Chapter 06: Caring for Lesbian, Gay, Bisexual, Transgender, Queer or Questioning, and Gender Diverse Patients

1. A new patient has not completed the health history form item indicating either male or female gender. The patient tells the nurse that neither option is accurate. Which response would the nurse provide? A. “How would you identify yourself?” B. “I think you are dressed like a male.” C. “What type of genitalia do you have?” D. “Choose one or the other, it doesn‘t matter.” ANS: A 2. A patient who identifies as a gay male is scheduling knee surgery. Which question would the nurse ask? A. Have you always been gay? B. When was your last HIV test? C. Are you currently sexually active? D. Do you plan to have gender changing surgery? ANS: B 3. A patient who is 40 years of age and identifies as lesbian is completing a health history. Which health behavior would the nurse identify as increasing this patient‘s risk for breast cancer? A. Tobacco avoidance B. Never having children C. Frequent physical activity D. Maintaining normal weight ANS: B 4. A patient who is being admitted for surgery tells the nurse that the preferred pronoun is “they” rather than he or she. What response would the nurse provide? A. “I will avoid talking about you so that I do not accidentally offend you.” B. “I will use the word that you prefer and ask that other staff do the same.” C. “That word is not important now because you will be asleep for surgery.” D. “We need to address you with words based on your visible characteristics.” ANS: B 5. A patient who has colon cancer and is near the end of life tells the nurse that estranged family members may try to take over health decisions when the patient is unable to make them. The patient would prefer that a long-term partner make any needed health decisions. Which recommendation is most important for the nurse to make? A. “Write down your preferences and mail them to your family members.” B. “Complete legal forms to designate your partner as the healthcare proxy.” C. “Tell your primary care physician who will make those decisions for you.” D. “Encourage familymembers and your partner to get along with one another.” ANS: B 6. A nurse is reviewing health assessment records for several patients undergoing gender affirming hormone therapy (GAHT). Which finding would be important to report to the primary care provider? A. A transgender man on testosterone therapy reports cessation of menses. B. A transgender woman develops an enlarged but symmetrical prostate gland. C. A transgender man who began testosterone therapy six months ago has increased body hair. D. A transgender woman who is taking estrogen and an anti-androgen agent develops breast buds. ANS: B 7. The nurse in the primary care clinic is completing a health history for a new patient who reports being in the process of gender change. The patient asks the nurse, “Why do you need to know so much personal information?” Which response would the nurse provide? A. “I don‘t want to be surprised with what I will find when I examine you.” B. “Completing the detailed information now will save you time at your next visit.” C. “Health screenings are based on your biology, hormone treatment, and sexual practices.” D. “I need to know whether you are really a man or a woman when I fill out the electronic health record.” ANS: C 8. A patient is considering taking feminizing hormone therapy. Which data in the patient‘s history would be a contraindication to all forms of estradiol therapy? A. Fear of injections B. Erectile dysfunction C. Deep vein thrombosis D. Migraines 4-6 times/year