An adult consulted a nurse practitioner because of an inability to achieve orgasm for 2 years, despite having been sexually active. This adult was frustrated and expressed concerns about the relationship with the sexual partner. Which documentation best indicates the treatment was successful?

Correct Answer: C

Rationale: Step 1: Choice C indicates satisfaction with sexual encounters and feeling supported by the partner, which suggest a positive outcome in addressing the inability to achieve orgasm and concerns about the relationship. Step 2: The patient feeling satisfied and supported signifies improvement in sexual function and relationship dynamics. Step 3: This documentation reflects a holistic approach to addressing the patient's concerns, focusing on emotional well-being and relationship quality. Step 4: Overall, choice C demonstrates a comprehensive resolution to the patient's initial complaints and indicates successful treatment. Summary: Choice C is the correct answer as it shows improvement in both sexual function and relationship satisfaction. Choices A, B, and D do not address the patient's concerns about the relationship or emotional well-being, making them less appropriate indicators of treatment success.

Correct Answer: A

Rationale: The correct answer is A: use of multiple drugs with anticholinergic effects. This is the highest priority because anticholinergic medications are commonly prescribed to older adults and can lead to serious adverse effects such as confusion, memory issues, and falls. Nurses must assess for these effects to prevent harm. Choice B (overuse of medications for erectile dysfunction) is not as high a priority as anticholinergic effects, as it is not as common and typically has less immediate serious consequences for older adults. Choice C (missed doses of medications for arthritis) is important but not as critical as assessing for anticholinergic effects, as missed doses can generally be managed through education and adherence support. Choice D (trading medications with acquaintances) is a serious concern but is not as high a priority as assessing for anticholinergic effects, as the immediate risks associated with anticholinergic medications are more severe.

Correct Answer: A

Rationale: The correct answer is A: Assist the patient to identify triggers to binge eating. The highest priority for a patient with bulimia nervosa is addressing the root cause of the behavior, which is often triggered by emotional or situational factors. By identifying triggers, the patient can learn to recognize and manage them effectively, ultimately reducing the frequency of binge eating episodes. This intervention focuses on addressing the underlying issue and promoting long-term recovery. Summary: B: Providing remedial consequences for weight loss is not the priority as the main concern is addressing the binge eating behavior. C: Assessing for signs of impulsive eating is important, but identifying triggers takes precedence in addressing the behavior. D: Exploring needs for health teaching may be relevant, but addressing triggers to binge eating is more immediate and crucial for managing bulimia nervosa.

Correct Answer: C

Rationale: The correct answer is C: Symptoms of hypokalemia. This is the priority because individuals with binge-purge bulimia often have electrolyte imbalances, including hypokalemia, which can lead to serious cardiac complications. Educating the patient on recognizing symptoms of hypokalemia, such as weakness, fatigue, and irregular heartbeats, is crucial for early intervention. A: Self-monitoring of daily food and fluid intake is important but not the priority when dealing with potential life-threatening complications like hypokalemia. B: Establishing the desired daily weight gain is not appropriate for individuals with binge-purge bulimia as the focus should be on addressing the underlying psychological issues rather than weight gain. D: Self-esteem maintenance is important in the long term but does not take precedence over addressing immediate health risks such as hypokalemia.

Correct Answer: A

Rationale: The correct answer is A because it indicates positive changes in mood, engagement, and social interaction, which are key indicators of effective treatment for severe depression. Sleeping 6 hours straight shows improved sleep patterns, singing with the activity group reflects increased participation and enjoyment, and being eager to see the grandchild demonstrates a renewed sense of joy and connection. Choice B is incorrect because although the patient denies suicidal ideation, the level of activity and engagement is not as high as in choice A. Choice C is incorrect as the focus is on physical aspects rather than emotional well-being and social interaction. Choice D is incorrect because the patient still shows signs of depression such as lack of appetite and loss of interest in activities.