Edited Text
A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

Use relaxation techniques to reduce excessive anxiety.

Avoid alcohol and other sedatives while taking the medication.

Move slowly from a sitting position to a standing position.

Stop taking the medication if intended effect is not immediate.

Answer and Explanation

The Correct Answer is D

The correct answer is d. Stop taking the medication if intended effect is not immediate.

Choice A Reason:

Using relaxation techniques to reduce excessive anxiety is a beneficial practice for managing generalized anxiety disorder (GAD). Techniques such as deep breathing, meditation, and progressive muscle relaxation can complement medication therapy and help reduce anxiety symptoms1. This statement does not require additional instruction as it aligns with recommended practices.

Choice B Reason:

Avoiding alcohol and other sedatives while taking lorazepam is crucial. Lorazepam is a benzodiazepine that can cause sedation and depress the central nervous system. Combining it with alcohol or other sedatives can enhance these effects, leading to dangerous levels of sedation, respiratory depression, or even overdose2. This advice is appropriate and does not need further instruction.

Choice C Reason:

Moving slowly from a sitting position to a standing position is important to prevent dizziness or lightheadedness, which can be side effects of lorazepam3. This precaution helps reduce the risk of falls and injuries, making it a suitable recommendation that does not require additional instruction.

Choice D Reason:

Stopping the medication if the intended effect is not immediate requires additional instruction. Lorazepam, like other benzodiazepines, may not produce immediate effects, especially in the context of anxiety management. It is important for clients to understand that medication may take some time to achieve the desired therapeutic effect and that abrupt discontinuation can lead to withdrawal symptoms and a potential rebound in anxiety4. The nurse should instruct the client to follow the prescribed regimen and consult their healthcare provider before making any changes to their medication.

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Correct Answer is ["B"]

Explanation

Choice A Reason:

Providing a PRN NSAID for gum discomfort is not advisable in this situation. NSAIDs can increase the risk of bleeding, which is already a concern for a client on anticoagulants. Therefore, this action could exacerbate the client’s condition and should be avoided.

Choice B Reason:

Obtaining a soft bristle toothbrush for the client is a good practice to help minimize gum irritation and bleeding. Soft bristle toothbrushes are gentler on the gums and can help prevent further bleeding and discomfort, making this a suitable action for the nurse to implement.

Choice C Reason:

Reviewing the most recent coagulation lab values is crucial in this scenario. Coagulation tests, such as INR (International Normalized Ratio) or aPTT (activated partial thromboplastin time), can help determine if the anticoagulant dosage is appropriate or if adjustments are needed. This step is essential to ensure the client’s safety and effective management of their anticoagulation therapy.

Choice D Reason:

Completing a medication variance report is not immediately necessary unless there is evidence of a medication error. The priority should be to address the client’s symptoms and ensure their safety. While documentation is important, it should not take precedence over direct patient care in this situation.

Choice E Reason:

Reporting findings to the healthcare provider is essential. The development of bleeding and new bruises indicates a potential adverse reaction to the anticoagulant. The healthcare provider needs to be informed to assess the situation, possibly adjust the medication, and provide further instructions for managing the client’s condition.

A. Avoid taking on an empty stomach. B. Consume 2 liters of water daily. C. Reduce caffeine and acidic intake. D. Double the dose if a dose is missed.

Correct Answer is D

Explanation

Choice A Reason:

Avoiding taking allopurinol on an empty stomach is a common recommendation to prevent stomach upset. Taking the medication with food can help reduce gastrointestinal discomfort, making this advice appropriate and not requiring additional instruction.

Choice B Reason:

Consuming 2 liters of water daily is advised when taking allopurinol to help prevent kidney stones and ensure proper hydration. Adequate fluid intake helps to dilute the urine and reduce the risk of uric acid crystal formation, making this advice correct and not needing further instruction.

Choice C Reason:

Reducing caffeine and acidic intake can be beneficial for individuals taking allopurinol, as these substances can increase uric acid levels and potentially exacerbate gout symptoms. This advice is appropriate and does not require additional instruction.

Choice D Reason:

Doubling the dose if a dose is missed is incorrect and potentially dangerous. Allopurinol should be taken exactly as prescribed, and doubling up on doses can increase the risk of side effects and toxicity. If a dose is missed, the client should take it as soon as they remember, but if it is almost time for the next dose, they should skip the missed dose and continue with their regular schedule. This instruction requires correction by the nurse.

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Edited TextA client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

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Naxlex Comprehensive Predictor Exams

After receiving the third dose of a new oral anticoagulant prescription, an older adult client develops bleeding and tender gums and has many new bruises. Which actions should the nurse implement? Select all that apply.

Correct Answer is ["B"]

Explanation

A client receives a prescription for allopurinol. Which information provided by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

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Edited Text
A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?