NURSING CARE OF CLIENTS WITH SEXUAL AND GENDER IDENTITY DISORDERS
During a routine yearly physical an older adult says to the nurse, "I have not had sex lately because I can no longer get it up!" The nurse's initial response should be: 1. "Let's discuss this concern a little more." 2. "Be sure to tell the physician about this problem." 3. "This is an expected physiological response to getting older." 4. "There is medication available for erectile dysfunction."
1. "Let's discuss this concern a little more." This response communicates to the client that the nurse is willing and able to explore this concern. It is an open-ended statement that allows the client to control the direction of the conversation.
A 25-year-old woman with the diagnosis of bipolar, manic episode, is admitted to the psychiatric unit. The nurse on the psychiatric unit review the admission information provided by the client's husband and assess the client. Based on the information in the chart below, what is an appropriate nursing intervention? 1. Assigning the client to a private room 2. Suggesting the client play cards with several other clients 3. Encoring the development of insight through introspection 4. Having the client sit at the communal dining table during meals
1. Assigning the client to a private room During the acute phase of mania, the focus of care should be on maintaining the safety of the client and other and decreasing the client's energy expenditure. Hyper sexuality is often associated with the manic episode of bipolar disorder. Obtaining sexual pleasure by exposing the genitals (exhibitionism) is a paraphilia. A private room protects the other clients and provides privacy for the client.
The physician orders sildenafil (Viagra) for a male client with erectile dysfunction. The nurse should teach the client about the common side effects of this drug. Indicate all that apply. 1. Flushing 2. Headache 3. Dyspepsia 4. Constipation 5. Hypertension
1. Flushing Flushing is a common central nervous system response to Viagra. 2. Headache Headache is a common central nervous system response to viagra 3. Dyspepsia Diarrhea, not constipation, is a common gastrointestinal response to viagra.
Which is a frequent finding in clients with paraphiliac sexual disorders? 1. Other covert or overt emotional problems are present 2. Gonadal and pituitary hormone deficiencies are involved 3. Overassociation with society's fringe groups has thwarted judgement 4. An inadequate physical development of the sexual organs has occurred
1. Other covert or overt emotional problems are present Clients with this sexual disorders usually have many other emotional problems that may be overt or covert in nature.
A 43-year-old, well-dressed man charged with molesting a 7 year-old child is admitted for psychiatric evaluation. When the nurse asks him to come to dinner, he refuses and states, "I don't want anyone to see me. Leave me alone." What is the nurse's best response? 1. "Certainly, I respect your wishes." 2. "You sound upset; let's talk about it." 3. "It will be easier to face other people right away." 4. "Only the staff members known why you are here."
2. "You sound upset; let's talk about it." This identifies feelings and provides the client with an opportunity to talk.
A male client with the diagnosis of gender identity disorder has been dressing and functioning in society as a woman for 2 years and has decided to have sex reassignment surgery. He tells the nurse that all his life he has considered himself to be female. Place the following nursing interventions in order of priority when caring for this client. 1. Treat the client with respect 2. Investigate own feelings about sexuality 3. Encourage the client to explore his feelings 4. Accept the decision to have sex reassignment surgery 5. Explore ways that the decision can be shared with significant others
2,1,3,4,5
The nurse identifies that a male client may have a sexual arousal disorder when during a yearly physical the client states: 1. "I have no interest in sex." 2. "I don't get very hard anymore." 3. "I climax almost before we get started." 4. "I take forever before I finally have an orgasm."
2. "I don't get very hard anymore." This statement is related to a sexual arousal disorder, which is a partial or complete failure to achieve a physiologic or psychologic response to sexual activity.
A male client with the diagnosis of pedophilia is admitted to the psychiatric hospital because of repeated episodes of exhibitionism. In the recreation room the client exposes himself to the nurse and begins to masturbate. The nurse should: 1. Turn away from the client and ignore the behavior 2. Tell the client that the behavior is unacceptable and to stop 3. Remove the client form the recreation room and escort him to his room 4. Recognize that the behavior is part of his illness and obtain an order for a libido-lowering medication
2. Tell the client that the behavior is unacceptable and to stop Exposing the genitals and masturbating in a public place are unacceptable behaviors. Unacceptable behavior should be pointed out to the client and the client should be instructed to stop. Exhibitionism usually is done for shock value rather than as a preamble for sexual assault or rape. If the client wishes to masturbate, this activity can be carried out in private.
A 4-year-old girl tells the school nurse that her father has been getting into bed with her at night and touching her. The nurse should: 1. Ask the child to describe the touching 2. Tell the teacher to report any inappropriate behavior 3. Report the child's conversation to child protective services 4. Contact the father to come to the school immediately
3. Report the child's conversation to child protective services The nurse is legally responsible to report suspected child abuse to the appropriate child protection agency. The agency must assess the situation and intervene if necessary to protect the child.
