Question 1

The nurse is working with a group of lesbian, bisexual, and transgender women. What statements should the nurse be most concerned about regarding psychological considerations in working this group of clients? (Select all that apply.)

Accepted Answer

1. The lesbian, bisexual, or transgender woman who does not live her identity openly must deal with the fear that someone will discover who she really is. Although these women grieve the loss of hiding who they are, the grief is not sanctioned by society and is another source of hidden stress. Lesbians or bisexual women may internalize negative social attitudes to their sexual identities, leading to greater risk of suicide. Coming out causes contradictory feelings of excitement and relief.
2. The lesbian, bisexual, or transgender woman who does not live her identity openly must deal with the fear that someone will discover who she really is. Although these women grieve the loss of hiding who they are, the grief is not sanctioned by society and is another source of hidden stress. Lesbians or bisexual women may internalize negative social attitudes to their sexual identities, leading to greater risk of suicide. Coming out causes contradictory feelings of excitement and relief.

Question 2

During an assessment the population health nurse believes that a client who identifies with the GLBT community is a gender nonconforming individual. What did the nurse assess to make this clinical determination?

Accepted Answer

2. A gender-nonconforming individual is one who by nature or choice does not conform to societal gender expectations A person who prefers to have sexual relations with both sexes would be considered bisexual. Transsexuals are persons who believe they were born into the "wrong" body and are actually members of the opposite gender. Cisgender refers to an individual whose self-perceived gender is congruent with his or her assigned birth gender.

Question 3

A client who identifies with the GLBT community tells the nurse that the only thing that makes him a male is having a penis and testosterone in the bloodstream. The population health nurse realizes that this client is using which perspectives to describe gender? (Select all that apply.)

Accepted Answer

1. There are four perspectives on sex or gender: anatomical, chromosomal, hormonal, and psychological. In the hormonal perspective, one's sex is defined by the balance of male and female hormones. The anatomical perspective relies on sex-specific internal and external organs such as a penis. The chromosomal perspective is based on the number of X and Y chromosomes one possesses. The final perspective involves one's felt identity or gender identity. Behavioral is not a perspective on sex or gender.
3. There are four perspectives on sex or gender: anatomical, chromosomal, hormonal, and psychological. In the hormonal perspective, one's sex is defined by the balance of male and female hormones. The anatomical perspective relies on sex-specific internal and external organs such as a penis. The chromosomal perspective is based on the number of X and Y chromosomes one possesses. The final perspective involves one's felt identity or gender identity. Behavioral is not a perspective on sex or gender.

Question 4

A client who is a MTG transgender is considering feminizing genitoplasty. Which surgical procedures should the population health nurse include when instructing this client? (Select all that apply.)

Accepted Answer

1. Feminizing genitoplasty for MTF transgenders usually includes orchiectomy, penectomy, vaginoplasty, and volvoplasty. Surgery for FTM transgender individuals often includes chest reconstruction or reduction mammoplasty.
2. Feminizing genitoplasty for MTF transgenders usually includes orchiectomy, penectomy, vaginoplasty, and volvoplasty. Surgery for FTM transgender individuals often includes chest reconstruction or reduction mammoplasty.
3. Feminizing genitoplasty for MTF transgenders usually includes orchiectomy, penectomy, vaginoplasty, and volvoplasty. Surgery for FTM transgender individuals often includes chest reconstruction or reduction mammoplasty.
4. Feminizing genitoplasty for MTF transgenders usually includes orchiectomy, penectomy, vaginoplasty, and volvoplasty. Surgery for FTM transgender individuals often includes chest reconstruction or reduction mammoplasty.

Question 5

A member of the GLBT community admits that anal intercourse is often conducted unprotected. What should the population health nurse recommend to reduce this client's risk of illness?

Accepted Answer

1. The one strategy to help prevent disease from unprotected anal intercourse is the use of a condom. Having monthly HIV testing is an inappropriate suggestion. Altering the type of intercourse does not meet the client's need. Considering a monogamous relationship does not reduce the threat of illness from unprotected anal intercourse.

Question 6

The population health nurse is concerned that members of a community are demonstrating heterosexism. Because of this, for which potential issues should the nurse be aware of occurring within the GLBT population? (Select all that apply.)

