Chapter 73: Care of Transgender Patients

Chapter 73: Care of Transgender Patients

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A nurse is reviewing the chart of a new client in the family medicine clinic and notes the client is identified as “George Smith.” The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?
   1. Apologize and declare confusion about the client.
   2. Ask Mrs. Smith where her husband is right now.
   3. Ask the client about preferred forms of address.
   4. Explain that the chart must contain an error.

ANS:   C

The nurse may encounter transgender clients whose outward appearance does not match their demographic data. In this case, the nurse should greet the client and ask the client to explain his or her preferred forms of address. Lengthy apologies can often create embarrassment. The nurse should not assume the client is not present in the room. The chart may or may not contain errors, but that is not related to determining how the client prefers to be addressed.

DIF:     Understanding/Comprehension         REF: 1523

KEY:   LGBTQ| therapeutic communication

MSC:   Integrated Process: Nursing Process: Assessment

NOT:   Client Needs Category: Psychosocial Integrity

2. A nurse is providing health teaching to a middle-aged male-to-female (MtF) client who has undergone gender reassignment surgery. What information is most important to this client?
   1. “Be sure to have an annual prostate examination.”
   2. “Continue your normal health screenings.”
   3. “Try to avoid being around people who are ill.”
   4. “You should have an annual flu vaccination.”

ANS:   A

The MtF client retains the prostate, so annual screening examinations for prostate cancer remain important. The other statements are good general health teaching ideas for any client.

DIF:     Applying/Application                         REF: 1523                   KEY: LGBTQ| health screening| male reproductive problems  MSC:               Integrated Process: Teaching/Learning                      NOT:   Client Needs Category: Health Promotion and Maintenance

3. A transgender client is taking transdermal estrogen (Climara). What assessment finding does the nurse report immediately to the provider?
   1. Breast tenderness
   2. Headaches
   3. Red, swollen calf
   4. Swollen ankles

ANS:           C

A red, swollen calf could be a manifestation of a deep vein thrombosis, a known side effect of estrogen. The nurse reports this finding immediately. The other manifestations are also side effects of estrogen, but do not need to be reported as a priority.

DIF:            Applying/Application                         REF:    1524                 KEY: LGBTQ| venous thromboembolism| estrogens| nursing assessment  MSC:                        Integrated Process: Communication and Documentation  NOT:         Client Needs Category: Physiological Integrity: Pharmacological and Parenteral Therapies

4. A transgender client taking spironolactone (Aldactone) is in the internal medicine clinic reporting heart palpitations. What action by the nurse takes priority?
   1. Draw blood to test serum potassium.
   2. Have the client lie down.
   3. Obtain a STAT electrocardiogram (ECG).
   4. Take a set of vital signs.

ANS:           C

Spironolactone is a potassium-sparing diuretic, and hyperkalemia can cause cardiac dysrhythmias. The nurse’s priority is to obtain an ECG, then to facilitate a serum potassium level being drawn. Having the client lie down and obtaining vital signs are also important care measures, but do not take priority.

DIF:            Applying/Application                         REF:    1525

KEY:          LGBTQ| electrolyte imbalances

MSC:          Integrated Process: Nursing Process: Implementation           NOT: Client Needs Category: Safe and Effective Care Environment: Management of Care