Which of the following clients is most likely to be at risk for drug dependence and difficulties with withdrawal?

A client who has recently begun treatment with propanolol (Inderal) for the treatment of social phobia.

A woman who has been taking lorazepam (Ativan) for several months after witnessing a traumatic motor vehicle accident.

A man whose obsessive-compulsive disorder (OCD) is being treated long-term with paroxetine (Paxil)

A client with generalized anxiety disorder who has responded well since beginning treatment with fluoxetine (Prozac) earlier in the year.

Answer and Explanation

The Correct Answer is B

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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Correct Answer is B

Explanation

A. client's anxiety level decreased: While reducing anxiety is important, it is not the initial priority when a client is experiencing physical pain that is affecting their ability to engage in the assessment.

B. client's pain level decreased: The initial desired outcome is to address the client's immediate physical pain. Once the pain is managed, the client will likely be better able to participate in the assessment and respond to questions about their mental health.

C. assessment completed: Completing the assessment is important, but it should not be prioritized over managing the client's immediate physical pain, which is currently hindering their ability to participate.

D. client understood the importance of the assessment: The client’s understanding of the assessment’s importance is less critical than addressing their immediate physical discomfort, which is a more pressing concern in this scenario.

A. Instruct to resume regular activities such as driving. B. Administer lithium before meals. C. Withhold if serum level is less than 1.5 mEq. D. Instruct to avoid breastfeeding.

Correct Answer is D

Explanation

A. Instruct to resume regular activities such as driving. It is not safe to instruct the client to resume activities like driving immediately, especially at the beginning of lithium therapy, as lithium can cause side effects that may impair the client's ability to safely perform tasks such as driving.

B. Administer lithium before meals. Lithium is typically taken with food to minimize gastrointestinal upset. Administering it before meals may increase the risk of side effects like nausea.

C. Withhold if serum level is less than 1.5 mEq. Lithium should be withheld if the serum level is above the therapeutic range (typically 0.6–1.2 mEq/L), as higher levels can lead to toxicity. Withholding lithium if the level is less than 1.5 mEq/L is incorrect and could lead to inadequate treatment.

D. Instruct to avoid breastfeeding. Lithium is excreted in breast milk and can pose a risk to the infant, so the client should be advised against breastfeeding while on lithium therapy.

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Which of the following clients is most likely to be at risk for drug dependence and difficulties with withdrawal?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A psychiatric-mental health nurse is conducting an initial interview with a client admitted for hallucinations and abdominal pain. The client is focused on the pain and cannot concentrate on the assessment questions being asked. What is the initial desired outcome of the client?

Correct Answer is B

Explanation

Which of the following nursing interventions should a nurse perform when caring for a female client with mood disorder who is prescribed lithium?

Correct Answer is D

Explanation

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