Chapter 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias
Halter: Varcarolis’ Foundations of Psychiatric Mental Health
Nursing: A Clinical
... [Show More] Approach, 8th Edition
MULTIPLE CHOICE
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
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)
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 self-awareness
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 toviewing 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 [Show Less]