A client is prescribed alprazolam for acute anxiety. What client history should cause a nurse to question this order?

A personality disorder.

Hypertension.

Alcohol use disorder.

Schizophrenia.

Answer and Explanation

The Correct Answer is C

Choice A Reason
While a personality disorder can present challenges in managing medications due to the complexity of the psychiatric condition, it is not typically a contraindication for the use of alprazolam. However, caution is advised as the dynamics of personality disorders can affect medication adherence and response.

Choice B Reason
Hypertension is not a direct contraindication for alprazolam. However, since alprazolam can sometimes cause changes in blood pressure, it is important for the nurse to monitor the client's blood pressure and consult with the physician if there are concerns.

Choice C Reason
Alcohol use disorder is a significant concern when prescribing alprazolam. Alprazolam is a benzodiazepine, and concurrent use with substances like alcohol can increase the risk of respiratory depression, sedation, and misuse or addiction. Therefore, a history of alcohol use disorder should prompt the nurse to question the order and discuss alternative treatments with the physician.

Choice D Reason
Schizophrenia itself is not a contraindication for the use of alprazolam, but it is essential to consider the overall treatment plan for the client. Alprazolam is not a primary treatment for schizophrenia and is used for anxiety management. The nurse should ensure that the use of alprazolam does not interfere with the treatment of schizophrenia.

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Correct Answer is D

Explanation

Choice A Reason
Using an antiemetic one hour after administration of methotrexate is not a standard recommendation. Antiemetics are typically used to prevent nausea and vomiting associated with chemotherapy and are taken before or at the time of methotrexate administration, not afterward.

Choice B Reason
Drinking 2-3 liters of water per day is important for patients taking methotrexate to prevent kidney damage by ensuring adequate hydration and facilitating the excretion of the drug¹. Methotrexate can be nephrotoxic, and proper hydration helps to mitigate this risk.

Choice C Reason
Rinsing the mouth with an alcohol-based mouthwash is not recommended for patients taking methotrexate. Alcohol can cause drying and irritation, which might exacerbate any mouth sores caused by methotrexate. Instead, patients should use a gentle, non-alcoholic mouthwash to maintain oral hygiene.

Choice D Reason
Taking methotrexate with an NSAID is not advised without specific medical guidance. NSAIDs can increase the toxicity of methotrexate by displacing it from protein-binding sites and reducing its renal clearance, potentially leading to increased side effects.

A. A blood glucose level of 80 mg/dL before eating. B. Gaining 5 pounds in the last 7 months. C. Waking up with a fever. D. Insomnia.

Correct Answer is C

Explanation

Choice A Reason:
A blood glucose level of 80 mg/dL before eating falls within the normal fasting blood glucose range, which is between 70 mg/dL to 110 mg/dL. Therefore, this finding is not a priority concern for a client taking prednisone.

Choice B Reason:
Gaining 5 pounds over 7 months is not typically a priority concern unless it is sudden or unexplained. Prednisone can cause fluid retention and weight gain as a common side effect, but this gradual weight change does not indicate an immediate health risk.

Choice C Reason:
Waking up with a fever is a priority finding as it may indicate an infection. Patients on prednisone are at increased risk of infections due to its immunosuppressive effects¹. Fever could also signify an exacerbation of inflammatory bowel disease or other complications.

Choice D Reason:
While insomnia is a common side effect of prednisone and can impact quality of life, it is not typically a priority over signs that could indicate infection or exacerbation of the underlying condition

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A client is prescribed alprazolam for acute anxiety. What client history should cause a nurse to question this order?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

What instruction for oral administration of methotrexate should the nurse include when teaching a client diagnosed with rheumatoid arthritis?

Correct Answer is D

Explanation

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Correct Answer is C

Explanation

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