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: 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.

Correct Answer: D

Rationale: The correct answer is D, collaborating with the social worker. The client's immediate needs involve addressing the loss of job and driver's license, which impacts their housing situation. The social worker can assist in planning housing arrangements, connecting the client with resources for stable housing, and addressing any social determinants of health contributing to the client's situation. This collaboration will provide a holistic approach to addressing the client's needs beyond just the alcohol use disorder. The other choices are incorrect because: A: In this scenario, the client's primary need is not related to anxiety but rather to the practical consequences of losing their job and driver's license due to alcohol use disorder. B: While counseling sessions to explore stressors may be beneficial in the long term, the client's immediate need is more urgent, focusing on practical solutions. C: Retraining and job placement may be important in the future, but at this time, the client's priority is addressing the housing situation and other immediate needs.

Correct Answer: A

Rationale: The correct answer is A because respecting the client's preferences is essential in providing patient-centered care. By avoiding touching during initial interactions, the nurse acknowledges and accommodates the client's discomfort with touch, promoting a trusting and therapeutic relationship. Choice B is incorrect because forcing the client to incorporate touch in communication may further distress them. Choice C is incorrect as open communication about feelings related to touch is important for understanding and addressing the client's aversions. Choice D is incorrect as wearing gloves during all interactions is unnecessary and may not address the client's specific discomfort with touch.

Correct Answer: C

Rationale: The correct answer is C. This response demonstrates understanding of mental illness as a biological condition by acknowledging that it is not the individual's fault. Bipolar disorder is known to have a strong genetic component and is influenced by neurobiological factors. This statement indicates recognition that mental illnesses are not simply a result of personal weakness or character flaws. It also implies an understanding of the complexity and chronic nature of mental disorders. Choices A, B, and D focus on environmental factors, family dynamics, and developmental issues, respectively, which do not directly align with the biological perspective of mental illness.