Deck 21: Sexual Dysfunction and Sexual Disorders

Question 1

A 55-year-old patient is recuperating from a myocardial infarction.At a follow-up visit to his physician's office,he tells the nurse practitioner,"I haven't had much interest in sex since my heart attack.My wife is wondering if something's wrong with me.The truth is,I know having sex puts a strain on my heart,and I don't know if my heart is strong enough." The nursing diagnosis for this patient would be:

A) Sexual dysfunction related to self-esteem disturbance.
B) Sexual dysfunction related to knowledge deficit.
C) Disturbed body image related to lifestyle changes.
D) Disturbed body image related to treatment side effects.

Answer 1

Sexual dysfunction related to knowledge deficit.

Question 2

A nurse is performing a nursing assessment for a 59-year-old man who is hypertensive.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 and nonprescription drugs.
B) Such questions are an indirect way of learning about the patient's drug 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.

Answer 2

Sexual dysfunction may result from use of prescription and nonprescription drugs.

Question 3

A woman consulted the nurse practitioner because she had not been able to have an orgasm,despite having been sexually active for 2 years.She was very frustrated and felt it was harming the relationship with her spouse.Which nursing process evaluation of an identified patient outcome would best indicate that treatment has been successful?

A) "Patient reports achieving orgasm last week;seems very happy."
B) "Reports satisfaction with sexual encounters;feels spouse is supportive."
C) "Reports achieving orgasm occasionally;relationship with spouse is 'OK'."
D) "Patient offers no complaints related to sexual function;to return next week."

Answer 3

"Reports satisfaction with sexual encounters;feels spouse is supportive."

Question 4

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) frotteurism.
B) exhibitionism.
C) fetishism.
D) voyeurism.

Question 5

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.Each has 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."

Question 6

The nursing action that takes priority when working with a patient who has a problem of sexual dysfunction or disorder is:

A) acquiring knowledge of the patient's sexual roles.
B) developing an understanding of human sexual response.
C) clarifying the nurse's personal values about sexuality.
D) assessing the patient's sexual functioning and needs.

Question 7

Which of these statements about erectile dysfunction is accurate?

A) When present in young men,the cause is usually physical.
B) It can be caused by medication,anxiety,or depression.
C) Acquired erectile dysfunction affects about 40% of males.
D) It is usually treated via individual and couples counseling.

Question 8

A woman consults the nurse practitioner because she has not been able to have an orgasm,despite having been sexually active for 2 years.She is very frustrated and feels it is harming the relationship with her spouse.Which nursing diagnosis would be most appropriate for this presentation?

A) Sexual dysfunction
B) Relational impairment
C) Ineffective sexuality pattern
D) Impaired sexual arousal

Question 9

A 25-year-old patient tells the nurse he is living a miserable existence.All his life,he states,he has thought,felt,and acted like a woman while living in the body of a man.He has lived as a female and dressed in feminine attire for more than a year.He has decided to change jobs so as not to compromise the new identity and now wishes to "take the next step" with surgery.The first patient request the physician will likely address is:

A) "Will you order estrogen therapy?"
B) "Can you refer me for psychotherapy?"
C) "Will you alter my medical records?"
D) "Please give me something to make me a man."

Question 10

While performing a nursing assessment,the nurse says to a patient,"While growing up,most of us have 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) determine possible homosexuality.
B) identify sexual misinformation.
C) identify areas of sexual dysfunction for treatment.
D) introduce the topic of masturbation.

Question 11

A woman consults the nurse practitioner because she has not been able to have an orgasm,despite having been sexually active for 2 years.This is an example of:

A) anorgasmia.
B) dyspareunia.
C) diminished desire.
D) low libido.

Question 12

A man is admitted to an inpatient mental health unit after arrest for attempting sexual contact with a minor.Which medication would the nurse most expect to be prescribed? Select all that apply.

