Nokea
A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?
- A. I can drink alcohol now that I am decreasing my Xanax.
- B. I should not take another Xanax pill. Here is what is left of my last prescription.
- C. I should take three pills per day next week, then two pills for one week, then one pill for one week.
- D. I should expect to be sleepy for several days after stopping the medicine.
Correct Answer: C
Rationale: Xanax, like other benzodiazepines, can cause withdrawal symptoms that include agitation, insomnia, hypertension, seizures, and abdominal pain. The drug must be slowly decreased to prevent withdrawal symptoms.
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An elderly client denies that abuse is occurring. Which of the following factors could be a barrier for the client to admit being a victim?
- A. knowledge that elder abuse is rare
- B. personal belief that abuse is deserved
- C. lack of developmentally appropriate screening tools
- D. fear of reprisal or further violence if the incident is reported
Correct Answer: D
Rationale: Barriers to reporting elder abuse include victim shame, fear of reprisals, fear of loss of caregiver, and lack of knowledge of agencies that provide services. Many elders fear that reporting abuse results in their placement in long-term care because the current caregiver is the abuser.
In performing a psychosocial assessment, the nurse begins by asking questions that encourage the client to describe problematic behaviors and situations. The next step is to elicit the client's:
- A. feelings about what has been described
- B. thoughts about what has been described
- C. possible solutions to the problem
- D. intent in sharing the description
Correct Answer: B
Rationale: Eliciting the client's thoughts after describing issues provides insight into their perspective and interpretation, guiding further assessment. Feelings and solutions come later.
A nurse is reviewing a patient's serum glucose levels. Which of the following scenarios would indicate abnormal serum glucose values for a 30 year-old male.
- A. 70 mg/dl
- B. 55 mg/dl
- C. 110 mg/dl
- D. 100 mg/dl
Correct Answer: B
Rationale: 60-115 mg/dl is standard range for serum glucose levels.
A client admitted to the medical nursing unit has classic symptoms of tuberculosis (TB) and tests positive on the purified protein derivative (PPD) skin test. Several months later, the nurse who cared for the client also tests positive on an annual TB skin test for work. The most likely course of treatment if the chest X-ray (CXR) is negative is to:
- A. repeat a TB skin test in six months.
- B. treat the nurse with an anti-infective agent for six months.
- C. monitor for signs and symptoms within the next year.
- D. follow up in one year at the next annual physical with CXR only.
Correct Answer: B
Rationale: Exposure with a positive TB skin test usually requires six months of prophylactic treatment unless contraindicated.
A nurse observes a client sitting alone and talking. When asked, the client reports that he is 'talking to the voices.' The nurse's next action should be:
- A. touching the client to help him return to reality
- B. leaving the client alone until reality returns
- C. asking the client to describe what is happening
- D. telling the client there are no voices
Correct Answer: C
Rationale: Asking the client to describe the hallucinations validates their experience and provides insight into their condition, aiding therapeutic communication. Touching may be intrusive, leaving them alone is non-therapeutic, and denying the voices dismisses their reality.