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A nurse is providing health teaching to a middle-aged male-to-female (MtF) client who has undergone gender reassignment surgery. What information is most important to this client?
- A. Be sure to have an annual prostate examination.
- B. You may have a higher risk of cancer.
- C. Try to avoid being around people who are ill.
- D. You may have a higher risk of flu and flu shot.
Correct Answer: A
Rationale: The MtF client retains the prostate, so annual screening examinations for prostate cancer remain important. The other statements are good general health teaching ideas for any client.
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A transgender client taking spironolactone (Aldactone) is in the internal medicine clinic reporting heart palpitations. What action by the nurse takes priority?
- A. Draw blood to test serum potassium.
- B. Have the client lie down.
- C. Obtain a STAT electrocardiogram (ECG).
- D. Take a set of vital signs.
Correct Answer: C
Rationale: Spironolactone is a potassium-sparing diuretic, and hyperkalemia can cause cardiac dysrhythmias. The nurse's priority is to obtain an ECG, then to facilitate a serum potassium level being drawn. Having the client sit down and obtaining vital signs are also important care measures, but do not take priority.
The nurse is reviewing possible complications from a phalloplasty. What factors does the nurse include? (Select all that apply.)
- A. Infection of donor site
- B. Necrosis of the nonpenis
- C. Rectal perforation
- D. Urinary tract stenosis
- E. Vaginal infections
Correct Answer: A,B,D
Rationale: Complications from phalloplasty include infection or scarring of the donor site, necrosis, and stenosis of the urinary tract. Rectal perforation can occur with vaginoplasty, as can infections.
A client is preparing for gender reassignment surgery and will transition from male to female. The client is concerned about the possibility of having a voice change. What should the nurse tell the client?
- A. Ask if the client has considered vocal cord surgery to change the voice
- B. Refer the client for vocal therapy with speech-language pathology.
- C. Teach the client that there will be no effect on the client's voice.
- D. Tell the client that the use of hormones will eventually change the voice.
Correct Answer: B
Rationale: Male-to-female clients can consult with a speech-language pathologist for vocal training to help with intonation and pitch. While vocal surgery is possible, it may not be the best first option due to cost and invasiveness. Telling the client there will be no change in the voice does not give the client information to address the concern. While the hormones this client is taking will not affect the voice, simply stating that fact does not help the client manage this issue.
The nurse is teaching a transgender client about the medication goserelin (Zoladex). What action by the client indicates good understanding?
- A. The client states that the medication is effective.
- B. Administers a subcutaneous injection
- C. Prepares an implanted port for IV insertion
- D. States that the axillary area will be clothed
Correct Answer: B
Rationale: Goserelin is administered via subcutaneous injection. The other actions are not related to self-management while on this medication.
A transgender client is taking transdermal estrogen (Climara). What assessment finding does the nurse report immediately to the provider?
- A. Breast tenderness
- B. Headaches
- C. Red, swollen calf
- D. Swollen ankles
Correct Answer: C
Rationale: A red, swollen calf could be a manifestation of a deep vein thrombosis, a known side effect of estrogen. The nurse reports this finding immediately. The other manifestations are also side effects of estrogen, but do not need to be reported as a priority.