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 C
Explanation
Choice A Reason:
Depression screening is important for overall health and well-being, especially in weight management programs where mental health can significantly impact outcomes. However, it is not the primary measure for determining the effectiveness of orlistat. Orlistat works by inhibiting the absorption of fats from the diet, leading to weight loss. Therefore, while mental health monitoring is crucial, it does not directly measure the medication’s effectiveness.
Choice B Reason:
Daily calorie count is a useful tool in weight management programs to ensure that clients are adhering to a calorie-restricted diet. However, it is not a direct measure of the effectiveness of orlistat. While calorie counting can help manage weight, the primary goal of orlistat is to reduce fat absorption, which is better reflected in changes in body weight and BMI.
Choice C Reason:
Body mass index (BMI) is a key indicator of weight management and is directly related to the effectiveness of orlistat. BMI is calculated based on height and weight, providing a clear measure of changes in body weight over time. Monitoring BMI helps determine if the client is losing weight as expected, making it the most appropriate assessment for evaluating the effectiveness of orlistat.
Choice D Reason:
Serum protein levels are important for assessing nutritional status and overall health. However, they do not directly measure the effectiveness of orlistat in a weight management program. Orlistat’s primary function is to reduce fat absorption, and its effectiveness is better assessed through changes in body weight and BMI rather than serum protein levels.
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