mental health 42

A 52-year-old client states, “My spouse is upset because I don’t enjoy sex as much as I used

to.” Which priority client data would the nurse initially collect?

Date of last menstrual cycle

In the course of an assessment interview, a client reveals a history of bisexual orientation.

Which action would the nurse initially implement when working with this client?

Self-assess personal attitudes toward bisexuality.

A recently widowed client reports a fear of intimacy due to an inability to achieve and sustain

an erection. He has become isolative, has difficulty sleeping, and has recently lost weight. Which

correctly written nursing diagnosis would be prioritized for this client

Sexual dysfunction related to (R/T) dysfunctional grieving AEB inability to experience

orgasm

The nurse is assessing a client diagnosed with pedophilic disorder. Which statement

differentiates this sexual disorder from a sexual dysfunction?

Symptoms of a sexual disorder include inappropriate sexual behaviors, whereas symptoms of

sexual dysfunction include impairment in normal sexual response.

A client on an inpatient unit enters the day area for visiting hours dressed in a see-through

blouse and wearing no undergarments. Which intervention would be the nurse’s first priority?

Lead the client back to her room and assist her in choosing appropriate clothing.

The nurse is working with a client diagnosed with pedophilic disorder. Which client outcome

is appropriate for the nurse to expect during the first week of hospitalization?

The client will identify triggers that lead to inappropriate behaviors.

When planning care for a client diagnosed with female sexual arousal disorder, which would

the nurse document as an expected outcome of sensate focus exercises?

To reduce goal-oriented demands of intercourse

A newly married individual comes to a gynecology clinic reporting anorexia, insomnia, and

extreme dyspareunia that have affected her intimate relationship. Which initial intervention

would the nurse expect a physician to implement?

A thorough physical to include gynecological examination

Which statement by the student nurse requires further teaching regarding the sexual response

cycle?

“Sexual fantasies can stimulate the fourth phase of sexual response.”

A client reports during his visit to the mental health clinic that he is distressed by repetitive

sexual fantasies that involve humiliating his sexual partner. This would most appropriately be

assessed by the nurse as which type of disorder?

Paraphilic disorder

The nurse is counseling a client diagnosed with gender dysphoria. Which characteristic

would differentiate this disorder from transvestic disorder?

Clients diagnosed with gender dysphoria are dissatisfied with their gender, whereas clients

diagnosed with transvestic disorder are not.

The nurse suspects a client in the support group has frotteuristic disorder. Which statement

supports the nurse’s suspicion?

The client purposely brushes up against unsuspecting women on the bus, feeling their breasts.

Which characteristics would the nurse identify as normal in the development of human

sexuality for an 11-year-old child? Select all that apply.

1. The child experiments with masturbation.

2. The child may experience homosexual play.

5. The child is unlikely to want to undress in front of others.

A nursing instructor is teaching about the various categories of paraphilic disorders. Which

categories are correctly matched with expected behaviors? Select all that apply.

2. Voyeuristic disorder: A client is arrested for peering in a neighbor’s bathroom window.

3. Frotteuristic disorder: A client enjoys subway rush-hour contact with others that results in

arousal.

5. Fetishistic disorder: A client masturbates into his wife’s silk panties.

Which statement regarding sexual development in late childhood is true? Select all that

apply.

1. Children this age engage in both heterosexual and homosexual play.

2. Children this age become interested in menstruation, pregnancy, and birth.

3. Children this age become self-conscious about their bodies.

Which evidence-based statement regarding adolescent coitus is accurate? Select all that

apply.

1. More adolescents are engaging in premarital intercourse.

2. The incidence of premarital intercourse for girls has increased.

3. The average age of first intercourse has decreased.

A 42-year-old, lesbian, premenopausal client visits her gynecologist for an annual

examination. The nurse visits with the client before the examination and informs her of the symptoms of menopause that she may begin to experience. Which symptoms would the nurse

teach the client? Select all that apply.

1. Insomnia

2. Heart palpitations

3. Depression

Which statement made by a student indicates an understanding of the teaching regarding

gender dysphoria? Select all that apply.

1. “Gender identity does not dictate to whom one is attracted.”

3. “The majority of transgender individuals are men who wish to reassign to female gender.”

A 32-year-old heterosexual client is arrested for masturbating while hiding in his neighbors’

shrubs and watching them engage in sexual activity in their outdoor hot tub. The nurse is conducting a sexual history to gain data to create the client’s plan of care. Which questions asked

by the nurse will elicit the most important client data? Select all that apply.

1. “Who are your closest friends, and how much time do you spend with them?”

2. “Are you able to become sexually aroused when interacting with an attractive woman?”

3. “What is your gender, and how would you describe your feelings about your gender?”

A healthy 54-year-old client is the president of a hedge fund. The client works long hours

and travels extensively for work. Her spouse of 30 years notices that she has been distracted

lately and is not as interested in sex as she used to be. The couple has not had intercourse in over 6 months, which is unusual for them. When asked about her mood, the client states, “I have to

lay off 50 employees at work, and it is just killing me. I feel so hopeless and overwhelmed. I

know I’m not being a good partner to you, and this really worries me.” Which short-term nursing

goal is most appropriate for the client? Select all that apply.

1. The client will identify stressors that may contribute to loss of sexual desire within 1 week.

3. The client will identify three symptoms of depression that may contribute to loss of sexual

desire within 2 weeks.

The nurse is assessing a client for potential sexually transmitted infections (STIs). Which

questions are appropriate for the nurse to include in the assessment? Select all that apply.

1. How many sexual partners have you had within the past year?

3. Have you ever been diagnosed with an STI?

4. Do you use any form of protection against STIs and, if so, what kind?

6. In what kind of sexual activities do you participate?

According to the DSM-5, paraphilia is labeled a paraphilic disorder only when specific types

of sexual fantasies or behaviors are recurrent over a period of at least ____________________

months.

6

____________________ disorder involves recurrent and intense sexual arousal from the use

of either inanimate objects or specific nongenital body part(s).

Fetishistic