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According to an evidence-based approach, what is the most productive way to treat anxiety disorders?
- A. Provide the client with a powerful medication.
- B. Uncover and address the cause of anxiety.
- C. Allow the client to self-medicate with OTC medications.
- D. Immediately start multiple-drug therapy.
- G. B
Correct Answer: Medication alone isn't most productive. Cognitive behavioral therapy addressing anxiety causes is evidence-based. Self-medication and multiple drugs initially are not recommended.
Rationale: The correct answer is B: Uncover and address the cause of anxiety. An evidence-based approach for treating anxiety disorders involves cognitive behavioral therapy (CBT) to address the underlying causes of anxiety. By identifying and working through the root causes of anxiety, clients can develop coping strategies and long-term solutions. Providing powerful medications (A) may only offer temporary relief and not address the underlying issues. Allowing self-medication with OTC medications (C) can be dangerous and lead to misuse. Immediately starting multiple-drug therapy (D) can increase the risk of side effects and interactions without addressing the root cause of anxiety. Thus, focusing on uncovering and addressing the causes of anxiety through CBT is the most productive and evidence-based approach.
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A client taking an MAOI should be instructed to avoid which item?
- A. Large amounts of water
- B. A diet that is high in salt
- C. A diet that is high in fat
- D. Foods that contain tyramine and caffeine .
- G. D
Correct Answer: Water, salt, and fat don't interact with MAOIs. Tyramine and caffeine can cause hypertensive crises with MAOIs.
Rationale: The correct answer is D: Foods that contain tyramine and caffeine. MAOIs inhibit the breakdown of tyramine and caffeine, leading to an accumulation in the body. Tyramine can cause a dangerous increase in blood pressure known as a hypertensive crisis. Caffeine can also contribute to this effect. Large amounts of water (A), a high-salt diet (B), and a high-fat diet (C) do not interact with MAOIs in a way that poses a significant risk. Therefore, instructing the client to avoid foods containing tyramine and caffeine is crucial to prevent potential adverse reactions.
A teenage client is taking duloxetine (Cymbalta) for a generalized anxiety disorder. The dose has been changed by the physician. What adverse effects will the nurse advise the client and family to watch?
- A. Warning signs of suicide.
- B. Fatigue.
- C. Irritability.
- D. Weight gain.
- G. A,B,C
Correct Answer: Suicidal thoughts are a risk, especially in teens with dose changes. Fatigue and irritability are common. Weight gain is possible but less urgent to monitor than A, B, C.
Rationale: The correct answer is G: A, B, C. When a teenage client is taking duloxetine for generalized anxiety disorder and the dose has been changed, the nurse should advise the client and family to watch for warning signs of suicide (A) because duloxetine can increase the risk of suicidal thoughts, especially in teens with dose changes. Fatigue (B) and irritability (C) are common side effects of duloxetine and should also be monitored closely. While weight gain (D) is a possible side effect of duloxetine, it is less urgent to monitor compared to the risk of suicidal thoughts, fatigue, and irritability. Therefore, choices A, B, and C are the most important adverse effects to watch for in this scenario.
Why are antianxiety medications used cautiously in older adults?
- A. The drug is not distributed as well due to poor circulation.
- B. The liver metabolizes the drug faster, making it ineffective.
- C. There is an inability to absorb the drugs due to decreased acid production.
- D. There is reduced elimination, leading to a buildup in the circulation.
- G. D
Correct Answer: Poor circulation affects distribution but isn't primary. Liver metabolism slows, not hastens. Acid production impacts some drugs, not anxiolytics. Reduced elimination increases buildup, risking side effects.
Rationale: The correct answer is D: There is reduced elimination, leading to a buildup in the circulation. In older adults, the kidneys tend to function less efficiently, resulting in reduced elimination of medications from the body. This decreased clearance can lead to a buildup of antianxiety medications in the bloodstream, potentially causing adverse effects or toxicity. This is why antianxiety medications should be used cautiously in older adults to prevent these risks.
Choices A, B, and C are incorrect because poor circulation, faster liver metabolism, and decreased acid production are not the primary reasons why antianxiety medications are used cautiously in older adults. These factors may influence drug absorption or metabolism, but the key concern with antianxiety medications in older adults is the reduced elimination leading to potential drug accumulation and its associated risks.
A patient is allergic to penicillin. Which class of antibiotics might they also have a cross-allergy to?
- A. Cephalosporins
- B. Sulfonamides
- C. Macrolides
- D. Aminoglycosides
- G. A
Correct Answer: Cephalosporins share a similar structure with penicillin, risking cross-allergy. Sulfonamides, macrolides, and aminoglycosides lack this relation.
Rationale: The correct answer is A: Cephalosporins. Cephalosporins have a beta-lactam ring structure similar to penicillin, leading to potential cross-allergy. Sulfonamides, macrolides, and aminoglycosides have different chemical structures, reducing the likelihood of cross-allergy. Therefore, individuals allergic to penicillin may have a cross-allergy to cephalosporins due to structural similarity, making it the correct choice.
The healthcare provider has ordered 1000 mL of 0.9% sodium chloride to be administered intravenously over 5 hours. The drop factor on the tubing is 15 drops/mL. How many milliliters per hour and how many drops per minute will you administer?
- A. 200 mL/hr and 45 drops/min
- B. 250 mL/hr and 45 drops/min
- C. 250 mL/hr and 50 drops/min
- D. 200 mL/hr and 50 drops/min
- G. D
Correct Answer: 1000 mL ÷ 5 hr = 200 mL/hr. 200 mL/hr ÷ 60 min = 3.33 mL/min × 15 drops/mL = 49.95 drops/min, rounded to 50. Thus, 200 mL/hr and 50 drops/min.
Rationale: The correct answer is D: 200 mL/hr and 50 drops/min. To calculate the mL per hour, you divide the total mL by the total hours (1000 mL ÷ 5 hr = 200 mL/hr). To find the mL per minute, you divide the mL per hour by 60 minutes (200 mL/hr ÷ 60 min = 3.33 mL/min). Next, to determine the drops per minute, you multiply the mL per minute by the drop factor (3.33 mL/min × 15 drops/mL = 49.95 drops/min, rounded to 50 drops/min). Therefore, the correct administration rate is 200 mL/hr and 50 drops/min.
Choices A, B, and C are incorrect because they do not align with the correct calculation based on the given parameters. Choice A and B have incorrect mL per hour values, and Choice C has an incorrect drops per minute value.