NCLEX Substance Abuse and Domestic Violence Practice Questions

A chronic alcoholic is admitted to the medical unit for pneumonia. Which medication would the nurse expect the health-care provider to prescribe to prevent delirium tremors? 1. chlordiazepoxide (Librium) 2. Thiamine (vitamin B1) 3. disulfiram (antabuse) 4. fluoxetine (Prozac)

1. chlordiazepoxide (Librium)

Opiod and narcotic risk factors include but are not limited to: *(select all)* 1. constipation 2. endocarditis 3. fatal overdose 4. HIV

1. constipation 2. endocarditis 3. fatal overdose 4. HIV

A factor used to make the differentiation between a social drinker and an alcoholic would be : 1. degree of need 2. heredity 3. race 4. type of alcohol

1. degree of need

Signs and symptoms of fetal alcohol syndrome include: *(select all)* 1. microcephaly 2. growth retardation 3. short palpebral fissures 4. maxillary hypoplasia 5. hypotension

1. microcephaly 2. growth retardation 3. short palpebral fissures 4. maxillary hypoplasia

The following people would benefit from attending al-anon meetings: *(select all)* 1. mother of an addict 2. grandson of a recovering addict 3. husband of an addict who has been sober for 22 years. 4. sister of an addict who is actively using.

1. mother of an addict 2. grandson of a recovering addict 3. husband of an addict who has been sober for 22 years. 4. sister of an addict who is actively using.

Catapres (clonidine) has been shown to relieve symptoms of narcotic withdrawal. which symptoms does this drug dismiss? 1. muscle aches 2. salivation 3. abdominal cramping 4. scratching

1. muscle aches 2. salivation 3. abdominal cramping

Which of the following symptoms is most worrisome in a patient undergoing alcohol withdrawal? 1. Agitation 2. Delirium tremens 3. Tachycardia 4. Bradycardia

2. Delirium tremens Delirium tremens (DT) is a rapid onset of confusion seen during alcohol withdrawal. The symptoms of DT include altered mental status, autonomic instability, and even seizures. DT is also characterized by hallucinations such as the sensation of something "crawling" on the patient. DT is the most severe consequence of withdrawal and can be fatal if untreated.

A nurse is monitoring an 18 year old who is experiencing heroin withdrawal. What symptoms might the nurse observe? 1. Coma and convulsions 2. Yawning, cramps, and diarrhea 3. Seizures, tremors, and tachycardia 4. Nausea and fainting

2. Yawning, cramps, and diarrhea Yawning, cramps, and diarrhea are common signs of heroin withdrawal.

The following meds are given for opiate toxicity or narcotic withdrawal: 1. vicodan 2. narcan 3. methadone 4. heparin

2. narcan

Morphine, Codeine, and Methadone have a high potential for abuse or physiological/psychological dependency. Which class of drugs do they belong in? 1. designer drugs 2. stimulants 3. narcotics 4. inhalants

3. narcotics

A nurse is caring for a client who has been prescribed disulfiram (Antabuse) as a deterent to alcohol relapse. Which information should the nurse include when teaching the client about this medication? 1. "only oral ingestion of alcohol will cause a reaction when taking this drug" 2. "it is safe to drink beverages that have only 12% alcohol content" 3. "this medication will decrease your cravings for alcohol" 4. "reactions to combining antabuse with alcohol can occur 2 weeks after stopping the drug."

4. "reactions to combining antabuse with alcohol can occur 2 weeks after stopping the drug."

The nurse should recommend which of the following self-help groups for a 14 year old recovering heroin addict that was sold into prostitution? 1. Calix society 2. Al-Anon 3. Drugs Anonymous 4. Alateen

4. Alateen

Which of the following drugs is considered a central nervous system (CNS) depressant? 1. Atenolol 2. Marijuana 3. Cyclobenzaprine 4. All of these

4. All of these All of the drugs listed are considered to be CNS depressants. While generally classified as a psychedelic, marijuana has multiple central depressant effects such as sedation and muscle relaxation. Also, alcohol is another commonly used depressant.

