C HAPTER 20: S EXUAL D YSFUNCTIONS ,
G ENDER D YSPHORIA , AND P ARAPHILIC
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edit ion
MULTIPLE CHOICE
1. A nurse is anxious about assessing the sexual history of a client who is
considerabl y older than the nurse is. Which statement would be most
appropriate for obtaining information about the c lient’s sexual practices?
a. “Some people are not sexuall y 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 wit h
me so I can share it with your health care provider. It might be
helpful in planning your treatment.”
ANS: A
Explaining that sexual practices vary helps reduce client anxiet y about
the topic by normalizing the full range of sexual practices so that
whatever his situation, the client can feel comfortable sharing it. “It’s
, your business of course …” implies the nurse does not have a valid
reason to seek the information and in effect suggests that the client
perhaps should not answer the question. “It migh t be helpful …” makes
the information seem less valid or important for the nurse to pursue
and, again, could discourage the client from responding full y. Asking
if the client has any sexual problems that staff should know about is
not unprofessional, but i t is a very broad question that may increase a
client’s uncertaint y about what the nurse wants to hear, thus increasing
his anxiet y. Defining or giving an example of “sexual problem” would
make this inquiry more effective.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Assessment MSC: Client Needs:
Health Promotion and Maintenance
2. 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 behavior is most
accurate?
a. It is a sexual disorder. The behavior is sociall y at ypical. 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
behavior does not hurt others or involve intrusion into the personal
space of those observed.
d. An action is or is n ot a sexual disorder depending on applicable
local laws, so whether this meets the definition of a sexual disorder
depends on the location.
ANS: A
, A sexual disorder is defined as an activity that is sociall y at ypical, has
the potential to disrupt signifi cant relationships, and may result in
insult or injury to others. The behavior described constitutes a sexual
disorder (voyeurism). Although laws vary, an act does not have to be
illegal to constitute a sexual disorder. The fact that the behavior occurs
in a public setting could have a bearing on whether it is illegal, but not
on whether it is considered to be a sexual disorder.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
3. 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 professionall y describes the current
understanding of gender identit y?
a. “A child’s interest in the activities of the opposite gender is not
unusual or related to sexualit y. 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.”
ANS: A
G ENDER D YSPHORIA , AND P ARAPHILIC
D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edit ion
MULTIPLE CHOICE
1. A nurse is anxious about assessing the sexual history of a client who is
considerabl y older than the nurse is. Which statement would be most
appropriate for obtaining information about the c lient’s sexual practices?
a. “Some people are not sexuall y 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 wit h
me so I can share it with your health care provider. It might be
helpful in planning your treatment.”
ANS: A
Explaining that sexual practices vary helps reduce client anxiet y about
the topic by normalizing the full range of sexual practices so that
whatever his situation, the client can feel comfortable sharing it. “It’s
, your business of course …” implies the nurse does not have a valid
reason to seek the information and in effect suggests that the client
perhaps should not answer the question. “It migh t be helpful …” makes
the information seem less valid or important for the nurse to pursue
and, again, could discourage the client from responding full y. Asking
if the client has any sexual problems that staff should know about is
not unprofessional, but i t is a very broad question that may increase a
client’s uncertaint y about what the nurse wants to hear, thus increasing
his anxiet y. Defining or giving an example of “sexual problem” would
make this inquiry more effective.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
TOP: Nursing Process: Assessment MSC: Client Needs:
Health Promotion and Maintenance
2. 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 behavior is most
accurate?
a. It is a sexual disorder. The behavior is sociall y at ypical. 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
behavior does not hurt others or involve intrusion into the personal
space of those observed.
d. An action is or is n ot a sexual disorder depending on applicable
local laws, so whether this meets the definition of a sexual disorder
depends on the location.
ANS: A
, A sexual disorder is defined as an activity that is sociall y at ypical, has
the potential to disrupt signifi cant relationships, and may result in
insult or injury to others. The behavior described constitutes a sexual
disorder (voyeurism). Although laws vary, an act does not have to be
illegal to constitute a sexual disorder. The fact that the behavior occurs
in a public setting could have a bearing on whether it is illegal, but not
on whether it is considered to be a sexual disorder.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
3. 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 professionall y describes the current
understanding of gender identit y?
a. “A child’s interest in the activities of the opposite gender is not
unusual or related to sexualit y. 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.”
ANS: A
