam says to Jack, "Every time we make love, you always rush to get inside me. I would prefer that we take more time before getting to that point." This honest communication could be improved by 1. using humor. 2. beginning the conversation with, "I don't want to hurt you, but. . . ." 3. avoiding "all-ness" words. 4. being less direct.

answer

3. avoiding "all-ness" words.

question

Rhonda believes that if she lets Derek believe she is interested in being sexual with him, he is more likely to ask her to go with him to an upcoming big event. As she gets ready for her date, she rehearses how she will cleverly drop hints about this. Such strategies are usually perceived as 1. direct communication. 2. convincing and inviting. 3. awkward. 4. manipulative.

answer

4. manipulative.

question

Which of the following is NOT a constructive way of addressing conflicts in relationships? 1. Listening to each other carefully 2. Expressing anger freely but without escalating 3. Working toward negotiation and compromise 4. Backing up accusations with evidence

answer

4. Backing up accusations with evidence

question

Jan and Bob are both married to other people. However, several times a month they meet at a hotel room and engage in intense lovemaking. Afterwards, they typically order a meal to be brought to their room and make arrangements for their next meeting. This relationship appears to be high in 1. passion. 2. intimacy. 3. commitment. 4. companionship.

answer

1. passion.

question

During quarrels, men typically 1. confront. 2. initiate. 3. appease. 4. withdraw.

answer

4. withdraw

question

When it comes to terms for sex-related things or ideas, 1. people are more likely to use slang terms rather than scientific terms. 2. college students tend to use terms that follow the norms of their parents. 3. women tend to use far more specific terms than men. 4. men tend to use more negative terms for male than for female sexual organs.

answer

1. people are more likely to use slang terms rather than scientific terms.

question

Before an individual can be vulnerable and deal with hurt, he or she needs to have 1. adequate self-esteem and self-confidence. 2. a high level of sexual knowledge regarding pleasuring techniques. 3. a willingness to depend on another to validate feelings. 4. sufficient sexual experience to impress a partner.

answer

1. adequate self-esteem and self-confidence.

question

One of the most difficult aspects of conversation can be 1. talking rather than listening. 2. expressing opinions. 3. dealing with silence. 4. trying to persuade another person.

answer

3. dealing with silence.

question

Effective resolution of relational impasses is associated with 1. shifting to mutuality. 2. having good evidence to back up accusations. 3. referring to an outside authority. 4. appealing to logic and reason.

answer

1. shifting to mutuality.

question

What are pheromones? 1. Natural painkillers released by the brain 2. Scents that function as sexual attractants 3. Endocrine secretions that guide the development of secondary sex characteristics 4. Neurotransmitters that stimulate the hypothalamus and the pituitary gland

answer

2. Scents that function as sexual attractants

question

One of the most important elements in a full and satisfying sexual relationship is 1. knowledge of various sexual techniques. 2. the availability of a variety of partners. 3. equality of experience. 4. effective mutual communication.

answer

4. effective mutual communication.

question

Relationships that are created and maintained on the Internet 1. tend to involve people with few common interests. 2. tend to stagnate, never developing beyond a superficial level. 3. are indistinguishable from face-to-face relationships. 4. tend to develop very rapidly and can quickly become eroticized.

answer

4. tend to develop very rapidly and can quickly become eroticized.

question

According to recent research on close relationships, quarreling 1. is a sign of dissatisfaction and unhappiness. 2. invigorates relationships, and both partners should initiate such interchanges. 3. indicates inequality in the partners' levels of commitment to the relationship. 4. is inevitable and, if done constructively, can improve relationships.

answer

4. is inevitable and, if done constructively, can improve relationships.

question

Juanita undergoes surgery for an ectopic pregnancy. The surgery will 1. remove the blastocyst from the fallopian tubes or abdominal cavity. 2. remove the morula from the uterus before it develops into a blastocyst. 3. repair the amnion and chorion. 4. implant the blastocyst more securely into the endometrium.

answer

1. remove the blastocyst from the fallopian tubes or abdominal cavity.

question

The technique of selective reduction is applied when 1. an older woman already has several children. 2. large-multiple pregnancies develop as a result of fertility drugs. 3. identical triplets are developing. 4. too many sperm have reached the unfertilized ovum.

answer

2. large-multiple pregnancies develop as a result of fertility drugs.

question

Currently, the most commonly used pain-relieving intervention during childbirth involves 1. epidural blocks. 2. general anesthesia. 3. hypnosis. 4. deep breathing.

answer

1. epidural blocks.

question

A problem associated with IVF procedures is the 1. possibility of complete infertility later in life. 2. unforeseen changes that occur in the DNA of both ova and sperm. 3. ensuing legal and ethical problems regarding inheritance rights. 4. low rates of successful pregnancy.

answer

4. low rates of successful pregnancy.

question

What is the social significance of the trend toward natural childbirth? 1. The relatives of the birth mother are no longer involved in the birth process. 2. Control of the birth process has been returned to women and their partners. 3. Midwives are now viewed as the sole appropriate practitioners for childbirth. 4. There has been a decrease in the number of episiotomies and cesarian births.

answer

2. Control of the birth process has been returned to women and their partners.

question

A very important step in preventing birth defects and low-birth-weight babies is 1. maintaining a regular program of prenatal care. 2. using a physician rather than a midwife to deliver the infant. 3. limiting the sexual activity of the mother-to-be. 4. ensuring that the parents really want a child.

answer

1. maintaining a regular program of prenatal care.

question

To date, the effort to map the human genome has 1. unraveled the mystery behind genetic diseases. 2. produced successful treatments for scores of human diseases. 3. generated information that is being used to develop tests and potential treatments for genetic diseases. 4. been temporarily abandoned because of its complexity.

answer

3. generated information that is being used to develop tests and potential treatments for genetic diseases.

question

In the U.S., research on embryos 1. can only be conducted on certain animals. 2. was recently endorsed by the federal government and freed from special restrictions. 3. is restricted by federal law and by National Institute of Health (NIH) research guidelines. 4. is prohibited by federal law.

