The older patient is discussing chronic pain and asks the primary care provider for a prescription. Which medication should the nurse anticipate being ordered rather than an opioid?

Correct Answer: A

Rationale: The correct answer is A: Gabapentin. Gabapentin is a medication commonly used to treat neuropathic pain, which is often associated with chronic pain in older patients. It is considered a safer alternative to opioids due to its lower risk of addiction and overdose. Acetaminophen (B) is an over-the-counter pain reliever but may not be sufficient for chronic pain. Morphine (C) and Fentanyl (D) are opioids, which have a higher risk of side effects, addiction, and overdose compared to Gabapentin. Therefore, Gabapentin is the most suitable choice for managing chronic pain in older patients.

Correct Answer: B

Rationale: The correct answer is B: Switching to a longer acting preparation. By switching to a longer-acting preparation of methylphenidate, the child will receive a sustained release of the medication throughout the day, which can help control symptoms more effectively. This would prevent the dip in medication effectiveness before lunch. A: Giving the second dose at 1 PM or later may not be as effective in maintaining symptom control throughout the school day. C: Splitting the early morning dose in half may not provide consistent symptom control throughout the day. D: Switching to another class of medication is not necessary if the child is responding well to methylphenidate, and a longer-acting preparation of the same medication can be a more appropriate solution.

Correct Answer: B

Rationale: The correct answer is B because contracts in a therapeutic setting are meant to clearly outline the roles and responsibilities of both the nurse and the patient. By establishing expectations and boundaries, a contract helps ensure mutual understanding and agreement on the treatment process. Choice A is incorrect because contracts are not just about what the nurse will do, but also about the patient's responsibilities. Choice C is incorrect as contracts focus on the practical aspects rather than the emotional dynamics. Choice D is incorrect because while contracts provide structure, they do not prevent parties from ending the relationship if necessary.

Correct Answer: A

Rationale: Step 1: The correct answer is A because there isn't enough empirical evidence to confirm the role of ethnicity and race in the prevalence of personality disorders. Step 2: Culture and ethnic background can influence the development of personality disorders, but current research is inconclusive. Step 3: Choice B is incorrect because it makes a generalized statement without providing evidence or sources to support it. Step 4: Choice C is incorrect because culture and ethnic background can indeed play a role in the development of personality disorders. Step 5: Choice D is incorrect because while genetic factors may contribute to personality disorders, cultural factors also play a significant role.

Correct Answer: D

Rationale: The correct answer is D: Ineffective coping. The patient is exhibiting intense anger, acting out behaviors, and expressing negative emotions, indicating a maladaptive response to stress. Ineffective coping addresses the inability to manage stressors and emotions effectively. A: Disturbed thought processes typically involve cognitive impairments or disorganized thinking, which is not the primary issue presented here. B: Low self-esteem focuses on negative self-perception, which may not be the root cause of the patient's current distress. C: Hopelessness pertains to a sense of despair and pessimism about the future, which may not be the main concern in this case. In summary, the patient's behaviors and statements suggest a lack of effective coping mechanisms, making "Ineffective coping" the most appropriate nursing diagnosis.

Correct Answer: B

Rationale: The correct answer is B because in stepfamilies, caring for the children can be a primary stressor to the marital partners due to the complexities of blending different family dynamics. This can lead to increased tension and challenges in the relationship, impacting mental health. Explanation: 1. Stepfamilies involve integrating individuals from previous relationships, leading to potential conflicts and adjustments. 2. Caring for children from previous relationships can create additional stress and strain on the marital partners. 3. Balancing different parenting styles and expectations can lead to disagreements and increased stress levels. 4. These stressors can contribute to mental health issues such as anxiety, depression, and relationship conflicts within stepfamilies. Summary: Choice A is incorrect as it generalizes about middle-aged childless adults without considering individual circumstances. Choice C is incorrect as separation due to relocation may not always result in additional support from extended family. Choice D is incorrect as mental health outcomes in same-sex families can vary and may not always demonstrate lower rates of depression

Correct Answer: A

Rationale: The correct answer is A: "How much sleep do you usually get each night?" This question directly relates to circadian rhythms, which regulate the sleep-wake cycle and impact overall quality of life. Sleep patterns are influenced by circadian rhythms, and inadequate sleep can have negative effects on health. Choices B, C, and D do not directly address circadian rhythms or their impact on quality of life. B is related to cardiac issues, C to infections, and D to urinary problems. Therefore, A is the most relevant question to assess the effects of circadian rhythms on quality of life.

Correct Answer: C

Rationale: The correct answer is C: Brahmans. In Hinduism, Brahmans are considered the highest caste due to their traditional role as priests and scholars who perform religious rituals and preserve sacred knowledge. They are tasked with upholding spiritual and moral values in society. Kshatriyas are the warrior caste, Vaisyas are the merchant and farmer caste, and Untouchables are considered outside the caste system and historically faced discrimination. Brahmans hold the highest social status and are respected for their spiritual knowledge and leadership in religious practices.

Correct Answer: C

Rationale: The correct technique for de-escalating a client with OCPD experiencing extreme anxiety is employing active listening. Active listening involves fully concentrating, understanding, responding, and remembering what the client is saying. This technique can help the client feel heard, validated, and understood, which can reduce their anxiety. It also allows the client to express their thoughts and feelings, promoting a sense of control and autonomy. This approach is client-centered and respectful, aligning with the principles of effective therapy for OCPD. Summary: A: Physically directing the client may increase their anxiety and worsen the situation. B: Holding steady eye contact may be perceived as confrontational and intrusive, escalating the client's anxiety. D: Taking control and instructing the client may trigger resistance and exacerbate feelings of lack of control, which are common in OCPD.