Behaviors- addiction

A client who is obese and has a history of alcohol abuse is admitted to the hospital with the diagnosis of acute pancreatitis. Which is the initial priority expected client outcome in response to therapy at this time? 1 Report decreased pain 2 Insert nasogastric (NG) tube quickly 3 Join Alcoholics Anonymous 4 Lose four pounds (1.8 kilograms) a week

1

A client with a 20-year history of excessive alcohol use is admitted to the hospital with jaundice and ascites. What is the priority nursing action during the first 48 hours after the client's admission? 1 Monitor the client's vital signs. 2 Increase the client's fluid intake. 3 Improve the client's nutritional status. 4 Determine the client's reasons for drinking.

1

A woman who abused drugs during pregnancy gave birth to a drug-dependent neonate. Which nursing interventions would be beneficial to the neonate? Select all that apply. 1 To administer smaller doses of the dependent drug 2 To administer pain relievers during delivery 3 To monitor the neonate carefully and closely 4 To educate the mother about the risks of drug abuse 5 To stop the drug on which the neonate is dependent immediately to avoid dependence

1,3,4

Clients addicted to alcohol often use the defense mechanism of denial. What is the reason that this defense is so often used? 1 It reduces their feelings of guilt. 2 It creates the appearance of independence. 3 It helps them live up to others' expectations. 4 It makes them look better in the eyes of others.

1

A recovering alcoholic joins Alcoholics Anonymous (AA) to help maintain sobriety. What type of group is AA? 1 Social group 2 Self-help group 3 Resocialization group 4 Psychotherapeutic group

2

When planning care for a client who has just completed withdrawal from multiple-drug abuse, what reality in relation to the client should the nurse take into consideration? 1 Unable to give up drugs 2 Unconcerned with reality 3 Unable to delay gratification 4 Unaware of the danger of drug addiction

3

A primary healthcare provider prescribes oxazepam for a client who is beginning to experience withdrawal symptoms while undergoing detoxification. What are the primary reasons that oxazepam is given during detoxification? 1 Prevents injury and protects the client when seizures occur 2 Enables the client to sleep and eat better during periods of agitation 3 Encourages the client to cooperate with and accept treatment for alcoholism 4 Reduces the anxiety-tremor state and prevents more serious withdrawal symptoms

4

Within a few hours of alcohol withdrawal the nurse should assess the client for the presence of what symptoms? 1 Irritability and tremors 2 Yawning and convulsions 3 Disorientation and paranoia 4 Fever and profuse diaphoresis

1

A nurse discusses the philosophy of Alcoholics Anonymous (AA) with the client who has a history of alcoholism. What need must self-help groups such as AA meet to be successful? 1 Trust 2 Growth 3 Belonging 4 Independence

3

A nurse is discussing plans with a client who has decided to withdraw from alcohol. What should the nurse recommend as one of the most effective treatments for alcoholism? 1 Daily administration of disulfiram 2 Individual or group psychotherapy 3 Admission to an alcoholic unit in a hospital 4 Active membership in Alcoholics Anonymous

4

When planning for a client's care during the detoxification phase of acute alcohol withdrawal, what need should the nurse anticipate? 1 Checking on the client frequently 2 Keeping the client's room lights dim 3 Addressing the client in a loud, clear voice 4 Restraining the client during periods of agitation

1

A client with a history of chronic alcoholism was admitted to a surgical unit after surgery to repair a severely fractured right ankle. The nurse is concerned that the client is experiencing manifestations of acute alcohol withdrawal when certain documentation and assessment data from the last 6 hours seem to indicate this problem. Which data are the cause of the nurse's concern? Select all that apply. 1 Tremors in both hands make it difficult for the client to hold a cup. 2 The client's systolic blood pressure has dropped 6 points over last 6 hours. 3 The client was observed falling asleep while talking on the telephone to family. 4 The client's bed linens and pajamas had to be changed during the night as a result of increased diaphoresis. 5 The usually cooperative client becomes verbally abusive when asked to lower the volume of the television

1,4,5

A nurse is in the process of developing a therapeutic relationship with a client who has an addiction problem. What client communication permits the nurse to conclude that they are making progress in the working stage of the relationship? Select all that apply. 1 Describes how others have caused the addiction 2 Verbalizes difficulty identifying personal strengths 3 Expresses uncertainty about meeting with the nurse 4 Acknowledges the effects of the addiction on the family 5 Addresses how the addiction has contributed to family distress