answer

3. is restricted by federal law and by National Institute of Health (NIH) research guidelines.

question

Which of the following is NOT an aspect of the Lamaze method? 1. Use of different breathing and relaxation techniques all through the birthing process 2. Active participation by the mother in birthing her baby 3. Coaching of the birth mother by her partner or another willing person 4. Use of anesthesia to facilitate an enjoyable birth experience

answer

4. Use of anesthesia to facilitate an enjoyable birth experience

question

The overall number of multiple births has increased over recent years largely as a result of 1. improved male fertility and use of more varied coital positions. 2. improved prenatal care among ethnic groups who are more prone to multiple births. 3. intercourse at younger ages and a tendency for women to have more sex partners. 4. more older women becoming pregnant and increased use of fertility drugs.

answer

4. more older women becoming pregnant and increased use of fertility drugs.

question

Carla and Jim decide to use the Leboyer method for their baby's birth. This implies that their baby will be born 1. via an incision in the mother's abdomen. 2. in a cool, brightly lit hospital delivery room. 3. at home, while friends and relatives are celebrating. 4. in a quiet, dimly lit room, and that he or she will be gently bathed.

answer

4. in a quiet, dimly lit room, and that he or she will be gently bathed.

question

Sperm deposited during the ________________ovulation are most likely to lead to conception. 1. 2 days following 2. 6 days preceding 3. 4 days following 4. 2 days preceding

answer

2. 6 days preceding

question

What contention is at the basis of the controversy that surrounds cesarian sections? 1. This procedure can reduce the likelihood of future pregnancies. 2. This procedure can result in pain and discomfort in the vaginal area long after a birth. 3. This procedure is a violation of human rights. 4. This procedure is unnecessary in many cases in which it is performed.

answer

4. This procedure is unnecessary in many cases in which it is performed.

question

Leonard and Jane mention that they do not have intercourse since they learned that Jane is pregnant. They are concerned that such vigorous activity could cause a miscarriage. What does research suggest about their concern? 1. In the absence of a medical problem, intercourse may occur, as long as it is comfortable for both individuals. 2. Multiple pregnancies could result from intercourse during pregnancy, so condoms should be used. 3. A somewhat higher rate of birth defects is associated with having intercourse during pregnancy. 4. Except in the first trimester, intercourse is permissible during pregnancy.

answer

1. In the absence of a medical problem, intercourse may occur, as long as it is comfortable for both individuals.

question

Melissa has decided to become a single mother, and she seeks artificial insemination. In other words, Melissa will 1. undergo in vitro fertilization. 2. have intercourse with a volunteer. 3. donate an ovum to a very fertile woman. 4. have donated sperm placed in her vagina or uterus.

answer

4. have donated sperm placed in her vagina or uterus.

question

What was the significance of the "Baby M" case and/or other surrogate motherhood "babies"? 1. It showed that the cloning of both animals and humans is possible. 2. It resulted in changes in NIH guidelines regarding embryo research. 3.It tested legal and ethical issues surrounding gestational surrogacy. 4. It demonstrated the negative results of sex selection techniques.

answer

3.It tested legal and ethical issues surrounding gestational surrogacy.

question

Which of the following statements most accurately describes IVF? 1. Ova are fertilized normally in the fallopian tubes, removed, and then frozen for implantation at a later date. 2. Genetically altered DNA is injected into the ovaries of a woman who has a genetic disorder, and this procedure corrects that disorder. 3. Donor sperm is placed inside a woman's uterus or vagina with a baster. 4. A woman's ovum is surgically removed from the ovary, fertilized, and then placed in her prepared uterus.

answer

4. A woman's ovum is surgically removed from the ovary, fertilized, and then placed in her prepared uterus.

question

Traditionally, North American physicians have cut vaginal tissue during the birthing process. This procedure is called 1. infibulation. 2. effacement. 3. cesarian section. 4. episiotomy.

answer

4. episiotomy.

question

Which of the following does NOT occur during the first stage of labor? 1. Increasing frequency and strength of uterine contractions 2. Movement of the fetus through the vagina 3. Dilation of the cervical opening 4. Thinning of the cervix

answer

2. Movement of the fetus through the vagina

question

Which of the following has NOT been implicated as a possible cause of increased infertility? 1. Injuries to the testes 2. Regular use of condoms and spermicides 3. A history of pelvic inflammatory disease 4. Alcohol and tobacco use

answer

2. Regular use of condoms and spermicides

question

Greg and Gina rush off to begin their week's vacation. In all the excitement, they forget Gina's contraceptive pills. They should 1. purchase and use minipills to tide them over the week. 2. have sex as usual because the pills are effective for a week after she stops taking them. 3. use an alternative method of contraception for the rest of her present cycle. 4. use a different position for intercourse to reduce the likelihood of impregnation.

answer

3. use an alternative method of contraception for the rest of her present cycle.

question

Data from various studies on birth control in the U.S. indicate that 1. about 12 to 13 percent of unmarried, noncohabitating individuals never use contraceptive devices. 2. compared with Canadians, U.S. adults report great trust in the effectiveness of birth control methods. 3. almost everyone who has access to a contraceptive uses it. 4. compared with the Dutch, Americans report far lower rates of unplanned pregnancies.

answer

1. about 12 to 13 percent of unmarried, noncohabitating individuals never use contraceptive devices.

question

The greatest disadvantage of hormonal contraceptives is the 1. fact that they do not protect against disease and cannot be safely used by many women. 2. number of medical check-ups required. 3. time it takes for fertility to return to normal. 4. side effects and low level of effectiveness.

answer

1. fact that they do not protect against disease and cannot be safely used by many women.

question

The effectiveness of oral contraceptives may be reduced when women 1. take certain antibiotics. 2. use vitamins regularly. 3. are underweight. 4. fail to exercise sufficiently.

answer

1. take certain antibiotics.

question

Which of the following statements is true of the typical failure rate of a contraceptive? 1. It is usually much lower than the theoretical failure rate. 2. It depends on the quality control used in its manufacture. 3. It takes human error and carelessness into consideration. 4. It assumes that the method is used correctly and consistently.

