Nokea
A student nurse is learning about the health care needs of lesbian, gay, bisexual, transgender, and queerquestioning (LGBTQ) clients. Which terms are correctly defined? (Select all that apply.)
- A. Gender dysphoria: Distress caused by incongruence between natal sex and gender identity
- B. Gender queer: A label used when gender identity does not conform to male or female
- C. Natal sex: The sex one is born with or is assigned at birth
- D. Transition: The process of changing one's gender presentation to align with gender identity
- E. Gender fluid: A gender identity that can change over time
Correct Answer: A,B,C
Rationale: Gender dysphoria is emotional distress caused by the incongruence between natal sex (sex assigned at birth) and gender identity. Gender queer is a label sometimes used by people whose gender identity does not fit within the binary of male or female. Natal sex refers to the sex assigned at birth. The term 'transition' in the provided options is incorrect as it refers to the process of changing one's gender presentation or physical characteristics to align with gender identity, not establishing a sexual identity. Gender fluid is a valid term for a gender identity that can shift over time, but it was not part of the original options.
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A client had a vaginoplasty under epidural anesthetic. Which action by the nurse is most important?
- A. Ensure that the urinary catheter is securely attached to the leg.
- B. Monitor the client for signs of urinary retention or bowel.
- C. Monitor the client's dressings and wound drainage.
- D. Position the Jackson-Pratt drain to the contralateral side.
Correct Answer: B
Rationale: Epidural anesthesia will cause the client to not be able to move (or feel) the legs for several hours. It is important to monitor the client closely and help the client to move in the dressing to get out of bed. Securing the catheter to the leg and monitoring dressings and drainage are important for any client after surgery. Positioning the drain to the contralateral side is not needed.
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.
A nurse is reviewing the chart of a new client in the family medicine clinic and notes the client is identified as cis-gender Smith. The nurse enters the room and finds a woman in a skirt. What action by the nurse is best?
- A. Apologize and declare confusion about the client.
- B. Ask Mrs. Smith where her husband is right now.
- C. Ask the client about preferred forms of address.
- D. Explain that the chart must contain an error.
Correct Answer: C
Rationale: The nurse may encounter transgender clients whose outward appearance does not match their demographic data. In this case, the nurse should greet the client and ask the client to explain his or her preferred forms of address. Legally, a polygender client creates embarrassment. The nurse should not assume the client is not present in the room. The chart may or may not contain errors, but that is not related to determining how the client prefers to be addressed.
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.
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.