A nurse is caring for a client who was recently diagnosed with an opioid use disorder. They were a student in a local community college but were recently dismissed for failing their classes. Their previous diagnoses include anxiety. Crohn's disease, and chronic back pain due to a gymnastics injury in high school Which of the following should the nurse identify as potential underlying reasons why the client might have started using opioids?

To treat hallucinations and perform better at work

Because they witnessed their parents using drugs or alcohol to cope

To promote sleep and rest

To treat pain and ease anxiety

Answer and Explanation

The Correct Answer is D

A. Using opioids to treat hallucinations is not a common reason, as opioids are not typically prescribed for this purpose. Hallucinations might be indicative of another underlying mental health condition that needs assessment and appropriate treatment.

B. Witnessing parents using drugs or alcohol to cope is a risk factor for substance use disorders, but it does not directly explain the client's initiation of opioid use. There may be other contributing factors, such as pain or anxiety.

C. Using opioids to promote sleep and rest is a possibility, especially if the client has chronic pain or anxiety affecting their sleep. Opioids can have sedative effects, which might be appealing to individuals experiencing sleep difficulties. However, treating pain and anxiety is often a primary reason for opioid use in such cases.

D. To treat pain and ease anxiety.
Chronic back pain due to a gymnastics injury and anxiety are identified as pre-existing conditions. The client may have started using opioids to manage chronic pain and potentially as a way to cope with anxiety. Opioids are often prescribed for pain relief, and individuals may misuse them to self-medicate emotional distress.

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Correct Answer is B

Explanation

A. Checking the bruises at the next visit may delay necessary intervention. If abuse is suspected, immediate action, such as reporting, is essential to protect the client.

B. Following the agency's guidelines for reporting suspected abuse is the priority when abuse is suspected. Reporting abuse to the appropriate authorities, such as adult protective services or law enforcement, is crucial to ensure the safety and well-being of the older adult.

C. Instituting more frequent visits to the client's home might be part of a safety plan, but it should not be the first action. Reporting suspected abuse is the priority to involve the appropriate authorities.

D. Arranging a referral for family therapy is not the first step in suspected elder abuse. Safety and protection of the older adult take precedence. Once the immediate safety concerns are addressed, additional interventions, such as family therapy, may be considered.

A. "Avoid foods that contain tyramine." B. "Plant to discontinue this medication as soon as your depression is relieved." C. "Expect that your mood might take one to three weeks to begin improving." D. "Stop taking this medication if weight loss or gain occurs."

Correct Answer is C

Explanation

A. "Avoid foods that contain tyramine" is not relevant to fluoxetine. Tyramine restriction is a concern with certain medications, such as monoamine oxidase inhibitors (MAOIs), but not with SSRIs like fluoxetine.

B. "Plan to discontinue this medication as soon as your depression is relieved" is not advisable. Discontinuing an antidepressant abruptly can lead to withdrawal symptoms and may not allow for the full resolution of depressive symptoms. The decision to discontinue medication should be made in consultation with a healthcare provider.

C. "Expect that your mood might take one to three weeks to begin improving" is a crucial piece of information to provide because fluoxetine, a selective serotonin reuptake inhibitor (SSRI), often takes a few weeks to start exerting its therapeutic effects. It's important for the client to understand that the full benefits of the medication may not be felt immediately.

D. "Stop taking this medication if weight loss or gain occurs" is not an appropriate instruction. Weight changes are potential side effects of fluoxetine, but the decision to continue or discontinue the medication should be based on consultation with a healthcare provider. Abruptly stopping medication without medical guidance can lead to withdrawal symptoms and is not recommended.

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Naxlex Comprehensive Predictor Exams

Correct Answer is B

Explanation

A nurse is reinforcing teaching with a client who has a new prescription for fluoxetine. Which of the following instructions should the nurse Include?

Correct Answer is C

Explanation

A nurse is collecting data from a group of clients who have anxiety disorders and have prescriptions for various psychotropic medications. The nurse should recognize which of the following clients as having an increased risk for suicide?

A nurse is assisting with the plan of care for a client who is newly diagnosed with borderline personality disorder. Which of the following Interventions is the nurse's priority?

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A nurse is collecting data from a client who has major depressive disorder (MDD). Which of the following findings should the nurse expect?

A nurse is caring for a client who reports a state of increasing anxiety and the inability to sleep and concentrate. Which of the following is an appropriate response by the nurse?

A nurse is caring for a client who has bipolar disorder and states that his latest computer project is "revolutionizing the industry." Which of the following behaviors is the client exhibiting?

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