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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Avoiding crowds and people who are sick is crucial for clients taking methotrexate and adalimumab. Both medications suppress the immune system, increasing the risk of infections. Methotrexate is an immunosuppressant that can reduce the body’s ability to fight infections. Adalimumab, a TNF inhibitor, also lowers the immune response, making clients more susceptible to infections. Therefore, avoiding exposure to potential sources of infection is essential to prevent serious health complications.
Choice B reason:
While undergoing annual eye examinations is important for overall health, it is not directly related to the use of methotrexate and adalimumab. Methotrexate can cause ocular side effects, but these are relatively rare. Regular eye exams are a good practice but not the most critical instruction in this context.
Choice C reason:
Obtaining routine vaccinations is generally recommended for clients on immunosuppressive therapy. However, live vaccines should be avoided as they can cause infections in immunocompromised individuals. Non-live vaccines, such as the flu shot, are safe and should be administered according to the vaccination schedule. This instruction is important but secondary to avoiding exposure to infections.
Choice D reason:
Having a chest x-ray prior to the first dose of adalimumab is necessary to check for latent tuberculosis (TB). Adalimumab can reactivate latent TB, so screening is essential before starting the medication. However, this is a one-time requirement and not an ongoing instruction like avoiding crowds and sick people.
Correct Answer is D
Explanation
Choice A Reason:
Nausea is a common side effect of many medications, including metoclopramide. While it is important to monitor, it is not the most critical adverse effect to report. Metoclopramide is often prescribed to manage nausea, so experiencing this symptom may indicate the need for dosage adjustment or additional supportive care, but it is not an emergency.
Choice B Reason:
Diarrhea is another common side effect of metoclopramide. It can be uncomfortable and may require management, but it is not typically life-threatening. The nurse should monitor the client and provide supportive care, but this side effect does not necessitate immediate reporting unless it becomes severe or persistent.
Choice C Reason:
Unusual irritability can occur with metoclopramide use. While it is important to note changes in mood or behavior, this symptom is not as critical as some other potential adverse effects. The nurse should monitor the client and consider discussing this symptom with the healthcare provider, but it is not the most urgent concern.
Choice D Reason:
Involuntary movements, such as those seen in tardive dyskinesia, are a serious adverse effect of metoclopramide. Tardive dyskinesia is a potentially irreversible condition characterized by repetitive, involuntary movements, often of the face and tongue. This side effect is significant and requires immediate reporting to the healthcare provider, as it may necessitate discontinuation of the medication and further evaluation.
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