answer

3. It takes human error and carelessness into consideration.

question

According to recent research, most women choose their first method of birth control based on the method's 1. possible health impact. 2. ease of use. 3. acceptability to their partners. 4. effectiveness.

answer

4. effectiveness.

question

The principal purpose of the Comstock Laws was to 1. disseminate information about the benefits of condom use. 2. prevent abortions among married women. 3. suppress information about contraception. 4. encourage families to practice birth control.

answer

3. suppress information about contraception.

question

A major advantage of the patch, the vaginal ring, and injections of progestin compared with oral contraceptives is that they 1. do not need attention every day. 2. can be obtained without a prescription. 3. are free of side effects. 4. do not interfere with the normal ovulatory cycle.

answer

1. do not need attention every day.

question

In general, for which of the following women are oral contraceptives probably the best choice as a contraceptive method? 1. Carla, age 35, who is the mother of three children 2. Anne, age 18, who is sexually active and smokes 3. Doris, age 45, who is recently divorced 4. Betty, age 22, who is cohabiting with Aaron and does not smoke

answer

4. Betty, age 22, who is cohabiting with Aaron and does not smoke

question

In the U.S., family planning clinics 1. cannot receive any public funds directly or indirectly. 2. often receive funds from federal health programs but are subject to restrictions that change as political power shifts. 3. are illegal. 4. are run by state governments but do not receive federal funds.

answer

2. often receive funds from federal health programs but are subject to restrictions that change as political power shifts.

question

The major reason for the high failure rate for coitus interruptus is that 1. only very sexually experienced men know when they are about to ejaculate. 2. sperm may be present in pre-ejaculatory secretions. 3. vaginismus may prevent the penis from being withdrawn. 4. vaginal contractions may squeeze out semen before ejaculation.

answer

2. sperm may be present in pre-ejaculatory secretions.

question

A new method of male contraception that is being researched involves 1. spreading gossypol ointment on the penis. 2. taking a daily pill that reduces HCG. 3. taking progestin orally each day. 4. receiving testosterone injections or implants.

answer

4. receiving testosterone injections or implants.

question

Research on birth control indicates that among developed countries, 1. rates of unintended pregnancy in Canada and the Netherlands are especially high. 2. the rate of unintended pregnancy in the U.S. is above average. 3. rates of unintended pregnancy vary very little. 4. the rate of unintended pregnancy in the United States is lower than average.

answer

2. the rate of unintended pregnancy in the U.S. is above average.

question

Harry wants to buy the most effective condom available. Which of the following is NOT a feature that he should look for in the condoms? 1. They should be made of latex. 2. They should have a small nipple at the tip. 3. They should be lubricated with a spermicide. 4. They should be made from natural materials.

answer

4. They should be made from natural materials.

question

Which of the following is NOT a warning signal associated with the use of a birth control pill? 1. Lack of ovulation 2. Abdominal or chest pain 3. Changes in vision 4. Headaches

answer

1. Lack of ovulation

question

Why is Margaret Sanger an important person in the history of sexuality in the U.S.? 1. She developed the surgical technique used in male sterilization. 2. She pioneered the use of condoms as contraceptive devices. 3. She advocated passage of the Comstock Laws. 4. She fought the legal system to provide information on birth control to women.

answer

4. She fought the legal system to provide information on birth control to women.

question

The theoretical failure rate of a contraceptive refers to the 1. effectiveness rate observed among actual people. 2. expected failure rate if the method is used perfectly. 3. level of effectiveness desired by scientists and researchers. 4. failure rate based on psychological theories or models.

answer

2. expected failure rate if the method is used perfectly.

question

A disadvantage of spermicides is that they 1. are very expensive and difficult to find. 2. require considerable motivation and planning. 3. require medical administration and supervision. 4. are not very effective if used alone and may irritate the vagina.

answer

4. are not very effective if used alone and may irritate the vagina.

question

How does RU 486 work? 1. It delays release of the ovum during a normal cycle. 2. It decreases the motility of sperm in the uterus and fallopian tubes. 3. It interferes with preparation or maintenance of the uterine lining for implantation. 4. It involves the introduction of a copper wire into the uterus to prevent implantation.

answer

3. It interferes with preparation or maintenance of the uterine lining for implantation.

question

Which of the following contraceptives has the fewest health-related side effects? 1. IUD 2. Condoms 3. Contraceptive pill 4. Hormonal patch

answer

2. Condoms

question

Individuals who feel guilty about their sexual activities tend to 1. consult both religious and medical authorities about contraceptive use. 2. ignore their partner's wishes regarding contraceptives. 3. make poor contraceptive decisions. 4. be perfectionists in their use of contraceptives.

answer

3. make poor contraceptive decisions.

question

Which of the following is NOT a step necessary in order to avoid unwanted pregnancy if one is sexually active? 1. Acknowledging that sexual activity could lead to pregnancy 2. Obtaining adequate information about contraceptive techniques 3. Using a contraceptive technique consistently and properly 4. Douching or bathing immediately after intercourse

answer

4. Douching or bathing immediately after intercourse

question

The method of abortion most often used during the second trimester of pregnancy is 1. vacuum curettage. 2. dilation and evacuation. 3. mifepristone-induced abortion. 4. saline-induced abortion.

answer

2. dilation and evacuation.

question

The most commonly used oral contraceptive is the 1. inert pill. 2. minipill. 3. progestin-only pill. 4. combination pill.

answer

4. combination pill.

question

Sexually active individuals should understand that contraceptives 1. can be relied upon only if they have a high theoretical failure rate. 2. of all types interfere with sexual spontaneity. 3. that require regular medical supervision have the lowest typical failure rate. 4. can only reduce the risk of pregnancy, not eliminate it.

answer

4. can only reduce the risk of pregnancy, not eliminate it.

question

According to Masters and Johnson, how did most men define "excessive" masturbation? 1. Masturbating more than twice a month 2. Masturbating more than they themselves did 3. Masturbating more than once a week 4. Masturbating more than twice a day

answer

2. Masturbating more than they themselves did

question

The most common method of masturbation among women involves 1. inserting a vibrator into the vagina. 2. engaging in intense sexual and romantic fantasies. 3. indirectly stimulating the clitoris with the hands. 4. rubbing against an object.

