Chapter 29: Sexual Disorders Nursing School Test Banks

Chapter 29: Sexual Disorders
Test Bank

MULTIPLE CHOICE

1. The end of the continuum that is marked by sexual actions harmful to self or others in some manner is known as:
a. Adaptive
b. Homosexual
c. Maladaptive
d. Functional
ANS: C
As the continuum moves toward maladaptive, sexual behaviors become impaired or dysfunctional. The adaptive end of the continuum consists of satisfying sexual behaviors that respect the rights and wishes of others. The other options do not relate to the continuum.

DIF: Cognitive Level: Knowledge REF: p. 337 OBJ: 1
TOP: Continuum of Sexual Responses KEY: Nursing Process Step: Assessment
MSC: Client Needs: Psychosocial Integrity

2. A strong influence on discussion of sexual issues with clients is the nurses or caregivers:
a. Self-awareness
b. Self-confidence
c. Sexual knowledge
d. Assessment abilities
ANS: A
The caregiver must be aware of his or her values regarding sexuality. Values are easily conveyed, often through nonverbal messages, if the caregiver is not fully aware of his or her beliefs.

DIF: Cognitive Level: Comprehension REF: p. 337 OBJ: 2
TOP: Self-Awareness and Sexuality KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

3. The caregiver has been assigned to care for Mr. X, a pedophile who is being treated for AIDS. The thought of caring for him disgusts her. The caregivers therapeutic interactions and interventions are most likely to be:
a. Effective
b. Ineffective
c. Well received
d. Effective if she can conceal her true feelings
ANS: B
Caregivers values often are communicated to clients. Disapproval dampens the effectiveness of the therapeutic relationship.

DIF: Cognitive Level: Comprehension REF: p. 337 OBJ: 2
TOP: Self-Awareness and Sexuality KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

4. Children learn to label themselves according to their sex around the age of ____ year(s).
a. 1
b. 6
c. 2
d. 4
ANS: C
Around the age of 2 years, children learn to label themselves according to their sex. Most respond to being called good girls or brave boys by adults.

DIF: Cognitive Level: Knowledge REF: p. 338 OBJ: 3
TOP: Sexuality in Childhood KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

5. By the time they enter school, it is thought that most children identify with:
a. Same-sex peers
b. Opposite-sex peers
c. The same-sex parent
d. The opposite-sex parent
ANS: C
By school age, most children identify with the same-sex parent.

DIF: Cognitive Level: Knowledge REF: p. 338 OBJ: 3
TOP: Sexuality in Childhood KEY: Nursing Process Step: N/A
MSC: Client Needs: Health Promotion and Maintenance

6. An image of the older adult as an asexual, unintelligent person who is not interested in sex represents:
a. A myth
b. An ideal
c. The truth
d. An attitude
ANS: A
The picture of the older adult as asexual and not interested in sex is a myth. The emphasis of the older adults sexual expression is on companionship and intimate communication, rather than procreation as it was in adulthood.

DIF: Cognitive Level: Knowledge REF: p. 339 OBJ: 3
TOP: Sexuality in Older Adulthood KEY: Nursing Process Step: N/A
MSC: Client Needs: Health Promotion and Maintenance

7. The client was injured in a work accident. He now has a fused spine and moves with difficulty. He wonders if he will ever be able to be intimate with his wife. What is the nurses most accurate response?
a. You will not be able to engage in sexual activity.
b. You can enjoy a satisfying sex life with some adaptation.
c. You eventually will return to the preinjury level of functioning.
d. You will become more sexually active after you recover from the injuries.
ANS: B
Many permanently disabled persons are able to enjoy rich and satisfying sex lives with some adaptation. The other options provide inaccurate information.