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V) criteria for substance abuse includes all of the following except __________. 1. Continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance 2. Recurrent substance use in situations in which it is physically hazardous 3. Recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home 4. All of these are part of the DSM V criteria for substance abuse

4. All of these are part of the DSM V criteria for substance abuse All of the items listed are part of the DSM V criteria for substance abuse. In addition, the individual's symptoms must not qualify for substance dependence and recurrent substance-related legal problems are other DSM V criteria for substance abuse.

An emergency room nurse is assessing a 26 year old female patient who frequently uses opium. What symptoms would indicate that she is experiencing withdrawal? 1. Nausea, vomiting, and depression 2. Irritability, tremors, and seizures 3. Diaphoresis, seizures, and apathy 4. Fatigue, disorientation, and craving

4. Fatigue, disorientation, and craving Fatigue, disorientation, and craving are common symptoms of opium withdrawal.

Prolonged alcohol abuse can result in a severe deficiency in what vitamin? 1. Vitamin C 2. Niacin (B3) 3. Folate 4. Thiamine (B1)

4. Thiamine (B1) Prolonged alcohol abuse can result in a severe deficiency in thiamine, or vitamin B1 by reducing dietary thiamine intake, impairing gastrointestinal absorption of thiamine, and causing impaired thiamine utilization in cells. Note that individuals who partake in prolonged alcohol abuse may have various other dietary deficiencies.

Alcohol abuse-induced thiamine deficiency can cause which of the following? 1. Wolf-Hirschhorn syndrome 2. Lewy body dementia 3. Agnosia 4. Wernicke-Korsakoff syndrome

4. Wernicke-Korsakoff syndrome Wernicke-Korsakoff syndrome is caused by a severe deficiency in thiamine, often seen in severe alcohol dependency. It is characterized by visual disturbances, ataxia, and altered consciousness.

During a prenatal assessment, the clinic nurse suspects that her client has been abused. Which of the following questions would be most appropriate? A. "Are you being threatened or hurt by your partner?" B. "Are you frightened of your partner?" C. "Is something bothering you?" D. "What happens when you and your partner argue?"

A. "Are you being threatened or hurt by your partner?" The use of simple, direct question, asked in an emphatic manner, is best to validate the presence of an abusive situation. The other questions are indirect and may not lead to the discussion of an abusive situation.

Which situation would Nurse Sally identify as placing a client at high risk for caregiver abuse? A. Antonia, an adult child quits her job to move in and care for a parent with severe dementia. B. Mr. Wright, an elderly man with severe heart disease resides in a personal care home and is visited frequently by his adult child. C. Mrs. Hale, an elderly parent with limited mobility lives alone and receives help from several adult children. D. Antoinette cares for her husband who is in early stages of Alzheimer's disease and has a network of available support persons.

A. Antonia, an adult child quits her job to move in and care for a parent with severe dementia. In this situation, the adult child has given up her usual role as well as moved her place of residence to care for her parent. Caring for someone with severe dementia is very stressful, requiring almost 24-hour vigilance to ensure safety and meet needs. This situation places the caregiver at high risk for stress and abuse.

The newly hired nurse at Nurseslabs Medical Center is assessing a client who abuses barbiturates and benzodiazepine. The nurse would observe for evidence of which withdrawal symptoms? A. Anxiety, tremors, and tachycardia B. Respiratory depression, stupor, and bradycardia C. Muscle aches, cramps, and lacrimation D. Paranoia, depression, and agitation

A. Anxiety, tremors, and tachycardia Barbiturates and benzodiazepine are CNS depressants; therefore, withdrawal symptoms are related to CNS stimulation caused by the rebounding of neurotransmitters (norepinephrine). Symptoms include increased anxiety, tremors, and vital sign changes (such as tachycardia and hypertension).

