Chapter 25: Sexual Responses and Sexual Disorders My Nursing Test Banks

Chapter 25: Sexual Responses and Sexual Disorders

Test Bank

MULTIPLE CHOICE

1. Parents are upset after learning that their child is homosexual. They ask the nurse, What causes homosexuality; was it something we did? The nurse responds best when stating:

a.

The cause of homosexuality has not been determined as of yet.

b.

Its thought that homosexuality is transmitted via the X chromosome.

c.

Many people consider homosexuality to be an expression of normal sexual behavior.

d.

You sound as though you are expressing concern about both your child and yourself.

ANS: A

Giving a direct answer is appropriate because the patient is seeking information. To mention a possible genetic origin may cause the parent to needlessly feel responsible. Saying that homosexuality is a normal expression of sexual behavior denies the parents right to be distressed. Suggesting that the patient is concerned for self may be considered challenging.

DIF: Cognitive Level: Application REF: Text Page: 502

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

2. A person states, I feel as though Im really a woman trapped in this male body. This type of statement is characteristically expressed by someone who is a:

a.

transsexual.

b.

transvestite.

c.

pedophile.

d.

homosexual.

ANS: A

A transsexual is a person who is anatomically a male or female but who expresses strong conviction that he or she has the mind and feelings of the opposite gender.

DIF: Cognitive Level: Comprehension REF: Text Page: 503

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

3. A nurse requests that a patient assignment be changed, saying, I learned in school that homosexuality is not an illness and I want to be therapeutic, but every time I see my patient with a same-sex partner, I think its a sickness! The nurse is experiencing which stage of the self-awareness process?

a.

Anger

b.

Anxiety

c.

Choosing values

d.

Cognitive dissonance

ANS: D

Cognitive dissonance arises when two opposing beliefs exist at the same time.

DIF: Cognitive Level: Comprehension REF: Text Pages: 500-501

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

4. A nurse shares with a mentor, When my patient brought up the subject of resuming sexual relations after surgery, I felt flustered. While I realized I wasnt letting the patient express concerns, I couldnt stop monopolizing the conversation. The nurse describes experiencing the stage of the self-awareness process called:

a.

anger.

b.

action.

c.

anxiety.

d.

cognitive dissonance.

ANS: C

In the stage of anxiety, the nurse may exhibit behaviors that hinder the discussion of sexual issues, such as talking too much, failing to listen, and being preoccupied with facts rather than feelings.

DIF: Cognitive Level: Comprehension REF: Text Page: 501

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

5. A patient is hospitalized for an acute episode of schizophrenia. A nurse finds the patient in the lounge nude and telling everyone, I am the body beautiful. The most appropriate intervention for the nurse would be to:

a.

tell the patient to put on clothes immediately and to not undress in public again.

b.

take the patient back to the assigned room and then assist the patient with getting appropriately dressed.

c.

ignore the behavior and share with the other patients that the patient has no control over it.

d.

seclude the patient until control can be regained and clearly define why the behavior is unacceptable.

ANS: B

The sexual expression of patients with psychiatric illness may be inappropriate and, at times, intrusive. The patient may not be able to understand or control sexual thoughts or impulses. Nursing intervention should protect the patient from the consequences of poor judgment whenever possible and should be achieved in a neutral, nonjudgmental manner.

DIF: Cognitive Level: Application REF: Text Page: 505

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

6. A patient is seeking help after being diagnosed with hypertension. A nurse plans to include questions about sexual health in the assessment. Which question would be most effective to introduce this topic?

a.

Which elements of sexual dysfunction have you noticed since your diagnosis of hypertension?

b.

I assume your hypertension hasnt caused you any significant problems with sex, has it?

c.

How are you and your partner getting along sexually since youve developed hypertension?

d.

Can you identify any changes in your sexual activity since you learned about your hypertension?

ANS: D

This open-ended question is more sensitive than the other answers and is worded so as to make the patient more comfortable in answering, encouraging the patient to share information.

DIF: Cognitive Level: Application REF: Text Page: 502

TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

7. A patient hospitalized for depression will be discharged tomorrow. The patient asks a nurse, Could the two of us meet for coffee away from the hospital sometime? The most therapeutic response by the nurse would be:

a.

That sounds nice, but Im already in a romantic relationship with someone.

b.

The hospital has a policy that does not allow professional staff to date patients.

c.

I guess there would be no harm in meeting for coffee, if we know in advance that were meeting just as friends.

d.

Weve developed a positive working relationship, and meeting socially would have a negative impact on that relationship.

ANS: D

Termination is a time for evaluating progress and bidding farewell. Patients who view their nurses in a positive fashion are often reluctant to terminate and seek to continue the relationship on a social basis after discharge. Helping the patient clarify the therapeutic aspect of the nursing role is appropriate.

DIF: Cognitive Level: Application REF: Text Pages: 517-518

TOP: Nursing Process: Implementation

MSC: NCLEX: Safe, Effective Care Environment: Management of Care

8. A patient being treated for cellulitis tells a nurse, I feel like you and I should get romantic tonight. What do you say to closing the door and crawling into bed with me? The nurse should respond by saying:

a.

