Chapter 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

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1. A new staff nurse tells the clinical nurse specialist, ―I am unsure about my role when patients bring up sexual problems.‖ The clinical nurse specialist should give clarification by saying, �... ��All nurses a. qualify as sexual counselors. Nurses have knowledge about the biopsychosocial aspects of sexuality throughout the life cycle.‖ b. should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths.‖ c. should defer questions about sex to other health care professionals because of their limited knowledge of sexuality.‖ d. who are interested in sexual dysfunction can provide sex therapy for individuals and couples.‖ ANS: B testbanks_and_xanax The basic education of nurses provides information sufficient to qualify the generalist to assess for sexual dysfunction and perform health teaching. Taking a detailed sexual history and providing sex therapy requires additional training in sex education and counseling. Nurses with basic education are not qualified to be sexual counselors. Additional education is necessary. A registered nurse may provide basic information about sexual function, but complex questions may require referral. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-2, 3, 20, 21 TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 2. A nurse is performing an assessment for a 59-year-old man with a long history of hypertension. What is the rationale for including questions about prescribed medications and their effects on sexual function in the assessment? a. Sexual dysfunction may result from use of prescription medications for management of hypertension. b. Such questions are an indirect way of learning about the patient‘s medication adherence. c. These questions ease the transition to questions about sexual practices in general. d. Sexual dysfunction can cause stress and contribute to increased blood pressure. ANS: A Some of the drugs used to treat hypertension can interfere with normal sexual functioning and lead to sexual disorders. Hypertension itself can lead to acquired erectile dysfunction. It would not be appropriate or necessary to use such inquiries as a lead-in to other sexual health topics. Sexual dysfunction, while stressful, does not cause hypertension. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-15, 52 (Table 20-1) | Page 20-57 (Table 20-3) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 3. An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult says, ―I haven‘t had much interest in sex since my heart attack. I finished my rehabilitation program, but having sex strains my heart. I don‘t know if my heart is strong enough.‖ Which nursing diagnosis applies? a. Deficient knowledge related to faulty perception of health status b. Disturbed self-concept related to required lifestyle changes c. Disturbed body image related to treatment side effects d. Sexual dysfunction related to self-esteem disturbance ANS: A Patients who have had a myocardial infarction often believe sexual intercourse will cause another heart attack. The patient has completed the rehabilitation, but education is needed regarding sexual activity. These patients should receive information about when sexual activity may begin, positions that conserve energy, and so forth. The scenario does not suggest self-concept or body image disturbance. PTS: 1 DIF: Cognitive Level: Apply (Application) testbanks_and_xanax REF: Pages 20-18, 19 TOP: Nursing Process: Diagnosis/Analysis MSC: Client Needs: Health Promotion and Maintenance 4. Which nursing action should occur first regarding a patient who has a problem of sexual dysfunction or sexual disorder? The nurse should a. develop an understanding of human sexual response. b. assess the patient‘s sexual functioning and needs. c. acquire knowledge of the patient‘s sexual roles. d. clarify own personal values about sexuality. ANS: D Before one can be helpful to patients with sexual dysfunctions or disorders, the nurse must be aware of his or her own feelings and values about sex and sexuality. Nurses must keep their personal beliefs separate from their patient care in order to remain objective, professional, and effective. Nurses must be comfortable with the idea that patients have a right to their own values and must avoid criticism and censure. The other options are indicated as well, but selfawareness must precede them to provide the best care. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 20-17, 18 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 5. A patient tells the nurse that his sexual functioning is normal when his wife wears short, red camisole-style nightgowns. He states, ―Without the red teddies, I am not interested in sex.‖ The nurse can assess this as consistent with a. exhibitionism. b. voyeurism. c. frotteurism. d. fetishism. ANS: D To be sexually satisfied, a person with a sexual fetish finds it necessary to have some external object present, in fantasy or in reality. Frotteurism involves deriving sexual pleasure from rubbing against others surreptitiously. Exhibitionism is the intentional display of the genitalia in a public place. Voyeurism refers to viewing others in intimate situations. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-33, 34 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 6. While performing an assessment, the nurse says to a patient, ―While growing up, most of us heard some half-truths about sexual matters that continue to puzzle us as adults. Do any come to your mind now?‖ The purpose of this question is to a. identify areas of sexual dysfunction for treatment. b. determine possible homosexual urges. c. introduce the topic of masturbation. d. identify sexual misinformation. testbanks_and_xanax ANS: D Misinformation about normal sex and sexuality is common. Lack of knowledge may affect an individual‘s sexual adjustment. Once myths have been identified, the nurse can give information to dispel the myth. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 20-16, 17, 55 (Table 20-2) TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 7. A woman tells the nurse, ―My partner is frustrated with me. I don‘t have any natural lubrication when we have sex.‖ What type of sexual disorder is evident? a. Genito-pelvic pain/penetration disorder b. Female sexual interest/arousal disorder c. Hypoactive sexual desire disorder d. Female orgasmic disorder ANS: B One feature of female sexual interest/arousal disorder relates to inability to maintain physiological requirements for intercourse. For women, this includes problems with lubrication and swelling. The patient‘s description does not meet criteria for diagnoses in the distracters. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-10, 61 (Table 20-5), 65 (Box 20-1) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 8. The male manager of a health club placed a hidden video camera in the women‘s locker room and recorded several women as they showered and dressed. The disorder most likely represented by this behavior is a. homosexuality. b. exhibitionism. c. pedophilia. d. voyeurism. ANS: D Voyeurism is achieving sexual pleasure through the viewing of others in intimate situations, such as undressing, bathing, or having sexual relations. A homosexual individual would be interested in watching members of the same sex, and homosexuality is not typically associated with voyeurism. Exhibitionists are interested in exposing their genitals to others. Pedophiles seek sexual contact with children. [Show More]

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