Mental Health- PrepU Chapter 31

A client who is abusing substances is to undergo brief intervention. The nurse understands that this technique is most effective for a client who exhibits which symptoms?

Short history of drug use

The nurse is caring for an adolescent who reports using alcohol daily. Which question would the nurse ask to help determine the length of time the client has been using alcohol?

"At what age did you start using alcohol?"

The nurse is caring for a client who is prescribed disulfiram prior to being discharged from an inpatient treatment facility. Which teaching statement will the nurse prioritize?

"Check ingredients of all beauty products you use."

As a component of the standard nursing admission assessment at the hospital, a nurse is using the CAGE tool. Which of the following questions will the nurse ask the client?

"Have you ever felt like you should cut down on your drinking?"

A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse?

"I can still hang out with my old friends. I am just not going to use."

A client with alcohol use disorder is admitted for treatment. Which statement indicates that the nurse has an issue with the client's condition?

"I have family members with the same problem."

The nurse is educating a client with alcoholism that has been in rehabilitation for two weeks to prepare for discharge. Which statement made by the client indicates that education was effective and the client is best prepared for discharge?

"In order to give myself the best chance for sobriety, I will abstain from alcohol."

The nurse is conducting a health promotion class on drug awareness with a group of junior high school students. Which of the following teaching points should the nurse include in this session?

"Marijuana use can result in psychological dependence, which can have a very negative effect on your life."

A client is admitted for the third time for a substance use disorder. Which statement indicates the nurse is approaching the client with an open and objective attitude?

"Sometimes it takes a few times before relapses stop occurring."

The nurse is interviewing family members of a client being treated for substance use disorder. Which statement by a family member would alert the nurse to the possibility of codependency?

"My sibling would not drink as much if their spouse was more understanding."

The nurse is talking with the spouse of a client admitted for substance use disorder and overdose. Which statement(s) made by the spouse indicates that they are exhibiting enabling behaviors? Select all that apply.

- "I am so scared about my spouse getting fired; I often call in sick so they won't." - "If I don't give them money for the drugs, they will just steal it anyway." - "My spouse had a terrible childhood and I would probably do the same things."

A client is experiencing severe alcohol withdrawal. Which would the nurse identify during the assessment that correlates with the withdrawal symptoms? Select all that apply.

- Marked diaphoresis - Auditory hallucinations - Gross uncontrollable tremors

The nurse is caring for a client who has an acute intoxication of cocaine. Which assessment finding(s) will the nurse most likely find? Select all that apply.

- oral temperature of 38°C - moist skin

In a person who abuses alcohol or is a chronic drinker, alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or an attempt to decrease consumption?

12 hours

The body can metabolize how much beer per hour without intoxication?

12 oz

A client who has been abusing opioids for about one year has run out of the drug. The last time he used the drug was at 12 noon. The client would most likely develop signs and symptoms of withdrawal by which time?

9 PM

A client's history reveals that he continues to use cocaine despite the negative consequences. The nurse identifies this as which of the following?

Addiction

The nurse is caring for a client with alcohol use disorder that is acutely intoxicated. Which action will the nurse perform to treat the Wernicke-Korsakoff syndrome the client is experiencing?

Administer Vitamin B1.

The nurse is caring for a client experiencing alcohol withdrawal. Which intervention will the nurse perform to alleviate the physical effects associated with alcohol withdrawal?

Administer fixed-dose chlordiazepoxide as prescribed.

A client is brought to the Emergency Department by a family member that found the client unresponsive and "barely breathing." The family member states the client is a heroin addict. Which is the priority action by the nurse?

Administer naloxone immediately.

The client is brought to the emergency room with opioid overdose. After the initial assessment for central nervous system (CNS) function, what will be the nurse's priority action?

Administer naloxone.

A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. The nurse recognizes these symptoms as typical of which of the following?

