Nursing Elites

1. A client has been taking alprazolam (Xanax) for four years to manage anxiety. The client reports taking 0.5 mg four times a day. Which statement indicates that the client understands the nurse's teaching about discontinuing the medication?

• A. "I can drink alcohol now that I am decreasing my Xanax."?
• B. "I should not take another Xanax pill. Here is what is left of my last prescription."?
• C. "I should take three pills per day next week, then two pills for one week, then one pill for one week."?
• D. "I can expect to be sleepy for several days after stopping the medicine."?

Correct answer: C

Rationale: Explanation: When discontinuing alprazolam (Xanax) after long-term use, it is crucial to taper the dosage gradually to prevent withdrawal symptoms. The correct statement indicates an understanding of this by planning a structured decrease in dosage over time. Choice A is incorrect as drinking alcohol while decreasing Xanax can be dangerous and is not recommended. Choice B is incorrect as abruptly stopping Xanax is not safe and can lead to withdrawal symptoms. Choice D is incorrect as expecting to be sleepy for several days after stopping the medication does not address the need for a gradual tapering process to avoid withdrawal symptoms.

2. In a brief treatment program for a client who was raped, what is a realistic short-term goal?

• A. Identify all psychosocial problems.
• B. Eliminate the client's enticing behaviors.
• C. Resolve feelings of trauma and fear.
• D. Verbalize feelings about the event.

Correct answer: D

Rationale: In this scenario, a realistic short-term goal for the client who was raped and starting a brief treatment program is to verbalize feelings about the event. This goal promotes the expression of emotions, which is crucial in the healing process. Identifying all psychosocial problems is too broad and not typically achievable in a brief treatment program. Eliminating the client's enticing behaviors is not a suitable short-term goal as the focus should be on emotional recovery. While resolving feelings of trauma and fear is important, verbalizing feelings about the event is a more specific and achievable goal in the short term.

3. The nurse is assigned to care for an infant with physiologic jaundice. Which action by the nurse would facilitate elimination of the bilirubin?

• A. Increasing the infant's fluid intake
• B. Maintaining the infant's body temperature at 98.6°F
• C. Minimizing tactile stimulation
• D. Decreasing caloric intake

Correct answer: A

Rationale: Bilirubin is excreted through the kidneys, therefore increasing fluid intake can help facilitate its elimination. Maintaining the infant's body temperature is important for overall health but does not directly assist in eliminating bilirubin, making choice B incorrect. Choices C and D are irrelevant to bilirubin elimination in this scenario and do not address the specific issue of physiologic jaundice.

4. An elderly client denies that abuse is occurring. Which of the following factors could be a barrier for the client to admit being a victim?

• A. knowledge that elder abuse is rare
• B. personal belief that abuse is deserved
• C. lack of developmentally appropriate screening tools
• D. fear of reprisal or further violence if the incident is reported

Correct answer: D

Rationale: Barriers to reporting elder abuse include victim shame, fear of reprisals, fear of loss of caregiver, and lack of knowledge of agencies that provide services. Many elders fear that reporting abuse results in their placement in long-term care because the current caregiver is the abuser. Choice A is incorrect because knowledge of the frequency of elder abuse is not a significant factor in a victim's reluctance to report. Choice B is also incorrect; while some victims may have feelings of undeservedness, it is not a common primary barrier to reporting abuse. Choice C is incorrect as the lack of appropriate screening tools may hinder identification but is not a significant barrier for the client to admit being a victim. Therefore, the correct answer is D, as the fear of reprisal or further violence if the incident is reported is a common and significant barrier for elderly clients to admit being a victim.

5. Social support systems include all of the following except:

• A. call-in help lines
• B. emotional assistance provided by others
• C. community support groups
• D. use of coping skills and verbalization for anger management

Correct answer: D

Rationale: The correct answer is the use of coping skills and verbalization for anger management. Social support systems involve external sources of support from others or the community. Call-in help lines, emotional assistance provided by others, and community support groups all represent social support systems where individuals can seek help and assistance from outside sources. On the other hand, the use of coping skills and verbalization for anger management refers to individual strategies rather than external social support.

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