Deck 22: Sexual Dysfunction, Gender Dysphoria, and Paraphilias

Question 1

A man with hypospadias tells the nurse, "Intercourse with my new bride is painful." Which term applies to the patient's complaint?

A) Delayed ejaculation
B) Erectile dysfunction
C) Premature ejaculation
D) Dyspareunia

Answer 1

Dyspareunia

Question 2

Which statement about paraphilic disorders is accurate?

A) Paraphilic behaviour is controllable by willpower, but most persons with these disorders fail to do so.
B) People with paraphilic disorders rarely experience shame and are not distressed by their acts.
C) People with paraphilic disorders prey primarily on female children between the ages of 12 and 15 years.
D) Acts of paraphilia are common because people with the disorders commit the acts repeatedly, but paraphilic disorders are uncommon.

Answer 2

Acts of paraphilia are common because people with the disorders commit the acts repeatedly, but paraphilic disorders are uncommon.

Question 3

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

Answer 3

Fetishism

Question 4

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 5

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 6

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 7

The male manager of a health club placed a hidden video camera in the women's locker room and recorded several women as they showered and dressed. The disorder most likely represented by this behaviour is which of the following?

A) Homosexuality
B) Exhibitionism
C) Pedophilia
D) Voyeurism

Question 8

A patient's medical record documents sexual masochism. This patient derives sexual pleasure in which of the following ways?

A) From inanimate objects
B) By inflicting pain on a partner
C) When sexually humiliated by a partner
D) From touching a nonconsenting person

Question 9

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 10

A woman consults the nurse practitioner because she has not achieved orgasm for 2 years, despite having been sexually active. This is an example of which of the following?

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

Question 11

Which characteristic fits the usual profile of an individual diagnosed with pedophilic disorder?

A) Homosexual
B) Ritualistic behaviours
C) Seeks access to children
D) Self-confident professional

Question 12

An adult seeks treatment for urges involving sexual contact with children. The adult has not acted on these urges but feels shame. Which finding best indicates that this adult is making progress in treatment?

A) The adult consistently avoids schools and shops at malls only during school hours.
B) The adult indicates sexual drive and enjoyment from sex have decreased.
C) The adult reports an active and satisfying sex life with an adult partner.
D) The adult volunteers to become a scout troop leader.

Question 13

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.

Question 14

A respected school 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 children were harmed.

Question 15

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 16

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 17

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 18

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 19

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 20

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."

Question 21

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?"

Question 22

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 23

A nurse assesses a patient diagnosed with pedophilic disorder. Which findings are most likely? Select all that apply.

A) Childhood history of attention deficit hyperactivity disorder (ADHD)
B) A poorly managed endocrine disorder
C) History of brain injury
D) Cognitive distortions
E) Grandiosity

Question 24

A man who reports frequently experiencing 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 25

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.