Accepted Answer

1. Heterosexism is the assumption that all people are heterosexual and belief that heterosexuality is "normal" and superior to other sexual orientations. Heterosexism results in oppression, stigmatization, discrimination, and violence against members of GLBT populations. Family rejection is a response to disclosure of a family member's homosexuality. This is not an outcome of heterosexism.
2. Heterosexism is the assumption that all people are heterosexual and belief that heterosexuality is "normal" and superior to other sexual orientations. Heterosexism results in oppression, stigmatization, discrimination, and violence against members of GLBT populations. Family rejection is a response to disclosure of a family member's homosexuality. This is not an outcome of heterosexism.
3. Heterosexism is the assumption that all people are heterosexual and belief that heterosexuality is "normal" and superior to other sexual orientations. Heterosexism results in oppression, stigmatization, discrimination, and violence against members of GLBT populations. Family rejection is a response to disclosure of a family member's homosexuality. This is not an outcome of heterosexism.
4. Heterosexism is the assumption that all people are heterosexual and belief that heterosexuality is "normal" and superior to other sexual orientations. Heterosexism results in oppression, stigmatization, discrimination, and violence against members of GLBT populations. Family rejection is a response to disclosure of a family member's homosexuality. This is not an outcome of heterosexism.

Question 7

A client recovering from MTG sexual reassignment surgery asks what can be done to change the sex and name on the client's driver's license. What should the population health nurse do to assist the client with this issue?

Accepted Answer

4. Transgender individuals may need assistance with legal issues surrounding gender identification such as legal name changes and change of gender on identification or the birth certificate. Birth gender can be legally changed. Name and gender changes should not be attempted through an automotive club. There is no reason for the client to wait after this type of surgery to have gender and name changed on a driver's license.

Question 8

The population health nurse is assessing a community member who identifies with the GLBT community. When discussing sexual orientation the nurse knows that three aspects are being assessed which are: (Select all that apply.)

Accepted Answer

1. Sexual orientation refers to one's preferred choice of sexual or romantic partners or the gender(s) of people to whom one is attracted. Sexual orientation comprises three aspects: attraction, behavior, and identity. Acceptance and coming out are not aspects of sexual orientation.
2. Sexual orientation refers to one's preferred choice of sexual or romantic partners or the gender(s) of people to whom one is attracted. Sexual orientation comprises three aspects: attraction, behavior, and identity. Acceptance and coming out are not aspects of sexual orientation.
3. Sexual orientation refers to one's preferred choice of sexual or romantic partners or the gender(s) of people to whom one is attracted. Sexual orientation comprises three aspects: attraction, behavior, and identity. Acceptance and coming out are not aspects of sexual orientation.

Question 9

An adolescent shares with the nurse that he is gay and that he is going to tell his parents. The nurse knows that parental response to the disclosure of homosexuality is strongly influenced by the: (Select all that apply.)

Accepted Answer

1. The parental response to the disclosure of homosexuality is strongly influenced by a variety of factors, which include: the strength of traditional gender role conceptions, perceptions of the probable attitudes of significant others in the family's social network, and parental age and education level. The younger and better educated parents tend to be more accepting. Race is not an influencing factor.
2. The parental response to the disclosure of homosexuality is strongly influenced by a variety of factors, which include: the strength of traditional gender role conceptions, perceptions of the probable attitudes of significant others in the family's social network, and parental age and education level. The younger and better educated parents tend to be more accepting. Race is not an influencing factor.
3. The parental response to the disclosure of homosexuality is strongly influenced by a variety of factors, which include: the strength of traditional gender role conceptions, perceptions of the probable attitudes of significant others in the family's social network, and parental age and education level. The younger and better educated parents tend to be more accepting. Race is not an influencing factor.
4. The parental response to the disclosure of homosexuality is strongly influenced by a variety of factors, which include: the strength of traditional gender role conceptions, perceptions of the probable attitudes of significant others in the family's social network, and parental age and education level. The younger and better educated parents tend to be more accepting. Race is not an influencing factor.

Question 10

A client who is awaiting FTM gender assignment surgery is scheduled for a routine health examination at the community clinic. What screenings should the client receive? (Select all that apply.)

Accepted Answer

1. Most FTM transgender individuals continue to need regular cervical cancer screening and screening for breast cancer. The client is genetically female so a prostate gland is not a part of the client's anatomy. Throat cultures and tuberculosis tests are not considered routine screenings.
2. Most FTM transgender individuals continue to need regular cervical cancer screening and screening for breast cancer. The client is genetically female so a prostate gland is not a part of the client's anatomy. Throat cultures and tuberculosis tests are not considered routine screenings.