2,4,5

A 20-year-old carpenter falls from a roof and sustains fractures of the right femur and left tibia. The client reveals a history of substance abuse. What is the primary consideration for the nurse who is caring for this client? 1 Confronting the client about substance abuse 2 Avoiding calling attention to the client's drug abuse 3 Determining the amount and time of last use of the substance 4 Realizing that this client will need more pain medication than a nonabuser

3

he nurse encourages a client with Raynaud disease to stop smoking. Which primary goal is the nurse trying to achieve? 1 Prevent pain and tingling 2 Prevent cyanosis and necrosis 3 Prevent peripheral vasoconstriction 4 Prevent excessive blood oxygen content

3

A nurse is conducting cholesterol screening for a manufacturing corporation during a health fair. A 50-year-old man who is 6 feet (183 cm) tall and weighs 293 pounds (133 kg) puts out his cigarette and asks the nurse how to modify his risk factors for coronary artery disease. On which risk factors should the nurse help the client focus? Select all that apply. 1 Age 2 Height 3 Weight 4 Smoking 5 Family history

3,4

A client who is on the third day of detoxification therapy becomes agitated and restless. What are the signs and symptoms that indicate impending alcohol withdrawal delirium? Select all that apply. 1 Polydipsia 2 Drowsiness 3 Diaphoresis 4 Tachycardia 5 Hypertension

3,4,5

A client being admitted for alcoholism reports having had alcoholic blackouts. What is the best description of an alcoholic blackout? 1 A fugue state resembling absence seizures 2 Fainting spells followed by loss of memory 3 Loss of consciousness lasting less than 10 minutes 4 Absence of memory in relation to drinking episodes

4

A client who has a long history of alcoholism has not worked for the past 10 years. When the nurse asks about daily activities the client responds, "I currently work in the office of a local construction company." Which mental mechanism should the nurse suspect that the client is using? 1 Regression 2 Sublimation 3 Compensation 4 Confabulation

4

A school nurse is teaching a high school health class about inhalant abuse. What serious effect of using inhalants should the nurse discuss? 1 Esophageal varices 2 Acute electrolyte imbalances 3 Extrapyramidal tract symptoms 4 Death in one third of first-time users

4

A client with a 20-year history of excessive alcohol use has developed jaundice and ascites and is admitted to the hospital. What is the priority nursing action during the first 48 hours after the client's admission? 1 Monitor vital signs 2 Increase fluid intake 3 Obtain a foam mattress 4 Improve nutritional status

1

A nurse provides smoking-cessation education to a client with chronic obstructive pulmonary disease (COPD). The nurse concludes that the client is ready to quit smoking when the client makes which statement? 1 "I'll just finish the carton that I have at home." 2 "I'll cut back to a half pack a day." 3 "I find that smoking is the only way I can relax." 4 "I should find this easy because I don't smoke when I drink."

2

A person who is hospitalized for alcoholism becomes boisterous and belligerent and verbally threatens the nurse. What is the most appropriate response by the nurse? 1 Placing the client in restraints 2 Sedating and placing the client in a controlled environment 3 Encouraging the client to play table tennis with another client 4 Setting firm limits on the client's behavior and enforcing adherence to them

2

What characteristic is the nurse likely to identify when planning care for a client who has abused multiple drugs? 1 Lack of concern with reality 2 Inability to delay gratification 3 Sensitivity to the needs of others 4 Lack of awareness of the dangers of drug addiction

2

Which assessment question will provide the best information regarding a client's risk for waking in the night and interrupted sleep related to lifestyle choices? 1 "Do you consider yourself a deep sleeper?" 2 "Do you smoke cigarettes, cigars, or a pipe?" 3 "Do you adhere to a regular bedtime routine?" 4 "Do you keep the television on when you're falling asleep?"

