ANS: A
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The parent’s inquiry is representing two questions: (1) whether the child’s behavior suggests an increased risk of developing mental illness and (2) what the child’s future sexual preference will be. The psychiatric disorder that most directly addresses gender preferences and cross-gender activities is gender identity disorder. Pointing out that cross-gender activities are not necessarily related to gender identity and not likely to be carried into adulthood is supported by current research. Saying the child will grow up to be “normal” implies that to be homosexual is to be abnormal, which reflects a cultural perspective that most professionals would believe to be inappropriate to share in a professional setting. Research provides information about the relationship between cross-gender interests in childhood and adulthood, so a comment that “research is incomplete” is not entirely accurate. Stating that the child is a wonderful boy the father will be proud of, whatever happens, evades the parent’s question and suggests that parental bonds should not be affected by gender issues. The nurse has a professional obligation to maintain an objective, therapeutic relationship.
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PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 20-25, 30 TOP: Nursing Process: Implementation MSC: Client Needs: Health Promotion and Maintenance
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16. Which statement about paraphilic disorders is accurate? a. Paraphilic behavior is controllable by willpower, but most persons with these
disorders fail to do so.
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b. Persons with paraphilic disorders rarely experience shame and are not distressed
by their acts. ages of 12 and 15 years.
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c. Persons with paraphilic disorders prey primarily on female children between the d. Acts of paraphilia are common because persons with the disorders commit the acts
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repeatedly, but paraphilic disorders are uncommon. ANS: D
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Paraphilic disorders are uncommon; however, because persons with these disorders repeatedly enact behaviors associated with their disorders, paraphilic acts are relatively common. The majority of victims of pedophiles are males in early adolescence; those pedophiles who prefer females usually prefer prepubescent children. Some persons with paraphilic disorders experience shame and are at higher risk for suicide due to the stigma, shame, and embarrassment. Biological and psychological drives underlying paraphilic behavior can be very strong and often are not controllable by willpower alone. Persons with paraphilic disorders have difficulty controlling their behavior, even when very motivated to do so.
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PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 20-38 TOP: Nursing Process: Assessment MSC: Client Needs: Psychosocial Integrity
17. A respected school coach was arrested after a student reported the coach attempted to have
sexual contact. Which nursing action has priority in the period immediately following the coach’s arrest? a. Determine the nature and extent of the coach’s sexual disorder. b. Assess the coach’s potential for suicide or other self-harm. c. Assess the coach’s self-perception of problem and needs. d. Determine whether other children were harmed.
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