According to the PLISSIT model, the nurse should begin with which action?

• A. Asking the client's permission to discuss sexuality
• B. Assessing for physiologic problems
• C. Addressing the client's psychosocial status
• D. Conducting a preliminary assessment

Answer: (A)

The first action in the PLISSIT approach is to ask the patient for permission to discuss sexuality. This step centers on consent and respect, creating a safe, comfortable space so the patient feels in control of whether and how the topic is explored. Once permission is granted, the nurse can proceed with the next steps—providing limited information, offering specific suggestions, and, if needed, referring for intensive therapy. Without obtaining permission, opening up sexual health topics can feel intrusive and hinder open communication. The other actions—assessing physiologic problems, addressing psychosocial status, or doing a general preliminary assessment—may be important later, but they don’t establish the patient’s willingness to engage in this discussion first.