A 45-year-old woman with a history of depression tells a nurse in her doctor's office that she has difficulty with sexual arousal and is fearful that her husband will have an affair. Which of the following factors would the nurse identify as least significant in contributing to the client's sexual difficulty?

Correct Answer: A

Rationale: The correct answer is A: Education and work history. The nurse would identify this as least significant in contributing to the client's sexual difficulty because education and work history do not directly impact sexual arousal or fear of infidelity in a marriage. Rationale: 1. B: Medication used - Medications can have side effects that affect sexual arousal and libido. 2. C: Physical health status - Physical health can impact sexual function and overall well-being. 3. D: Quality of spousal relationship - Relationship dynamics can significantly influence sexual arousal and fear of infidelity. In summary, the client's education and work history are less likely to directly affect her sexual difficulties compared to medication, physical health, and the quality of her spousal relationship.

Correct Answer: C

Rationale: Rationale: C is correct because assessing the client's perception of the triggering event helps understand their crisis context, and evaluating situational supports is crucial for intervention planning. A is not as essential because coping skills can vary. B focuses on emotions but may not address the root cause. D is important but not as critical as understanding the triggering event and available supports.

Correct Answer: B

Rationale: The correct answer is B: Diphenhydramine (Benadryl). Phenelzine is an MAOI, which interacts with many medications, including diphenhydramine, leading to potential hypertensive crisis. Acetaminophen (A) is safe with MAOIs. Furosemide (C) can cause low blood pressure but not a significant interaction. Isosorbide dinitrate (D) is a vasodilator and should be used cautiously with MAOIs, but it is not the most concerning interaction compared to diphenhydramine.

Correct Answer: D

Rationale: The correct answer is D because confabulation is a symptom of dementia where the individual unknowingly fills memory gaps with fabricated information or fantasy to compensate for memory loss. In this case, the 75-year-old client with Alzheimer's type dementia is likely confabulating due to cognitive impairment. Choice A is incorrect because being jovial does not directly relate to confabulation. Choice B is incorrect as confabulation is not intentional deception. Choice C is incorrect as rationalizing behaviors is different from confabulation, which involves filling in memory gaps with fantasy.

Correct Answer: C

Rationale: The correct answer is C: Enmeshment. Enmeshment is a relationship style where boundaries between family members are blurred, leading to a lack of individual autonomy. In this scenario, the parents' inability to understand their daughter's behavior despite her hospitalization for anorexia nervosa suggests a lack of recognition of her autonomy and individual needs. The parents' expectation for her to always please them reflects enmeshment, as they may prioritize their own desires over her well-being. Choice A: Differentiation refers to the ability to maintain a sense of self within a relationship, which is not evident in the parents' behavior. Choice B: Disengagement involves emotional distance between family members, which is not the case here as the parents are actively involved in their daughter's life. Choice D: Scapegoating involves unfairly blaming one family member for issues, which is not apparent in the scenario.