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TONIS COLLEGE College Of Nursing Bulanao, Tabuk City, Kalinga Nursing Care Management 105 : Sexual & Dissociative Disorders Name : Section : Date :

IINSTRUCTIONS: Choose and encircle the best answer for the following items. No erasures, alterations, and unnecessary markings. Make your answer sheets as clean as possible. 1. Which would the nurse expect to assess in a client diagnosed with fetishism? A. History of exposing genitalia to strangers. B. History of sexually arousing fantasies involving nonliving objects. C. History of urges to touch and rub against non-consenting individuals. D. History of fantasies involving the act of being humiliated, beaten, or bound. A client admitted with dissociative fugue is being evaluated. Which assessment information would indicate that the client is ready for discharge? A. The client is able to maintain reality during stressful situations. B. The client is able to verbalize why the personalities exist. C. The client is able to discuss feelings such as depersonalization. D. The client is able to integrate sub-personalities into a whole personality. A client is diagnosed with male orgasmic disorder. Which assessed behavior supports this diagnosis? A. Inability to maintain an erection. B. A delay in or absence of ejaculation following normal sexual excitement. C. Premature ejaculation. D. Dyspareunia. A client who is self-identified as homosexual is discussing sexual orientation. Which client statement is true as it relates to this concept? A. The psychiatric community does not consider consensual homosexuality to be a mental disturbance. B. Homosexuality is described on Axis I of the DSM-IV-TR. C. Homosexuality is considered deviant behavior, and I will need therapeutic counseling. D. Altered levels of testosterone affect the diagnosis of homosexuality and must be corrected to deal with the symptoms of this disorder. Which client situation supports a potential diagnosis of a dissociative fugue? A. A client enters the emergency department in New York City without understanding who he or she is or how he or she got there. B. A client known as being shy and passive comes into the emergency department angry and demanding. C. A client brought to the emergency department after a car accident is unable to recall his or her address or phone number. D. A client seen in the emergency department complains of feeling detached from the current situation. A 65-year-old woman with a history of prostitution is seen in the emergency department experiencing a recent onset of auditory hallucinations and bizarre behaviors. Which diagnosis would the nurse expect to document? A. Schizophrenia. B. Tertiary syphilis. C. Gonorrhea. D. Schizotypal personality disorder. A client diagnosed with depersonalization disorder has a shortterm outcome that states, The client will verbalize an alternate way of dealing with stress by day 4. Which nursing diagnosis reflects the problem that this outcome addresses? A. Disturbed sensory perception R/T severe psychological stress. B. Ineffective coping R/T overwhelming anxiety. C. Self-esteem disturbance R/T dissociative events. D. Anxiety R/T repressed traumatic events. A client diagnosed with dissociative identity disorder has been hospitalized for 7 days. The client has a nursing diagnosis of ineffective coping R/T repressed severe anxiety. Which outcome would be appropriate? A. The client will recover deficits in memory by day 14. B. The client will verbalize awareness of multiple personalities and the reason for their existence by day 14. C. The client will demonstrate the ability to perceive stimuli accurately. D. The client will demonstrate one adaptive way to deal with stressful situations by day 14. A client newly admitted to an in-patient psychiatric unit has a diagnosis of pedophilia. When working with this client, which would be the nurses initial action? A. Assess the part of the sexual response cycle in which the disturbance occurs. B. Evaluate the nurses feelings regarding working with the client. C. Establish a therapeutic nurse-client relationship. D. Explore the developmental alterations associated with pedophilia. A client diagnosed with exhibitionism is newly admitted to an inpatient psychiatric unit. Which would be an example of a behavioral nursing intervention for this client? A. Encourage the client to pair noxious stimuli with sexually deviant impulses. B. Help the client identify unresolved conflicts and traumas from early childhood. C. Administer prescribed medications that block or decrease circulating androgens. D. Administer prescribed progestin derivatives to decrease the clients libido. A newly admitted client is diagnosed with dissociative identity disorder. Which nursing intervention is a priority? A. Establish an atmosphere of safety and security. B. Identify relationships among sub-personalities and work with each equally. C. Teach new coping skills to replace dissociative behaviors. D. Process events associated with the origins of the disorder. A newly admitted client diagnosed with depersonalization disorder has a nursing diagnosis of anxiety R/T family stressors. Which nursing intervention would be most helpful in building a trusting nurse-client relationship? A. Identify stressors that increase anxiety levels. B. Encourage use of adaptive coping mechanisms to decrease stress. C. Discuss events surrounding episodes of depersonalization. D. Reassure the client of safety and security during periods of anxiety. The nursing student is learning about the sexual disorder of paraphilia. Which student statement indicates that learning has occurred? A. The term paraphilia is used to identify repetitive or preferred sexual fantasies or behaviors. B. Individuals diagnosed with a paraphilia experience extreme personal distress and frequently seek treatment. C. Oral-genital, anal, homosexual, and sexual contact with animals is currently viewed as paraphilia. D. Most individuals with a paraphilia are women, and more than 50% of these individuals have onset of their paraphilic arousal after age 18.

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14. The nursing student is learning about depersonalization disorder. Which student statement indicates that learning has occurred? A. Depersonalization disorder has an alteration in the perception of the external environment. B. The symptoms of depersonalization are rare, and few adults experience transient episodes. C. Depersonalization disorder is characterized by temporary change in the quality of self-awareness. D. The alterations in perceptions are experienced as relaxing and are rarely accompanied by other symptoms. 15. A client diagnosed with dissociative identity disorder attributed to childhood sexual abuse has an outcome that states, The client will verbalize causative factors for the development of multiple personalities. Which charting entry would support a successful evaluation of this outcome? A. Able to state the particular function of each of the different personalities. B. Discussed history of childhood sexual abuse. C. Was able to be redirected to topic at hand during group therapy. D. Verbalizes understanding that treatment may be lengthy. 16. Which of the following nursing evaluations for a hospitalized client diagnosed with dissociative identity disorder would lead the treatment team to consider discharge? Select all that apply. A. The client is able to recall events associated with a traumatic or stressful situation. B. The client is able to communicate increased levels of anxiety before dissociation occurs. C. The client is able to demonstrate more adaptive coping strategies to avert dissociative behaviors. D. The client is able to verbalize the existence of multiple personalities and the purposes they serve. E. The client demonstrates continued use of alternate personalities to deal with stressful situations. 17. A client is diagnosed with a sexual aversion disorder. A nursing diagnosis of sexual dysfunction is documented for this client. Which behavior indicates successful resolution of this clients problem? A. Client resumes sexual activities at a level satisfactory to self and partner. B. Client expresses satisfaction with own sexual patterns. C. The clients deviant sexual behaviors have decreased. D. The client accepts homosexual drives as normal sexual functioning. -===== Good luck & God bless =====Prepared by: Lucky P. Roaquin, RN, MAN STCI-CON Faculty