Stop joking around. Youve got to be kidding.

b.

Now that youve gotten my attention, tell me what you really need.

c.

Sex is not part of our relationship. Your comment makes me uncomfortable.

d.

I wonder what I did to make you think I would be willing to have sex with you.

ANS: C

When patients behave seductively toward nurses, it is appropriate to set limits firmly and matter-of-factly.

DIF: Cognitive Level: Application REF: Text Page: 512

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

9. A couple come to the clinic for treatment of sexual dysfunction. A therapist obtains a detailed sexual history and decides to employ the Masters and Johnson model of therapy. The nurse expects that treatment planning will include:

a.

examination of performance failures.

b.

enhancing mutual feelings of warmth.

c.

exploring the couples early sexual experiences.

d.

delving into the early growth and development of each person.

ANS: B

Masters and Johnson believe that attitudes and ignorance are responsible for most sexual dysfunction. Their therapeutic model emphasizes education about sexual function, alleviation of performance anxiety, and an increase in warm, comfortable feelings between partners. There is no attempt to employ the uncovering used in psychoanalytical treatment.

DIF: Cognitive Level: Comprehension REF: Text Page: 516

TOP: Nursing Process: Planning MSC: NCLEX: Psychosocial Integrity

10. What factor is most important during evaluation of effectiveness of sexual counseling or intervention?

a.

Patient satisfaction with treatment

b.

Patient reduction in use of fantasy

c.

Nursing involvement in forming the sex education plan

d.

Patient agreement with the moral norms of the community

ANS: A

Evaluation factors include patient sense of well-being, functioning ability, and satisfaction with treatment.

DIF: Cognitive Level: Comprehension REF: Text Pages: 517-518

TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity

11. A nurse assesses a patient who reports that she is unable to have intercourse because of involuntary contractions at the vaginal opening. The nurse can correctly assess this as:

a.

vaginismus.

b.

dyspareunia.

c.

arousal disorder.

d.

orgasmic dysfunction.

ANS: A

Vaginismus is defined as recurrent or persistent involuntary spasm of the musculature of the outer third of the vagina that interferes with coitus.

DIF: Cognitive Level: Comprehension REF: Text Page: 503 | Text Page: 509

TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity: Physiological Adaptation

12. Which nursing diagnosis could be applied to both a patient who is upset that she has developed vaginismus associated with fear of pregnancy as well as a patient with diabetes who is concerned that he cannot attain an erection?

a.

Sexual dysfunction

b.

Sexual arousal disorder

c.

Sexual aversion disorder

d.

Ineffective sexuality pattern

ANS: A

Sexual dysfunction is a state in which an individual expresses concern about his or her sexuality. This diagnosis would be equally applicable to either of the patients described above.

DIF: Cognitive Level: Application REF: Text Page: 503

TOP: Nursing Process: Diagnosis|Nursing Process: Application

MSC: NCLEX: Psychosocial Integrity

13. A nurse consults with local elementary and secondary school teachers about implementing strategies to reinforce the concept of say no to unwanted sexual advances. The most helpful method the nurse can suggest is:

a.

pretesting for accurate sexual knowledge.

b.

explaining why saying no is appropriate for teens.

c.

role playing assertive behavior in potentially difficult sexual situations.

d.

brainstorming examples of behaviors that will promote good sexual health.

ANS: C

Understanding that one should say no is much simpler than saying no when under pressure. A sex education program must give students tools with which to make appropriate decisions and the behavioral skills necessary to implement the decisions. Role playing assertive ways of saying no is the most effective behaviorally focused intervention listed.

DIF: Cognitive Level: Application REF: Text Page: 511

TOP: Nursing Process: Planning MSC: NCLEX: Health Promotion and Maintenance

14. Which statement made by a patient shows a correct understanding of human sexuality?

a.

Oral intercourse is dangerous.

b.

Sex during menstruation should be avoided.

c.

Advanced age is not by itself a deterrent to sexual function.

d.

Alcohol ingestion enhances sexual pleasure and performance.

ANS: C

Sexually, men and women in good health can function effectively throughout the life span. The other answers are sexual myths that the nurse should address.

DIF: Cognitive Level: Comprehension REF: Text Page: 510

TOP: Nursing Process: Evaluation MSC: NCLEX: Psychosocial Integrity

15. A nurse caring for an attractive patient of similar age and background begins fantasizing about having a social and sexual relationship with the patient. The most effective means of dealing with these feelings is to:

a.

make a personal promise to not act on the feelings.

b.

limit contact with the patient to include only care.

c.

ask to change patient assignments immediately.

d.

seek advice from an experienced peer.

ANS: D

Sexual attraction and fantasy are part of the human experience. Nurses are not immune. Nurses, however, must recognize and deal appropriately with the feelings or risk interference with the quality of care. The feelings should not be denied, nor should they be tested or shared with the patient. It is the nurses responsibility to preserve professional boundaries. Consultation is a constructive way of dealing with the situation.