Alcohol withdrawal syndrome

A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The nurse assesses the client and finds the client is oriented but is tremulous, weak, sweaty and has some gastrointestinal (GI) symptoms. Which issue do these symptoms correlate with?

Alcohol withdrawal syndrome

The nurse is performing a history and physical examination on a client with chronic alcoholism. The client has a history of gastritis, esophagitis, elevated liver enzymes, cardiomyopathy, and pancreatitis. Which of these conditions are attributable to the client's history of alcohol abuse?

All the conditions are attributable to the alcohol abuse

Children of those who abuse substances are at high risk for both substance abuse and which of the following?

Behavior disorders

Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?

Benzodiazepines

A client is brought to the emergency department by law enforcement after suspicion of driving under the influence. A blood alcohol level is drawn and is found to be 0.10 mg%. Which of the following would the nurse expect to assess?

Difficulty coordinating movements

The nurse in an outpatient rehabilitation program is speaking with a group of clients who have recently recovered from alcohol abuse. Which issue should the nurse raise before the clients leave for the day?

Help them to identify appropriate diversional activities.

Disulfiram has which of the following effects on prothrombin time?

Increase

A client is being treated for alcoholism. Which of the following medications is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

A client with a history of alcohol use disorder has presented to the emergency department with hallucinations and relays being followed by the police. Which action will the nurse take given this information?

Monitor for Korsakoff syndrome from long-term effects of alcohol use.

A client is brought for emergency care for symptoms that developed after ingesting mescaline, a hallucinogen. Which action will the nurse make a priority when caring for the client?

Reduce environmental stimuli.

The nurse reviews the medical record of a client with a substance use condition. For which reason would the nurse approach the care of the client with understanding and compassion?

Substance use is a chronic recurring condition.

Which statement most accurately describes the etiology of substance-related disorders?

Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors.

A psychiatric-mental health clinical nurse specialist is teaching a group of staff nurses about substance use and dependence. After teaching the group about the different approaches used to treat substance use and dependence, the nurse determines that the education was successful when the group identifies which aspect as associated with the social approach?

The environment, not the person, is responsible.

The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that the friend's relationship with the client was codependent and enabling. Which behavior identified does the nurse correlate with codependent behavior?

The friend called the client every night to make sure the client got home safely and looks for the client if not at home.

A client is readmitted to the detox unit for the fourth time in 3 years. The nurse states in the morning report, "Not again! Why should we keep trying to help them? They obviously don't want it." Which statement is reflective of the nurse?

The nurse lacks the self-awareness to work effectively with this addicted client.

The nurse is caring for a client with a substance use disorder. When speaking with the client's spouse, the nurse finds the family member hides the client's disorder from others and helps cover for the client when the client is hungover. Which statement is true?

The spouse is acting in a codependent manner.

Wernick-Korsakoff syndrome is a neurologic condition that can result from heavy drinking. Which of the following medications is used to prevent Wernicke-Korsakoff syndrome?

Thiamine (vitamin B1)

A client is admitted to the emergency department for intoxication with alcohol. The client has an unsteady gait, myopathy, and neuropathy and cannot remember past or recent events. When treated with thiamine, the client's symptoms greatly improve. Which condition was the client likely experiencing?

Wernicke-Korsakoff syndrome

The nurse is working with a group of health care professionals on a program to address the use of substances in the community. Which information would the nurse emphasize to include in the program?

actions to prevent relapse

The nurse is caring for a client experiencing acute alcohol withdrawal. The nurse understands that safe withdrawal is usually accomplished by administering which class of medication to the client?

benzodiazepines

The nurse is caring for a client with delirium tremens (DTs). Which development constitutes a medical emergency?

development of seizure activity

The nurse is caring for a young adult brought to the emergency department with a blood alcohol level just over the legal limit. Which finding is likely to be present when gathering data on this client?

familial pattern of alcohol-related problems

The public health nurse is planning community education on substance use. Which will the nurse prioritize?

prevention