DIF: Cognitive Level: Application REF: p. 339 OBJ: 3
TOP: Sexuality and Disability KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

8. People who express their sexuality with members of the opposite sex are:
a. Asexual
b. Bisexual
c. Homosexual
d. Heterosexual
ANS: D
Persons who express their sexuality with members of the opposite sex are heterosexual. Asexual refers to a group of individuals who fall into the category of homosexual, who engage in little to no sexual activity; bisexual refers to individuals who are sexually attracted to members of both genders; and homosexual refers to individuals who prefer expression of their sexual identity with members of the same gender.

DIF: Cognitive Level: Knowledge REF: p. 339 OBJ: 4
TOP: Heterosexuality KEY: Nursing Process Step: N/A
MSC: Client Needs: Health Promotion and Maintenance

9. Experiencing sexual excitement from wearing the clothing of the opposite sex is defined as:
a. Cross-acting
b. Transvestism
c. Transsexuality
d. Sexual dysfunction
ANS: B
Transvestism is defined as sexual excitement derived from wearing the clothing of the opposite sex.

DIF: Cognitive Level: Knowledge REF: p. 341 OBJ: 4
TOP: Transvestism KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

10. The client confides in the nurse that intercourse has been painful since she became menopausal. What is the nurses most therapeutic response?
a. Dont worry; it will pass.
b. Are you still sexually active?
c. Perhaps we can discuss this with your doctor.
d. I understand how difficult it is to discuss sex.
ANS: C
Many sexual dysfunctions are treatable, so clients should be referred to their physicians. Saying that the pain will pass is a nontherapeutic response that disregards the feelings of the client; asking the client if she is still sexually active makes the client feel that she is not normal; and empathizing with the client is helpful but does not address the problem.

DIF: Cognitive Level: Application REF: p. 342 OBJ: 6
TOP: Sexual Dysfunctions KEY: Nursing Process Step: Intervention
MSC: Client Needs: Psychosocial Integrity

11. Between the ages of __________ years, the greatest amount of sexual activity with multiple partners and serial relationships occurs.
a. 13 and 17
b. 18 and 24
c. 25 and 34
d. 35 and 44
ANS: B
Because of the decreased age of first intercourse and the increased age of marriage, more unmarried adults are engaging in this type of sexual activity in todays society.

DIF: Cognitive Level: Knowledge REF: p. 338 OBJ: 3
TOP: Sexuality in Adulthood KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

12. An individual is bisexual. The belief that this individuals sexual variation is related to genetic influences is the belief held by _____ theorists.
a. Biological
b. Behavioral
c. Psychosocial
d. Psychoanalytical
ANS: A
Biological theorists believe that an individuals sexual variation is related to genetic influences. Behavioral theorists believe that modes of sexual expression are learned responses, and psychoanalytical theorists view modes of sexual expression other than heterosexual expression to be neurotic or psychopathic in nature and due to the Oedipus/Electra complex of childhood. Psychosocial theory is not cited as a theory on sexual orientation.

DIF: Cognitive Level: Knowledge REF: p. 341 OBJ: 4
TOP: Theories Relating to Psychosexual Variations
KEY: Nursing Process Step: Assessment MSC: Client Needs: Health Promotion and Maintenance

13. A female client is suffering from vaginismus. The nurse is aware that this is a type of:
a. Paraphilia
b. Sexual dysfunction
c. Psychosexual disorder
d. Gender identity disorder
ANS: B
Vaginismus refers to the persistent involuntary contractions of muscles around the vagina when penetration is attempted; it is classified as a sexual dysfunction. Sexual dysfunction refers to any disturbance in the four stages of the sexual response cycle and/or any discomfort or pain that occurs during sexual intercourse. Paraphilia refers to a group of sexual variations that depart from societys traditional and acceptable modes of seeking sexual gratification; a psychosexual disorder is a broad reference to problems that cause distress or impaired functioning in an individuals sexual functioning; and gender identity disorder is inconsistency between an individuals biological gender and the gender with which he or she identifies.

