Older Adult Final Exam
1.Which statement made by a nurse reflects a lack of understanding regarding sexual intimacy
and the older adult patient?
a. "Older adults express less interest in intimacy as both acute and chronic illnesses develop."
b. "Sexual expression is considered an enhancement to the quality of the older adult's life."
c. "Expressing sexual needs may be difficult or impossible for some older adults."
d. "Interest in physical contact tends to persist throughout life for both genders." - ANSA
2. A 70-year-old female patient shares with the nurse her concern that recently it takes more
time to achieve an orgasm. The nurse responds most therapeutically when answering:
a. "You've described a common result of aging for both men and women."
b. "If you experience difficulty achieving orgasms, you should discuss that with your doctor."
c. "Your body produces fewer sex hormones now, and you need more stimulation to climax."
d. "I understand your concern. Let's talk more about the changes you've noticed." - ANSC
3. A type 2 insulin-dependent diabetic 70-year-old recently lost his wife and is experiencing
impotence. Besides educating the patient on the normal effects of aging on sexual function, the
nurse should initially include information regarding:
a. the effect that stress has on sexual performance.
b. the effect of diabetes mellitus on the vascular system.
c. the link between depression and sexual dysfunction.
d. sexual dysfunction related to long-term use of insulin. - ANSB
4. Upon entering the room of a cognitively impaired older adult patient, the nurse observes that
he is exposed and rubbing his genitals. The nurse's initial concern is to:
a. alert staff to be aware of this new behavior.
b. provide the patient with privacy.
c. assess him for possible pain and fever.
d. provide a verbal cue for him to stop the behavior. - ANSC
5. To effectively assess an older adult patient's sexual needs, the nurse must initially:
a. reflect on personal feelings that create barriers to effective communication with the patient.
b. be familiar with the sexual needs of the older adult population.
c. assess the patient's physical capacity to engage in sexual activities.
d. inform the patient of the personal nature of the detailed questioning this assessment requires.
- ANSA
6. An older adult patient recovering from a radical prostatectomy is discussing his postsurgical
care plan with the nurse when he expresses concern about long-term impotence. The nurse
initially responds:
a. "I'd suggest a consult with a sexuality counselor for you and your partner."
,b. "When you've healed sufficiently, we can discuss prosthetic devices that help."
c. "There are medications called phosphodiesterase inhibitors that minimize that problem."
d. "While postsurgical erectile dysfunction is likely, it is generally temporary." - ANSD
7. The charge nurse on an extended care unit recognizes an immediate need for additional unit
education regarding sexuality and the older adult when overhearing a staff member state:
a. "I've had to tell her to stop touching my breasts twice today."
b. "Someone needs to tell him to keep his pants zipped."
c. "I realize they have needs, but I'm not sure how to handle that."
d. "It's sad that Alzheimer disease causes them to become sexual perverts." - ANSD
8. An older adult female patient who has multiple sexual partners asks the nurse if the risk for
contracting HIV really does increase as we age. The nurse shows the best understanding of this
risk when responding:
a. "Any time one engages in sex with multiple partners, the risk for contracting HIV increases."
b. "Changes in vaginal tissue and immune function increase the risk, especially if sex is
unprotected."
c. "Unless you are engaging in unprotected oral sex, your risk does not increase substantially."
d. "Yes, your risk of contracting a sexually transmitted disease (STD) including HIV, dramatically
increases as you age." - ANSB
9. Through the open door of the patient's room, the nurse observes a male patient and his
long-term partner in a romantic embrace. The nurse's priority intervention is directed toward:
a. reinforcing for the staff the patient's intimacy needs.
b. explaining to the patient the challenges that his relationship poses for the staff.
c. offering to discuss the barriers to intimacy that the patient and his partner face.
d. quietly closing the door to address the patient's right to privacy. - ANSD
10. The gerontologic nurse wants to begin assessing concerns related to sexuality among the
population of patients seen in the clinic. What action by the nurse is best?
a. Give the patients questionnaires to fill out.
b. Get permission to discuss sexuality with them.
c. Tell the patients you are now assessing sexuality.
d. Ask the patients if they have concerns about sex. - ANSB
11. The nursing manager feels that intimacy needs are not being assessed or addressed by the
staff on the unit. What action by the manager is best?
a. Tell the staff sexuality is expected to be assessed.
b. Provide the staff with education on sexuality.
c. Obtain tools for staff to use when assessing sexuality.
d. Allow those with cultural objections to opt out. - ANSB
12. The nurse notes the patient's chart lists "dyspareunia" as a complaint. What teaching does
the nurse plan to provide?
