Question 1

An older man who recently had a myocardial infarction is being discharged home from the hospital. He tells a nurse, "I am really worried about having sex with my wife. I am afraid that I am going to have another heart attack." The best response by the nurse includes which of the following? (Select all that apply.)

Accepted Answer

Individuals who are post MI who are able to engage in mild to moderate physical activity without symptoms can generally resume sexual activity; those with a complicated MI may need to resume sexual activity gradually over a longer period of time. Suggestions include avoiding large meals several hours before sex and suggesting alternative positions to avoid strain. If the individual does experience chest pain, it is important to stop and rest if he or she feels chest pain, take nitroglycerin if prescribed, and seek emergency treatment for sustained chest pain. There is no reason to wait 3 months post MI to resume sexual activity.

Question 2

An older widow who is a newly admitted resident of a long-term care facility develops a romantic relationship with a male resident. When the resident's daughter demands that the staff "put a stop to this sexual behavior right now," the nurse's response is based on the understanding that:

Accepted Answer

The needs of older adults for love and intimacy remain the same regardless of whether the individuals are institutionalized. Meeting the needs of the residents for sexuality and intimacy is as important as the need for food and hydration. Sexual desire is present in older adults. Sexual activity is not dangerous for older adults. Some accommodations for chronic conditions might be required.

Question 3

Two older residents of a long term care facility are engaged in a romantic relationship. The residents are both cognitively intact. A nurse finds the two residents engaging in sexual activity. The response of the nurse includes which of the following? (Select all that apply.)

Accepted Answer

Residents in a long term care facility have the right to engage in sexual activity. The role of the nursing staff is to provide a safe and private area for the residents and to provide education on safe sexual practices and be open to answering questions and providing information to the residents. Ignoring the residents' activity is not an appropriate response. Calling the residents' family members is also not appropriate as they are cognitively intact and able to make their own decisions.

Question 4

Which question has priority when assessing a client for risk factors related to the use of sildenafil (Viagra)?

Accepted Answer

The use of phosphodiesterase inhibitors (PE5s) such as sildenafil (Viagra), vardenafil (Levitra), and tadalafil (Cialis) might be contraindicated when a client is taking certain antihypertensive medications.

Question 5

Based on recent studies, which statement regarding touch and touch zones is most accurate?

Accepted Answer

The comfort of touch depends on the location, situation, social status, and age. Older adults are frequently isolated and are not touched. There is no evidence to support the statement that graduate nurses touch patients less than nursing students. The zone of intimacy is within an arm's length of the individual, and it is the space used for comforting, protecting, and lovemaking.

Question 6

A nurse practitioner is using the PLISSIT model to guide a discussion of sexuality with an older patient in the geriatric clinic. Which of the following are congruent with the PLISSIT model? (Select all that apply.)

Accepted Answer

The PLISSIT model is a helpful guide for discussion of sexuality with older adults. The steps of the model are Permission: Obtain permission from the client to initiate sexual discussion, Limited Information: Provide the limited information to function sexually, Specific Suggestions: Offer suggestions for dealing with problems, Intensive Therapy: Refer as appropriate for complex problems that require specialist intervention. Option A falls into the permission step, option B falls into the limited information step, and option C falls into the specific suggestion step. Options D and E do not fall into any of the steps of this model.

Question 7

The partner of a client comments, "Our sex life will certainly suffer now that he's had a heart attack." Which statement is the basis for the nurse's response?

Accepted Answer

Many individuals are not given adequate information regarding the impact of illness on sexual relations and therefore are fearful and reduce sexual activity. Changes might be needed in order to accommodate the illness, but curtailing sexual relations is not necessary. The energy expended during sex is not equivalent to briskly climbing six flights of stairs. And while the couple may benefit from attending a support group, that fact does not address the immediate situation.

Question 8

Which intervention has priority before touching a client's consent zone?

Accepted Answer

The consent zone requires the nurse to seek out or ask permission to touch or initiate procedures to these areas. The touch should not occur unless it is absolutely necessary. Draping is appropriate but doesn't occur until permission is granted. Having another nurse present is not always necessary unless the touch is by a male nurse upon a female client.

Question 9

Which outcome regarding the effects of touch on the skin is not supported by current research?

Accepted Answer

There is no evidence that therapeutic touch improves skin integrity. There is research to support the remaining options.

Question 10

What intervention should a nurse implement when an older male diagnosed with dementia is observed masturbating in the unit's dayroom?

Accepted Answer

When sexually inappropriate behavior occurs, it should be assessed, like any other behavior, as to cause, precipitating factors, and response to interventions. It is appropriate to remove the resident from the dayroom because the behavior may be distressing to staff and other residents. Covering the resident with a blanket and leaving him in the dayroom does not address the cause of the behavior, and it might be distressing for other residents and staff. The resident has dementia and is not capable of altering his behavior based on the information that it is inappropriate. Distracting the resident will only temporarily interrupt the behavior.

Question 11

Symptoms of HIV are often under-recognized in older adults because:

Accepted Answer

The classic symptoms of weakness, anorexia, and fatigue are common to other conditions common in older adults; additionally, they may also be attributed to normal age-related changes. The incidence of AIDS in older adults is increasing, rising faster among older adults than among younger adults. The symptoms are identical in older and younger populations. AIDS progresses more quickly in older adults than it does in younger adults.

Quiz 33: Intimacy and Sexuality