Question 1

Which statement by the student nurse indicates an understanding regarding female inmates?&#10;A) &#34;Many inmates are single mothers, but they will regain custody of their children once they are released.&#34;&#10;B) &#34;Most female inmates are in prison for aggressive crimes, such as armed robbery.&#34;&#10;C) &#34;Prison health for women is adequate, so their health care needs are typically met.&#34;&#10;D) &#34;Depression and aggressive behavior is common among female inmates.&#34;&#10;

Accepted Answer

1.This is incorrect. This statement requires further teaching regarding female inmates. Although many inmates are single mothers, most lose custody to the state.
2.This is incorrect. This statement requires further teaching. Many females are in prison for drug-related offenses.
3.This is incorrect. This statement requires further teaching. Health care in the prison system is inadequate for women, and most of their health care needs are unmet.
4.This is correct. This statement indicates an understanding regarding teaching about female inmates. Depression and aggressive behavior are common among female inmates.

Question 2

The nurse is assessing a client diagnosed with pedophilic disorder. Which statement differentiates this sexual disorder from a sexual dysfunction?&#10;A) Symptoms of sexual dysfunction include inappropriate sexual behaviors, whereas symptoms of a sexual disorder include impairment in normal sexual response.&#10;B) Symptoms of a sexual disorder include inappropriate sexual behaviors, whereas symptoms of sexual dysfunction include impairment in normal sexual response.&#10;C) Sexual dysfunction can be caused by increased levels of circulating androgens, whereas levels of circulating androgens do not affect sexual disorders.&#10;D) Sexual disorders can be caused by decreased levels of circulating androgens, whereas levels of circulating androgens do not affect sexual dysfunction.&#10;

Accepted Answer

1.This is incorrect. Pedophilic disorder is a sexual disorder in which individuals partake in inappropriate sexual behaviors. The essential feature of pedophilic disorder is sexual arousal derived from prepubescent or early-pubescent children equal to or greater than that derived from physically mature persons. Sexual dysfunction involves impairment in normal sexual response.
2.This is correct. Pedophilic disorder is a sexual disorder in which individuals partake in inappropriate sexual behaviors. The essential feature of pedophilic disorder is sexual arousal derived from prepubescent or early-pubescent children equal to or greater than that derived from physically mature persons. Sexual dysfunction involves impairment in normal sexual response.
3.This is incorrect. Pedophilic disorder is a sexual disorder in which individuals partake in inappropriate sexual behaviors. The essential feature of pedophilic disorder is sexual arousal derived from prepubescent or early-pubescent children equal to or greater than that derived from physically mature persons. Sexual dysfunction involves impairment in normal sexual response. Seventy-four percent of those with paraphilias have abnormal hormone levels.
4.This is incorrect. Pedophilic disorder is a sexual disorder in which individuals partake in inappropriate sexual behaviors. The essential feature of pedophilic disorder is sexual arousal derived from prepubescent or early-pubescent children equal to or greater than that derived from physically mature persons. Sexual dysfunction involves impairment in normal sexual response. Sexual dysfunction is related to abnormal androgen levels.

Question 3

Which statement by the student nurse requires further teaching regarding the sexual response cycle?&#10;A) &#34;During phase 1, the desire to have sex can occur in response to visual stimulation.&#34;&#10;B) &#34;In the second phase, sexual arousal and erotic pleasure occur.&#34;&#10;C) &#34;During phase 3, sexual tension is released as orgasm is achieved.&#34;&#10;D) &#34;Sexual fantasies can stimulate the fourth phase of sexual response.&#34;&#10;

Accepted Answer

1.This is incorrect. This statement does not require further teaching. This statement accurately describes phase 1 of the sexual response cycle.
2.This is incorrect. This statement does not require further teaching. This statement accurately describes phase 2 of the sexual response cycle.
3.This is incorrect. This statement does not require further teaching. This statement accurately describes phase 3 of the sexual response cycle.
4.This is correct. This statement requires further teaching. This statement describes the first phase (desire). Phase 4 is resolution. If orgasm is achieved, disgorgement occurs. If orgasm did not occur, resolution may take several hours, causing discomfort.

