A client with schizophrenia is reluctant to take his prescribed oral medication. The most therapeutic response by the nurse to this refusal is:

"I can see that you're uncomfortable now, so we can wait until tomorrow."

"If you refuse these pills, you'll have to get an injection

"What is it about the medicine that you don't like?"

"You know you have to take this medicine for your own good."

Answer and Explanation

The Correct Answer is C

A. "I can see that you're uncomfortable now, so we can wait until tomorrow." Delaying the medication could worsen the client's condition and does not address the underlying reason for the refusal.

B. "If you refuse these pills, you'll have to get an injection." This response is coercive and could damage trust between the client and the nurse. It does not explore the client's concerns.

C. "What is it about the medicine that you don't like?" This response is therapeutic as it opens a dialogue with the client to understand their concerns, which can help in addressing the reluctance and promoting adherence to the medication.

D. "You know you have to take this medicine for your own good." This response is paternalistic and dismisses the client's autonomy and concerns, which may lead to further resistance.

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Correct Answer is B

Explanation

A. Chemical agents: Chemical agents (e.g., tobacco smoke, asbestos) are significant carcinogens but are not the most influential across all types of cancer.

B. Environmental factors: Environmental factors, including exposure to radiation, chemicals, and lifestyle choices, have a broad impact on cancer development. This is the most comprehensive factor, as it encompasses various elements that contribute to cancer risk.

C. Viruses: Certain viruses (e.g., HPV, Hepatitis B) are linked to specific cancers, but they are not the primary cause of most cancers.

D. Defective genes: Genetic mutations play a critical role in cancer development, but they are often triggered by environmental factors, making environmental factors the most significant overall.

A. A client who has recently begun treatment with propanolol (Inderal) for the treatment of social phobia. B. A woman who has been taking lorazepam (Ativan) for several months after witnessing a traumatic motor vehicle accident. C. A man whose obsessive-compulsive disorder (OCD) is being treated long-term with paroxetine (Paxil) D. A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine (Prozac) earlier in the year.

Correct Answer is B

Explanation

A. A client who has recently begun treatment with propranolol (Inderal) for the treatment of social phobia. Propranolol, a beta-blocker, does not have a significant risk for dependence or withdrawal symptoms. It is primarily used for physical symptoms of anxiety, such as tachycardia.

B. A woman who has been taking lorazepam (Ativan) for several months after witnessing a traumatic motor vehicle accident. Lorazepam is a benzodiazepine, which has a high potential for dependence and withdrawal, especially with long-term use. This client is the most at risk for these issues.

C. A man whose obsessive-compulsive disorder (OCD) is being treated long-term with paroxetine (Paxil). While discontinuation symptoms can occur with SSRIs like paroxetine, the risk of dependence is significantly lower than with benzodiazepines.

D. A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine (Prozac) earlier in the year. Like paroxetine, fluoxetine is an SSRI, and while discontinuation symptoms may occur, the risk of dependence is low.

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A client with schizophrenia is reluctant to take his prescribed oral medication. The most therapeutic response by the nurse to this refusal is:

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