,a. Use of water-soluble lubricants
b. Performing Kegel exercises
c. Deep breathing and relaxation
d. Use of antifungal medications - ANSA
13. The nurse using the permission, limited information, specific suggestions, and intensive
therapy (PLISSIT) model offers specific suggestions when:
a. Referring the patient to a sex therapist.
b. Discussing over-the-counter lubricants.
c. Teaching safer sex practices.
d. Discussing sexual positioning after hip surgery. - ANSD
14. The patient who recently had a radical prostatectomy has the nursing diagnosis of
ineffective sexuality patterns. What assessment by the nurse best indicates that the goals for
this diagnosis have been met?
a. Patient states he can live without sex.
b. Patient says that impotence is temporary.
c. Patient states his needs are being met.
d. Patient asks about medication for ED. - ANSC
15. An older adult has begun dating after being widowed for many years. The adult confides to
the nurse about having several sexual partners. What action by the nurse is best?
a. Warn the patient that the family may not appreciate the situation.
b. Teach the patient about safer sexual practices including condoms.
c. Ask the patient if there are any medical concerns related to sex.
d. Tell the patient he or she may begin to have feelings of guilt. - ANSB
16. What information about sexuality is contrary to research on sexuality in older men?
a. Erections are not as firm.
b. It takes longer to obtain erections.
c. Erectile dysfunction is inevitable.
d. Ejaculation may not be a strong. - ANSC
17. A patient with arthritis has difficulty participating is sex because of joint pain and stiffness.
What action by the nurse is best?
a. Suggest a warm shower prior to sexual activity.
b. Ask the patient if he or she needs more pain medication.
c. Explore other ways of expressing sexuality.
d. Refer the patient to a rheumatologist. - ANSA
18. An older male patient is seen in the family practice clinic and tells the nurse he no longer
takes his metoprolol (Toprol) because "it interferes with my lifestyle." What action by the nurse is
best?
a. Warn the patient of the complications of hypertension.
, b. Ask the patient if he can afford the medication.
c. Tell the patient this drug often causes erectile dysfunction.
d. Take the patient's blood pressure and record the findings. - ANSC
19. A male patient takes carbamazepine (Tegretol). The spouse reports sexual dysfunction, but
the patient adamantly denies he has this problem. What response by the nurse is best?
a. Telling him, "You need to think of your wife's needs too."
b. Telling him this is common and can be discussed if wanted.
c. Questioning the patient again about sexual functioning
d. Telling the doctor to change the patient's prescription - ANSB
20. A patient has many sexual partners but does not use condoms. What action by the nurse is
best?
a. Ask the patient what he or she knows about HIV.
b. Assess the patient for barriers to using condoms.
c. Give the patient statistics on HIV in older adults.
d. Tell the patient safer sex practices should be used. - ANSB
21. A recently widowed patient reports new onset of sexual dysfunction. There are no new
medications or illnesses. What action by the nurse is best?
a. Assess the patient's alcohol intake.
b. Refer the patient for counseling.
c. Ask if there are new partners.
d. Have the patient speak to the doctor. - ANSA
22. A patient lives in a long-term care facility and has mild dementia. The patient has been
showing interest in another resident. What action by the nurse is best?
a. Determining if the resident has decision-making capacity.
b. Refusing to allow the residents to be alone together.
c. Asking the resident's family if the relationship is okay.
d. Providing time for the residents to be together. - ANSA
23. The family of a resident in an assisted living facility contacts the director to say they are
"appalled" that the resident is allowed to have pornographic magazines in the room. What
response by the director is most appropriate?
a. "We will take those away immediately."
b. "Your loved one has the right to have these."
c. "How do you know about these magazines?"
d. "He cannot stay here if he has these in the room." - ANSB
1. The nurse working in long-term care knows there are several barriers to sexual expression for
older patients. Which of the following are barriers? (Select all that apply.)