DIF: Cognitive Level: Application REF: Text Page: 511

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

16. A patient with a new colostomy tells a nurse, This surgery is the end of my sex life. This statement should lead the nurse to take the initial step of:

a.

making a referral to an ostomy self-help group.

b.

bringing the patients partner into the discussion.

c.

helping the patient fully express fears and feelings.

d.

reframing the effect of illness on the patients sexual functioning.

ANS: C

Exploration of fears and feelings should be the initial intervention after the patients statement of concern. Each of the other interventions might be appropriate at a later time.

DIF: Cognitive Level: Application REF: Text Pages: 512-513

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

17. What is the rationale for seeking information about the effects of prescribed medications on a patients sexual function?

a.

Sexual dysfunction may result from use of prescription medications.

b.

The question eases the transition to questioning about sexual practices.

c.

Patients are more comfortable talking about medications than about sex.

d.

The question provides an opening to question about nonprescription drug use.

ANS: A

A nursing history should include questions about sexual health. The side effects of several groups of drugs include impotence or delayed ejaculation in men and diminished responsiveness in women.

DIF: Cognitive Level: Comprehension REF: Text Page: 505

TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

18. Which classification of drugs has the greatest potential for causing sexual dysfunction?

a.

Diuretics

b.

Antihypertensives

c.

Appetite suppressants

d.

Gastrointestinal (GI) antiinflammatory agents

ANS: B

Antihypertensive medications, antihistamines, anticholinergics, chemotherapeutic agents, and antiseizure drugs can cause reduced sexual desire and/or orgasmic disorders in both men and women. The other drug classes listed are not known for these types of effects.

DIF: Cognitive Level: Comprehension REF: Text Page: 505

TOP: Nursing Process: Assessment

MSC: NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

19. When a patient tells a nurse, I think Im impotent, which response by the nurse would be most therapeutic?

a.

That must be very scary for you.

b.

How is your overall health?

c.

What medications are you currently taking?

d.

Please tell me what you mean by impotent.

ANS: D

Validating terminology is a vital first step. After the nurse understands the patients complaint, further assessment can take place.

DIF: Cognitive Level: Application REF: Text Page: 502

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

20. The best expected outcome for a patient with maladaptive sexual response is, The patient will

a.

identify sexual questions and problems.

b.

implement one new behavior to improve sexual functioning.

c.

state comfort and satisfaction with gender identity and sexual orientation.

d.

achieve a mutually acceptable level of sexual response with a consenting partner.

ANS: D

An expected outcome is a broad statement relating to resolution of maladaptive sexual response. The remaining options are more circumscribed and are considered short-term goals.

DIF: Cognitive Level: Application REF: Text Page: 499

TOP: Nursing Process: Outcome Identification

MSC: NCLEX: Psychosocial Integrity

21. A patient with a sexual response disorder reports hypersexuality. During the interview, a nurse should inquire about a history of which psychiatric disorder?

a.

Mania

b.

Depression

c.

Personality disorder

d.

Obsessive-compulsive disorder

ANS: A

Hypersexuality may be the first symptom of a manic episode. In depression, sexuality responses tend to be decreased. There are no specific patterns of altered sexuality associated with personality disorders or obsessive-compulsive disorder.

DIF: Cognitive Level: Application REF: Text Page: 505

TOP: Nursing Process: Assessment MSC: NCLEX: Psychosocial Integrity

22. A couple reports having rare-to-occasional variations in their sexual response patterns. The nurse should conclude that this couple has:

a.

no medically diagnosed health problem.

b.

behaviors in accordance with sexual dysfunction.

c.

engaged in sexual perversion or deviations regularly.

d.

at least one partner who experiences a gender identity disorder.

ANS: A

Many people who have transient variations in sexual response do not have a medically diagnosed health problem. Those with more severe or persistent problems are classified as having one of the disorders outlined in the remaining options.

DIF: Cognitive Level: Comprehension REF: Text Page: 507

TOP: Nursing Process: Diagnosis|Nursing Process: Analysis

MSC: NCLEX: Psychosocial Integrity

23. A patient with gender identity disorder (gender dysphoria) tells a nurse about a wish to undergo a sex change operation. Which statement correctly reflects one prerequisite for sexual reassignment surgery?

a.

The patient must be of legal age.

b.

At least three clinicians must agree that the reassignment is appropriate.

c.

The patient must live in the role of the preferred gender for at least 6 months.

d.

The patient must undergo approximately 5 years of psychotherapy after surgery.

ANS: A

Patients who believe they are transsexual and request surgical reassignment must be of legal age, have two therapists agree that the surgery is indicated, and live in the preferred gender identity role for at least 1 year. Although follow-up care also is generally recommended, there is no specific time requirement.

DIF: Cognitive Level: Comprehension REF: Text Page: 515

TOP: Nursing Process: Implementation MSC: NCLEX: Psychosocial Integrity

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