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 B

Explanation

Choice A Reason:
Asking the client to share the joke may imply that the nurse believes the client is laughing at a joke, which may not be the case. It's important to recognize that uncontrollable laughter can be a symptom of schizophrenia and not necessarily a response to humor.

Choice B Reason:
This response is open-ended and nonjudgmental, inviting the client to explain their behavior without making assumptions. It allows the client to share their experience, which could be related to an internal stimulus such as a hallucination or simply a response they cannot control.

Choice C Reason:
Asking "Why are you laughing?" could be perceived as confrontational or accusatory. It might make the client feel defensive or misunderstood, especially if the laughter is a symptom of their condition and not something they are doing voluntarily.

Choice D Reason:
Saying "I don't think I said anything funny" focuses on the nurse's perspective rather than the client's experience. It could inadvertently dismiss the client's behavior as inappropriate or unjustified, which is not supportive in a therapeutic relationship.

A. Apply cool compresses to the affected limb every six hours. B. Place a soft pillow under the affected knee. C. Promote bedrest for 24 hours. D. Encourage increased fluid intake.

Correct Answer is D

Explanation

Choice A Reason
Applying cool compresses to the affected limb can help reduce swelling and provide pain relief. However, it's important to follow the surgeon's specific postoperative orders, as the application of cold can vary depending on the surgical technique and patient's condition.

Choice B Reason
Placing a soft pillow under the knee is not recommended after total knee replacement surgery. This position can lead to decreased range of motion and contractures. The knee should be kept in a more extended position to promote healing and mobility.

Choice C Reason
Promoting bedrest for an extended period is not typically advised following knee replacement surgery. Early mobilization is important to prevent complications such as deep vein thrombosis and to encourage circulation and healing. The duration of bedrest should be as per the surgeon's protocol.

Choice D Reason
Encouraging increased fluid intake is important after surgery to prevent dehydration, promote kidney function, and ensure adequate blood volume and circulation. Proper hydration is essential for healing and can help with the metabolism of medications used during and after surgery.

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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

The nurse is sitting with a client diagnosed with schizophrenia, who starts to laugh uncontrollably, although the nurse has not said anything funny. The nurse should say:

Correct Answer is B

Explanation

Eight hours postoperative following a total knee replacement, which intervention should the nurse implement for the client?

Correct Answer is D

Explanation

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