Deck 26: Sexuality and Gender

Question 1

A man says, "I enjoy watching women when I am out in public. I like to go to places where I can observe women crossing their legs in hopes of seeing something good." Which statement about this behaviour is most accurate?

A) It is a sexual disorder. The behaviour is socially atypical. It could disrupt relationships and could be insulting to others.
B) It is not a sexual disorder. These events occur in public, where those he observes do not have a reasonable expectation of privacy.
C) It is not a sexual disorder. Because it occurs in public areas, this behaviour does not hurt others or involve intrusion into the personal space of those observed.
D) An action is or is not a sexual disorder depending on applicable local laws, so whether this meets the definition of a sexual disorder depends on the location.

Answer 1

It is a sexual disorder. The behaviour is socially atypical. It could disrupt relationships and could be insulting to others.

Question 2

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 which of the following?

A) "All nurses qualify as sexual counsellors. Nurses have knowledge about the biopsychosocial aspects of sexuality throughout the life cycle."
B) "All nurses should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviours, and myths."
C) "All nurses should defer questions about sex to other health care professionals because of their limited knowledge of sexuality."
D) "All nurses who are interested in sexual dysfunction can provide sex therapy for individuals and couples."

Answer 2

"All nurses should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviours, and myths."

Question 3

A respected university coach was arrested after a student reported the coach attempted to have sexual contact. Which nursing action has priority in the period immediately following the coach's arrest?

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

Answer 3

Assess the coach's potential for suicide or other self-harm.

Question 4

A woman tells the nurse, "My partner is frustrated with me. I don't have any natural lubrication when we have sex." What type of sexual disorder is evident?

A) Genito-pelvic pain/penetration disorder
B) Female sexual interest/arousal disorder
C) Hypoactive sexual desire disorder
D) Female orgasmic disorder

Question 5

A patient's medical record documents gender as unknown. This patient may be addressed in which of the following ways?

A) Initially assume the gender related to the most obvious physical traits
B) Begin by asking questions about their sexual health history
C) Allow the patient to tell you when they are ready
D) Approach the patient with the name listed on the document and ask if this is their preferred name

Question 6

An adult consulted a nurse practitioner because of an inability to achieve orgasm for 2 years, despite having been sexually active. This adult was frustrated and expressed concerns about the relationship with the sexual partner. Which nursing diagnosis is most appropriate for this scenario?

A) Defensive coping
B) Sexual dysfunction
C) Ineffective sexuality pattern
D) Disturbed sensory perception, tactile

Question 7

A man presents to the nurse stating, "Intercourse with my new bride is painful for her and she seems disinterested in doing this with me." How may you address the patient's complaint?

A) "Can you tell me more about your relationship?"
B) "Do you feel she is disinterested in sex?"
C) "Tell me about her sexual health history."
D) Discuss the stress of a new marriage as the likely reason for this issue.

Question 8

An adult seeks treatment for homosexual desires. The adult has not acted on these urges but feels shame. Which finding best indicates that this adult is making progress in understanding and accepting the desires?

A) The adult consistently avoids opportunities to explore the homosexual desires.
B) The adult indicates sexual drive and enjoyment from sex have decreased.
C) The adult reports an active and satisfying sex life with a heterosexual partner.
D) The adult begins to talk about a history of these desires dating back to early childhood and can see the progression in sexual identity.

Question 9

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?" What is the purpose of this question?

A) To identify areas of sexual dysfunction for treatment
B) To determine possible homosexual urges
C) To introduce the topic of masturbation
D) To identify sexual misinformation

Question 10

Which characteristic fits the usual profile of an individual diagnosed with gender dysphoria?

A) Aggression
B) Persistent low mood
C) Promiscuous
D) Attention seeking

Question 11

An adult experienced a myocardial infarction 6 months ago. At a follow-up visit, he 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

Question 12

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 which of the following?

A) Exhibitionism
B) Voyeurism
C) Frotteurism
D) Fetishism

Question 13

A woman consults the nurse practitioner because she has not achieved orgasm for 2 years, despite having been sexually active. The nurse may initially explore with the patient, which of the following?