2

A 20-year-old woman is admitted to the labor and delivery unit after reporting that she is experiencing severe contractions. She is 38 weeks +2 days' gestation. External fetal monitoring has been initiated. During the assessment the nurse notes that the woman is sweating profusely, has dilated pupils and irregular respirations, is hypertensive, and continues to complain of very severe pain with contractions. The external fetal monitor shows fetal tachycardia with excessive fetal activity. What should the nurse suspect? 1 Heroin abuse 2 Marijuana use 3 Cocaine abuse 4 Alcohol withdrawal

3

A client has been in the alcohol detoxification unit for 5 days. In the evening the client complains of numbness and tingling in the feet and legs. What is the most appropriate nursing intervention? 1 Massaging the client's legs with lotion 2 Emphasizing the need to rest and keep the legs elevated 3 Keeping the bed linens off the client's legs with a mechanical aid 4 Monitoring the progression of symptoms and assessing the pedal pulses frequently

3

A client has been instructed to stop smoking. The nurse discovers a pack of cigarettes in the client's bathrobe. What is the nurse's initial action? 1 Notify the healthcare provider. 2 Report this to the nurse manager. 3 Tell the client that the cigarettes were found. 4 Discard the cigarettes without commenting to the client.

3

A client reports a history of bilateral blanching and pain in the fingers on exposure to cold. When rewarmed, the fingers become bright red and "tingly" with a slow return to their usual color. The client smokes one to two packs of cigarettes per day. Which sign or symptom leads the nurse to determine that the client has Raynaud disease and not Raynaud phenomenon? 1 Tingling sensation 2 Skin color changes 3 Bilateral involvement 4 Changes in skin temperature

3

A client with a history of substance abuse is brought to the emergency department. The client is having seizures, is hypertensive, and has hyperthermia. What drug should the nurse consider that the client may have been abusing? 1 Alcohol 2 Fentanyl 3 Oxycodone 4 Methamphetamine

4

A client with emphysema has a history of smoking two packs of cigarettes a day. What is the best approach for the nurse to help the client stop smoking? 1 Teach pursed-lip breathing. 2 Encourage the client to reduce emotional stress. 3 Obtain a referral to a smoking-cessation program in the community. 4 Suggest that the client limit smoking to one pack of cigarettes a day.

4

A nurse is discussing Alcoholics Anonymous (AA) with a client. What behavior expected of members of AA should the nurse include in the discussion? 1 Speaking aloud at weekly meetings 2 Promising to attend at least 12 meetings yearly 3 Maintaining controlled drinking after 6 months 4 Acknowledging an inability to control the problem

4

A client who is a heavy smoker has been prescribed a high-calorie, high-protein diet. The nurse should encourage the client to eat foods that are high in which vitamin? 1 Niacin 2 Thiamine 3 Vitamin C (ascorbic acid) 4 Vitamin B12

3

The nurse refers a client to a self-help group. What does the nurse anticipate that a self-help group such as Alcoholics Anonymous (AA) will help its members learn? 1 That their problems are not unique 2 That they do not need a crutch to lean on 3 That their problems are caused by alcohol 4 That the group can stop them from drinking

1

What is a priority nursing intervention in the care of a drug-dependent mother and infant? 1 Supporting the mother's positive responses toward her infant 2 Requesting that family members share responsibility for infant care 3 Keeping the infant separated from the mother until the mother is drug free 4 Helping the mother understand that the infant's problems are a result of her drug intake

1

What is most important for the nurse to do when caring for a client who is in an alcohol detoxification program? 1 Accept the client as a worthwhile person. 2 Provide nurturing because the client needs it. 3 Discuss with the client the ill effects of alcohol. 4 Promote compliance by gently prodding the client.

1

A 42-year-old adult with a long history of alcohol abuse seeks help in one of the local hospitals. What does the nurse consider to be the major underlying factor for success in a client's alcohol treatment program? 1 Family 2 Motivation 3 Practitioner 4 Self-esteem

2

A client undergoing alcohol detoxification asks about attending Alcoholics Anonymous (AA) meetings after discharge. What is the nurse's best initial reply? 1 "You'll find that you'll need their support." 2 "How do you feel about going to those meetings?" 3 "They'll help you to learn how to cope with your problem." 4 "Don't you think it's better to wait until you're sure that you're ready?"