Question 4

The nurse suspects a client in the support group has frotteuristic disorder. Which statement supports the nurse's suspicion?&#10;A) The client purposely brushes up against unsuspecting women on the bus, feeling their breasts.&#10;B) The client observes his unsuspecting neighbor dressing for work in the morning.&#10;C) The client dresses in women's clothing and goes to the local bar.&#10;D) The client uses his wife's stockings to achieve an orgasm.&#10;

Accepted Answer

1.This is correct. This client likely has frotteuristic disorder. Intense sexual arousal is achieved from touching and rubbing against a nonconsenting person.
2.This is incorrect. This describes voyeurism. These individuals like to watch unsuspecting individuals in acts such as undressing or sexual activity.
3.This is incorrect. This describes transvestism. This individual enjoys dressing in clothing of the opposite sex.
4.This is incorrect. This describes fetishism. These individuals have fantasies involving nonliving objects, such as an article of clothing.

Question 5

Which statement made by a student indicates an understanding of the teaching regarding gender dysphoria? Select all that apply.&#10;A) &#34;Gender identity does not dictate to whom one is attracted.&#34;&#10;B) &#34;Gender dysphoria is caused by an increase in female hormones.&#34;&#10;C) &#34;The majority of transgender individuals are men who wish to reassign to female gender.&#34;&#10;D) &#34;Impaired family dynamics lead to gender dysphoria.&#34;&#10;

Accepted Answer

1.This is correct. Transgender individuals experience incongruence between their biological/assigned gender and gender identity. Colloquially, this term is sometimes abbreviated to simply "trans." Gender identity does not dictate to whom one is attracted; in other words, transgender individuals may or may not have same-sex relationships.
2.This is incorrect. The etiology of transgender identity is unknown. There is no significant evidence linking this condition to hormone or chromosome variations. Some small postmortem studies of brain tissue have demonstrated that male-to-female transgender individuals (also referred to as trans women) had typically female patterns of sexual differentiation in both the stria terminalis and the hypothalamic uncinate nucleus, leading researchers to suggest that perhaps this is a sexual differentiation issue that affects the brain.
3.This is correct. An estimated 1 in 30,000 men and 1 in 100,000 women identify as transgender. In other words, most transgender individuals (approximately 75%) were assigned "male" sex at birth but identify as female, and the remaining 25% were assigned "female" sex at birth but identify as male. Some transgender individuals choose not to surgically alter their bodies. Others have a strong desire to change their physical bodies to reflect their gender identities.
4.This is incorrect. Gender roles are certainly influenced by culture, as parents encourage masculine or feminine behaviors in their children. However, there is no clear evidence that psychological factors or family dynamics cause gender dysphoria. Parents may present with anxiety over their child's gender-nonconforming behavior based on their attitudes and perceptions. Likewise, children may present with symptoms of anxiety and depression related to negative attitudes toward their gender-nonconforming behaviors.

Question 6

A 32-year-old heterosexual client is arrested for masturbating while hiding in his neighbors' shrubs and watching them engage in sexual activity in their outdoor hot tub. The nurse is conducting a sexual history to gain data to create the client's plan of care. Which questions asked by the nurse will elicit the most important client data? Select all that apply.

A) "Who are your closest friends, and how much time do you spend with them?"
B) "Are you able to become sexually aroused when interacting with an attractive woman?"
C) "What is your gender, and how would you describe your feelings about your gender?"
D) "How much time do you spend on the Internet looking at child pornography?"

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Accepted Answer

1.This is correct. The questions that are asked in a sexual history collect information about the client's thoughts, feelings, and behaviors in several domains, because a disturbance in these areas may contribute to development of a sexual or psychological disorder. One of these domains is the ability to establish relationships with others.
2.This is correct. The questions that are asked in a sexual history collect information about the client's thoughts, feelings, and behaviors in several domains, because a disturbance in these areas may contribute to development of a sexual or psychological disorder. One of these domains is sexual responsiveness (arousal to appropriate stimuli).
3.This is correct. The questions that are asked in a sexual history collect information about the client's thoughts, feelings, and behaviors in several domains, because a disturbance in these areas may contribute to development of a sexual or psychological disorder. One of these domains is gender identity (one's sense of maleness or femaleness).
4.This is incorrect. This question is asking the client about pedophilic disorder, in which the client is sexually aroused by prepubescent or early-pubescent children. This is not the disorder the client is experiencing.

