A nurse is caring for an older adult client who has a history of depression and low self-esteem.

The client tells the nurse, “I don’t feel attractive or desirable anymore. I don’t think anyone would want to have sex with me.” How should the nurse respond?

The correct answer is B.

“Why do you say that?.

What makes you feel that way?.” This is an open-ended question that encourages the client to express their feelings and thoughts, and shows empathy and respect from the nurse.

The nurse can then explore the factors that contribute to the client’s low self-esteem and depression, and provide appropriate interventions and referrals.

Choice A is wrong because it is a false reassurance that does not address the client’s underlying issues.

It may also make the client feel invalidated or patronized.

Choice C is wrong because it dismisses the client’s sexual needs and implies that they are not important.

Sexuality is a basic human need and a source of pleasure and intimacy for many people, regardless of age.

Choice D is wrong because it suggests that the client’s appearance is the cause of their low self-esteem and depression, and that changing it will solve their problems.

This may reinforce the client’s negative self-image and make them feel more insecure.

Older adults who have depression and low self-esteem may benefit from nursing interventions such as:.

• Providing a safe and supportive environment that promotes trust and rapport.

• Assessing for risk factors and signs of depression, such as loss of interest, hopelessness, guilt, insomnia, appetite changes, suicidal ideation, etc.

• Assessing for physical, psychological, social, and environmental factors that may affect the client’s self-esteem and sexual function, such as chronic illness, medication side effects, cognitive impairment, abuse, isolation, stigma, etc.

• Educating the client about depression and its treatment options, including medication, psychotherapy, counseling, support groups, etc.

• Encouraging the client to participate in activities that enhance their mood, self-esteem, and social interaction, such as exercise, hobbies, volunteering, etc.

• Encouraging the client to express their feelings and concerns, and listening actively and empathically.

• Helping the client identify their strengths and achievements, and challenging their negative thoughts and beliefs about themselves.

• Helping the client set realistic and attainable goals, and providing positive feedback and reinforcement.

• Respecting the client’s sexual needs and preferences, and providing information and resources on sexual health and safety.

• Referring the client to appropriate professionals or agencies for further assessment and intervention if needed.

The correct answer isD.

“I don’t need to worry about sexually transmitted infections at my age.” This statement indicates a need for further education because older adults are still at risk of contracting sexually transmitted infections (STIs) if they are sexually active and do not use protection.According to the National Institute on Aging, STIs can affect anyone who is sexually active, regardless of age, and some STIs may not have any symptoms.Therefore, older adults should use condoms or other barrier methods to prevent STIs, and get tested regularly if they have multiple partners or a new partner.

Choice A is wrong because it is a correct statement.

“I know that my sexual response may be slower or less intense as I age.” This statement shows that the client has realistic expectations about the normal changes in sexual function that occur with aging.As people age, their bodies change, and their sexual response may take longer or require more stimulation.This does not mean that they cannot enjoy sex or intimacy, but they may need to adapt to these changes and communicate with their partner.

Choice B is wrong because it is not necessarily a sign of a need for education.

“I sometimes feel depressed or anxious about my sexual performance.” This statement reflects the client’s emotional state, which can affect their sexuality and intimacy.Some older adults may feel insecure about their aging bodies, their sexual abilities, or their attractiveness to their partner.

These feelings are normal and understandable, but they can also interfere with sexual satisfaction and intimacy.

The client may benefit from counseling or therapy to address these feelings, but they do not indicate a lack of knowledge about sexuality.

Choice C is wrong because it is a correct statement.

“I use lubricants and different positions to make sex more comfortable.” This statement shows that the client is aware of some strategies to cope with the physical changes that can affect sexual comfort in older adults.For example, vaginal dryness is a common problem for older women, especially after menopause, and it can make sex painful or uncomfortable.Using lubricants can help reduce friction and increase pleasure.Similarly, changing positions can help avoid discomfort or injury caused by arthritis or other conditions that affect mobility or flexibility.

Normal ranges for sexual activity and satisfaction vary widely among older adults, depending on their individual preferences, health status, relationship status, and other factors.

There is no one right way to express sexuality or intimacy in older age, as long as it is safe, consensual, and enjoyable for both partners.