2

A client who has a history of alcohol abuse now has recurrent exacerbations of chronic pancreatitis. The nurse asks the client to obtain a stool specimen. When assessing the client's stool, what would the nurse expect to observe? 1 Melena 2 Steatorrhea 3 Hard, dry stool 4 Ribbon-shaped stool

2

A client with bipolar disorder has been admitted for alcohol detoxification, and laboratory tests are performed. Which results should prompt the nurse to notify the admitting health care provider? Select all that apply. 1 Hemocrit: 47% 2 Prothrombin time: 13.9 seconds 3 Serum albumin: 2.9 g/dL (29 g/L) 4 Lithium level: 1.2 mEq/L (1.2 mmol/L) 5 Serum sodium: 140 mEq/L (140 mmol/L) 6 Blood urea nitrogen: 25 mg/dL (9.0 mmol/L)

2,3,6

Which physical assessment of the skin indicates that a client is addicted to phencyclidine? 1 Burns 2 Vasculitis 3 Diaphoresis 4 Red and dry skin

4- Phencyclidine is PCP

A client is admitted to the drug detoxification unit for cocaine withdrawal. What is the nurse's primary concern while working with clients withdrawing from cocaine? 1 Risk for self-injury 2 Potential for seizure 3 Danger of dehydration 4 Probability of injuring others

1

A client who is a polysubstance abuser is mandated to seek drug and alcohol counseling. What is an appropriate initial outcome criterion for this client? 1 Verbalizes that a substance abuse problem exists 2 Discusses the effect of drug use on self and others 3 Explores the use of substances and problematic behaviors 4 Expresses negative feelings about the current life situation

1

A male client with the dual diagnosis of major depression and polysubstance abuse has been attending group therapy. One day the client tells the nurse, "The things they talk about in group don't really pertain to me." What is the most therapeutic response by the nurse? 1 Confronting the client with realistic feedback 2 Identifying the client's stress-coping tolerance 3 Informing the client that he needs to get more involved 4 Asking the client what therapy he thinks would be more helpful

1

A nurse in the clinic is conducting a routine assessment of a primigravida client. The nurse notes bruises on the client's upper arms. When questioned, the client responds that her boyfriend was upset and hit her. What is the priority nursing action? 1 Developing a safety plan with the client 2 Calling the nurse manager to inspect the bruises 3 Informing the client that her pregnancy is in danger 4 Notifying social services to monitor the home situation

1

A nurse knows that individuals who are alcoholics use alcohol for what reason? 1 Blunt reality 2 Precipitate euphoria 3 Promote social interaction 4 Stimulate the central nervous system

1

A client tells the nurse, "All my friends experiment with drugs. I like the high I get when I huff paint. Nothing bad is going to happen to me." What is the best response by the nurse? 1 "Inhalants can cause a mild state of intoxication." 2 "Huffing paint can damage your lungs, kidneys, and liver." 3 "Withdrawal problems will start if you continue huffing paint." 4 "Limiting the type of inhalant used decreases respiratory irritation."

2

A client with a long history of alcohol abuse develops cirrhosis of the liver. The client exhibits the presence of ascites. What does the nurse conclude is the most likely cause of this client's ascites? 1 Impaired portal venous return 2 Impaired thoracic lymph channels 3 Excess production of serum albumin 4 Enhanced hepatic deactivation of aldosterone secretion

1

A nurse is working in a clinic that provides services to clients who abuse drugs. What effect of cocaine should the nurse consider as the reason that it easily causes dependence? 1 Eases pain 2 Blurs reality 3 Clears the sensorium 4 Decreases motor activity

2

A client reports drinking two drinks per day every day with no negative consequences. How should this person be classified? 1 Daily drinker 2 Substance abuser 3 Functional alcoholic 4 Substance dependent

1

A client is admitted to the hospital with ascites. The client reports drinking a quart (liter) of vodka mixed in orange juice every day for the past three months. To assess the potential for withdrawal symptoms, which question would be appropriate for the nurse to ask the client? 1 "When was your last drink of vodka?" 2 "What prompts your drinking episodes?" 3 "Do you also eat when you drink?" 4 "Why do you mix the vodka with orange juice?"

1

A client is diagnosed with acute gastritis secondary to alcoholism and cirrhosis. The client reports frequent nausea, pain that increases after meals, and black, tarry stools. The client recently joined Alcoholics Anonymous. The nurse should give priority to which client history item? 1 Black, tarry stools 2 Frequent nausea 3 Joining Alcoholics Anonymous 4 Pain that increases after meals

1

A client with a long history of alcohol abuse is admitted to the detoxification unit of an alcohol rehabilitation center. The nurse manager should assign the client to a room with what qualities? 1 Well lit and away from areas of activity 2 Without windows and close to the nurses' station 3 Illuminated by adequate lighting from the corridor 4 With dim lighting and shared by a quiet, withdrawn client

1

A client with a long history of alcohol abuse is admitted to the hospital with ascites and jaundice. A diagnosis of hepatic cirrhosis is made. Which is a nursing priority? 1 Institute fall prevention/safety measures. 2 Monitor respiratory status. 3 Measure abdominal girth daily. 4 Test stool specimens for blood.

