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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo Robinson Test Bank Chapter 54. Transgendered Clients as Patients

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Pharmacotherapeutics for Advanced Practice Nurse Prescribers 5th Edition Woo Robinson Test Bank Chapter 54. Transgendered Clients as Patients and Chapter 55

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  • 2 de mayo de 2022
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Pharmacotherapeutics for Advanced
Practice Nurse Prescribers 5th Edition
Woo Robinson Test Bank


Chapter 54. Transgendered Clients as Patients


MULTIPLE CHOICE
1. A nurse is reviewing the chart of a new client in the family medicine clinic and notes the client is
identified as George 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. ANS: C
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. Lengthy apologies can often create 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.
2. 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. Continue your normal health screenings.
c. Try to avoid being around people who are ill.
d. You should have an annual flu vaccination.
ANS: A
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.
3. 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 ANS: C
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.

, 4. 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.
ANS: C
Spironolactone is a potassium-sparing diuretic, and hyperkalemia can cause cardiac dysrhythmias. The
nurses priority is to obtain an ECG, then to facilitate a serum potassium level being drawn. Having the
client lie down and obtaining vital signs are also important care measures, but do not take priority.
5. The nurse is teaching a transgender client about the medication goserelin (Zoladex). What action by the
client indicates good understanding?
a. Takes a manual blood pressure
b. Administers a subcutaneous injection
c. Prepares an implanted port for IV insertion
d. States that the axillary area will be clothed
ANS: B
Goserelin is administered via subcutaneous injection. The other actions are not related to self-management
while on this medication.
6. A client is preparing for gender reassignment surgery and will transition from male to female. The
client is worried about the voice not sounding feminine enough. What action by the nurse is best? 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 clients voice.
d. Tell the client that the use of hormones will eventually change the voice. ANS: B
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 to 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.
7. A client has returned from the postanesthesia care unit after a vaginoplasty. What comfort measure does
the nurse provide for this client?
a. Apply ice to the perineum.
b. Elevate the legs on pillows.
c. Position the client on the left side.
d. Raise the head of the bed. ANS: A
Ice is applied to the perineum to reduce pain and discomfort. Elevating the legs on pillows is not
recommended after a lengthy procedure in the lithotomy position, which predisposes the client to venous
thromboembolism.
Positioning the client on the left side and raising the head of the bed are not comfort measures related to
this procedure.
8. 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. Instruct the client not to try to get out of bed unassisted.
c. Monitor the clients dressings and wound drainage.

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