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A client is prescribed alprazolam (Xanax) for acute anxiety. What client history should cause a nurse to question this order?
- A. History of alcohol dependence
- B. History of personality disorder
- C. History of schizophrenia
- D. History of hypertension
Correct Answer: A
Rationale: The correct answer is A: History of alcohol dependence. Alprazolam is a benzodiazepine and can be addictive, especially for individuals with a history of substance abuse like alcohol dependence. This client population is at higher risk for misuse, addiction, and overdose. It is important for the nurse to question this order to avoid potential harm. Choices B, C, and D are incorrect as they do not directly impact the safety or efficacy of alprazolam for acute anxiety.
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When an individuals stress response is sustained over a long period of time, which physiological effect of the endocrine system should a nurse anticipate?
- A. Decreased resistance to disease
- B. Increased libido
- C. Decreased blood pressure
- D. Increased inflammatory response
Correct Answer: A
Rationale: The correct answer is A: Decreased resistance to disease. Prolonged stress can weaken the immune system, making individuals more susceptible to illnesses. Chronic stress suppresses immune functions, leading to decreased resistance to diseases. The other choices are incorrect because increased libido (B) and decreased blood pressure (C) are not typical physiological effects of sustained stress. While stress can lead to increased inflammatory response (D), the primary concern with chronic stress is its negative impact on the immune system, making choice A the most appropriate answer in this context.
During the sixth week of a 10-week parenting skills group, a nurse observes as several members get into a heated dispute about spanking. As a group, they decide to create a pros-and-cons poster on the use of physical discipline. At this time, what is the role of the group leader?
- A. To referee the debate
- B. To adamantly oppose physical discipline measures
- C. To redirect the group to a less controversial topic
- D. To encourage the group to solve the problem collectively
Correct Answer: D
Rationale: The correct answer is D: To encourage the group to solve the problem collectively. The role of the group leader in this situation is to promote group cohesion and problem-solving skills. By encouraging the group to collectively address the issue of differing opinions on spanking, the leader fosters open communication, respect for diverse perspectives, and teamwork. This approach allows group members to explore the topic in a constructive manner, learn from each other, and reach a consensus or understanding.
Choice A is incorrect because the leader's role is not to referee or take sides in the debate. Choice B is incorrect as the leader should not impose personal views but facilitate a balanced discussion. Choice C is incorrect as avoiding controversial topics hinders group growth and learning.
When under stress, a client routinely uses an excessive amount of alcohol. Finding her drunk, her husband yells at her about the chronic alcohol abuse. Which reaction should the nurse recognize as the use of the defense mechanism of denial?
- A. Hiding liquor bottles in a closet
- B. Yelling at their son for slouching in his chair
- C. Burning dinner on purpose
- D. Saying to the spouse, I dont drink too much!
Correct Answer: D
Rationale: The correct answer is D because the client is using denial as a defense mechanism to cope with the stress of being confronted about her alcohol abuse. By saying "I don't drink too much," she is refusing to acknowledge the reality of her excessive alcohol consumption. This denial allows her to avoid facing the uncomfortable truth and the need for change.
A: Hiding liquor bottles in a closet is an example of a defense mechanism called displacement, not denial.
B: Yelling at their son for slouching in his chair is an example of a defense mechanism called projection, not denial.
C: Burning dinner on purpose is an example of a defense mechanism called passive-aggression, not denial.
A client is taking chlordiazepoxide (Librium) for generalized anxiety disorder symptoms. In which situation should a nurse recognize that this client is at greatest risk for drug overdose?
- A. When the client has a knowledge deficit related to the effects of the drug
- B. When the client combines the drug with alcohol
- C. When the client takes the drug on an empty stomach
- D. When the client fails to follow dietary restrictions
Correct Answer: B
Rationale: The correct answer is B: When the client combines the drug with alcohol. Combining chlordiazepoxide with alcohol can potentiate the central nervous system depression effects, leading to respiratory depression, sedation, and potential overdose. Alcohol can enhance the sedative effects of chlordiazepoxide, increasing the risk of overdose. A, C, and D are incorrect because a knowledge deficit, taking the drug on an empty stomach, or failing to follow dietary restrictions are not directly related to increasing the risk of drug overdose in this specific scenario.
A client diagnosed with post-traumatic stress disorder is admitted to an inpatient psychiatric unit for evaluation and medication stabilization. Which therapeutic communication technique used by the nurse is an example of a broad opening?
- A. What occurred prior to the rape, and when did you go to the emergency department?
- B. What would you like to talk about?
- C. I notice you seem uncomfortable discussing this.
- D. How can we help you feel safe during your stay here?
Correct Answer: B
Rationale: The correct answer is B because it allows the client to lead the conversation and express their concerns freely. By asking, "What would you like to talk about?" the nurse demonstrates empathy, respect, and openness to the client's needs, facilitating a client-centered approach. Choice A is specific and may not be what the client wants to discuss. Choice C reflects the nurse's observation rather than encouraging the client to share. Choice D focuses on the nurse's agenda rather than the client's preferences.