DIF: Cognitive Level: Comprehension REF: p. 342 OBJ: 6
TOP: Sexual Dysfunctions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

14. A male client is transsexual and decides to become a female through major surgery and hormonal therapy. The nurse informs the client that this process may be delayed for as long as _____ years.
a. 2
b. 5
c. 8
d. 10
ANS: A
The process of changing ones identity is purposely delayed for up to 2 years because this transformation is irreversible. In addition to the surgery and the hormonal therapy, intense psychological counseling is part of the process.

DIF: Cognitive Level: Knowledge REF: p. 343 OBJ: 9
TOP: Gender Identity Disorder KEY: Nursing Process Step: Intervention
MSC: Client Needs: Health Promotion and Maintenance

15. A homosexual couple lives together, but both partners continue to have sexual experiences with others. This is an example of a(n) _____ relationship.
a. Functional
b. Dysfunctional
c. Close-coupled
d. Open-coupled
ANS: D
These couples are not firmly committed to their primary relationship. A functional relationship refers to homosexuals who have several sexual partners with no one specific partner; a dysfunctional relationship refers to homosexual individuals who regret their sexual orientation; and a close-coupled relationship refers to a homosexual couple that is analogous to a traditional married couple in a monogamous relationship.

DIF: Cognitive Level: Comprehension REF: p. 341 OBJ: 4
TOP: Homosexuality KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

16. The rate of pregnancy and transmission of HIV is higher in the adolescent population than the general population of sexually active adults due to the fact that because adolescents:
a. Have more sexual partners
b. Utilize ineffective contraception
c. Have not been educated regarding sexuality
d. Seek behaviors that reflect their need to be independent
ANS: B
Most adolescent girls use ineffective or no contraception at all and most adolescent boys do not use condoms. Because of this practice, the sexually transmitted disease (including human immunodeficiency virus/acquired immunodeficiency syndrome [HIV/AIDS]) and pregnancy rates are higher for adolescents than the general population of sexually active adults.

DIF: Cognitive Level: Comprehension REF: p. 338 OBJ: 3
TOP: Sexuality in Adolescence KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

17. An individuals orientation, whether heterosexual, homosexual, or bisexual, is established by the time of:
a. Adolescence
b. Early adulthood
c. Late childhood
d. Early childhood
ANS: C
Ones sexual orientation is established by late childhood. It continues to develop through adulthood. Gender is understood in early childhood.

DIF: Cognitive Level: Comprehension REF: p. 340 OBJ: 3
TOP: Homosexuality KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

18. While performing a search of an adult males home based on suspicion of criminal activity, the police find pictures of him with young children between the ages of 5 and 10. The pictures are sexual in nature. The man is suspected of:
a. Voyeurism
b. Sexual sadism
c. Pedophilia
d. Necrophilia
ANS: C
Pedophilia is fondling and/or other types of sexual activities with a prepubescent child (usually under age 13 years and having not yet developed secondary sex characteristics). Sexual sadism is sexual arousal achieved by inflicting pain or humiliation on someone else, voyeurism is sexual arousal achieved by observing unsuspecting persons in the act of disrobing or engaging in sexual activity. Necrophilia deals with sexual activity with a corpse.

DIF: Cognitive Level: Comprehension REF: p. 343 OBJ: 7
TOP: Description of Paraphilias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

19. A 68-year-old man is being treated for an enlarged prostate. While discussing health history with the nurse, he states that he seems to be having erectile difficulties and is not sure if it is from his medical condition or the medication he is taking. Which nursing diagnosis is most appropriate?
a. Sexual dysfunction
b. Injury, risk for
c. Coping, ineffective
d. Family processes, dysfunction
ANS: A
Sexual dysfunction is a disturbance anywhere that occurs at any time during these four stages of the sexual response cycle. The causes are often related to psychological distresses, medication or illicit drug use, and many physical conditions. Arthritis, diabetes, and chronic illness can result in various sexual dysfunctions or alterations in sexual desire. The other nursing diagnoses do not apply in this situation.