1

A community health nurse is educating a client who is interested in discontinuing cigarette smoking. What should the teaching plan include? 1 Helping the client set a date to stop smoking 2 Referring the client to the American Red Cross (Canada: Canadian Red Cross) 3 Encouraging the client to eat when the desire to smoke occurs 4 Telephoning the client several weeks after the preset target date

1

A husband is upset that his wife's alcohol withdrawal delirium has persisted for a second day. What is the most appropriate initial response by the nurse? 1 "I see that you're worried. We're using medication to ease your wife's discomfort." 2 "This is expected. I suggest that you go home because there's nothing you can do to help." 3 "Are you afraid that your wife will die? I assure you, very few alcoholics die during the detoxification process." 4 "Are you worried that your wife is uncomfortable while she's going through withdrawal? I'm sure that she's not in pain."

1

The nurse is caring for a newborn whose mother was prescribed an opioid analgesic throughout pregnancy. Which action should the nurse include in the plan of care? 1 Offering small, frequent feedings 2 Increasing the environmental stimuli 3 Discouraging the mother from giving care 4 Keeping the infant exposed in a heated crib

1

What drug does a nurse anticipate that the primary healthcare provider will prescribe for a client demonstrating clinical manifestations associated with an opioid overdose? 1 Naloxone 2 Methadone 3 Epinephrine 4 Amphetamine

1

A client who is experiencing acute alcohol withdrawal delirium appears frightened, points toward the bed, and says, "Bugs are crawling all over me and my bed!" What is the most therapeutic response by the nurse? 1 "Just try to brush them off." 2 "I don't see any bugs on you or your bed." 3 "They'll go away when you start feeling better." 4 "The bugs that you see are just the design on the bedspread."

2

A client who is homeless is hospitalized for alcohol withdrawal. When considering the type of personal protective equipment that is needed for the client's care, what condition does the nurse recall that homeless persons are at risk for? 1 Prostatitis 2 Tuberculosis 3 Osteoarthritis 4 Diverticulosis

2

A client with a history of alcoholism and cirrhosis is admitted with severe dyspnea as a result of ascites. Which process that most likely caused the ascites should the nurse consider when planning care? 1 Increased secretion of bile salts 2 Increased pressure in the portal vein 3 Increased interstitial osmotic pressure 4 Increased production of serum albumin

2

A nurse is planning care for a client with substance-induced persisting dementia resulting from long-term alcohol use. Which nutritional problem, in addition to the effect of alcohol on brain tissue, has contributed to substance-induced persisting dementia? 1 Increase in serotonin 2 Deficiency of thiamine 3 Reduction in iron intake 4 Malabsorption of riboflavin

2

A nurse uses the CAGE screening test for alcoholism to determine an individual's potential for a drinking problem. What is one of the four questions included on this test? 1 "Do you feel that you are a normal drinker?" 2 "Have you ever felt bad or guilty about your drinking?" 3 "Are you always able to stop drinking when you want to?" 4 "How often did you have a drink containing alcohol in the past year?"

2

A client with a history of chronic alcoholism is admitted to the mental health unit. What does the nurse identify as the cause of a client's use of confabulation? 1 Ideas of grandeur 2 Need to get attention 3 Marked loss of memory 4 Difficulty accepting the truth

3

A client with a history of drug abuse begins group therapy. After attending the first meeting the client says to the nurse, "It helps to know that I'm not the only one with this type of problem." What concept does this statement reflect? 1 Altruism 2 Catharsis 3 Universality 4 Transference

3

A client with a history of excessive alcohol use develops hepatic portal hypertension and an elevated serum aldosterone level. For which complications should the nurse assess this client? 1 Chloride depletion and hypovolemia 2 Potassium retention and dysrhythmias 3 Sodium retention and fluid accumulation 4 Calcium depletion and pathologic fractures

