Chapter 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias |Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. 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, ―All nurses a. qualify as sexual counselors. Nurses have knowledge about the biopsychosocial aspects of sexuality throughout the life cycle.‖ b. should be able to screen for sexual dysfunction and give basic information about sexual feelings, behaviors, and myths.‖ c. should defer questions about sex to other health care professionals because of their limited knowledge of sexuality.‖ d. who are interested in sexual dysfunction can provide sex therapy for individuals and couples.‖ ANS: B The basic education of nurses provides information sufficient to qualify the generalist to assess for sexual dysfunction and perform health teaching. Taking a detailed sexual history and providing sex therapy requires additional training in sex education and counseling. Nurses with basic education are not qualified to be sexual counselors. Additional education is necessary. A registered nurse may provide basic information about sexual function, but complex questions may require referral. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-2, 3, 20, 21 TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance 2. A nurse is performing an assessment for a 59-year-old man with a long history of 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. ANS: A Some of the drugs used to treat hypertension can interfere with normal sexual functioning and lead to sexual disorders. Hypertension itself can lead to acquired erectile dysfunction. It would not be appropriate or necessary to use such inquiries as a lead-in to other sexual health topics. Sexual dysfunction, while stressful, does not cause hypertension. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-15, 52 (Table 20-1) | Page 20-57 (Table 20-3) TOP: Nursing Process: Assessment MSC: Client Needs: Physiological Integrity 3. An adult experienced a myocardial infarction six months ago. At a follow-up visit, this adult 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