An older male patient has suffered with episodic pruritus and skin eruptions for over 2 years. This patient tells the nurse, "When my skin gets better for a few days, I start worrying that it’s going to start itching again soon. I think my worry may actually trigger the problems to start all over again.” Which self-help technique should the nurse consider suggesting for this patient?

Correct Answer: B

Rationale: The correct answer is B: Meditation. Meditation can help the patient manage stress and anxiety, which may be triggering or exacerbating the skin issues. By practicing mindfulness and relaxation techniques through meditation, the patient can learn to better cope with worries and reduce the likelihood of stress-induced flare-ups. Incorrect choices: A: Melatonin is a hormone that regulates sleep-wake cycles, not directly related to stress management or skin conditions. C: Purification is vague and not a recognized self-help technique for stress or skin issues. D: Acupuncture may offer benefits for some conditions but is not specifically indicated for stress management in this context.

Correct Answer: A

Rationale: The correct answer is A: Client factors. In this scenario, the patient's belief that taking medication implies being "crazy" reflects a negative attitude or belief held by the patient (client factor). This belief is likely influencing the patient's decision to refuse medication. Clinician factors (B) would refer to issues related to the healthcare provider, structural factors (C) would pertain to systemic barriers, and environmental factors (D) would involve external influences on the patient. In this case, the primary reason for nonadherence is the patient's own beliefs and attitudes, making client factors the most relevant choice.

Correct Answer: C

Rationale: The correct answer is C: Temporal lobe. The temporal lobe is responsible for handling memory functions and emotions, including anxiety. It contains the hippocampus, a crucial structure for memory formation. The frontal lobe (choice A) is primarily involved in executive functions and decision-making. There is no specific "Anxiety center" (choice B) in the brain. The central sulcus (choice D) is a groove that separates the frontal and parietal lobes and is not directly associated with memory or anxiety processing. Therefore, the temporal lobe is the correct choice based on its known functions related to memory and emotional processing.

Correct Answer: B

Rationale: The correct answer is B: voltage-dependent (gated) calcium channels. These channels are crucial for neurotransmitter release as they allow calcium ions to enter the presynaptic neuron upon depolarization, triggering vesicle fusion and neurotransmitter release. Voltage-sensitive sodium channels (A) are responsible for action potential initiation, not neurotransmitter release. Neurotransmitter receptor potassium channels (C) are involved in postsynaptic responses, not release. Voltage-dependent chloride channels (D) are not directly involved in neurotransmitter release.

Correct Answer: C

Rationale: The correct answer is C: Structural. Structural factors refer to external barriers such as lack of access to affordable medication and rising costs, which directly impact medication adherence. This is because individuals may struggle to afford their medications or face logistical challenges in obtaining them. Provider factors (A) pertain to healthcare professionals, environmental factors (B) involve physical surroundings, and client factors (D) relate to individual characteristics, which are not directly linked to access and cost issues affecting medication adherence.