answer

3. indirectly stimulating the clitoris with the hands.

question

Which of the following statements about masturbation is accurate? 1. Couples who love each other usually find it very easy to talk to each other about masturbation. 2. Individuals who have happy, healthy sexual and emotional relationships may also masturbate frequently. 3. Individuals who do not have a regular partner tend to masturbate the most frequently. 4. Frequent masturbation can diminish one's interest in shared sexual activities.

answer

2. Individuals who have happy, healthy sexual and emotional relationships may also masturbate frequently.

question

According to one recent study of the attitudes of U.S. college students toward masturbation, 1. the attitudes of men and women do not differ. 2. many women have negative feelings about a man's masturbating. 3. men react very negatively to female masturbation. 4. most women masturbate at least once a week.

answer

2. many women have negative feelings about a man's masturbating.

question

Whether a couple lives in Europe or the United States, the positions they are most likely to use in intercourse involve : 1. being face to face. 2. deepest penetration. 3. greater control by the man. 4. maximum clitoral stimulation.

answer

1. being face to face.

question

Which of the following population groups is most likely to engage in oral sex? 1. Young, better-educated white persons 2. Elderly married couples 3. Teenagers who are members of minority groups 4. African-American men

answer

1. Young, better-educated white persons

question

The best external lubricants for sexual intercourse are 1. water-soluble preparations. 2. petroleum jellies. 3. hand and body cream. 4. silicone lubricants.

answer

1. water-soluble preparations.

question

Which of the following is NOT typically regarded as an erogenous zone in Western societies? 1. The buttocks 2. The earlobes 3. The inner thighs 4. The elbows

answer

4. The elbows

question

The chemical used most often with sexual activity is 1. nicotine. 2. amyl nitrite. 3. alcohol. 4. marijuana.

answer

3. alcohol.

question

Why is it unsafe to blow on an erect penis or blow into a vagina? 1. These activities may result in permanently premature orgasm. 2. These activities may force bacteria or air into a person's body. 3. These activities can spread STDs. 4. These activities indicate the presence of a personality disturbance.

answer

2. These activities may force bacteria or air into a person's body.

question

An important difference between the Kinsey studies and the National Health and Social Life Survey (NHSLS) is that the NHSLS 1. surveyed both men and women. 2. studied only abnormal sexual behaviors. 3. used the survey method, whereas Kinsey depended on laboratory data. 4. provided reliable statistics that can be generalized to the total population.

answer

4. provided reliable statistics that can be generalized to the total population.

question

Which of the following is NOT a problem associated with anal intercourse? 1. Infections as a result of later inserting the penis into the mouth or vagina 2. Increased risk of HIV transmission 3. Greater likelihood of deviant sexual behavior 4. Possible anal or rectal injuries

answer

3. Greater likelihood of deviant sexual behavior

question

In examining statistical data about sexual activities, it is important to remember that 1. these numbers represent the extremes of sexual behavior, not the norms. 2. to be normal, one should adjust one's sexual behavior to match the statistical norms. 3. such data do not determine what one's sexual behavior ought to be. 4. such data represent sexual ideals, and not actual sexual behavior.

answer

3. such data do not determine what one's sexual behavior ought to be.

question

Which of the following is NOT a type of oral sex? 1. "Sixty-nine" 2. Cantharides 3. Fellatio 4. Cunnilingus

answer

2. Cantharides

question

According to the NHSLS, the major reason adults masturbate is to 1. relieve sexual tension. 2. substitute for not having a sexual partner. 3. avoid sexual activity with a partner. 4. avoid the possibility of STD infection.

answer

1. relieve sexual tension.

question

Which of the following is NOT a myth associated with masturbation? 1. Excessive masturbation can reduce interest in shared sexual activity. 2. Masturbation can be a shared sexual activity. 3. Masturbation is essentially a substitute for partnered sexual activity. 4. Masturbation is not as physically satisfying as shared sexual activity.

answer

2. Masturbation can be a shared sexual activity.

question

A dangerous male masturbatory activity involves 1. attempting autofellatio. 2. stimulation of the anal region. 3. the use of artificial vaginas. 4. inserting objects into the urethra.

answer

4. inserting objects into the urethra.

question

The degree of pleasure experienced by both partners during intercourse can be enhanced by 1. communication and openness. 2. an especially large or long penis. 3. using only one position for intercourse. 4. an especially sensitive clitoris.

answer

1. communication and openness.

question

Oral-anal contact 1. is safer than fellatio. 2. is safe. 3. even with thorough washing brings the risk of transmitting disease. 4. is safe if strict hygienic measures are followed.

answer

3. even with thorough washing brings the risk of transmitting disease.

question

The most common technique of male masturbation involves 1. inserting the penis into objects. 2. running a stream of warm water over the genital region. 3. rubbing the legs together. 4. grasping and stroking the shaft of the penis.

answer

4. grasping and stroking the shaft of the penis.

question

Which of the following factors has NOT been found to be important in the amount of pleasure experienced by women in sexual intercourse? 1. Rate and vigor of pelvic movements 2. Communication and cooperation between partners 3. Penis size 4. Positions of both partners

answer

3. Penis size

question

Medical authorities in the eighteenth century said that masturbation was harmful because 1. genital stimulation leads to infection with sexually transmitted diseases. 2. expending sexual fluids leads to physical illness. 3. only lower primates engage in masturbation. 4. pleasure from masturbation prevents the pursuit of shared sexual activities.

answer

2. expending sexual fluids leads to physical illness.

question

When aphrodisiacs work, it is probably because 1. sexual response is basically a chemical response. 2. they cause constriction of the genital blood vessels. 3. users believe in their effectiveness. 4. activity in the cerebral cortex increases.

answer

3. users believe in their effectiveness.

question

Oral stimulation of the female genitals is called 1. intromission. 2. fellatio. 3. cunnilingus. 4. intrafemoral intercourse.

answer

3. cunnilingus.