a. Decreasing desire
b. Medication side effects
1.Which statement made by a nurse reflects a lack of understanding regarding sexual intimacy
and the older adult patient?
a. "Older adults express less interest in intimacy as both acute and chronic illnesses develop."
b. "Sexual expression is considered an enhancement to the quality of the older adult's life."
c. "Expressing sexual needs may be difficult or impossible for some older adults."
d. "Interest in physical contact tends to persist throughout life for both genders." - ANSA
2. A 70-year-old female patient shares with the nurse her concern that recently it takes more
time to achieve an orgasm. The nurse responds most therapeutically when answering:
a. "You've described a common result of aging for both men and women."
b. "If you experience difficulty achieving orgasms, you should discuss that with your doctor."
c. "Your body produces fewer sex hormones now, and you need more stimulation to climax."
d. "I understand your concern. Let's talk more about the changes you've noticed." - ANSC
3. A type 2 insulin-dependent diabetic 70-year-old recently lost his wife and is experiencing
impotence. Besides educating the patient on the normal effects of aging on sexual function, the
nurse should initially include information regarding:
a. the effect that stress has on sexual performance.
b. the effect of diabetes mellitus on the vascular system.
c. the link between depression and sexual dysfunction.
d. sexual dysfunction related to long-term use of insulin. - ANSB
4. Upon entering the room of a cognitively impaired older adult patient, the nurse observes that
he is exposed and rubbing his genitals. The nurse's initial concern is to:
a. alert staff to be aware of this new behavior.
b. provide the patient with privacy.
c. assess him for possible pain and fever.
d. provide a verbal cue for him to stop the behavior. - ANSC
5. To effectively assess an older adult patient's sexual needs, the nurse must initially:
a. reflect on personal feelings that create barriers to effective communication with the patient.
b. be familiar with the sexual needs of the older adult population.
c. assess the patient's physical capacity to engage in sexual activities.
d. inform the patient of the personal nature of the detailed questioning this assessment requires.
- ANSA
6. An older adult patient recovering from a radical prostatectomy is discussing his postsurgical
care plan with the nurse when he expresses concern about long-term impotence. The nurse
initially responds:
a. "I'd suggest a consult with a sexuality counselor for you and your partner."
,b. "When you've healed sufficiently, we can discuss prosthetic devices that help."
c. "There are medications called phosphodiesterase inhibitors that minimize that problem."
d. "While postsurgical erectile dysfunction is likely, it is generally temporary." - ANSD
7. The charge nurse on an extended care unit recognizes an immediate need for additional unit
education regarding sexuality and the older adult when overhearing a staff member state:
a. "I've had to tell her to stop touching my breasts twice today."
b. "Someone needs to tell him to keep his pants zipped."
c. "I realize they have needs, but I'm not sure how to handle that."
d. "It's sad that Alzheimer disease causes them to become sexual perverts." - ANSD
8. An older adult female patient who has multiple sexual partners asks the nurse if the risk for
contracting HIV really does increase as we age. The nurse shows the best understanding of this
risk when responding:
a. "Any time one engages in sex with multiple partners, the risk for contracting HIV increases."
b. "Changes in vaginal tissue and immune function increase the risk, especially if sex is
unprotected."
c. "Unless you are engaging in unprotected oral sex, your risk does not increase substantially."
d. "Yes, your risk of contracting a sexually transmitted disease (STD) including HIV, dramatically
increases as you age." - ANSB
9. Through the open door of the patient's room, the nurse observes a male patient and his
long-term partner in a romantic embrace. The nurse's priority intervention is directed toward:
a. reinforcing for the staff the patient's intimacy needs.
b. explaining to the patient the challenges that his relationship poses for the staff.
c. offering to discuss the barriers to intimacy that the patient and his partner face.
d. quietly closing the door to address the patient's right to privacy. - ANSD
10. The gerontologic nurse wants to begin assessing concerns related to sexuality among the
population of patients seen in the clinic. What action by the nurse is best?
a. Give the patients questionnaires to fill out.
b. Get permission to discuss sexuality with them.
c. Tell the patients you are now assessing sexuality.
d. Ask the patients if they have concerns about sex. - ANSB
11. The nursing manager feels that intimacy needs are not being assessed or addressed by the
staff on the unit. What action by the manager is best?
a. Tell the staff sexuality is expected to be assessed.
b. Provide the staff with education on sexuality.
c. Obtain tools for staff to use when assessing sexuality.
d. Allow those with cultural objections to opt out. - ANSB
12. The nurse notes the patient's chart lists "dyspareunia" as a complaint. What teaching does
the nurse plan to provide?
