Deck 19: Sexual Dysfunctions, Gender Dysphoria, and Paraphilic Disorders

Question 1

The nurse is caring for a patient who has had opioid use disorder for several years and now presents with a sexual dysfunction. For which clinical manifestations will the nurse assess the patient? Select all that apply.

A) Difficulty with orgasm
B) Difficulty with ejaculation
C) Difficulty maintaining an erection
D) Difficulty becoming sexually aroused
E) Difficulty performing sexually due to pain

Answer 1

Difficulty with orgasm
Difficulty with ejaculation

Question 2

The nurse is caring for a female patient with female orgasmic disorder. The nurse explains that a number of factors are involved in the development of the disorder. Which factors will the nurse discuss as being associated with female orgasmic disorder? Select all that apply.

A) Hostility toward the partner
B) Fear of becoming pregnant
C) Fear of sex
D) Fear of vaginal damage
E) Fear of losing control

Answer 2

Hostility toward the partner
Fear of becoming pregnant
Fear of vaginal damage
Fear of losing control

Question 3

The nurse is caring for a patient with a sexual dysfunction and is referring to the DSM-5 as guide of reference. What subtype of sexual dysfunction does the DSM-5 refer to as occurring regardless of partner, situation, or type of stimulation?

A) Situational
B) Lifelong
C) Acquired
D) Generalized

Answer 3

Generalized

Question 4

The nurse is caring for a patient with female sexual arousal disorder. The nurse understands that psychological as well as biological factors contribute to the etiology of this disorder. Which does the nurse recognize as a contributing factor to the development of female sexual arousal disorder?

A) Low serum estrogen
B) Elevated serum dopamine
C) Low serum testosterone
D) Elevated serum androgen

Question 5

The nursing instructor is teaching a group of nursing students about the stages of the sexual response cycle. Which stage is the instructor describing when teaching about the release of the neurotransmitters acetylcholine, dopamine, and nitric oxide?

A) Excitement
B) Plateau
C) Orgasm
D) Resolution

Question 6

The nurse is researching the genetic link to sexual dysfunction and sexual disorders. Which sexual dysfunction syndromes or disorders does the nurse learn are directly related to chromosomal inheritance? Select all that apply.

A) Turner syndrome
B) Gender dysphoria
C) Kleinfelter syndrome
D) Paraphilic disorder
E) Intersex condition

Question 7

The student nurse is learning about the stages of the sexual response cycle in order to care for patients with sexual disorders. The student will learn that the primary physiology of excitement or arousal involves which system?

A) Sympathetic nervous system
B) Parasympathetic nervous system
C) Renin-angiotensin-aldosterone system
D) Peripheral nervous system.

Question 8

The student nurse is learning about the impact of biological, psychological, social, cultural, and spiritual domains on sexual development and dysfunctions. According to the attachment theory, which alternative form of attachment, linked to sexual identity, may occur if parental attachment is compromised? Select all that apply.

A) Preoccupied
B) Authoritarian
C) Fearful
D) Permissive
E) Dismissive

Question 9

The nurse is caring for a female patient with a suspected sexual dysfunction. In order for the health care provider to diagnose this condition, which must be true of the symptoms? Select all that apply.

A) They always prevent the desired participation in sexual activity.
B) They frequently prevent the desired participation in sexual activity.
C) They have been present for at least 12 months.
D) They have been present for at least 6 months.
E) They are not caused by some other mental, behavioral, or medical condition.

Question 10

The nurse is caring for a patient with gender dysphoria who is in the process of gender reassignment. The patient tells the nurse, "Why does this process take so long? I'm tired of living like the opposite sex." What is the nurse's best response?

A) "It allows you to reflect on the whether or not you are serious about the procedure."
B) "It allows you to make a social transition to the opposite gender before any hormonal or surgical procedure begins."
C) "It allows the health care provider time to decide whether you are a good candidate for the procedure."
D) "It allows you time to make a physical transition to the opposite gender before any hormonal procedure."

Question 11

The psychiatric-mental health nurse preparing to provide patient education to a patient with a sexual dysfunction. Which information about orgasm will the nurse include in the session?

A) It is mediated by dopamine, produced by the brain.
B) It is mediated by norepinephrine, produced by the sympathetic nervous system.
C) It is mediated by nitric oxide, produced by the vascular system.
D) It is mediated by epinephrine, produced by the parasympathetic nervous system.

Question 12

According to the Masters and Johnson model, which best describes the pattern of the human sexual response cycle?

A) Linear
B) Nonlinear
C) Cluster
D) Gap

Question 13

The nurse is assessing a female patient who complains of pain during intercourse. The nurse will review the patient history for which factors that may contribute to genitopelvic pain/penetration disorder? Select all that apply.

A) Latex allergy
B) Chronic stress
C) Vaginal infections
D) Endometriosis
E) Urinary tract infections

Question 14

The nurse is caring for a male patient with hypothyroidism who complains of sexual dysfunction. What sexual disorder is most likely in this patient? Select all that apply.

