A nurse who has worked with a client diagnosed with generalized anxiety disorder (GAD) when he was an inpatient on the psychiatric unit sees the client in the waiting room of the outpatient psychiatric clinic. The client motions to the nurse to come over so he can tell the nurse how things have been going since he was discharged. While talking with the client, the nurse determines that the client's therapy has been effective when the client states which of the following?

Correct Answer: B

Rationale: The correct answer is B because the client's behavior of going to the workshop to work on projects when his mother-in-law visits indicates a healthy coping mechanism to manage stress. This shows that the therapy has been effective in helping the client find a constructive way to deal with his anxiety triggers. Choice A indicates ongoing stress, which suggests therapy may not be effective. Choice C shows a habit that has not changed, indicating little progress. Choice D suggests the use of alcohol as a coping mechanism, which is not a healthy or sustainable way to manage anxiety.

Correct Answer: A

Rationale: The correct answer is A: Diphenhydramine (Benadryl). Dystonic reactions are extrapyramidal side effects commonly seen with antipsychotic medications. Diphenhydramine is a first-line treatment for dystonic reactions due to its anticholinergic properties. It helps block the excessive dopamine activity in the brain that causes these reactions. Propranolol (B) is a beta-blocker and not typically used for dystonic reactions. Risperidone (C) and Aripiprazole (D) are antipsychotic medications themselves and would not be used to treat dystonic reactions caused by antipsychotic medications.

Correct Answer: B

Rationale: The correct answer is B. Having the shaman meet the attending physician at the hospital is the most appropriate nursing intervention because it allows for collaboration between traditional beliefs and modern medical care. This approach respects the client's cultural and spiritual preferences while ensuring the client receives necessary medical treatment. It also helps establish a supportive and holistic care environment. Choice A is incorrect because denying the shaman access may lead to resistance from the client and hinder effective communication and trust-building. Choice C is inappropriate as it disregards the client's autonomy and may create conflict within the family. Choice D is incorrect as blaming the shaman for the client's condition is disrespectful and unprofessional.

Correct Answer: D

Rationale: The correct answer is D: Homeless individuals. Homeless individuals are the most at risk due to the severe impact of poverty and the downward economic spiral on their mental health. Homelessness often results from poverty, leading to chronic stress, lack of access to basic needs, social isolation, and increased vulnerability to mental health issues. Homeless individuals face multiple stressors that can exacerbate existing mental health conditions or lead to the development of new ones. Older adults (A) may face financial challenges but are not necessarily homeless. Individuals with physical disabilities (B) may encounter economic difficulties but are not automatically homeless. Single-parent families (C) may struggle financially, but homelessness is not exclusive to this group.

Correct Answer: C

Rationale: The correct answer is C: avoid alcoholic beverages. This is because alprazolam is a central nervous system depressant, and alcohol also has depressant effects. Combining the two can potentiate sedation and respiratory depression. Reporting drowsiness (A) is important but not specific to alprazolam. Eating a tyramine-free diet (B) is relevant for certain medications like MAOIs, not alprazolam. Adjusting dose and frequency based on anxiety level (D) is not recommended as it can lead to misuse or dependence.