,a. Use of water-soluble lubricants
b. Performing Kegel exercises
c. Deep breathing and relaxation
d. Use of antifungal medications - ANSA
13. The nurse using the permission, limited information, specific suggestions, and intensive
therapy (PLISSIT) model offers specific suggestions when:
a. Referring the patient to a sex therapist.
b. Discussing over-the-counter lubricants.
c. Teaching safer sex practices.
d. Discussing sexual positioning after hip surgery. - ANSD
14. The patient who recently had a radical prostatectomy has the nursing diagnosis of
ineffective sexuality patterns. What assessment by the nurse best indicates that the goals for
this diagnosis have been met?
a. Patient states he can live without sex.
b. Patient says that impotence is temporary.
c. Patient states his needs are being met.
d. Patient asks about medication for ED. - ANSC
15. An older adult has begun dating after being widowed for many years. The adult confides to
the nurse about having several sexual partners. What action by the nurse is best?
a. Warn the patient that the family may not appreciate the situation.
b. Teach the patient about safer sexual practices including condoms.
c. Ask the patient if there are any medical concerns related to sex.
d. Tell the patient he or she may begin to have feelings of guilt. - ANSB
16. What information about sexuality is contrary to research on sexuality in older men?
a. Erections are not as firm.
b. It takes longer to obtain erections.
c. Erectile dysfunction is inevitable.
d. Ejaculation may not be a strong. - ANSC
17. A patient with arthritis has difficulty participating is sex because of joint pain and stiffness.
What action by the nurse is best?
a. Suggest a warm shower prior to sexual activity.
b. Ask the patient if he or she needs more pain medication.
c. Explore other ways of expressing sexuality.
d. Refer the patient to a rheumatologist. - ANSA
18. An older male patient is seen in the family practice clinic and tells the nurse he no longer
takes his metoprolol (Toprol) because "it interferes with my lifestyle." What action by the nurse is
best?
a. Warn the patient of the complications of hypertension.
, b. Ask the patient if he can afford the medication.
c. Tell the patient this drug often causes erectile dysfunction.
d. Take the patient's blood pressure and record the findings. - ANSC
19. A male patient takes carbamazepine (Tegretol). The spouse reports sexual dysfunction, but
the patient adamantly denies he has this problem. What response by the nurse is best?
a. Telling him, "You need to think of your wife's needs too."
b. Telling him this is common and can be discussed if wanted.
c. Questioning the patient again about sexual functioning
d. Telling the doctor to change the patient's prescription - ANSB
20. A patient has many sexual partners but does not use condoms. What action by the nurse is
best?
a. Ask the patient what he or she knows about HIV.
b. Assess the patient for barriers to using condoms.
c. Give the patient statistics on HIV in older adults.
d. Tell the patient safer sex practices should be used. - ANSB
21. A recently widowed patient reports new onset of sexual dysfunction. There are no new
medications or illnesses. What action by the nurse is best?
a. Assess the patient's alcohol intake.
b. Refer the patient for counseling.
c. Ask if there are new partners.
d. Have the patient speak to the doctor. - ANSA
22. A patient lives in a long-term care facility and has mild dementia. The patient has been
showing interest in another resident. What action by the nurse is best?
a. Determining if the resident has decision-making capacity.
b. Refusing to allow the residents to be alone together.
c. Asking the resident's family if the relationship is okay.
d. Providing time for the residents to be together. - ANSA
23. The family of a resident in an assisted living facility contacts the director to say they are
"appalled" that the resident is allowed to have pornographic magazines in the room. What
response by the director is most appropriate?
a. "We will take those away immediately."
b. "Your loved one has the right to have these."
c. "How do you know about these magazines?"
d. "He cannot stay here if he has these in the room." - ANSB
1. The nurse working in long-term care knows there are several barriers to sexual expression for
older patients. Which of the following are barriers? (Select all that apply.)
a. Decreasing desire
b. Medication side effects
