Chapter 68: Concepts of Care for
Transgender Patients
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching a transgender client about taking testosterone. What statement
by the client indicates good understanding?
a. “My periods should stop immediately.”
b. “Some effects can take up to a year to see.”
c. “I am glad I don’t have to watch my diet.”
d. “There are very few side effects since it’s a normal hormone.”
ANS: B
Testosterone is used as masculinizing drug therapy. Some desired effects may take up
to a year to be noticed. Menses should stop within the first few months of therapy.
Testosterone increases the risk of heart disease, so clients should follow a heart-
healthy diet. Testosterone has several side effects, including acne, seborrhea, weight
gain, edema, headaches, and possible psychosis.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Transgender care, Masculinizing drug therapy MSC:
Client Needs Category: Physiological Integrity: Pharmacological and
Parenteral Therapies
2. A client is preparing for MtF gender–affirming surgery. The client is worried about
the voice not sounding feminine enough. What action by the nurse is best?
a. Ask if the client has considered vocal cord surgery to change the voice.
, b. Refer the client for vocal therapy with a speech–language pathologist.
c. Teach the client that there will be no effect on the patient’s voice.
d. Tell the client that the use of hormones will eventually change the voice.
ANS: B
Male-to-female clients can consult with a speech–language pathologist for vocal
training to help with intonation and pitch. While vocal surgery is possible, it may not
be the best first option due to cost and invasiveness. Telling the client that there will
be no change to the voice does not give the client information to address the concern.
While the hormones this client is taking will not affect the voice, simply stating that
fact does not help the client manage this issue.
DIF: Applying TOP: Integrated Process: Communication and
Documentation KEY: Transgender care, Referrals, Communication
MSC: Client Needs Category: Safe and Effective Care Environment:
Management of Care
3. A client has returned from the postanesthesia care unit after a vaginoplasty. What
comfort measure does the nurse provide for this client?
a. Apply ice to the perineum.
b. Elevate the legs on pillows.
c. Position the client on the left side.
d. Raise the head of the bed.
ANS: A
Ice is applied to the perineum intermittently to reduce bruising, pain, and discomfort.
Elevating the legs on pillows is not recommended after a lengthy procedure in the
lithotomy position, which predisposes the client to venous thromboembolism.
Positioning the client on the left side and raising the head of the bed are not comfort
measures related to this procedure.
Transgender Patients
Ignatavicius: Medical-Surgical Nursing, 10th Edition
MULTIPLE CHOICE
1. The nurse is teaching a transgender client about taking testosterone. What statement
by the client indicates good understanding?
a. “My periods should stop immediately.”
b. “Some effects can take up to a year to see.”
c. “I am glad I don’t have to watch my diet.”
d. “There are very few side effects since it’s a normal hormone.”
ANS: B
Testosterone is used as masculinizing drug therapy. Some desired effects may take up
to a year to be noticed. Menses should stop within the first few months of therapy.
Testosterone increases the risk of heart disease, so clients should follow a heart-
healthy diet. Testosterone has several side effects, including acne, seborrhea, weight
gain, edema, headaches, and possible psychosis.
DIF: Analyzing TOP: Integrated Process: Nursing Process: Evaluation
KEY: Transgender care, Masculinizing drug therapy MSC:
Client Needs Category: Physiological Integrity: Pharmacological and
Parenteral Therapies
2. A client is preparing for MtF gender–affirming surgery. The client is worried about
the voice not sounding feminine enough. What action by the nurse is best?
a. Ask if the client has considered vocal cord surgery to change the voice.
, b. Refer the client for vocal therapy with a speech–language pathologist.
c. Teach the client that there will be no effect on the patient’s voice.
d. Tell the client that the use of hormones will eventually change the voice.
ANS: B
Male-to-female clients can consult with a speech–language pathologist for vocal
training to help with intonation and pitch. While vocal surgery is possible, it may not
be the best first option due to cost and invasiveness. Telling the client that there will
be no change to the voice does not give the client information to address the concern.
While the hormones this client is taking will not affect the voice, simply stating that
fact does not help the client manage this issue.
DIF: Applying TOP: Integrated Process: Communication and
Documentation KEY: Transgender care, Referrals, Communication
MSC: Client Needs Category: Safe and Effective Care Environment:
Management of Care
3. A client has returned from the postanesthesia care unit after a vaginoplasty. What
comfort measure does the nurse provide for this client?
a. Apply ice to the perineum.
b. Elevate the legs on pillows.
c. Position the client on the left side.
d. Raise the head of the bed.
ANS: A
Ice is applied to the perineum intermittently to reduce bruising, pain, and discomfort.
Elevating the legs on pillows is not recommended after a lengthy procedure in the
lithotomy position, which predisposes the client to venous thromboembolism.
Positioning the client on the left side and raising the head of the bed are not comfort
measures related to this procedure.
