Nokea
The manager of a health club put a hidden camera in the women's locker room and videotaped women as they showered and dressed. Which sexual dysfunction is evident?
- A. Frotteurism
- B. Exhibitionism
- C. Pedophilia
- D. Voyeurism
Correct Answer: D
Rationale: Voyeurism is the viewing of others in intimate situations such as undressing, bathing, or having sexual relations. Voyeurs are often called 'peeping Toms.' Frotteurism is touching or rubbing against a nonconsenting person to achieve sexual gratification. Exhibitionists are interested in exposing their genitals to others. Pedophiles seek sexual contact with prepubescent children.
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A patient diagnosed with severe and persistent mental illness lives independently. This patient often has command hallucinations and shouts warnings to neighbors. After a short hospitalization, the patient's landlord says, 'You can't come back here. You cause too much trouble.' What problem is the patient experiencing?
- A. Grief
- B. Stigmatization
- C. Recidivism
- D. Lack of insurance parity
Correct Answer: B
Rationale: The inability to obtain shelter because of negative attitudes about mental illness is an example of stigmatization. Stigma is defined as damage to reputation, shame, and ridicule society places on mental illness. Data are not present to identify grief as the patient's problem. Recidivism refers to repetition of a previous offense. Insurance parity is not relevant to this scenario.
A nurse cares for a patient diagnosed with paraphilia. The nurse expects the health care provider may prescribe which type of medication to reduce paraphilic behaviors?
- A. Stimulants
- B. Erectile dysfunction medication
- C. Atypical antipsychotic medication
- D. Mood stabilizer
Correct Answer: D
Rationale: Pharmacological treatment typically involves medications that reduce impulsive or compulsive behavior, such as antidepressants, naltrexone, antipsychotics, mood stabilizers, or medications that interfere with the production of sexual hormones in order to reduce sexual urges. The other medications are not indicated for this disorder.
A patient diagnosed with severe and persistent mental illness who recently moved to a homeless shelter says, 'My life is out of control. I'm like a leaf at the mercy of the wind.' The nurse formulates the diagnosis Powerlessness. Outcomes will focus on which goal?
- A. Instilling hope
- B. Controlling anxiety
- C. Planning social activities
- D. Developing personal autonomy
Correct Answer: D
Rationale: Powerlessness is associated with feeling unable to control events in one's life. It is often associated with low self-esteem. The goal is to increase one's sense of autonomy. The scenario does not indicate hopelessness or anxiety. Socialization is not the primary need.
The parent of an adult diagnosed with severe and persistent mental illness asks the nurse, 'Why are you making a referral to that vocational rehabilitation program? My child won't ever be able to hold a job.' Which is the nurse's best reply?
- A. We made this referral to maintain eligibility for federal funding.'
- B. Are you concerned that we're trying to make your child too independent?'
- C. If you think the program would be detrimental, we can postpone it for a time.'
- D. Most patients are capable of employment at some level, competitive or supported.'
Correct Answer: D
Rationale: Studies have shown that most patients who complete vocational rehabilitation programs are capable of some level of employment; also, they demonstrate significant improvement in assertiveness and work behaviors, as well as decreased depression, and improved self-esteem and socialization.
A man tells the nurse, 'All my life, I have felt and acted like a woman while living in a man's body. For the past year, I have lived and dressed as a woman. I changed jobs to protect my new identity.' Which request is the patient likely to make to the health care provider?
- A. Can you refer me for psychological testing?'
- B. Will you prescribe hormonal therapy?'
- C. Will you alter my medical records?'
- D. What should I tell my parents?'
Correct Answer: B
Rationale: Before sexual reassignment surgery, the step that follows living as a member of the other sex is hormone therapy. The patient's decision to live as a woman makes this a natural request. Psychological testing occurs before sexual reassignment surgery, often after hormone therapy has begun. The patient has likely told his parents by this point.