A) Priapism
B) Erectile disorder
C) Delayed ejaculation
D) Premature ejaculation
E) Male hypoactive sexual desire disorder

Question 15

Which intervention is most appropriate for the nurse to offer when helping a patient with gender dysphoria?

A) Promote comfort with the chosen gender role.
B) Encourage living as the individual's assigned gender.
C) Avoid patient discussions of hormonal treatment.
D) Discourage genital reassignment surgery.

Question 16

The nurse is caring for a patient who has been diagnosed with gender dysphoria. The patient desires sexual reassignment surgery. What does the nurse recognize as the first phase of this type of treatment?

A) Hormonal therapy
B) Diagnostic testing
C) Nutritional therapy
D) Therapeutic testing

Question 17

The nurse is caring for a patient who has been diagnosed with a sexual disorder. When discussing the role hormones play in sexuality, what information will the nurse provide regarding oxytocin?

A) Regulates the menstrual cycle
B) Responsible for the sex drive in both sexes
C) Promotes grooming, arousal, and orgasmic activity
D) Causes the mammary glands to prepare for milk production

Question 18

The nurse is caring for a 55-year-old male patient with Parkinson disease who is being treated for a sexual disorder. Which sexual disorder is most likely in this patient?

A) Delayed ejaculation
B) Priapism
C) Male hypoactive sexual desire disorder
D) Premature ejaculation

Question 19

The nurse is caring for a patient with gender dysphoria who underwent gender reassignment surgery 14 months ago. The patient tells the nurse that she regrets her decision of having the surgery. What is the most common reason individuals feel regret after gender reassignment surgery?

A) Failure to acknowledge the social implications of living as a member of the opposite gender.
B) Failure to live as a member of the opposite gender for a significant period of time prior to undergoing surgery.
C) Failure to comply with long-term pharmacologic and hormonal therapy after surgery.
D) Failure to go through diagnostic testing prior to undergoing surgery.

Question 20

The nurse at a pediatric clinic is assessing a 14-year-old male patient. The patient and his parents are concerned that he has not started puberty. The nurse anticipates the need to provide patient education about which disorder or condition?

A) Gender dysphoria
B) Priapism
C) Intersex
D) Erectile dysfunction

Question 21

The nurse is caring for a male pedophile who is undergoing treatment for his condition. Why might the nurse anticipate an order for medroxyprogesterone (Provera or Depo Provera)?

A) It is used as a temporary chemical castration.
B) It is used to increase the hormone testosterone.
C) It is used to increase luteinizing hormone.
D) It is used as a permanent chemical castration.

Question 22

The nurse is caring for a patient with paraphilia who is prescribed a selective serotonin-reuptake inhibitor (SSRI) for symptom management. What additional treatment is often used in conjunction with SSRIs for patients with paraphilia?

A) MAOI
B) Electroconvulsive therapy (ECT)
C) Group psychotherapy
D) Individual therapy

Question 23

The nurse is caring for a patient with gender dysphoria. When promoting open communication with the patient, what is the nurse's best action?

A) Use closed questions.
B) Convey willingness to learn.
C) Present him or herself as the expert to the patient.
D) Convey sympathy.

Question 24

The nurse is caring for a male patient with pedophilia who is undergoing treatment for his condition. The patient is prescribed lueprolide (Lupron) for symptom management. What potential complication will the nurse discuss with the patient?

A) Deep vein thrombosis (DVT)
B) Tachycardia
C) Hypertension
D) Hyperlipidemia

Question 25

The nurse is caring for a patient who has been diagnosed with sexual masochism. The nurse anticipates that the patient may require education related to which class of medications?

A) Typical antipsychotics
B) SSRIs
C) MAOIs
D) Atypical antipsychotics

Question 26

What factors should the nurse self-assess periodically when working with a patient who is diagnosed with a sexual disorder? Select all that apply.

A) Professional standards of care about sex
B) Personal practices about sex
C) Educational practices about sex.
D) Knowledge about sex
E) Personal attitudes about sex

Question 27

The nurse is planning care for a patient diagnosed with a sexual disorder. Which nursing action is important during the preinteraction phase of the nurse-patient relationship?

A) Discuss the nurse's beliefs with the patient.
B) Agree with the patient's sexual values.
C) Participate in values clarification.
D) Provide appropriate sexual health care.

Question 28

The nurse is caring for a patient who has gender dysphoria. What is the nurse's best action to reduce and eliminate discrimination when caring for this patient?

A) Ask close-ended questions to elicit direct answers when talking about sex with the patient.
B) Ask open-ended questions that engage the patient to actively participate in care.
C) Ask the charge nurse to reassign the nurse if the nurse is uncomfortable.
D) Ask the nurse's co-worker to discuss the patient's condition, in order to avoid direct questions with the patient.