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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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A nurse notes that an elderly client suddenly does not keep appointments and is not wearing appropriate clothing. Which statement by the client raises the suspicion of financial abuse?
- A. I am having difficulty paying for this new antibiotic the physician prescribed.
- B. I am a little short on cash since my daughter moved in to help me.
- C. I have not felt like shopping since the weather has gotten worse.
- D. People do not realize how difficult it is to make ends meet on a fixed income.
Correct Answer: B
Rationale: Signs of financial abuse include an inability to pay for necessities like clothes, and the statement about being short on cash since the daughter moved in suggests possible misuse of funds by a caregiver.
A nurse is planning a brief treatment program for a client who was raped. A realistic, short-term goal is to:
- A. identify all psychosocial problems.
- B. eliminate the client's enticing behaviors.
- C. resolve feelings of trauma and fear.
- D. verbalize feeling about the event.
Correct Answer: D
Rationale: A realistic short-term goal is for the client to verbalize feelings about the event. A brief treatment program is not designed to identify or resolve problems. The focus is on managing acute symptoms. If in-depth psychological problems are identified, the nurse might make referrals for treatment.
A health care worker is concerned about a new mother being overwhelmed by caring for her infant. The health care worker should:
- A. immediately contact child protective services.
- B. provide the mother with literature about child care.
- C. consult a therapist to help the mother work out her fears.
- D. refer the mother to parenting classes.
Correct Answer: D
Rationale: Prevention of child abuse is centered on teaching the parents how to care for their child and cope with the demands of infant care. Parenting classes can help build self-confidence, self-esteem, and coping skills. Parents benefit by understanding the developmental needs of their children, while learning how to manage their home environment more effectively. The classes also increase the parents' social contacts and teach about community resources.
The anemias most often associated with pregnancy are:
- A. folic acid and iron deficiency.
- B. folic acid deficiency and thalassemia.
- C. iron deficiency and thalassemia.
- D. thalassemia and B12 deficiency.
Correct Answer: A
Rationale: Folic acid and iron deficiency anemia are the most common anemias, prevalent in women of childbearing age with 50% of pregnant women having this type of anemia. Iron deficiency anemia during pregnancy is a result (usually) of the increase in the plasma level during pregnancy but not in the constituent level. Also, if a woman has this type of anemia prepregnancy, it gets worse during pregnancy.
An adult who had been abused as a child is discussing the group therapy program. Which statement indicates that the client has gained insight?
- A. I think I was a lonely child because I could not tell anyone about my abuse.'
- B. I am now aware of how deep-seated my anger is. Before I did not realize I was angry.'
- C. The program has given me the courage to tell my mother how I felt about her role in my hurt.'
- D. There are so many people just like me, who are just normal people that had bad things happen to them.'
Correct Answer: B
Rationale: Children who are abused learn to cope with the painful experiences by ignoring painful feelings and avoiding getting close to people. As adults, victims of abuse usually continue to repress feelings, avoid close interpersonal relationships, and frequently use alcohol or drugs to block painful memories. Long-term effects in adults might include criminal/violent behavior (for adult males), substance abuse, and a variety of social and emotional problems (including suicidal thoughts, anxiety, hostility, dissociation, and interpersonal difficulties).