Question 1

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

Accepted Answer

A)   saying, "Let's go 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. A

Question 2

A patient's medical record documents sexual masochism. This patient derives sexual pleasure

Accepted Answer

A)   from inanimate objects.
B)   by inflicting pain on a partner.
C)   when sexually humiliated by a partner.
D)   from touching a nonconsenting person. C

Question 3

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

Accepted Answer

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

Question 4

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?

Accepted Answer

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 5

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?

Accepted Answer

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 6

A 10-year-old boy is diagnosed with gender dysphoria. Which assessment finding would the nurse expect?

Accepted Answer

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 7

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?

Accepted Answer

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 8

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

Accepted Answer

A)   exhibitionism.
B)   voyeurism.
C)   frotteurism.
D)   fetishism.

Question 9

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?

Accepted Answer

A)   Defensive coping
B)   Sexual dysfunction
C)   Ineffective sexuality pattern
D)   Disturbed sensory perception, tactile

Question 10

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 behavior is

Accepted Answer

A)   homosexuality.
B)   exhibitionism.
C)   pedophilia.
D)   voyeurism.

Question 11

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

Accepted Answer

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

Question 12

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

Accepted Answer

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."

Question 13

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

Accepted Answer

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

Question 14

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?

Accepted Answer

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 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?

Accepted Answer

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 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?

Accepted Answer

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

Which statement about paraphilic disorders is accurate?

Accepted Answer

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

Question 18

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.

Accepted Answer

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 19

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? The adult

Accepted Answer

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

Question 20

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

Accepted Answer

A)   Delayed ejaculation
B)   Erectile dysfunction
C)   Premature ejaculation
D)   Genito-pelvic pain/penetration disorder

Exam 20: Sexual Dysfunctions, Gender Dysphoria, and Paraphilias