A patient is admitted to the emergency department (ED) after ingesting MDMA (ecstasy). Which of the following symptoms would the healthcare provider anticipate? A. Chest pain B. Hypothermia C. Seizures D. Agitation E. Hypertension F. Flaccid extremities

A. Chest pain C. Seizures D. Agitation E. Hypertension

Which nursing assessment findings are physical signs of sexual abuse of a female child? *(Select all that apply.)* A. Enuresis B. Red and swollen labia and rectum C. Vaginal tears D. Injuries in different stages of healing E. Cigarette burns F. Lice infestation

A. Enuresis B. Red and swollen labia and rectum C. Vaginal tears

The interventions common to treatment plans for survivors include which of the following? *(Select all that apply.)* A. Establish trust and rapport. B. Identify areas of control. C. Remove the client from the home. D. Support the client in the decisions he/she makes. E. Encourage the client to pursue legal action.

A. Establish trust and rapport. B. Identify areas of control. D. Support the client in the decisions he/she makes. Identifying areas of control empowers the client. Supporting the client in the decisions he/she makes empowers the client and enhances the client's current problem-solving ability. Establishing trust and rapport provides the client with an ally.

A group of nursing students at Nurseslabs University is currently learning about family violence. Which of the following is true about the topic mentioned? A. Family violence affects every socioeconomic level. B. Family violence is caused by drugs and alcohol abuse. C. Family violence predominantly occurs in lower socioeconomic levels. D. Family violence rarely occurs during pregnancy.

A. Family violence affects every socioeconomic level.

The nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal. Which of the following would alert the nurse to the potential for delirium tremors? A. Hypertension, changes in LOC, hallucinations B. Hypotension, ataxia, hunger C. Stupor, agitation, muscular rigidity D. Hypotension, coarse hand tremors, agitation

A. Hypertension, changes in LOC, hallucinations Some of the symptoms associated with delirium tremors typically are anxiety, insomnia, anorexia, hypertension, disorientation, hallucinations, and changes in LOC, agitation, fever, and delusions.

A patient is brought to the emergency department by a family member. The patient has been agitated for the past several hours and has alternated between grandiosity and expressing a desire to commit suicide. Upon examination, the patient is diaphoretic, hypertensive, and tachycardic. Intoxication with which of the following substances would contribute to these symptoms? A. Methamphetamine B. Benzodiazepine C. Marijuana D. Alcohol

A. Methamphetamine

Select the appropriate interventions for caring for the client in alcohol withdrawal. *(select all that apply.)* A. Monitor vital signs B. Provide stimulation in the environment C. Maintain NPO status D. Provide reality orientation as appropriate E. Address hallucinations therapeutically

A. Monitor vital signs D. Provide reality orientation as appropriate E. Address hallucinations therapeutically

Which of these cognitive-behavioral interventions would the healthcare provider include in the plan of care for a patient who desires to quit smoking? A. Remind the patient that nicotine is an addictive substance B. Help the patient identify situations that elicit a desire to smoke C. Describe common symptoms of nicotine withdrawal D. Ensure the patient has social support to quit smoking E. Explain how smoking is a sign of a deviant oral fixation F. Provide the patient with graphic autopsy pictures of smokers

A. Remind the patient that nicotine is an addictive substance B. Help the patient identify situations that elicit a desire to smoke C. Describe common symptoms of nicotine withdrawal D. Ensure the patient has social support to quit smoking

During a well-child checkup, a mother tells the Nurse Rio about a recent situation in which her child needed to be disciplined by her husband. The child was slapped in the face for not getting her husband breakfast on Saturday, despite being told on Thursday never to prepare food for him. Nurse Rio analyzes the family system and concludes it is dysfunctional. All of the following factors contribute to this dysfunction except: A. conflictual relationships of parents. B. inconsistent communication patterns. C. rigid, authoritarian roles. D. use of violence to establish control.

A. conflictual relationships of parents. There is no evidence in this situation that the parents are in conflict; in fact, the mother is describing that the child "needed to be disciplined."