A) Discomfort with sexual activity
B) Prior history of sexual abuse
C) A comprehensive sexual health assessment
D) Nature of sexual orientation and preference

Question 14

An indigenous patient describes being conflicted about the presence of both a female and male energy in her body. The patient is referring to which indigenous cultural perspective on sexuality?

A) Homosexuality
B) Cisgender
C) Two-spirit
D) Bisexuality

Question 15

A nurse is performing an assessment for a 59-year-old man who has 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.

Question 16

Which statement about intersex is accurate?

A) Intersexed individuals fail to integrate their gender identity effectively
B) People with intersex rarely experience shame and are not distressed by their condition.
C) People with intersex would be described as being overly dependant personalities.
D) Intersex is not uncommon and people with the disorder are likely to receive adequate treatment to resolve the disorder.

Question 17

Which nursing action should occur first regarding a patient who has a problem of sexual dysfunction or sexual disorder?

A) The nurse should develop an understanding of human sexual response.
B) The nurse should assess the patient's sexual functioning and needs.
C) The nurse should acquire knowledge of the patient's sexual roles.
D) The nurse should clarify his or her own personal values about sexuality.

Question 18

A nurse is anxious about assessing the sexual history of a patient who is considerably older than the nurse is. Which statement would be most appropriate for obtaining information about the patient's sexual practices?

A) "Some people are not sexually active, others have a partner, and some have several partners. What has been your pattern?"
B) "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."
C) "It's your own business, of course, but it might be helpful for us to have some information about your sexual history. Could you tell me about that, please?"
D) "I would appreciate it if you could share your sexual history with me, so I can share it with your health care provider. It might be helpful in planning your treatment."

Question 19

An adult consulted a nurse practitioner because of an inability to achieve orgasm for 2 years, despite having been sexually active. This adult was frustrated and expressed concerns about the relationship with the sexual partner. Which documentation best indicates the treatment was successful?

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

Question 20

A parent who is very concerned about a 3-year-old son says, "He likes to play with girls' toys. Do you think he is homosexual or mentally ill?" Which response by the nurse most professionally describes the current understanding of gender identity?

A) "A child's interest in the activities of the opposite gender is not unusual or related to sexuality. Most children do not carry 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) "The research is incomplete, but many boys play with girls' toys and turn out normal as adults."
D) "I am sure that whatever happens, he will be a loving son, and you will be a proud parent."

Question 21

A patient approaches the nurse in the clinic waiting room and says, "I want to talk to you about a sexual matter." The nurse can best facilitate the discussion by doing which of the following?

A) Saying, "Let's go to my office."
B) Responding, "I want to help. Go ahead; I'm listening."
C) Telling the patient, "Let's schedule another appointment."
D) Offering to sit in a corner of the waiting room with the patient.

Question 22

A man who reports experiencing frequent premature ejaculation tells the nurse, "I feel like such a failure. It's so awful for both me and my partner. Can you help me?" Select the nurse's best response.

A) "Have you discussed this problem with your partner?"
B) "I can refer you to a practitioner who can help you with this problem."
C) "Have you asked your health care provider for prescription medication?"
D) "There are several techniques described in this pamphlet that might be helpful."

Question 23

Health disparities in the LGBTQ population have been linked to higher rates of which of the following?

A) Depression
B) Sexual dysfunction
C) Self-Harm
D) Suicide
E) Substance Abuse

Question 24

A 10-year-old boy is diagnosed with gender dysphoria. Which assessment finding would the nurse expect?

A) Having tea parties with dolls
B) A compromised sexual response cycle
C) Identifying with boys who are athletic
D) Intense urges to watch his parents have sex

Question 25

A man who regularly experiences premature ejaculation tells the nurse, "I feel like such a failure. It's so awful for both me and my partner." Select the nurse's most therapeutic response.

A) "I sense you are feeling frustrated and upset."
B) "Tell me more about feeling like a failure."
C) "You are too hard on yourself."
D) "What do you mean by awful?"