A client is prescribed lorazepam (Ativan) for the management of anxiety. Which statement by the client indicates the need for further teaching?

Correct Answer: B

Rationale: The correct answer is B. Clients should avoid alcohol while taking lorazepam (Ativan) due to potential interactions. Alcohol can increase the side effects of lorazepam, such as drowsiness and dizziness, which can be dangerous, especially when combined with activities like driving or operating machinery. Choice A is correct as it promotes medication adherence. Choice C is correct as lorazepam can impair cognitive and motor skills, impacting driving ability. Choice D is correct as lorazepam is not recommended during pregnancy due to potential harm to the fetus.

Correct Answer: A

Rationale: In cognitive-behavioral therapy (CBT), one of the primary objectives is to help clients identify and challenge their negative thoughts. This process allows the individual to reframe their thinking patterns and develop more adaptive coping strategies. Reporting an increase in suicidal thoughts (Choice B) or experiencing an increase in anxiety (Choice C) are not desired outcomes and may indicate a need for further intervention. Showing no change in behavior (Choice D) suggests that the therapy has not been effective. Therefore, the correct indicator of effective therapy in this context is the client's ability to identify and challenge negative thoughts (Choice A).

Correct Answer: B

Rationale: The correct answer is to advise the client to avoid drinking alcohol while taking fluoxetine (Prozac) due to potential interactions. Alcohol consumption can increase the risk of certain side effects and may reduce the effectiveness of the medication. Choice A is incorrect because fluoxetine can be taken with or without food. Choice C is incorrect as fluoxetine is usually taken daily regardless of the client's mood. Choice D is not the priority teaching point; while reporting side effects is important, avoiding alcohol is critical due to the potential interactions.

Correct Answer: C

Rationale: Buspirone (Buspar) is a medication used to treat generalized anxiety disorder, and its pharmacological properties and clinical use explain why choice C is correct while the others are incorrect. **Correct Answer (C):** Buspirone has a delayed onset of action, typically requiring **2-4 weeks** for noticeable therapeutic effects. Unlike benzodiazepines, which provide rapid relief, buspirone works by modulating serotonin and dopamine receptors over time. This slow mechanism means patients must take it consistently—not as needed—to achieve anxiety reduction. The statement "It may take several weeks for this medication to take effect" demonstrates accurate understanding, as it aligns with the drug's pharmacokinetics and prescriber instructions. **Incorrect Answer (A):** "I should take this medication as needed for anxiety" is incorrect because buspirone is not a PRN (as-needed) medication. It does not provide immediate relief like benzodiazepines (e.g., lorazepam) due to its gradual effect on neurotransmitter systems. Taking it intermittently would undermine its efficacy, as steady blood levels are required for therapeutic benefits. **Incorrect Answer (B):** "I need to avoid aged cheeses" is incorrect because this precaution applies to **MAO inhibitors** (e.g., phenelzine), not buspirone. MAO inhibitors interact with tyramine-rich foods (like aged cheeses), causing hypertensive crises. Buspirone lacks this interaction, so dietary restrictions are unnecessary. This statement reflects confusion with another drug class. **Incorrect Answer (D):** "I can stop taking this medication abruptly if I feel better" is incorrect because sudden discontinuation, though not typically associated with severe withdrawal (unlike benzodiazepines), can lead to symptom recurrence. Buspirone should be tapered under medical supervision to prevent rebound anxiety. Abrupt cessation disregards the need for gradual adjustment and ongoing management of anxiety disorders. The key distinctions lie in buspirone's **mechanism (slow-acting, non-sedating), dosing regimen (scheduled, not PRN), and lack of dietary or abrupt-discontinuation risks** compared to other anxiolytics. Choice C correctly reflects these nuances, while the others misrepresent the drug’s use or confuse it with other medications.

Correct Answer: D

Rationale: Encouraging the client to express their feelings is essential during alcohol withdrawal as it can help them cope with the emotional and psychological stress associated with the process. This intervention promotes open communication, allows the client to verbalize their emotions, and may prevent escalating anxiety or agitation, ultimately reducing the risk of complications. Providing a well-lit environment (Choice A) is not directly related to preventing complications of alcohol withdrawal. Administering antipsychotic medication (Choice B) is not the standard treatment for alcohol withdrawal; medications such as benzodiazepines are more commonly used. While monitoring vital signs (Choice C) is important, encouraging the client to express their feelings (Choice D) directly addresses emotional well-being, which is crucial during this vulnerable time.