Answer to Question 1
2
Rationale: The goal of treatment with transsexuals is to help them live and function in society in their cross-gender role. Experiencing guilt for enjoying sex is not a treatment goal. The nurse should encourage clients to develop and internalize their own positive expectations and beliefs about sex, not be dependent on the beliefs of others. Making a list of anxiety-producing sexual interactions may serve to reinforce the anxiety, unless there is a discussion about the list.
Answer to Question 2
4
Rationale: Traditional private practice is not associated with population or community-based levels of service, particularly groups previously neglected, or suffering from the effects of long-term institutionalizatio n. Case management, participation in social planning, and providing supportive interventions and community support to various populations are all part of the shift of services from private to community settings.