Johnette is reviewing her lessons in Pharmacology. She is aware that the general classification of drugs belonging to the opioid category is analgesic and: A. depressant. B. hallucinogenic. C. stimulant. D. tranquilizing.

A. depressant. Opiates are both analgesics and CNS depressants because they decrease the effect of neurotransmitters that are excitatory or stimulating.

A patient who is addicted to heroin begins a methadone maintenance program. Which of the following statements made by the healthcare provider correctly explains the rationale for treating this patient's substance abuse disorder with methadone. A. "It isn't possible for you to become addicted to methadone." B. "Methadone reduces the craving for heroin." C. "It's much safer to give methadone in large doses." D. "Methadone reduces the high that is felt with heroin." E. "If you take heroin while on methadone you'll get sick."

B. "Methadone reduces the craving for heroin." D. "Methadone reduces the high that is felt with heroin."

Nurse Angela is working in the emergency department of Nurseslabs Medical Center. She is conducting an interview with a victim of spousal abuse. Which step should the nurse take first? A. Contact the appropriate legal services. B. Ensure privacy for interviewing the victim away from the abuser. C. Establish a rapport with the victim and the abuser. D. Request the presence of a security guard.

B. Ensure privacy for interviewing the victim away from the abuser. Privacy, away from the abuser, is important. This allows the victim to discuss the problem freely, without fear of reprisal from the abuser (especially if she decides to return to the abusive situation).

A baby born to a mother addicted to opioids is experiencing neonatal abstinence syndrome (NAS). The healthcare provider will monitor the baby for which of the following clinical manifestations of NAS? A. Depressed respirations B. Exaggerated moro reflex C. Poor feeding D. Seizure activity E. Hypothermia F. High-pitched cry

B. Exaggerated moro reflex C. Poor feeding D. Seizure activity F. High-pitched cry

Nurse Sharie is assessing a parent who abused her child. Which of the following risk factors would the nurse expect to find in this case? A. Flexible role functioning between parents B. History of the parent having been abused as a child C. Single-parent home situation D. Presence of parental mental illness

B. History of the parent having been abused as a child

A patient who overdosed on oxycodone is given naloxone. When assessing the patient, the healthcare provider would anticipate which of these clinical manifestations of opioid withdrawal? A. Bradycardia and hyporthermia B. Irritability and nausea C. Hyperthermia and euphoria D. Depressed respirations and somnolence

B. Irritability and nausea The healthcare provider would expect to observe irritability and nausea. Heart rate and blood pressure will be baseline or elevated, and temperature will be unchanged.

Emergency medical personnel bring an unconscious patient to the emergency department. The patient's pupils are pinpoint and respirations are depressed. Intoxication of which of the following substances could contribute to these clinical signs? A. Methamphetamine B. Methadone C. Cocaine D. Ecstasy

B. Methadone

A patient is experiencing withdrawal from benzodiazepine dependence. The healthcare provider will monitor the patient for which of the following symptoms? *(select all that apply.)* A. Hypersomnia B. Tremors C. Anxiety D. Yawning E. Seizures

B. Tremors C. Anxiety E. Seizures

Which of the following assessment findings in a patient's health history supports a diagnosis of substance dependence? A. Numerous legal problems and interpersonal conflicts B. Withdrawal symptoms when not using the substance C. Impaired judgment and risk-taking behaviors D. Continued tardiness and absenteeism from work

B. Withdrawal symptoms when not using the substance

A patient presents to the clinic with a report of fatigue and difficulty concentrating. Which additional statement made by the patient would alert the healthcare provider to possible marijuana use? A. I feel nauseous and don't feel like eating." B. I feel anxious and have trouble sleeping." C. "I've noticed that my eyes are red lately." D. "I keep having really vivid and scary nightmares."

C. "I've noticed that my eyes are red lately." Marijuana use can cause corneal vasodilation and conjunctivitis. It's more likely that marijuana would increase appetite, decrease anxiety, and promote sleep.