A) Haloperidol (Haldol),a first generation antipsychotic drug
B) Medroxyprogesterone acetate (MPA),an analog of progesterone
C) Clonazepam (Klonopin),a benzodiazepine antianxiety drug
D) Cyproterone acetate (CPA),an inhibitor of testosterone
E) Serotonergic antidepressants such as fluoxetine (Prozac)

Question 13

Which statement about paraphilias is accurate?

A) Pedophiles prey primarily on female children between the ages of 12 and 15 years.
B) Persons with paraphilias rarely experience shame and are not distressed by their acts.
C) Paraphilic behavior is controllable by willpower,but most with the disorder fail to do so.
D) Paraphilias are uncommon,but paraphilic acts are common because they are committed repeatedly by persons with the disorder.

Question 14

A young father is very concerned because his 4-year-old son "enjoys playing girls' games more than with boys' toys." He wants to know if his son is gay or mentally ill.Which response most professionally describes our current understanding of gender identity?

A) "A child being interested in the activities of the opposite gender is not unusual and is not related to sexuality;most don't carry these cross-gender interests into adulthood."
B) "It's difficult to say for sure because the research is incomplete so far,but chances are that he will grow up to be a normal adult."
C) "We really do not know for sure because the research is incomplete,but I can tell you that many boys play girls' games and turn out to be fine as adults."
D) "I am sure that whatever happens,he will be a loving son,and you will be a proud father of that wonderful boy."

Question 15

A new nurse is doing her first admission assessment and is anxious about asking a patient who is considerably older than her for his sexual history.Which statement would be most appropriate for obtaining information about the patient's sexual practices?

A) "Some single people are not sexually active,others have a partner,and some have several partners.What has been your pattern?"
B) "It's your own business,of course,but it might be helpful for us to have some info about your sexual history.Could you tell me about that,please?"
C) "I would appreciate it if you could share your sexual history with me so I can pass it along to your doctor.You can never tell,it might be helpful."
D) "Sexual health can reflect a number of medical problems,so I'd like to ask if you have any sexual problems you think we should know about."

Question 16

The male manager of a health club has been discovered to have placed a hidden video camera in the women's locker room and has taped several women as they showered and dressed.The disorder most likely represented by this behavior is:

A) homosexuality.
B) exhibitionism.
C) pedophilia.
D) voyeurism.

Question 17

A respected school coach is arrested after a student reports that he attempted to have sexual contact with him.Which issue would be the priority for assessment in the period immediately following the coach's arrest?

A) Determine the nature and extent of his sexual disorder.
B) Investigate whether other children were harmed.
C) Assess the potential for suicide or other self-harm.
D) Assess the patient's perception of his problem and needs.

Question 18

A man seeks treatment for urges involving sexual contact with children.He has not acted on these urges and is ashamed of them.Which of the following outcomes would indicate that the patient is making progress in his treatment?

A) He consistently drives far around school yards and shops only during school hours.
B) He reports that he no longer has fantasies about sexual contact with children.
C) The patient indicates that his sexual drive and enjoyment from sex have decreased.
D) He reports that he has an active and satisfying his sex life with his adult partner.

Question 19

A man confesses that he enjoys watching women when he is out in public.Further exploration reveals that he goes to settings where he can observe women crossing their legs in hopes of "seeing something good." Which statement about this behavior is most accurate?

A) Because it occurs in public areas,this behavior does not hurt others or involve intrusion into the personal space of those he observes,so it is not a sexual disorder.
B) Although not physically harmful,the behavior is socially atypical,could disrupt relationships,and could be an insult to others,so it would be considered a sexual disorder.
C) An action is or isn't a sexual disorder depending on applicable local laws,so whether this meets the definition of a sexual disorder depends on the laws where he behaves this way.
D) The vistas he views occur in public,where those he observes do not have a reasonable expectation of privacy.So long as he does not photograph the women,his behavior isn't considered a sexual disorder.