question

If stimulation to a particular part of the body results in sexual arousal, that part of the body is called a(n) 1. autoerotic zone. 2. erotic zone. 3. erogenous zone. 4. zona pellucida.

answer

3. erogenous zone.

question

A panel of mental health experts interviews and tests 100 gay men and lesbians. They do the same with 100 other-gender-oriented individuals. On the basis of your knowledge of previous research, what is likely to be the outcome? 1. Gay men and lesbians will be shown to be less healthy and well-adjusted than the heterosexual sample. 2. While the gay men will show personality patterns that are quite different from those of the heterosexual men, no difference will be found between the two groups of women. 3. There will be no substantial differences in the mental or emotional health of the groups. 4. While the lesbians will show personality patterns that are quite different from those of the heterosexual women, no difference will be found between the two groups of men.

answer

3. There will be no substantial differences in the mental or emotional health of the groups.

question

The term homophobia refers to 1. laws that discriminate against individuals with a same-gender orientation. 2. people who are reluctant to identify themselves as gay, lesbian, or bisexual. 3. traditions such as that of the berdache. 4. irrational fears and strong negative attitudes toward gays and lesbians.

answer

4. irrational fears and strong negative attitudes toward gays and lesbians.

question

Which of the following statements most accurately reflects the conclusions of the researchers who conducted the National Health and Social Life Survey (NHSLS) regarding sexual orientation? 1. Many individuals who identify themselves as gay or lesbian live in rural areas. 2. A 10-point scale of classification for sexual orientation would be more helpful than a 6-point scale. 3. Sexual orientation is a multidimensional concept and cannot be described by a single number. 4. About 10 percent of adult men and 5 percent of women are exclusively gay or lesbian.

answer

3. Sexual orientation is a multidimensional concept and cannot be described by a single number.

question

Why was the Kinsey Scale of Sexual Behavior considered so important? 1. It described sexual expression as a continuum. 2. It delineated bisexuality as a clear-cut category. 3. It emphasized the romantic and affectional aspects of same-gender relationships. 4. It considered the ethnic and cultural context of same-gender sexual expression.

answer

1. It described sexual expression as a continuum.

question

Which of the following statements about the Kinsey Scale of Sexual Behavior is accurate? 1. It described the personality characteristics that went with various sexual orientations. 2. It classified sexual behavior into seven categories. 3. It measured the level of masculinity and femininity in a large sample of Americans. 4. It categorized people as homosexual, heterosexual, or bisexual.

answer

2. It classified sexual behavior into seven categories.

question

Bill is very conscious of his attraction to other men. He realizes this may mean he is gay and realizes how his family is likely to respond to this knowledge. He is also aware that he will be on the "outside" of many social norms. Cass would describe Bill as being in which stage of identity formation? : 1. Identity acceptance 2. Identity tolerance 3. Identity confusion 4. Identity comparison

answer

4. Identity comparison

question

Which of the following was NOT a finding of the classic Bell, Weinberg, and Hammersmith study on sexual orientation? 1. Same-gender attraction plays a greater role in eventual self-identification as gay or lesbian than any particular activities with others. 2. Most gay men and lesbians have never had heterosexual experiences. 3. Parental identification appears to play no significant role in the development of sexual orientation. 4. Sexual orientation appears to be largely determined before adolescence.

answer

2. Most gay men and lesbians have never had heterosexual experiences.

question

A somewhat intriguing finding regarding same-gender orientation is that it is more common among individuals who grew up in 1. rural settings. 2. West Coast areas. 3. suburbia. 4. urban centers.

answer

4. urban centers.

question

How do modern theologians in the Judeo-Christian-Muslim religious traditions view same-gender sexual behavior? 1. They vary, with some accepting and others condemning such behavior. 2. They uniformly condemn it as did all earlier religious scholars. 3. They condemn this and any other sexual expression outside of the marital relationship. 4. They accept such behavior if it occurs in a loving relationship.

answer

1. They vary, with some accepting and others condemning such behavior.

question

Agnes describes herself as lesbian, even though she has never been sexual with either a man or a woman. Such self-identification 1. indicates a personality disorder and perhaps mental illness. 2. implies that Kinsey's Scale should contain negative numbers to accommodate individuals who are not sexually active. 3. illustrates the subtleties involved in classifying individuals by their sexual orientation. 4. suggests that all people shift their sexual orientation during their lifetime.

answer

3. illustrates the subtleties involved in classifying individuals by their sexual orientation.

question

Which of the following has NOT been a focus of biological models of homosexuality? 1. Genetic factors 2. Viral or bacterial infections 3. Anatomical differences 4. Prenatal hormonal differences

answer

2. Viral or bacterial infections

question

Most contemporary theorists and researchers perceive same-gender sexual orientation as a 1. more mature but less common form of sexual expression than heterosexuality. 2. tolerable but abnormal form of sexual expression. 3. natural form of sexual expression less prevalent than heterosexuality. 4. sign of other disturbances in the personality.

answer

3. natural form of sexual expression less prevalent than heterosexuality.

question

Which description most accurately represents the modern psychological conception of same-gender orientation? 1. An acceptable but disabling psychological condition 2. A normal variation on human sexual expression 3. A pathological condition due to faulty parental relationships 4. A rare and exotic condition that implies other personality disturbance

answer

2. A normal variation on human sexual expression

question

Since adoption of the "Don't ask, don't tell" policy for the U.S. military, 1. people were still being discharged annually from the U.S. armed forces because of their sexual orientation. 2. the number of people discharged annually from the U.S. armed forces because of their sexual orientation or behavior has decreased. 3. discrimination against gay men and lesbians has ended. 4. the treatment of gay men and lesbians has not changed.

answer

1. people were still being discharged annually from the U.S. armed forces because of their sexual orientation.

question

European studies of same-gender sexual behavior found rates 1. lower in urban centers than in rural areas. 2. higher than those found by the NHSLS study. 3. slightly lower or similar to those found by the NHSLS study. 4. higher for males than those found by the NHSLS study.

answer

3. slightly lower or similar to those found by the NHSLS study.