3

A nurse is counseling a client who is experiencing substance abuse delirium. What communication strategies should be used by the nurse when working with this client? 1 Encouraging the client to practice self-control 2 Using humor when communicating with the client 3 Offering an introduction to the client at each meeting 4 Approaching the client from the side rather than the front

3

A nurse is counseling clients who are attending an alcohol rehabilitation program. Which substance poses the greatest risk of addiction for these clients? 1 Heroin 2 Cocaine 3 Nicotine 4 Marijuana

3

A nurse, planning care for a client who is an alcoholic, knows that the most serious life-threatening effects of alcohol withdrawal usually begin after a specific time interval. How many hours after the last drink do they occur? 1 8 to 12 2 12 to 24 3 24 to 72 4 72 to 96

3

Five minutes after birth, a newborn is given an Apgar score of 8. Twelve hours later the newborn becomes hyperactive and jittery, sneezes frequently, and has difficulty swallowing. What does the nurse suspect is the cause of these clinical findings? 1 Cerebral palsy 2 Neonatal syphilis 3 Opioid drug withdrawal 4 Fetal alcohol syndrome

3

On the third day of hospitalization, a client with a history of heavy drinking begins experiencing delirium alcohol withdrawal syndrome. What is the most appropriate response by the nurse when the client begins experiencing hallucinations? 1 Withholding intervention, because the client may be having vivid dreams 2 Asking the client to describe the hallucinations and explaining that they are not real 3 Administering the prescribed medication to the client to subdue the agitated behavior 4 Pretending to visualize the imaginary things the client is describing to foster acceptance

3

The nurse is caring for a client with a 25-year history of excessive alcohol use. Which assessment finding is consistent with the client's history? 1 Signs of liver infection 2 A low blood ammonia level 3 A small liver with a rough surface 4 An elevated temperature and a generalized rash

3

A newborn is diagnosed as having neonatal abstinence syndrome (NAS) after exhibiting jitteriness, irritability, and a shrill cry. What is the priority nursing care? 1 Administering an opioid antagonist 2 Limiting fluid intake to inhibit vomiting 3 Assessing for age-appropriate developmental level 4 Reducing environmental stimuli to promote relaxation

4

A person with a history of alcoholism says, "I've been drinking since last Friday to celebrate my son's graduation from college." What defense mechanism does the nurse identify? 1 Denial 2 Projection 3 Identification 4 Rationalization

4

An adolescent client with an antisocial personality disorder has been admitted to the hospital because of drug abuse and repeated sexual acting-out behavior. Which client behavior supports the nurse's conclusion that actions directed toward modifying the behavior of this client have been successful? 1 Promises never to take drugs again 2 Discusses the need to seduce other adolescents 3 Recognizes the need to conform to society's norms 4 Identifies the feelings underlying the acting-out behavior

4

What should the nurse initially plan to do to give clients with histories of long-term alcohol abuse greater responsibility for maintaining sobriety? 1 Confront them about their substance abuse. 2 Administer medications exactly as prescribed. 3 Explain what to expect in detoxification programs. 4 Assist them in adopting more healthful coping patterns.

4

What signs and symptoms of withdrawal does the nurse identify in a postpartum client who has a history of opioid abuse? 1 Paranoia and evasiveness 2 Extreme hunger and thirst 3 Depression and tearfulness 4 Irritability and muscle tremors

4

A client is brought to the emergency department by friends because of increasingly bizarre behavior. Which signs does the nurse identify that indicate that the client was using cocaine? Select all that apply. 1 Euphoria 2 Agitation 3 Panic attacks 4 Slurred speech 5 Hypervigilance 6 Impaired judgment

1,2,5,6

A client comes to the emergency department reporting symptoms of the flu. When the health history reveals intravenous drug use and multiple sexual partners, acute retroviral syndrome is suspected, and a test for the human immunodeficiency virus (HIV) is performed. Which clinical responses are associated most commonly with this syndrome? Select all that apply. 1 Malaise 2 Confusion 3 Constipation 4 Swollen lymph glands 5 Oropharyngeal candidiasis

1,4

What is the primary concern for a nurse caring for a client who is grossly impaired by stimulants? 1 Drowsiness 2 Seizure activity 3 Fluid imbalance 4 Suicidal ideation

2

While assessing an older adult client before noon the nurse smells alcohol on the man's breath. After noting certain other signs, the nurse suspects that the client is an alcoholic. What are these signs? Select all that apply. 1 Irritability 2 Poor hygiene 3 Family conflict 4 Good nutritional habits 5 Excessive mood swings 6 Maintenance of cognition