A patient is brought to the emergency department (ED) by a friend. The patient is unresponsive and respirations are slow and shallow. Which of the following is the priority intervention? A. Check the patient's blood glucose level B. Administer naloxone, per protocol C. Administer 100% oxygen per nasal cannula D. Ask the friend if they were using illicit drug

C. Administer 100% oxygen per nasal cannula

Which of the following goals would the healthcare provider identify as realistic for a patient with a substance abuse problem? A. Explore genetic anomalies associated with substance abuse B. Use the substance only in moderation and in certain situations C. Identify situations that trigger a desire to use the substance D. Focus on how cravings can be eliminated by enhancing willpower

C. Identify situations that trigger a desire to use the substance

A community nurse conducts a primary prevention, home-visit assessment for a newborn and mother. Mrs. Smith has three other children, the oldest of whom is age 12. She tells the nurse that her 12-year-old daughter is expected to prepare family meals, to look after the young children, and to clean the house once a week. Which of the following is the most appropriate nursing diagnosis for this family situation? A. Delayed growth and development, related to performance expectations of child. B. Anxiety (moderate), related to difficulty managing home situation. C. Impaired parenting, related to role reversal of mother and child. D. Social isolation, related to lack of extended family assistance.

C. Impaired parenting, related to role reversal of mother and child. The role of a 12-year-old child in a family should not be that of a parent. In this situation, the child and mother have reversed roles.

Mariefer is studying about abuse for the upcoming exam. For her to fully instill the topic, she should know that the priority nursing intervention for a child or elder victim of abuse is: A. Assess the scope of the abuse problem. B. Analyze family dynamics. C. Implement measures to ensure the victim's safety. D. Teach appropriate coping skills.

C. Implement measures to ensure the victim's safety. The priority intervention when a child or elderly person is involved in a situation of abuse is establishing the safety of the victim. Legislation in most states mandates the reporting of such abuse to ensure prompt intervention and safety.

A patient is admitted to the medical unit after experiencing chest pain. Which of these additional findings would support a diagnosis of cocaine abuse? A. Jaundice B. Hypotension C. Perforated nasal septum D. Profuse diarrhea

C. Perforated nasal septum Long-term intranasal use of cocaine is associated with a perforated nasal septum.

During a home visit to a family of three: a mother, a father, and their child. The mother tells the community nurse that the father (who is not present) has hit the child on several occasions when he was drinking. The mother further explains that she has talked her husband into going to Alcoholics Anonymous and asks the nurse not to interfere, so her husband won't get angry and refuse treatment. Which of the following is the best response of the nurse? A. The nurse agrees not to interfere if the husband attends an Alcoholics Anonymous meeting that evening. B. The nurse commends the mother's efforts and agrees to let her handle things. C. The nurse commends the mother's efforts and also contacts protective services. D. The nurse confronts the mother's failure to protect the child.

C. The nurse commends the mother's efforts and also contacts protective services. The nurse would validate and reinforce the mother's efforts to seek help; however, the nurse must also report the abuse to the appropriate protective services. The priority is to maintain the child's safety.

Nurse Julie recommends that the family of a client with substance-related disorder attend a support group, such as Al Anon and Alateen. The purpose of these groups is to help family members understand the problem and to: A. change the problem behaviors of the abuser. B. learn how to assist the abuser in getting help. C. maintain focus on changing their own behaviors. D. prevent substance problems in vulnerable family members.

C. maintain focus on changing their own behaviors. Family support groups, such as Al Anon and Alateen, emphasize the importance of changing one's own behavior rather than trying to change the behavior of the individual with a substance abuse problem.

