Ambulatory Care Nurse Certification Practice Exam

The appropriate nursing diagnosis in this scenario is gender dysphoria. Gender dysphoria refers to the psychological distress that results from a mismatch between a person’s gender identity and their assigned sex at birth. In this case, the patient’s feelings of believing she should have been born male and her preference for male clothing indicate a significant discomfort with her assigned female gender identity, which aligns with the criteria for gender dysphoria.

This diagnosis is relevant because it emphasizes the emotional and psychological challenges the patient may face and can guide the nursing care plan focused on providing support, understanding, and appropriate referrals for further evaluation and potential treatment options. Recognizing and addressing gender dysphoria is crucial in promoting a patient's overall well-being and affirming their gender identity.

Other concepts, such as delusions or altered thought processes, do not accurately reflect the context of the patient’s feelings, as the desire to identify as a different gender does not imply a detachment from reality or confusion in thinking. Personal identity disturbance focuses more on a vague sense of self rather than the clear expression of gender identity, which is better captured by the term gender dysphoria. Thus, the diagnosis of gender dysphoria is the most fitting and illustrative of the patient's experience.