Lorazepam (Ativan) is prescribed for a client experiencing severe acute anxiety. Most important teaching should include instructions to:

avoid taking opioid medications and other sedatives.

report insomnia

eat a tyramine-free diet.

adjust dose and frequency based on your anxiety level.

Answer and Explanation

The Correct Answer is A

Lorazepam belongs to a class of drugs called benzodiazepines, which are central nervous system (CNS) depressants.

Taking other CNS depressants such as opioids or sedatives along with lorazepam can lead to increased sedation, respiratory depression, and other serious side eﬀects. It is crucial for patients to avoid these medications while taking lorazepam.

Reporting insomnia is important, but it is not the most critical teaching for this medication. Eating a tyramine-free diet is not relevant to lorazepam use.

Adjusting the dose and frequency based on anxiety level is not recommended as it can lead to misuse or dependence on the medication. It is important to take lorazepam only as prescribed by a healthcare provider.

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Correct Answer is B

Explanation

This response acknowledges the client's distress and opens the opportunity for the client to express their feelings and concerns. It also demonstrates empathy and a willingness to listen, which can help deescalate the situation and build trust between the nurse and client.

Option a ("Others are being distracted; Please, quiet down and go to your room") is dismissive of the client's feelings and may further escalate the situation.

Option c ("Please go to your room to get control of yourself") is directive and may be perceived as confrontational, potentially increasing the client's agitation.

Option d ("What's going on? Be quiet") is insensitive and dismissive of the client's distress and may further agitate the client.

A. Avoid discussing past manipulative behaviors with the client. B. Allow manipulation so as to not raise the client's anxiety. C. Institute consequences for manipulative behavior D. Avoid discussing present behaviors with the client

Correct Answer is C

Explanation

Manipulative behavior is not acceptable in any situation, and it is important for the nurse to set clear boundaries and expectations with the client. Allowing manipulation can enable the client's behavior and reinforce it. Avoiding discussing past or present manipulative behaviors with the client may not eﬀectively address the issue and could potentially worsen the behavior. Bargaining with the client can also reinforce manipulative behavior.

Therefore, instituting consequences for manipulative behavior is the most appropriate intervention to include in the plan of care. This could involve setting clear limits on what is acceptable behavior and consistently enforcing consequences when those limits are exceeded. The consequences should be communicated clearly to the client, and the nurse should work with the client to identify more appropriate ways to communicate their needs and concerns.

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Lorazepam (Ativan) is prescribed for a client experiencing severe acute anxiety. Most important teaching should include instructions to:

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client is agitated and pacing in the hall near the nurses' station and swearing loudly. What response is the best for the registered nurse to provide? Select one:

Correct Answer is B

Explanation

A registered nurse is planning to care for a client who demonstrates manipulative behaviors. Which of the following interventions should be included in the plan of care?

Correct Answer is C

Explanation

A young female client is admitted to the emergency room because she was raped that evening by her date. How should the registered nurse record the client's chief complaint in the medical record?

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