question

Many transsexuals question the assumption that their needs and wishes 1. represent forms of variant sexuality. 2. require psychological treatment. 3. can be fulfilled with sex reassignment. 4. are based on chromosomal disorders.

answer

2. require psychological treatment.

question

When a particular sexual activity is considered atypical or outside mainstream sexual behavior, it is referred to as 1. variant. 2. dysfunctional. 3. abnormal. 4. perverse.

answer

1. variant.

question

Whether a sexual activity should be considered a problem may depend at least in part on 1. All of these 2. cultural values. 3. social judgments. 4. the participants' reactions.

answer

1. All of these

question

Which of the following sexual aids is most likely to cause physical damage? 1. A cock ring 2. A French tickler 3. A vibrator 4. A dildo

answer

1. A cock ring

question

A majority of transvestites are 1. erotomanic individuals of either gender. 2. gay men. 3. married, heterosexual men. 4. celibate men.

answer

3. married, heterosexual men.

question

Sexually arousing activities that involve bondage, pain, or humiliation are called 1. frotteurism. 2. coprophilia. 3. sadomasochism. 4. onanism.

answer

3. sadomasochism.

question

Which of the following is NOT part of the trial period of sex reassignment? 1. Adjustment counseling and legal advice 2. Reduced sexual activity 3. Dressing as a member of the desired sex 4. Living as a member of the desired sex

answer

2. Reduced sexual activity

question

According to recent research, individuals who have more sexual fantasies tend to 1. be very shy and withdrawn in relating to others. 2. be hypersexual and carry on more than one sexual relationship at a time. 3. be relatively happy with their sexual lives and have high rates of sexual activity. 4. have few real romantic or sexual relationships.

answer

3. be relatively happy with their sexual lives and have high rates of sexual activity.

question

When Roxanne and Carl make love he puts on a device that is designed to stimulate her clitoris during intercourse. This device is called a 1. vibrator. 2. penile implant. 3. French tickler. 4. dildo.

answer

3. French tickler.

question

Larry likes to dress up in women's clothes for fun. Mitchell experiences sexual arousal when he handles or dresses up in women's clothing. These two men would be described as 1. transvestites. 2. erotophobes. 3. deviants. 4. gay.

answer

1. transvestites.

question

The condition in which sexual arousal is generated by stealing is called 1. pyromania. 2. kleptomania. 3. autogynephilia. 4. erotomania.

answer

2. kleptomania.

question

The repeating male exhibitionist experiences pleasure from 1. orgasm. 2. watching others undress or be nude. 3. shocking his victims. 4. having his victims touch him.

answer

3. shocking his victims.

question

Vibrators can be effective aids for 1. women with orgasmic difficulties. 2. women who are close to menopause. 3. men who ejaculate prematurely. 4. men who cannot fantasize.

answer

1. women with orgasmic difficulties.

question

Among the sex related behaviors that have unwilling or unwitting victims are: 1. all of these. 2. frotteurism. 3. obscene telephone calls 4. toucherism.

answer

1. all of these.

question

How does a person form a preference for a particular sexual act or way of becoming sexually aroused? 1. This is unknown at present. 2. This is determined mainly by genetic factors. 3. This comes about through observation of parents and peers. 4. This is based on that person's individual anatomy.

answer

1. This is unknown at present.

question

An important thing to remember about celibacy is that it 1. can result in paraphilic behavior. 2. may be a way to hide impotence or same-gender orientation. 3. is virtually impossible to maintain. 4. is not necessarily a sign of sexual problems.

answer

4. is not necessarily a sign of sexual problems.

question

An unusually high level of sexual desire characterizes : 1. promiscuity. 2. hypersexuality. 3. hyposexuality. 4. nymphomania.

answer

2. hypersexuality.

question

According to recent research, which of the following factors appears to have the greatest impact on which sexual behaviors people engage in? 1. The sexual behaviors that a person observes among his or her peers 2. The genetically based need for contact comfort 3. An innate sex drive that seeks expression through any unblocked channel 4. Culture and the meanings given to various sexual behaviors in that culture

answer

4. Culture and the meanings given to various sexual behaviors in that culture

question

The most prevalent theme for the sexual fantasies of both women and men is 1. having sexual contact with animals or children. 2. intimate activities such as passionate kissing or mutual masturbation. 3. forced or forceful sexual contact. 4. engaging in same-gender sexual activities.

answer

2. intimate activities such as passionate kissing or mutual masturbation.

question

Higher levels of explicitness in sexual fantasies are associated with 1. greater likelihood of sexual dysfunction. 2. childhood sexual trauma. 3. increasing levels of sexual guilt. 4. more liberal sexual attitudes.

answer

4. more liberal sexual attitudes.

question

Someone who seeks surgery to alter his or her genital anatomy and hormonal treatments to change body contours may be described as a 1. transsexual. 2. practicing transvestite. 3. fetishist. 4. person with an other-gender orientation.

answer

1. transsexual.

question

Roberta feels disgusted when she views any sexual material and generally has a negative response to any conversation or situation that is at all sexual. Roberta may be described as 1. heterosexist. 2. homophobic. 3. erotophobic. 4. perverse.

answer

3. erotophobic.

question

Neal is 35 years old and seldom masturbates. He has had intercourse twice in his adult life. He seems indifferent to stimuli that relate to sexual matters. Neal appears to be satisfied with his adjustment. Neal may be described as 1. heterosexist. 2. erotomanic. 3. satyriac. 4. hyposexual.

answer

4. hyposexual.

question

Which of the following is NOT one of the main types of sexual fantasies? 1. Exploratory 2. Impersonal 3. Paraphilic 4. Sadomasochistic

answer

3. Paraphilic

question

A person who exhibits a paraphilia 1. prefers several unusual positions for intercourse. 2. is sexually aroused by objects or situations that are not considered normative. 3. prefers sexual relations with prostitutes. 4. includes objects such as lingerie and leather in lovemaking.

answer

2. is sexually aroused by objects or situations that are not considered normative.

