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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.”

ANS: A

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.

PTS: 1 DIF: Cognitive Level: Apply (Application)

REF: Pages 20-25, 30

TOP: Nursing Process: Implementation

MSC: Client Needs: Health Promotion and Maintenance

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.

b. Persons with paraphilic disorders rarely experience shame and are not distressed by their acts.

c. Persons with paraphilic disorders prey primarily on female children between the ages of 12 and 15 years.

d. Acts of paraphilia are common because persons with the disorders commit the acts repeatedly, but paraphilic disorders are uncommon.

ANS: D

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.

PTS: 1 DIF: Cognitive Level: Understand (Comprehension)

REF: Page 20-38 TOP: Nursing Process: Assessment

MSC: Client Needs: Psychosocial Integrity