A patient reports smoking 10 cigarettes per day for 40 years. How will the healthcare provider document this patient's smoking habit in terms of pack years? A. 20 pack years B. 10 pack years C. 4 pack years D. 5 pack years

D. 5 pack years

Mrs. Smith is admitted to the emergency department of Nurseslabs Medical Center with a fractured arm. She explains to the nurse that her injury resulted when she provoked her drunken husband, Mr. Smith, who then pushed her. Which of the following best describes the nurse's understanding of the wife's explanation? A. Mrs. Smith's explanation is appropriate acceptance of her responsibility. B. Mrs. Smith's explanation is an atypical reaction of an abused woman. C. Mrs. Smith's explanation is evidence that the woman may be an abuser as well as a victim. D. Mrs. Smith's explanation is a typical response of a victim accepting blame for the abuser.

D. Mrs. Smith's explanation is a typical response of a victim accepting blame for the abuser. Self-blame is a common psychological response for a woman who is a victim of abuse. In this situation, the message that violence occurred because the woman provoked the abuser is accepted and owned by the victim; however, the victim is not responsible for the violence.

When a client abuses a CNS depressant, withdrawal symptoms will be caused by which of the following? A. Acetylcholine excess B. Dopamine depletion C. Serotonin inhibition D. Norepinephrine rebound

D. Norepinephrine rebound CNS depressants, when abused, cause depletion of stimulating neurotransmitters. When the CNS depressant is stopped, the result is a rebound of excitatory or stimulating neurotransmitters, such as norepinephrine.

Joseph, a 12-year-old child, complains to the school nurse about nausea and dizziness. While assessing the child, the nurse notices a black eye that looks like an injury. This is the third time in 1 month that the child has visited the nurse. Each time, the child provides vague explanations for various injuries. Which of the following is the school nurse's priority intervention? A. Contact the child's parents and ask about the child's injury. B. Encourage the child to be truthful with her. C. Question the teacher about the parent's behavior. D. Report suspicion of abuse to the proper authorities.

D. Report suspicion of abuse to the proper authorities. The nurse is obligated to report suspicion of child abuse to the appropriate protective services. Failure to do so can risk further endangerment of the child, and failure to report is a misdemeanor violation on the part of the nurse.

Nurse Meredith is observing 8-year-old Anna during a community visit. Which of the following findings would lead the nurse to suspect that Anna is a victim of sexual abuse? A. The child is fearful of the caregiver and other adults. B. The child has a lack of peer relationships. C. The child has self-injurious behavior. D. The child has interest in things of a sexual nature.

D. The child has interest in things of a sexual nature. An 8-year-old child is in the latency phase of development; in this stage, the child's interest in peers, activities, and school is priority. Interest in sex and things of a sexual nature would occur appropriately during the age of puberty, not at this time.

A patient who has a history of chronic back pain requires a higher dose of an opioid medication in order to achieve adequate pain relief. The healthcare provider suspects that these findings are a result of which of the following? A. Dependence B. Pseudoaddiction C. Addiction D. Tolerance

D. Tolerance Tolerance is a decrease in sensitivity to a medication. It is a common occurrence when opioids are taken for an extended period time, and requires a progressively larger dose to achieve the same degree of pain management.

Sheila tells the community nurse that her boyfriend has been abusive and she is afraid of him, but she doesn't want to leave. The client asks the nurse for assistance. Which nursing interventions are appropriate in this situation? *(Select all that apply.)* A. Help Sheila to develop a plan to ensure safety, including phone numbers for emergency help. B. Help Sheila to get her boyfriend into an appropriate treatment program. C. Communicate acceptance, avoiding any implication that Sheila is at fault for not leaving. D. Help Sheila to explore available options, including shelters and legal protection. E. Tell Sheila that the she should leave because things will not improve. F. Reinforce concern for Sheila's safety and her right to be free of abuse.

F. Reinforce concern for Sheila's safety and her right to be free of abuse.

During an initial assessment of a client admitted to a substance abuse unit for detoxification and treatment, the nurse asks questions to determine patterns of use of substances. Which of the following questions are most appropriate at this time? *(Select all that apply.)* A. How long have you used substances? B. How often do you use substances? C. How do you get substances into your body? D. Do you feel bad or guilty about your use of substances? E. How much of each substances do you use? F. Have you ever felt you should cut down substance use? G. What substances do you use?

