C HAPTER 20: S EXUAL D YSFUNCTIONS ,
G ENDER D YSPHORIA , AND P ARAPHILIAS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A nurse is anxious about assessing the sexual history of a patient who is
considerabl y older than the nurse is. Which statement would be most
appropriate for obtaining information about the patients sexual practices?
a. Some people are not sexuall y 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 Id like
to ask if you have any sexual problems you think we should know
about.
c. Its 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.
ANS: A
Explaining that sexual practices vary help s reduce patient anxiet y
about the topic by normalizing the full range of sexual practices so that
whatever his situation, the patient can feel comfortable sharing it. Its
your business of course implies the nurse does not have a valid reason
to seek the information and in effect suggests that the patient perhaps
, should not answer the question. It might be helpful makes the
information seem less valid or important for the nurse to pursue and,
again, could discourage the patient from responding full y. Asking if
the patient has any sexual problems that staff should know about is not
unprofessional, but it is a very broad question that may increase a
patients uncertaint y about what the nurse wants to hear, thus increasing
his anxiet y. Defining or giving an exam ple of sexual problem would
make this inquiry more effective.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 377 TOP: Nursing Process: Assessment MSC:
Client Needs: Health Promotion and Maintenance
2. A man says, I enjoy watching women when I am out in public. I like to go
to places where I can observe women crossing their legs in hopes of
seeing something good. Which statement about this behavior is most
accurate?
a. It is a sexual disorder. The behavior is sociall y at ypical. It could
disrupt relationships and could be insulting to others.
b. It is not a sexual disorder. These events occur in public, where
those he observes do not have a reasonable expectation of privacy.
c. It is not a sexual disorder. Because it occurs in public areas, this
behavior does not hurt others or involve intrusion into the personal
space of those observed.
d. An action is or is not a sexual disorder depending on applicable
local laws, so whether this meets the definition of a sexual disorder
depends on the location.
ANS: A
, A sexual disorder is defined as an activity that is sociall y at ypical, has
the potential to disrupt significant relationships, and may result in
insult or injury to others. The behavior described constitutes a sexual
disorder (voyeurism). Although laws vary, an act does not have to be
illegal to constitute a sexual disorder. The fact that the behavior occurs
in a public setting could have a bearing on whether it is illegal, but not
on whether it is considered to be a sexual disorder.
PTS: 1 DIF: Cognitive Level : Understand (Comprehension)
REF: 373 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
3. 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 identit y?
a. A childs interest in the activities of the opposite gender is not
unusual or related to sexualit y. Most children do not carry cross -
gender interests i nto adulthood.
b. Its 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.
ANS: A
The parents inquiry is reall y two questions: (1) whether the childs
behavior suggests an increased risk of developing mental illness and
(2) what the childs future sexual p reference will be. The psychiatric
G ENDER D YSPHORIA , AND P ARAPHILIAS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. A nurse is anxious about assessing the sexual history of a patient who is
considerabl y older than the nurse is. Which statement would be most
appropriate for obtaining information about the patients sexual practices?
a. Some people are not sexuall y 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 Id like
to ask if you have any sexual problems you think we should know
about.
c. Its 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.
ANS: A
Explaining that sexual practices vary help s reduce patient anxiet y
about the topic by normalizing the full range of sexual practices so that
whatever his situation, the patient can feel comfortable sharing it. Its
your business of course implies the nurse does not have a valid reason
to seek the information and in effect suggests that the patient perhaps
, should not answer the question. It might be helpful makes the
information seem less valid or important for the nurse to pursue and,
again, could discourage the patient from responding full y. Asking if
the patient has any sexual problems that staff should know about is not
unprofessional, but it is a very broad question that may increase a
patients uncertaint y about what the nurse wants to hear, thus increasing
his anxiet y. Defining or giving an exam ple of sexual problem would
make this inquiry more effective.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 377 TOP: Nursing Process: Assessment MSC:
Client Needs: Health Promotion and Maintenance
2. A man says, I enjoy watching women when I am out in public. I like to go
to places where I can observe women crossing their legs in hopes of
seeing something good. Which statement about this behavior is most
accurate?
a. It is a sexual disorder. The behavior is sociall y at ypical. It could
disrupt relationships and could be insulting to others.
b. It is not a sexual disorder. These events occur in public, where
those he observes do not have a reasonable expectation of privacy.
c. It is not a sexual disorder. Because it occurs in public areas, this
behavior does not hurt others or involve intrusion into the personal
space of those observed.
d. An action is or is not a sexual disorder depending on applicable
local laws, so whether this meets the definition of a sexual disorder
depends on the location.
ANS: A
, A sexual disorder is defined as an activity that is sociall y at ypical, has
the potential to disrupt significant relationships, and may result in
insult or injury to others. The behavior described constitutes a sexual
disorder (voyeurism). Although laws vary, an act does not have to be
illegal to constitute a sexual disorder. The fact that the behavior occurs
in a public setting could have a bearing on whether it is illegal, but not
on whether it is considered to be a sexual disorder.
PTS: 1 DIF: Cognitive Level : Understand (Comprehension)
REF: 373 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
3. 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 identit y?
a. A childs interest in the activities of the opposite gender is not
unusual or related to sexualit y. Most children do not carry cross -
gender interests i nto adulthood.
b. Its 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.
ANS: A
The parents inquiry is reall y two questions: (1) whether the childs
behavior suggests an increased risk of developing mental illness and
(2) what the childs future sexual p reference will be. The psychiatric
