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Explaining that sexual practices vary helps reduce patient anxiety about the topic by normalizing the full range of sexual practices so that whatever his situation, the patient can feel comfortable sharing it. “It’s 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 fully. 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 patient’s uncertainty about what the nurse wants to hear, thus increasing his anxiety. Defining or giving an example of “sexual problem” would make this inquiry more effective. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 20-16 to 18, 55 (Table 20-2) TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance
14. A man says, “I enjoy watching women when I am out in public. I like to go to places where I
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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 socially atypical. 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
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A sexual disorder is defined as an activity that is socially atypical, 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.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Pages 20-36, 37 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity 15. A parent who is very concerned about a 3-year-old son says, “He likes to play with girls’ toys.
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Do you think he is homosexual or mentally ill?” Which response by the nurse most professionally describes the current understanding of gender identity? 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.”
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