Question 11

A therapist who works primarily with gay and lesbian couples is aware that the same kinds of stress that affect heterosexual relationships also affect gay and lesbian relationships. But the therapist knows that the stress is different with respect to:

Accepted Answer

4. With the exception of the stage of coming out, most issues that affect the stability or relationships among heterosexual and nonheterosexual couples are the same. Extended family involvement, inequalities of power, and disparity in income tend to have the same effect on gay and lesbian relationships.

Question 12

A client is recovering from MTF sexual reassignment surgery. What health teaching should the population health nurse provide to this client as a part of health restoration strategies? (Select all that apply.)

Accepted Answer

2. Population health nurses should help monitor transgender individuals for effects related to hormone therapy such as increased risk of heart disease, stroke, and breast cancer. Actions to prevent the development of a stroke, the risk of heart disease from hormone therapy, performing breast self-examination, and complying with recommendations for mammography are actions to support health restoration of this client. There is no need for routine PSA levels to be drawn for this client.
3. Population health nurses should help monitor transgender individuals for effects related to hormone therapy such as increased risk of heart disease, stroke, and breast cancer. Actions to prevent the development of a stroke, the risk of heart disease from hormone therapy, performing breast self-examination, and complying with recommendations for mammography are actions to support health restoration of this client. There is no need for routine PSA levels to be drawn for this client.
4. Population health nurses should help monitor transgender individuals for effects related to hormone therapy such as increased risk of heart disease, stroke, and breast cancer. Actions to prevent the development of a stroke, the risk of heart disease from hormone therapy, performing breast self-examination, and complying with recommendations for mammography are actions to support health restoration of this client. There is no need for routine PSA levels to be drawn for this client.
5. Population health nurses should help monitor transgender individuals for effects related to hormone therapy such as increased risk of heart disease, stroke, and breast cancer. Actions to prevent the development of a stroke, the risk of heart disease from hormone therapy, performing breast self-examination, and complying with recommendations for mammography are actions to support health restoration of this client. There is no need for routine PSA levels to be drawn for this client.

Question 13

The population health nurse is interviewing a client who states that she is a lesbian. What statement by the client indicates the need for more education?

Accepted Answer

2. There is a higher prevalence of certain risk factors for breast cancer among lesbian women. Women who engage in sexual activity exclusively with other women seem to be at lower risk for some sexually transmitted diseases. Routine Pap smears are as important for lesbians as for heterosexuals. There is an increased risk for heart disease among lesbians perhaps because lesbians smoke more than their heterosexual sisters and tend to have a higher body mass index.

Question 14

The most accurate description the population health nurse could give a colleague about homophobia is that it:

Accepted Answer

3. Homophobia is an irrational fear and intolerance of people who are homosexual or of homosexual feelings within oneself. Homophobia is not a law. Homophobia is not used to justify discrimination against lesbians. Homosexual activity is not criminalized in all states.

Question 15

The population health nurse is asked by a member of the GLBT community for information on how to prevent the onset of illnesses. What should the nurse recommend to this client? (Select all that apply.)

Accepted Answer

2. Effective illness and injury prevention strategies for the GLBT population include measures to prevent HIV infection and immunization for illnesses such as hepatitis A and B for those at risk of infection. Population health nurses can promote strengthening partner relationships. Other illness and injury prevention strategies would be similar to those for the general population and include eliminating risk behaviors such as smoking. Recommending hormone therapy would be appropriate to resolve an existing health problem.
3. Effective illness and injury prevention strategies for the GLBT population include measures to prevent HIV infection and immunization for illnesses such as hepatitis A and B for those at risk of infection. Population health nurses can promote strengthening partner relationships. Other illness and injury prevention strategies would be similar to those for the general population and include eliminating risk behaviors such as smoking. Recommending hormone therapy would be appropriate to resolve an existing health problem.
4. Effective illness and injury prevention strategies for the GLBT population include measures to prevent HIV infection and immunization for illnesses such as hepatitis A and B for those at risk of infection. Population health nurses can promote strengthening partner relationships. Other illness and injury prevention strategies would be similar to those for the general population and include eliminating risk behaviors such as smoking. Recommending hormone therapy would be appropriate to resolve an existing health problem.
5. Effective illness and injury prevention strategies for the GLBT population include measures to prevent HIV infection and immunization for illnesses such as hepatitis A and B for those at risk of infection. Population health nurses can promote strengthening partner relationships. Other illness and injury prevention strategies would be similar to those for the general population and include eliminating risk behaviors such as smoking. Recommending hormone therapy would be appropriate to resolve an existing health problem.

Quiz 20: Care of the Glbt Population