Chapter 21: Issues Related to Human Sexuality and Gender Dysphoria

Chapter 21: Issues Related to Human Sexuality and Gender Dysphoria

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

Multiple Choice

Identify the choice that best completes the statement or answers the question.

 

____     1.   A 52-year-old client states, “My husband is upset because I don’t enjoy sex as much as I used to.” Which priority client data should a nurse initially collect?

1.	History of hysterectomy
2.	Date of last menstrual cycle
3.	Use of birth control methods
4.	History of thought disorder

 

 

____     2.   In the course of an assessment interview, a female client reveals a history of bisexual orientation. Which action should the nurse initially implement when working with this client?

1.	Self-assess personal attitudes toward homosexuality.
2.	Review client’s possible childhood sexual abuse history.
3.	Encourage discussion of aversion to heterosexual relationships.
4.	Explore client’s family history of homosexuality.

 

 

____     3.   A widower reports a fear of intimacy because of an inability to achieve and sustain an erection. He has become isolative, has difficulty sleeping, and has lost weight over the past year. Which nursing diagnosis should be a priority for this client?

1.	Risk for situational low self-esteem AEB inability to achieve an erection
2.	Sexual dysfunction R/T dysfunctional grieving AEB inability to experience orgasm
3.	Social isolation R/T low self-esteem AEB refusing to engage in dating activities
4.	Disturbed body image R/T penile flaccidity AEB client statements

 

 

____     4.   A nurse is assessing a client diagnosed with pedophilic disorder. What would differentiate this sexual disorder from a sexual dysfunction?

1.	Symptoms of sexual dysfunction include inappropriate sexual behaviors, whereas symptoms of a sexual disorder include impairment in normal sexual response.
2.	Symptoms of a sexual disorder include inappropriate sexual behaviors, whereas symptoms of sexual dysfunction include impairment in normal sexual response.
3.	Sexual dysfunction can be caused by increased levels of circulating androgens, whereas levels of circulating androgens do not affect sexual disorders.
4.	Sexual disorders can be caused by decreased levels of circulating androgens, whereas levels of circulating androgens do not affect sexual dysfunction.

 

 

____     5.   A female client on an inpatient unit enters the common area for visiting hours dressed in a see-through blouse. Which intervention should be a nurse’s first priority?

1.	Discuss with the client the inappropriateness of her attire.
2.	Avoid addressing her attention-seeking behavior.
3.	Lead the client back to her room and assist her with a change of clothing.
4.	Restrict client to room until visiting hours are over.

 

MULTIPLE CHOICE

 

1. ANS:  2

Chapter: Chapter 21, Issues Related to Human Sexuality and Gender Dysphoria

Objective: Identify appropriate nursing interventions for clients with sexual dysfunctions and gender dysphoria in children.

Page: 534

Heading: Adulthood > The Middle Years—40 to 65

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Sexuality

Difficulty: Moderate

 

	Feedback
1	History of hysterectomy is not assessment data that the nurse should initially collect.
2	The nurse should assess the client’s last menstrual cycle to determine if the client is experiencing the onset of menopause. Menopause usually occurs around the age of 50. The decrease in estrogen can result in multiple symptoms, including a decrease in biological drives and sexual activity.
3	Use of birth control methods is not assessment data that the nurse should initially collect.
4	History of thought disorders are not assessment data that the nurse should initially collect.

 

 

PTS:   1                    CON:  Sexuality

 

2. ANS:  1

Chapter: Chapter 21, Issues Related to Human Sexuality and Gender Dysphoria

Objective: Discuss variations in sexual orientation.

Page: 560–561

Heading: Homosexuality > Special Concerns

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Application [Applying]

Concept: Sexuality

Difficulty: Moderate

 

	Feedback
1	The nurse should initially self-assess personal attitudes toward homosexuality. The nurse must be able to recognize when negative feelings compromise care. Unconditional acceptance of each individual is an essential component of compassionate nursing.
2	Once the nurse has assessed personal attitudes, the nurse can review the client’s possible childhood sexual abuse history.
3	Once the nurse has assessed personal attitudes, the nurse can encourage discussion of aversion to heterosexual relationships.
4	Once the nurse has assessed personal attitudes, the nurse can explore the client’s family history of homosexuality.

 

 

PTS:   1                    CON:  Sexuality

 

3. ANS:  2

Chapter: Chapter 21, Issues Related to Human Sexuality and Gender Dysphoria

Objective: Formulate nursing diagnoses and goals of care for clients with sexual dysfunctions and gender dysphoria in children.

Page: 544

Heading: Diagnosis and Outcome Identification

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis (Analyzing)

Concept: Sexuality

Difficulty: Moderate

 

	Feedback
1	Risk for situational low self-esteem AEB inability to achieve an erection is not the priority diagnosis.
2	The nurse should prioritize the nursing diagnosis sexual dysfunction R/T dysfunctional grieving AEB inability to experience orgasm. The nurse should assess the client’s mood and level of energy, because depression and fatigue can decrease desire for participation in sexual activity.
3	Social isolation R/T low self-esteem AEB refusing to engage in dating activities is not the priority diagnosis.
4	Disturbed body image R/T penile flaccidity AEB client statements is not the priority diagnosis.

 

 

PTS:   1                    CON:  Sexuality

 

4. ANS:  2

Chapter: Chapter 21, Issues Related to Human Sexuality and Gender Dysphoria

Objective: Identify various types of paraphilic and sexual dysfunction disorders and gender dysphoria.

Page: 535–537

Heading: Types of Paraphilic Disorders > Pedophilic Disorder, Role of the Nurse

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Sexuality

Difficulty: Moderate

 

	Feedback
1	Sexual dysfunction involves impairment in normal sexual response.
2	The nurse should identify that pedophilic disorder is a sexual disorder in which individuals partake in inappropriate sexual behaviors. Pedophilic disorder involves having sexual urges, behaviors, or sexually arousing fantasies involving sexual activity with a prepubescent child.
3	Sexual dysfunction is not caused by increased levels of circulating androgens.
4	Sexual disorders are not caused by decreased levels of circulating androgens.

 

 

PTS:   1                    CON:  Sexuality

 

5. ANS:  3

Chapter: Chapter 21, Issues Related to Human Sexuality and Gender Dysphoria

Objective: Identify appropriate nursing interventions for clients with sexual dysfunctions and gender dysphoria in children.

Page: 545–546

Heading: Table 21-1 Care Plan for the Client with a Sexual Disorder

Integrated Processes: Nursing Process

Client Need: Safe and Effective Care Environment: Management of Care

Cognitive Level: Analysis [Analyzing]

Concept: Sexuality

Difficulty: Moderate

 

	Feedback
1	Discussing the inappropriate attire would not be the nurse’s first priority; having the client change clothing would be.
2	The nurse should address this type of behavior immediately.
3	The most appropriate intervention by the nurse is to lead the client back to her room and assist her with a change of clothing. The client could be exhibiting symptoms of exhibitionistic disorder, which is characterized by urges to expose oneself to unsuspecting strangers.
4	Restricting the client to her room is not therapeutic and may cause behaviors to worsen.

 

 

PTS:   1                    CON:  Sexuality