DIF: Cognitive Level: Comprehension REF: p. 342 OBJ: 6
TOP: Sexual Dysfunctions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

MULTIPLE RESPONSE

20. Which are signs of sexual addiction? (Select all that apply.)
a. Inability to stop
b. Bragging to others about exploits
c. Refusing to stop enjoying the act
d. Out-of-control sexual behaviors
e. Enjoying cross-dressing
f. Persisting in behaviors despite severe consequences
g. Spending excessive time pursuing sexual experiences
ANS: A, D, F, G
Inability to stop, out-of-control sexual behaviors, persisting in behaviors despite severe consequences, and spending excessive time pursuing sexual experiences are characteristics of sexual addicts.

DIF: Cognitive Level: Knowledge REF: p. 344 OBJ: 9
TOP: Sexual Addiction KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

21. The criteria for healthy or adaptive sexual response include: (Select all that apply.)
a. Sexual acts between two consenting adults
b. Sexual acts that fulfill the desire of only oneself
c. Sexual acts that are not forced or coerced
d. Sexual acts that are conducted in privacy
e. Sexual acts that fulfill the desire between two people
ANS: A, C, D, E
These are conditions of sexuality that are considered adaptive. Sexual acts that fulfill only the desire of oneself are maladaptive because they do not consider others.

DIF: Cognitive Level: Comprehension REF: p. 337 OBJ: 1
TOP: Continuum of Sexual Responses KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

22. What are the types of relationships that put individuals at greatest risk for sexually transmitted diseases, including HIV/AIDS? (Select all that apply.)
a. Bisexual
b. Asexual
c. Functional homosexual
d. Dysfunctional homosexual
e. Open-coupled homosexual
f. Close-coupled homosexual
ANS: A, C, D, E
These relationships pose the greatest risk because of lack of monogamy. Asexual homosexual individuals have little desire or a low level of sexual activity, and close-coupled relationships are similar to traditional monogamous heterosexual marriages.

DIF: Cognitive Level: Comprehension REF: p. 340 OBJ: 4
TOP: Homosexuality KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

23. Which of the following are indicative of sexual dysfunction? (Select all that apply.)
a. Sexual aversion disorder
b. Sadism
c. Erectile disorder
d. Dyspareunia
e. Exhibitionism
ANS: A, C, D
Sexual aversion disorder, erectile disorder, and dyspareunia are examples of sexual dysfunctions that are disturbances in any phase of the sexual response cycle. They are usually related to psychological distress, medication, and physical illness. Sadism and exhibitionism are examples of paraphiliassexual variations that depart from societys traditional and acceptable modes of seeking sexual gratification.

DIF: Cognitive Level: Comprehension REF: p. 342 OBJ: 6
TOP: Sexual Dysfunctions KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

COMPLETION

24. The primary nursing diagnoses for a client who is experiencing problems with sexuality are sexual dysfunction and __________.

ANS:
ineffective sexuality pattern
These are the two most common nursing diagnoses seen in clients who are experiencing sexual problems. Other nursing diagnoses may apply to individual situations.

DIF: Cognitive Level: Knowledge REF: p. 344 OBJ: 9
TOP: Nursing Process KEY: Nursing Process Step: Nursing Diagnosis
MSC: Client Needs: Health Promotion and Maintenance

25. According to the DSM-IV-TR, sexual arousal that is attained by an individual while he is observing an unaware person who is naked, disrobing, or engaging in sexual activity is known as __________.

ANS:
voyeurism
This sexual disorder is a type of paraphilia. These individuals sometimes are referred to as peeping Toms.

DIF: Cognitive Level: Knowledge REF: p. 343 OBJ: 7
TOP: Paraphilias KEY: Nursing Process Step: Assessment
MSC: Client Needs: Health Promotion and Maintenance

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