1,2,3,5

For what clinical manifestations should the nurse assess a client during the first few hours of the alcohol withdrawal? Select all that apply. 1 Irritability 2 Tachycardia 3 Hallucinations 4 Increasing anxiety 5 Profuse diaphoresis

1,2,4

The laboratory results of a woman in labor indicate the presence of cocaine and alcohol. Which characteristics should cause the nurse to recognize fetal alcohol spectrum disorder (FASD) in the newborn? Select all that apply. 1 Hypotonia 2 Polydactyly 3 Umbilical hernia 4 Hypoplastic maxilla 5 Small, upturned nose

1,4,5

When talking with a client who has alcoholism, the nurse notes that the client becomes irritable, makes excuses, and blames family and friends for the drinking problem. Which defense mechanisms does the nurse conclude that the client is using? Select all that apply. 1 Projection 2 Suppression 3 Sublimation 4 Identification 5 Rationalization

1,5

After an automobile accident a person is arrested for driving while intoxicated and is admitted to the hospital. When the client becomes angry and blames the family for personal problems, the nurse can be most therapeutic by using which statement? 1 "You know that you are to blame for your alcohol abuse." 2 "You need help now or you're just going to get even sicker." 3 "I'll talk to your family about their behavior if you want me to." 4 "I can see that you're upset about your family, but we need to focus on what you need right now."

4

What behavior by a client with a long history of alcohol abuse is an indication that the client may be ready for treatment? 1 Drinking only socially 2 Not drinking for a week 3 Hospitalization for detoxification 4 Verbalizing an honest desire for help

4

Which medication should be administered to prevent symptoms of withdrawal in a laboring client who routinely uses heroin? 1 Butorphanol 2 Pentazocine 3 Nalbuphine 4 Dolophine

4

After detoxification a client with a long history of alcohol abuse decides to attend Alcoholics Anonymous (AA) meetings at the hospital. On the day of the second meeting the client says, "I can't go to the AA meeting today because I'm expecting an important phone call." What is the most therapeutic response by the nurse? 1 "You are expected to go to the meeting." 2 "Phone calls are not that important now." 3 "You can go to another meeting later in the day." 4 "Go to the meeting after you take the phone call."

1

While a client is attending an Alcoholics Anonymous (AA) meeting, a nurse talks with the client's spouse about the purpose of AA. What is the priority goal of this self-help group? 1 Changing destructive behavior 2 Developing functional relationships 3 Identifying how people present themselves to others 4 Understanding patterns of interacting within the group

1

A nurse notes that a client in the detoxification unit is exhibiting early signs of alcohol withdrawal. What clinical manifestations might the nurse have noted? Select all that apply. 1 Tremors 2 Anorexia 3 Agitation 4 Delusions 5 Confusion

1,2

A nurse assesses a client recently admitted to an alcohol detoxification unit. What common clinical manifestation should the nurse expect during the initial stage of alcohol detoxification? 1 Nausea 2 Euphoria 3 Bradycardia 4 Hypotension

1

A nurse on the psychiatric unit is conducting group therapy with clients who have diagnoses of polydrug abuse. This is a closed group. Four sessions have been held, and the group is now in the working phase. Which strategy is most beneficial for the nurse facilitator to use during the next session? 1 Providing a balance between support and skillful therapeutic confrontation 2 Continuing to be a supportive role model by using approved leadership behaviors 3 Teaching about the effects of drugs and alcohol on the body by using educational materials 4 Encouraging the group to rotate the leadership role among group members to enhance their self-esteem

1

After a client on the mental health unit with a known history of opioid addiction has a visit from several friends, a nurse finds the client in a deep sleep and unresponsive to attempts at arousal. The nurse assesses the client's vital signs and determines that an overdose of an opioid has occurred. Which findings support this conclusion? 1 Blood pressure of 70/40 mm Hg, weak pulse, and respiratory rate of 10 breaths/min 2 Blood pressure of 180/100 mm Hg, tachycardia, and respiratory rate of 18 breaths/min 3 Blood pressure of 120/80 mm Hg, regular pulse, and respiratory rate of 20 breaths/min 4 Blood pressure of 140/90 mm Hg, irregular pulse, and respiratory rate of 28 breaths/min

