Mental Health NCLEX Sexual Disorders: Sexual Dysfunctions and Paraphilias

Which of these individuals is experiencing a symptom of the DSM-IV-TR diagnosis sexual aversion disorder?

a. The patient who has genital pain associated with intercourse
b. The patient who avoids genital sexual contact with a partner
c. The patient who has absence of desire to engage in sexual activity
d. The patient who has delayed orgasm following sexual excitement

A patient who has a sexual disorder mentions to the nurse, “I don’t know why I bother looking for help. They don’t know much about sex problems.” Which statement best describes the evolution of research on sexuality and should serve as the basis for the nurse’s response?

a. Increased knowledge about sexual dysfunction has been available since the late 1960s.
b. Masters and Johnson were the first persons to explore the area of sexual dysfunction.
c. Kaplan was instrumental in identifying the need for psychoanalysis in treating sexual dysfunction.
d. Sigmund Freud, a sexologist, based his work on scientific data from studying human sexual behavior.

A patient who is being treated at the community health clinic complains of lack of sexual desire and mentions the problems this is causing in her marriage. Which of the following data is likely related to her sexual dysfunction?

a. Being an adopted only child
b. Taking an antidepressant medication
c. Growing up in a dysfunctional family
d. Living in an isolated area in the country

When a patient’s wife asks the nurse about fetishism, which example could the nurse give as part of an explanation?

a. Being sexually aroused only by touching female shoes
b. Standing on the street corner exposing genitals to others
c. Feeling sexually attracted to a 10-year-old child who lives next door
d. Achieving sexual pleasure from rubbing against a stranger in an elevator

Which assessment question will be most informative when interviewing a Hispanic female who reports having a sexual aversion?

a. “In your culture is the female expected to be subservient?”
b. “How old were you when you first became sexually active?”
c. “What are your religious beliefs regarding sexual intercourse?”
d. “When did you first begin experiencing pain during intercourse?”

A sexual history begins with the nurse asking the patient when she experienced her first menstrual period. What is the basis for beginning the assessment with this type of question?

a. Medical history is the initial focus of all history assessments.
b. Female sexual dysfunction has its roots in pre-pubescent experiences.
c. Females are more comfortable discussing physical issues than emotional ones.
d. To minimize embarrassment, the history is begun with nonthreatening questions.

What is the basis of the nurse’s response when a husband reports that, “Our problem is that my wife never initiates sex?”

a. Initiation of sex is generally viewed as the male’s role.
b. Communication between partners is vital to satisfying sex.
c. Men often enjoy sex that is initiated by their female partners.
d. Some women may become aroused only after they experience foreplay.

Which comment would support the sexual diagnosis of dyspareunia?

a. “I experience genital pain during intercourse.”
b. “I do not enjoy sexual intercourse and try to avoid it.”
c. “I cannot maintain adequate lubrication during intercourse.”
d. “My perineal muscles contract at the wrong times during intercourse.”

Which patient statement shows achievement of an expected outcome for a patient being treated for a paraphilic disorder who is receiving Depo-Provera injections?

a. “The vaginal pain issue is almost totally resolved.”
b. “I don’t have those sexual fantasies nearly as often now.”
c. “Sex is more pleasurable now that I’m getting the injections.”
d. “I haven’t had a problem maintaining an erection since I started the medication.”

Which assessment question demonstrates knowledge of possible risk factors for the development of a paraphilic disorder?

a. “When were you first diagnosed with schizophrenia?”
b. “Are you aware of a family history of obsessive-compulsive disorder?”
c. “When did you begin relying on printed pornography as a sexual stimulant?”
d. “Why do you find it difficult to take your prescribed antianxiety medication?”

Which of these statements reflect achievement of discharge criteria for a patient receiving in- hospital treatment for a paraphilic disorder?

a. “My wife is willing to attend counseling with me.”
b. “The medication I’m taking has helped me be less anxious.”
c. “I hope I will be able to know what causes me to think this way.”
d. “This injection I take will help me reach a pleasurable climax again.”

A patient admits to fondling his 3-year-old and 5-year-old nieces. Which statement best indicates that the patient lacks an understanding of the impact of this behavior?

a. “There is absolutely nothing wrong with me.”
b. “My babysitter used to do the same things to me.”
c. “Their mother is going to hate me and it’s your fault.”
d. “The children always want me to hold them in my lap.”

Which finding would the nurse expect to assess in a 17-year-old patient who has been diagnosed with Klinefelter’s syndrome?

a. Elevated sperm count
b. Decreased secretion of FSH
c. Gynecomastia in a teenage male
d. Hyperplasia of penis and scrotum

Which topic should be addressed when providing medication information to a patient prescribed Depo-Provera injections for a sexual disorder?

a. Nutritional supplementation to offset weight loss
b. Techniques to minimize exposure to viral infections
c. Ability to self-monitor for elevated diastolic blood pressure
d. Safety measures to protect against injuries related to manic activity

Which question would enable the nurse to assess for cognitive distortions during an interview with a patient diagnosed as having pedophilia?

a. “Is there a family history of sexual dysfunction?”
b. “Were you sexually abused as a child or adolescent?”
c. “How do you think the child felt being your sexual partner?”
d. “Will you be willing to take medication to treat your disorder?”

A patient approaches a clinic nurse in the waiting room and states, “I’d like to talk with you about a sexual problem I’m having.” Which response demonstrates an understanding on the nurse’s initial responsibility to this patient?

a. Offering, “Go ahead if you like. I have time to listen.”
b. Suggesting, “Would you prefer speaking to a sex therapist?”
c. Saying, “Let’s go into my office where there’s more privacy.”
d. Asking, “What type of sexual dysfunction are you experiencing?”

Which intervention should the nurse suggest when a couple expresses the concern that, “Neither of us is interested in sex at the same time.”

a. Scheduling a “sex date” at a time you both agree upon
b. Encouraging role playing to help minimize self-consciousness
c. Exploring new stimulation techniques to renew interest in sex
d. Learning communication techniques that facilitate open expression of feelings

A patient is receiving Depo-Provera. He drinks two to three beers a day, smokes, vacations in hot sunny climates, and is slightly overweight. The nurse knows that essential patient teaching should include the fact that:

a. It is vital to use a sunscreen consistently.
b. Smoking may increase the risk for deep vein thrombosis.
c. Drinking alcohol could cause delusions and hallucinations.
d. Losing weight is essential for efficacy of the medication.

Which interventions would a nurse include in the teaching plan for a patient diagnosed with a sexual dysfunction? Select all that apply.

a. Teach breathing techniques to encourage relaxation during sex.
b. Suggest positive imaging to improve body self-acceptance during sex.
c. Educate the patient regarding the affects of hormones on sexual functioning.
d. Instruct the patient on the use of progressive touch to facilitate sexual pleasure.
e. Suggest an external relaxant such as alcohol to promote self-confidence related to sex.

Which topics should be included in a discussion on risk factors for developing a sexually oriented dysfunction? Select all that apply.

a. Diabetes
b. Depression
c. Chronic pain
d. Gastric ulcers
e. Alcohol consumption