Question 7

A healthy 54-year-old client is the president of a hedge fund. The client works long hours and travels extensively for work. Her spouse of 30 years notices that she has been distracted lately and is not as interested in sex as she used to be. The couple has not had intercourse in over 6 months, which is unusual for them. When asked about her mood, the client states, "I have to lay off 50 employees at work, and it is just killing me. I feel so hopeless and overwhelmed. I know I'm not being a good partner to you, and this really worries me." Which short-term nursing goal is most appropriate for the client? Select all that apply.

A) The client will identify stressors that may contribute to loss of sexual desire within 1 week.
B) The client will resume sexual activity at a level satisfactory to self and partner within 6 months.
C) The client will identify three symptoms of depression that may contribute to loss of sexual desire within 2 weeks.
D) The client will verbalize willingness to seek professional assistance from a sex therapist to learn alternate ways of achieving sexual satisfaction within 2 months.

Accepted Answer

1.This is correct. The client's verbalization of feeling hopeless and overwhelmed indicates that she may be depressed. Her depression most likely stems from her work stress but also her worry about not being an active sexual partner in her marriage. Life circumstances, such as job and relationship stress, can impact sexual function. She is healthy and therefore most likely does not have a physiological condition that is affecting her sexual performance. The client's hypoactive sexual desire stems from psychological factors, which must be assessed by the nurse. Identifying stressors that may be affecting sexual performance within 1 week is a realistic short-term goal for the client.
2.This is incorrect. It is important for the client to resume sexual activity that is fulfilling to both her and her spouse, but achieving this within 6 months is a long-term goal. It is not realistic for the client to resolve her decreased libido in a short period of time, making this an unrealistic and unachievable short-term goal.
3.This is correct. The client's verbalization of feeling hopeless and overwhelmed indicates that she may be depressed. Her depression most likely stems from her work stress but also her worry about not being an active sexual partner in her marriage. Life circumstances, such as job and relationship stress, can impact sexual function. She is healthy and therefore most likely does not have a physiological condition that is affecting her sexual performance. The client's hypoactive sexual desire stems from psychological factors, which must be assessed by the nurse. Identifying symptoms of depression that may be affecting sexual performance within 2 weeks is a realistic short-term goal for the client.
4.This is incorrect. The client does not need to learn alternate ways of achieving sexual satisfaction because her decreased libido is due to psychological factors (stress and depression) and not physiological factors, such as possible erectile dysfunction caused by arteriosclerosis.

Question 8

The nurse is assessing a client for potential sexually transmitted infections (STIs). Which questions are appropriate for the nurse to include in the assessment? Select all that apply.&#10;A) How many sexual partners have you had within the past year?&#10;B) What religion do you practice?&#10;C) Have you ever been diagnosed with an STI?&#10;D) Do you use any form of protection against STIs and, if so, what kind?&#10;E) Are you able to easily achieve orgasm?&#10;F) In what kind of sexual activities do you participate?&#10;

Accepted Answer

1.This is correct. Inquiring about number of sexual partners is an appropriate question to ask when assessing risk for STIs.
2.This is incorrect. Asking about religious preference is not a relevant question to ask when assessing STI risk.
3.This is correct. Inquiring about past STI diagnoses is an appropriate question to assess for risk of STIs.
4.
This is correct. Asking the client about protection against STIs determines a client's risk for STIs.
5.This is incorrect. Ability to achieve orgasm does not determine a client's risk for STIs.
6.This is correct. Inquiring about sexual activities determines a client's risk for STIs.

Deck 23: Forensic Nursing, Issues Related to Human Sexuality and Gender Dysphoria