1

The nurse is caring for a 76-year-old obese client with a history of epigastric distress, esophageal burning, binge drinking, and frequent episodes of bronchitis. A diagnosis of hiatal hernia is made. Which health problems most likely contributed to the development of the hiatal hernia? Select all that apply. 1 Aging 2 Obesity 3 Bronchitis 4 Esophagitis 5 Binge drinking

1,2

Which nursing assessment is important to recognize to determine the causative factors in a client with a history of spontaneous abortions? 1 Use of sex hormones 2 Use of contraceptive pills 3 Presence of heart problems 4 History of alcohol consumption

4

A client in the outpatient clinic is denying that he is addicted to alcohol. He tells the nurse that he is not an alcoholic and that it is his nagging wife who causes him to drink. What is the most therapeutic response by the nurse? 1 "I don't think that your wife is the problem." 2 "Everyone is responsible for his own actions." 3 "Perhaps you should have marriage counseling." 4 "Why do you think that your wife is the cause of your problems?"

2

After a cocaine binge an individual is found unconscious and is admitted to the hospital with acute cocaine toxicity. What should the initial nursing action be directed toward? 1 Being understanding 2 Establishing a patent airway 3 Maintaining a drug-free environment 4 Establishing a therapeutic relationship

2

A client with a history of gambling is experiencing legal difficulties for embezzling money and has been required to obtain counseling. During an intake interview the client says, "I never would have done this if I'd been paid what I am worth." What factor will create the greatest difficulty in helping this client develop insight? 1 Feelings of boredom and emptiness 2 Grandiosity related to personal abilities 3 Projection of reasons for difficulties onto others 4 Anger toward those who are in authority positions

3

A client with a long history of alcohol abuse who has been hospitalized for 1 week tells the nurse, "I feel much better and probably won't need any more treatment." What does the nurse conclude when evaluating the client's progress? 1 The client has accepted the illness and now must use willpower to resist alcohol. 2 The client will probably not use alcohol again as long as the client's family remains supportive. 3 The client's lack of insight into the emotional aspects of the illness indicates the need for continued supervision. 4 The client's statement should be communicated to the practitioner so aversion therapy can be started before the client's discharge.

3

A nurse encourages a client to attend Alcoholics Anonymous (AA) meetings after discharge. What do self-help groups such as AA help their members do? 1 Set long-term goals. 2 Limit excessive drinking. 3 Foster changes in behavior. 4 Identify underlying causes of behavior.

3

A nurse is caring for a client who is recovering from an acute episode of alcoholism. Which component of a therapeutic diet should the nurse encourage the client to consume? 1 High fat 2 Low calorie 3 High protein 4 Low carbohydrate

3

A nurse is caring for a client with the diagnosis of alcohol withdrawal delirium. Which action is most appropriate for the nurse to implement? 1 Keeping the client calm by applying wrist restraints 2 Encouraging the client to relate the content of hallucinations 3 Assuring the client that the symptoms are part of the withdrawal syndrome 4 Dimming the client's room lights to counter the visual distortions being experienced

3

The nurse suspects that a newborn is experiencing opioid withdrawal. Which assessment finding supports this suspicion? 1 Lethargy and constipation 2 Grunting and low-pitched cry 3 Irritability and nasal congestion 4 Watery eyes and rapid respirations

3

A client who has been admitted to the hospital for an elective prostatectomy is extremely anxious and has hand tremors. The client's partner informs the nurse that the client has been drinking heavily for the last 5 years. While the client is unpacking the nurse sees him hiding a bottle of whiskey in the rear of a drawer. How should the nurse respond initially to this behavior? 1 Trying to catch the client drinking the alcohol 2 Confiscating the alcohol when the client is not looking 3 Waiting for the client to bring up the subject of drinking 4 Asking the client how much alcohol he consumes in a week

4

A nurse is caring for a client with a diagnosis of acute pancreatitis and alcoholism. The client asks, "What does my drinking have to do with my diagnosis?" What effect of alcohol should the nurse include when responding? 1 Promotes the formation of calculi in the cystic duct 2 Stimulates the pancreas to secrete more insulin than it can immediately produce 3 Alters the composition of enzymes so they are capable of damaging the pancreas 4 Increases enzyme secretion and pancreatic duct pressure that causes backflow of enzymes into the pancreas

4