question

Only one biology project can win the department prize. Sarita makes extra appointments with her biology professor, Dr. Jones, to explain how "important" he and the class subject matter have become to her. She sits a little too close to Dr. Jones and wears revealing clothing. Such behavior may constitute 1. paraphilic interest focused on animals. 2. sexual assault. 3. normal sexual interest. 4. sexual harassment.

answer

4. sexual harassment.

question

Which of the following is NOT a tactic identified for obtaining sex coercively? 1. Flirting in social settings 2. Physical force and harm 3. Emotional manipulation and lies 4. Exploitation of the intoxicated

answer

1. Flirting in social settings

question

Children are most likely to be molested by 1. relatives or acquaintances. 2. strangers and distant neighbors. 3. members of other ethnic groups. 4. physicians and teachers.

answer

1. relatives or acquaintances.

question

After having a long dinner with her boss, Susan is suddenly promoted to a higher position. Her boss now insists on more "affection." Researchers have found that Susan is likely to respond with 1. self-blame for allowing this situation to develop. 2. sexual dysfunction. 3. paraphilic behavior involving masculine garments. 4. aggression toward her boss.

answer

1. self-blame for allowing this situation to develop.

question

If the men in your class are typical, they are likely to be concerned about which aspect of their bodies? 1. Level of strength 2. Degree of hairiness 3. Height 4. Weight

answer

3. Height

question

A professor hints to a student that a better grade hinges on a "more personal relationship." This type of harassment is called 1. quid pro quo harassment. 2. sexual assault. 3. third-party effects harassment. 4. relational harassment.

answer

1. quid pro quo harassment.

question

If the women in your class are typical, they are likely to be concerned about which aspect of their bodies? 1. Level of strength 2. Height 3. Weight 4. Level of flexibility

answer

3. Weight

question

Research has shown tht there is a cause and effect relationship between sexual abuse of a child and that child's sexuality. True/ False

answer

False

question

Today, it is impossible in the eyes of the law for a woman to be raped by her husband. True/False

answer

False

question

Many factors can compromise the validity of consent for sexual actitivity and lead to charges of sexual coercion or force. True/False

answer

True

question

A key issue in many problematic sexual situations is whether or not consent has been given for the sexual activity to take place. True/False

answer

True

question

One of the best approaches to ending sexual harassment is to 1. immediately report the harassing behavior to the police. 2. counter the harassing behavior with aggressive acts. 3. write a clear, specific letter to the offender about his or her behavior. 4. share specific information about the offender's behavior with friends and neighbors.

answer

3. write a clear, specific letter to the offender about his or her behavior.

question

The main difference between pornography and obscenity is that obscene material 1. focuses on the physical aspects of sexual activity. 2. may be offensive to public taste and morals. 3. is sexually arousing. 4. presents sex in the context of human emotions.

answer

2. may be offensive to public taste and morals.

question

The term rape myth refers to the 1. belief that when women refuse sex, they don't mean it. 2. idea that women were meant to serve men sexually. 3. belief that rape statistics are seriously inflated. 4. bond men form by behaving aggressively toward women.

answer

1. belief that when women refuse sex, they don't mean it.

question

NHSLS data suggests that the stereotype of strangers committing most rapes is accurate. True/ False

answer

False

question

Whether a sexual activity should be considered a problem may depend at least in part on 1. social judgments. 2. All of these 3. the participants' reactions. 4. cultural values.

answer

2. All of these

question

Maria is the only female worker in her section. Male coworkers insist on keeping pictures of nude women on the walls. They often leave sex-related cartoons and drawings on her locker. This behavior may be considered 1. paraphilic. 2. sexual abuse. 3. sexual harassment. 4. sexual addiction.

answer

3. sexual harassment.

question

According to recent reviews of studies on sexually explicit materials, do these materials arouse viewers? 1. Although men do become physically aroused when viewing these materials, women do not. 2. Both genders demonstrate very positive emotional responses. 3. Both men and women become physically aroused, but the genders differ in their emotional responses. 4. No, most individuals respond in a neutral way to such materials.

answer

3. Both men and women become physically aroused, but the genders differ in their emotional responses.

question

The sex addiction model 1. is viewed with skepticism and has strong opponents among sexologists. 2. is almost universally accepted as an explanation for all compulsive sexual behaviors. 3. seems to apply to the compulsive sexual behavior of women but not that of men. 4. is widely accepted as an explanation for a small subset of compulsive sexual behaviors.

answer

1. is viewed with skepticism and has strong opponents among sexologists.

question

How did NHSLS researchers explain the great discrepancy between the small number of men who reported forcing a woman to have sex and the large number of women who reported being forced to have sex? 1. Women tend to exaggerate the frequency of forced sex to protect their reputations. 2. Men who had forced women did not perceive their behavior as coercive. 3. Women are less interested in sex and may experience what they do as forced. 4. Men are more likely to lie on such surveys because they fear prosecution.

answer

2. Men who had forced women did not perceive their behavior as coercive.

question

Which of the following is NOT a mythical performance standard for women? 1. Successful sex requires initiating the sexual encounter. 2. Successful sex requires intense arousal and quick readiness for intercourse. 3. Successful sex requires more than one orgasm. 4. Successful sex requires reaching orgasm without difficulty.

answer

1. Successful sex requires initiating the sexual encounter.

question

There are well-accepted definitions of sexual dysfunction that include 1. All of these 2. the idea that a sexual dysfunction exists if a sex-related difficulty leads a person to seek professional help. 3. the requirement that the condition must cause enough distress for the person to consider it a problem. 4. the idea that a person may have a dysfunction without realizing it or being upset by it.

answer

1. All of these

question

Hepatitis B is almost always transmitted by 1. contact with contaminated wet surfaces. 2. food contaminated with fecal material. 3. contaminated clothing and sneezes. 4. sexual contact.

answer

4. sexual contact.

question

Which statement most accurately describes the history of syphilis in the U. S? 1. Since antibiotics became easily accessible, rates of syphilis have gradually increased. 2. Syphilis has consistently remained the most commonly reported STD. 3. Beginning in 1900, it has gradually disappeared. 4. In 2000, the rate of syphilis infection had dropped to the lowest rate ever recorded, but has since increased.

