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Which nursing action should occur first when preparing to work with a patient who has a problem of sexual functioning?
- A. Acquire knowledge of the patient's sexual roles and preferences.
- B. Develop an understanding of human sexual responses.
- C. Assess the patient's sexual functioning.
- D. Clarify the nurse's own personal values.
Correct Answer: D
Rationale: Before a nurse can be helpful to patients with sexual dysfunction, he or she must be aware of and comfortable with his or her own feelings about sex and sexuality. Nurses must be comfortable with the idea that patients have a right to their own values and must avoid criticism and censure.
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A person diagnosed with severe and persistent mental illness enters a shelter for the homeless. Which intervention should be the nurse's initial priority?
- A. Develop a relationship.
- B. Find supported employment.
- C. Administer prescribed medication.
- D. Teach appropriate health care practices.
Correct Answer: A
Rationale: Basic psychosocial needs do not change because a person is homeless. The nurse's initial priority should be establishing rapport. Once a trusting relationship is established, then the nurse can pursue other interventions.
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.
Health maintenance and promotion efforts for patients diagnosed with severe mental illness should include education about the importance of what regular intervention?
- A. Home safety inspections
- B. Monitoring of self-care abilities
- C. Screening for cancer, hypertension, and diabetes
- D. Determination of adequacy of a patient's support system
Correct Answer: C
Rationale: Individuals diagnosed with severe and persistent mental illness have an increased prevalence of medical disorders. Patients should be taught the importance of regular visits to a primary care physician for screening for these illnesses. Home safety inspections are more often suggested for patients with physical impairments. Caregivers and family members usually evaluate self-care abilities, rather than the patient. Assessment of a patient's support system is not usually considered part of health promotion and maintenance.
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.
How is severe and persistent mental best characterized?
- A. Mental illness with longer than 2 weeks' duration.
- B. Major ongoing mental illness marked by significant functional impairments.
- C. Mental illness accompanied by physical impairment and severe social problems.
- D. Major mental illness that cannot be treated to prevent deterioration of cognitive and social abilities.
Correct Answer: B
Rationale: Severe mental illness' has replaced the phrase 'chronic mental illness.' Global impairments in function are evident, including social skills. Physical impairments may or may not be present. Severe mental illness can be treated, but remissions and exacerbations are part of the course of the illness. The distractors fail to effectively address the issue of functional impairment.