G. What substances do you use?

A school nurse notices bruises and scars on a child's body. The nurse suspects that the child is being physically abused. How should the nurse proceed with this information? a. As a health-care worker, report the suspicion to the Department of Health and Human Services. b. Check Jana again in a week and see if there are any new bruises. c. Meet with Jana's parents and ask them how Jana got the bruises. d. Initiate paperwork to have Jana placed in foster care.

a. As a health-care worker, report the suspicion to the Department of Health and Human Services.

Treatment interventions to assist the client with a current history of drug and alcohol abuse and prevent relapse include: *(select all that apply)* a. Twelve step program b. self-help group c. support from established friends d. lifestyle changes e. individual therapy

a. Twelve step program b. self-help group d. lifestyle changes e. individual therapy

Disorders that may be present with heroin abuse are: *(select all that apply)* a. alcohol abuse b. depression c. anxiety disorders d. PTSD

a. alcohol abuse b. depression c. anxiety disorders d. PTSD

A nurse is caring for a client who has a history of opioid and heroin abuse and monitoring for signs of withdrawal. Which clinical manifestations are associated with heroin and opioid withdrawal. *(select all that apply)* a. compulsive itching b. diaphoresis c. yawning and sneezing d. insomnia e. cramps and diarrhea

a. compulsive itching b. diaphoresis c. yawning and sneezing d. insomnia e. cramps and diarrhea

The nurse knows that the children of parents who abuse substances are at risk for: a. developing substance abuse problems b. developing criminal habits c. bullying d. SIDS

a. developing substance abuse problems

Personality traits associated with drug abuse include: *(select all that apply)* a. narcissistic behavior b. introverted personality c. established impulse control d. difficulty dealing with intimacy e. low self-esteem

a. narcissistic behavior e. low self-esteem

People who use opioids to treat pains sometimes get addicted after taking the meds by mouth. They may alter the route of administration by: *(select all that apply)* a. snorting b. injecting c. crushing in food d. mixing with alcohol

a. snorting b. injecting

A battered woman presents to the ED with multiple cuts and abrasions. Her right eye is swollen shut. She says that her husband did this to her. The priority nursing intervention is: a. tending to the immediate care of her wounds. b. providing her with information about a safe place to stay. c. administering the prn tranquilizer ordered by the physician. d. explaining how she may go about bringing charges against her husband.

a. tending to the immediate care of her wounds.

Sharon, a woman with multiple cuts and abrasions, arrives at the emergency department (ED) with her three small children. She tells the nurse her husband inflicted these wounds on her. She says, "I didn't want to come. I'm really okay. He only does this when he has too much to drink. I just shouldn't have yelled at him." The best response by the nurse is: a. "How often does he drink too much?" b. "It is not your fault. You did the right thing by coming here." c. "How many times has he done this to you?" d. "He is not a good husband. You have to leave him before he kills you."

b. "It is not your fault. You did the right thing by coming here."

Kate is an 18-year-old freshman at the state university. She was extremely flattered when Don, a senior star football player, invited her to a party. On the way home, he parked the car in a secluded area by the lake. He became angry when she refused his sexual advances. He began to beat her and finally raped her. She tried to fight him, but his physical strength overpowered her. He dumped her in the dorm parking lot and left. The dorm supervisor rushed Kate to the emergency department. Kate says to the nurse, "It's all my fault. I shouldn't have allowed him to stop at the lake." The nurse's best response is: a. "Yes, you're right. You put yourself in a very vulnerable position when you allowed him to stop at the lake." b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack." c. "There's no sense looking back now. Just look forward, and make sure you don't put yourself in the same situation again." d. "You'll just have to see that he is arrested so he won't do this to anyone else."

b. "You are not to blame for his behavior. You obviously made some right decisions, because you survived the attack."

