Question 1

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

A)   Inform the residents that they cannot engage in a sexual relationship while they are residents of the facility.
B)   Provide a safe private area where the residents can engage in sexual activity.
C)   Ignore the residents' activity.
D)   Provide education for the residents using the PLISSIT model.
E)   Contact the family members of the residents in order to get consent from them. B, D

Question 2

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

A)   The client should no longer have sexual relations because of the demand on his heart.
B)   The energy expenditure during sex is equivalent to briskly climbing six flights of stairs.
C)   People with heart disease reduce their sexual activity out of fear of their condition.
D)   The couple will benefit from attending a cardiac support group. C

Question 3

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

A)   "What concerns or questions do you have about fulfilling your sexual needs?"
B)   "Let me tell you about the impact of your cardiac disease on sexual activity."
C)   "I have a few suggestions on lubricants that might make intercourse more comfortable for you."
D)   "Most older adults are not comfortable talking about sexuality, but it is important to do so."
E)   "It is not unusual to have difficulty performing sexually as you age." A, B, C

Question 4

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

Accepted Answer

A)   "How old are you?"
B)   "Are you currently being treated for hypertension?"
C)   "Do you have a history of respiratory infections?"
D)   "Have you ever been told you have prostate problems?"

Question 5

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

Accepted Answer

A)   Remove the resident from the dayroom and complete an assessment of his behavior.
B)   Cover the resident's lap with a blanket and leave him in the dayroom.
C)   Counsel the resident by telling him that his behavior is inappropriate.
D)   Distract the resident so that he will stop the behavior.

Question 6

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

Accepted Answer

A)   Brings about sensory stimulation
B)   Helps relieves physical and psychosocial pain
C)   Is known to reduce anxiety and tension
D)   Improves skin integrity

Question 7

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

A)   "If you are able to engage in mild to moderate physical activity without symptoms, you can resume sexual activity."
B)   "You really should not engage in sexual activity until 3 months have passed post heart attack."
C)   "It is best if you avoid eating a large meal for several hours before you have sexual relations."
D)   "If you have chest pain while having sex, stop and rest, and take your nitroglycerin."
E)   "You might want to consider some alternate positions that avoid strain."

Question 8

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

A)   such activity in a long-term care facility is inappropriate.
B)   older adults need to express love and intimacy.
C)   sexual desire is usually absent in older adults.
D)   sexual activity can be dangerous for older adults with chronic illnesses.

Question 9

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

Accepted Answer

A)   Draping the area to minimize exposure
B)   Having another nurse present
C)   Explaining why the area will be touched while asking permission
D)   Assuring the client that the touch is absolutely necessary

Question 10

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

Accepted Answer

A)   there is a very low incidence of HIV in older adults.
B)   many of the classic symptoms are also common to other conditions common in older adults.
C)   presenting symptoms are markedly different from those in younger adults.
D)   AIDS progresses much slower in older adults so symptoms are not recognized easily.

Question 11

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

Accepted Answer

A)   People between the ages 66 and 100 are the most often touched.
B)   Newly graduated nurses tend to touch clients less often than do nursing students.
C)   When performing peri-care, the nurse is working within the zone of intimacy.
D)   The comfort of touch depends on place, situation, social status, and age.

Exam 33: Intimacy and Sexuality