answer

4. In 2000, the rate of syphilis infection had dropped to the lowest rate ever recorded, but has since increased.

question

A substantial proportion of women and men with gonorrhea are also infected with 1. scabies. 2. chlamydia. 3. syphilis. 4. herpes.

answer

2. chlamydia.

question

Which of the following is the most accurate predictor of who is likely to contract an STD? 1. Number of sex partners 2. Sexual orientation 3. General health habits 4. Level of formal education

answer

1. Number of sex partners

question

Which of the following questions reflects an ongoing issue in sex therapy? 1. When are sex therapists behaving unethically in inquiring about sexual behaviors? 2. When should a particular pattern of sexual response be labeled a disorder or dysfunction? 3. How can enough sex therapists be trained to treat all those with sexual problems? 4. How can therapists get more people to recognize they have a disorder or dysfunction?

answer

2. When should a particular pattern of sexual response be labeled a disorder or dysfunction?

question

The traditional term frigidity has been replaced with the term 1. hypoactive sexual desire disorder. 2. dyspareunia. 3. female sexual arousal disorder. 4. sexual aversion disorder.

answer

3. female sexual arousal disorder.

question

After unprotected sex, Rhonda believes there is a possibility she was exposed to HIV and goes for an HIV test. The result is negative. She should 1. notify all her previous sexual partners 2. be aware that her immune system is now compromised. 3. feel safe to continue unprotected sexual activities. 4. have a second test within 6 months.

answer

4. have a second test within 6 months.

question

Which of the following is NOT a mythical performance standard for men? 1. The longer ejaculation can be postponed, the better a sexual partner the man is. 2. An erect penis is necessary for sexual pleasure. 3. Orgasm must be reached without difficulty and is the ultimate pleasure. 4. A female partner must be brought to the point of multiple orgasms.

answer

4. A female partner must be brought to the point of multiple orgasms.

question

Vaginismus is considered a(n) 1. orgasmic disorder. 2. arousal disorder. 3. sexual pain disorder. 4. None of these

answer

3. sexual pain disorder.

question

Maria notices intense itching in the genital area. There is some discharge with a noticeable odor. Most likely her health care provider will diagnose this as 1. some type of vulvovaginitis. 2. herpes. 3. chlamydia. 4. an NGU.

answer

1. some type of vulvovaginitis.

question

How is it that some syphilitic patients get to the tertiary stage without treatment? 1. After each stage, symptoms seem to disappear completely, even without attention. 2. Since syphilis is so rare, many are not aware of its signs. 3. Primary and secondary stage symptoms are so subtle that many do not notice them. 4. Because infection is possible without sexual contact, many do not know they are infected.

answer

1. After each stage, symptoms seem to disappear completely, even without attention.

question

A clue that a sexual dysfunction may be caused by physical factors is that 1. the person and his or her partner are both concerned. 2. sexual functioning is not central to the self-concept of the person. 3. the problem began only after a long period of good functioning. 4. the difficulty involves pain.

answer

3. the problem began only after a long period of good functioning.

question

In regard to STDs, the NHSLS found that 1. transmission of STDs is twice as easy from a male to a female as it is from a female to a male. 2. women with the fewest sexual partners were more likely to contract any STD. 3. men were more likely to have had an STD than women were. 4. men tended to suffer more serious physical consequences from STDs.

answer

1. transmission of STDs is twice as easy from a male to a female as it is from a female to a male.

question

The STD that causes urethral pain and discharge among males is called 1. HPV. 2. herpes. 3. gonorrhea. 4. syphilis.

answer

3. gonorrhea.

question

The chronic asymptomatic phase of HIV infection is 1. the time during which the virus is most able to infect others 2. a time during which the virus is dormant and cannot be transmitted to others. 3. almost always very brief. 4. a time during which an infected person may still transmit HIV to others.

answer

4. a time during which an infected person may still transmit HIV to others.

question

In the U. S., the most commonly reported viral STD is : 1. herpes. 2. gonorrhea. 3. syphilis. 4. HPV.

answer

4. HPV.

question

Which of the following is NOT a potential consequence of chlamydia in women? 1. Infertility 2. Breast cancer 3. PID 4. Ectopic pregnancy

answer

2. Breast cancer

question

One current definition of premature ejaculation is ejaculation that 1. takes place after fewer than 10 pelvic thrusts. 2. persistently and recurrently occurs too rapidly for the man and his partner's enjoyment. 3. occurs before his partner reaches orgasm. 4. occurs in fewer than 30 minutes after penetration.

answer

2. persistently and recurrently occurs too rapidly for the man and his partner's enjoyment.

question

According to the NHSLS, among women who reported that they did not have orgasms, 1. up to three-fourths were actively seeking sex therapy. 2. a majority believed that there was something physically wrong with them. 3. up to one-third did not consider this a problem and found sex satisfying. 4. almost one-half blamed their husbands and lovers.

answer

3. up to one-third did not consider this a problem and found sex satisfying.

question

In recent years, the fight against STDs in the U. S. has been 1. complicated by the development of both new viral diseases and antibiotic-resistant strains of STDs. 2. largely halted by religious groups arguing for abstinence. 3. largely won, thanks to the development of vaccines. 4. largely won, thanks to antibiotics.

answer

1. complicated by the development of both new viral diseases and antibiotic-resistant strains of STDs.

question

One of the complaints very frequently brought to sex therapists is 1. inability to reach orgasm. 2. concern over fetishistic interests of a partner. 3. partner discrepancies in level of sexual desire. 4. vaginismus.

answer

3. partner discrepancies in level of sexual desire.

question

An interesting historical fact about sexually transmitted diseases is that they were 1. usually associated with excessive masturbation. 2. often completely treatable. 3. usually attributed to diet and poor health habits. 4. often blamed on some outside national or ethnic group.

answer

4. often blamed on some outside national or ethnic group.

question

Outbreaks of genital herpes sores are associated with 1. not wearing absorbent fiber underwear. 2. stress, illness, or exhaustion. 3. hot weather. 4. NSUs.

answer

2. stress, illness, or exhaustion.

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