Jana, age 5, is sent to the school nurse's office with an upset stomach. She has vomited and soiled her blouse. When the nurse removes her blouse, she notices that Jana has numerous bruises on her arms and torso, in various stages of healing. She also notices some small scars. Jana's abdomen protrudes on her small, thin frame. From the objective physical assessment, the nurse suspects that: a. Jana is experiencing physical and sexual abuse. b. Jana is experiencing physical abuse and neglect. c. Jana is experiencing emotional neglect. d. Jana is experiencing sexual and emotional abuse.

b. Jana is experiencing physical abuse and neglect.

A young woman who has just undergone a sexual assault is brought into the ED by a friend. The priority nursing intervention would be to: a. help her to bathe and clean herself up. b. provide physical and emotional support during evidence collection. c. provide her with a written list of community resources for survivors of rape. d. discuss the importance of a follow-up visit to evaluate for sexually transmitted diseases.

b. provide physical and emotional support during evidence collection.

Sharon, a woman with multiple cuts and abrasions, arrives at the ED with her three small children. She tells the nurse her husband inflicted these wounds on her. In the interview, Sharon tells the nurse, "He's been getting more and more violent lately. He's been under a lot of stress at work the last few weeks, so he drinks a lot when he gets home. He always gets mean when he drinks. I was getting scared. So I just finally told him I was going to take the kids and leave. He got furious when I said that and began beating me with his fists." With knowledge about the cycle of battering, what does this situation represent? a. Phase I. Sharon was desperately trying to stay out of his way and keep everything calm. b. Phase I. A minor battering incident for which Sharon assumes all the blame. c. Phase II. The acute battering incident that Sharon provoked with her threat to leave. d. Phase III. The honeymoon phase where the husband believes that he has "taught her a lesson and she won't act up again."

c. Phase II. The acute battering incident that Sharon provoked with her threat to leave.

A woman who has a long history of being battered by her husband is staying at the woman's shelter. She has received emotional support from staff and peers and has been made aware of the alternatives open to her. Nevertheless, she decides to return to her home and marriage. The best response by the nurse to the woman's decision is: a. "I just can't believe you have decided to go back to that horrible man." b. "I'm just afraid he will kill you or the children when you go back." c. "What makes you think things have changed with him?" d. "I hope you have made the right decision. Call this number if you need help."

d. "I hope you have made the right decision. Call this number if you need help."

A woman who was sexually assaulted six months ago by a man with whom she was acquainted has since been attending a support group for survivors of rape. From this group, she has learned that the most likely reason the man raped her was that: a. because he had been drinking, he was not in control of his actions. b. he had not had sexual relations with a girl in many months. c. he was predisposed to become a rapist by virtue of the poverty conditions under which he was reared. d. he was expressing power and dominance by means of sexual aggression and violence.

d. he was expressing power and dominance by means of sexual aggression and violence.

The nurse is completing an admission assessment for a client admitted with acute alcohol intoxication. When asked to describe drinking pattern and amount, the client states, "I only drink when I am under a lot of stress." The clients response indicates what defense mechanism? a. projection b. regression c. denial d. rationalization

d. rationalization

An effective communication technique with an addict would be: a. confront the patient right away b. provide group support at a local restaurant c. tell the patients parents so they can try to help d. teach the patient about the physical impact of drugs and alcohol.

d. teach the patient about the physical impact of drugs and alcohol.

A school nurse notices bruises and scars on a child's body, but the child refuses to say how she received them. Another way in which the nurse can get information from the child is to: a. have her evaluated by the school psychologist. b. tell her she may select a "treat" from the treat box (e.g., sucker, balloon, junk jewelry) if she answers the nurse's questions. c. explain to her that if she answers the questions, she may stay in the nurse's office and not have to go back to class. d. use a "family" of dolls to role-play the child's family with her.

d. use a "family" of dolls to role-play the child's family with her.