33 - Intimacy & Sexuality Flashcards
Which question has priority when assessing a client for risk factors related to the use of sildenafil (Viagra)?
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?”
b.) “Are you currently being treated for hypertension?”
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.
Based on recent studies, which statement regarding touch and touch zones is most accurate?
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.
d.) The comfort of touch depends on place, situation, social status, and age.
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.
Which intervention has priority before touching a client’s consent zone?
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
c.) Explaining why the area will be touched while asking permission
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.
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:
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.
b.) older adults need to express love and intimacy.
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.
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?
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.) People with heart disease reduce their sexual activity out of fear of their condition.
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.
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.)
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.”
a, c, d, e
a.) “If you are able to engage in mild to moderate physical activity without symptoms, you can resume sexual activity.”
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.”
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.
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.)
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
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.”
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.
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.)
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
b.) Provide a safe private area where the residents can engage in sexual activity.
d.) Provide education for the residents using the PLISSIT model.
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.
What intervention should a nurse implement when an older male diagnosed with dementia is observed masturbating in the unit’s dayroom?
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.
a.) Remove the resident from the dayroom and complete an assessment of his behavior.
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.
Symptoms of HIV are often under-recognized in older adults because:
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.
b.) many of the classic symptoms are also common to other conditions common in older adults.
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.
Which outcome regarding the effects of touch on the skin is not supported by current research?
a. ) Brings about sensory stimulation
b. ) Helps relieves physical and psychosocial pain
c. ) Is known to reduce anxiety and tension
d. ) Improves skin integrity
d.) Improves skin integrity
There is no evidence that therapeutic touch improves skin integrity.
There is research to support the remaining options.
