ch 19: addiction

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The nurse is interviewing a client with alcohol use disorder. Which client statement would alert the nurse that the client is not coping with their addiction? "I'm usually happy go lucky but when I drink I get aggressive and angry." "I appreciate the help I'm getting and now I can stop drinking on my own." "Often I wake up and don't know how I got there or where I am." "I have lots of friends that drink a lot more than I do and they have lost their jobs."

"I appreciate the help I'm getting and now I can stop drinking on my own." Usually, nurses encounter individuals during crisis when they are seeking professional help. Denial can be expressed in diverse behaviors and attitudes and may not be expressed as an overt denial of the problem. For example, clients may admit to a problem and even thank the nurse for helping them to realize they have a problem but insist they can overcome the problem on their own and do not need outside help. Statements regarding not knowing where they are, how their temperment changes when inhibited by alcohol, and the realization that others have lost their jobs due to alcohol is showing that the client is talking about the effects that alcohol has or could have on themselves.

A client has entered treatment for alcohol dependency at the client's spouse's insistence. The client's spouse has threatened to leave the marriage unless the client seeks treatment. The client admits that the client drinks every day, but that the drinking is well in control. The nurse recognizes the client's comments as denial. What is the best response by the nurse? "Your spouse doesn't seem to think your drinking is in control. Do you know why?" "How much do you drink per day as compared to your friends?" "What negative consequences have resulted from your drinking?" "You're in denial, which is common in the early stages of recovery."

"What negative consequences have resulted from your drinking?" To confront denial, the nurse points to the evidence of severe dysfunction that inevitably appears in the substance abuser's life. Job losses, financial problems, possible estrangement from family and friends, and legal problems are common, and the nurse can respectfully but firmly remind the client that many of these problems are a result of alcohol or drug abuse.

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? 48 hours 18 hours 12 hours 24 hours

12 hours In clients with alcoholism or in chronic drinkers, alcohol withdrawal syndrome usually begins within 12 hours after abrupt discontinuation or an attempt to decrease consumption.

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? Pancreatitis and elevated liver enzymes All the conditions are attributable to the alcohol abuse Gastritis and elevated liver enzymes Pancreatitis, esophagitis, gastritis, and elevated liver enzymes

All the conditions are attributable to the alcohol abuse Various medical conditions may alert the nurse to the early recognition of alcohol abuse problems, including gastritis or gastric ulcers, pancreatitis, esophagitis, mild to moderate hypertension, cardiomyopathy, arrhythmias, alcoholic hepatitis, cirrhosis of the liver, decreased white blood cell production, decreased granulocyte adherence, and thrombocytopenia, or cancers of the mouth, pharynx, larynx, esophagus, pancreas, stomach, and colon.

According to the psychodynamic theory regarding addiction, it is most important that the nurse assesses the client with an alcohol use disorder by considering what? Asking the client to describe any incidences of physical childhood traumas Observing the client for antisocial tendencies Asking the client to describe the client's childhood relationship with the client's parents Observing how often the client engages in cultural rituals

Asking the client to describe the client's childhood relationship with the client's parents . According to the psychodynamic theory regarding addiction, it is most important that the nurse assesses the alcoholic client by asking the client to describe the client's childhood relationship with the client's parents. Children of people with alcohol use disorders are four times more likely to develop alcoholism compared with the general population.

The mental health nurse should focus on preventative efforts including educational interventions related to the abuse of prescription drugs on which client group? Cognitively impaired, 60 years of age and older Chronically ill females regardless of age Both genders between the age of 12 and 17 Males between the age of 25 and 50

Both genders between the age of 12 and 17 Prescription drug abuse among youth 12 to 17 years of age has been increasing at an alarming rate, so the mental health nurse concentrates assessments and educational interventions related to the abuse of prescription drugs on both genders between the age of 12 and 17.

A client admitted for acute alcohol intoxication begins to experience mild sweating, tachycardia, fever, and nausea and vomiting. Of the following, the drug treatment of choice would be what? Chlordiazepoxide Paroxetine Haloperidol Carbamazepine

Chlordiazepoxide Chlordiazepoxide would be the drug of choice to manage alcohol withdrawal.

A client enters the emergency room exhibiting tremors, agitation, and restlessness. Upon assessment, the client's blood pressure is 160/90, pulse is 110, and respirations are 22. It has been 36 hours since the client's last drink of alcohol. The nurse would suspect which conditions to be occurring? Wernicke's encephalopathy Alcohol tolerance Delirium tremens Korsakoff's psychosis

Delirium tremens Delirium tremens may occur 24 to 72 hours after the client's last drink. Elevation of vital signs accompanies restlessness, tremulousness, agitation, and hyperalertness. Tolerance is a need for markedly increased amounts of alcohol to achieve the desired effect. Korsakoff's psychosis is a form of amnesia characterized by a loss of short-term memory and the inability to learn new skills. Wernicke's encephalopathy is an inflammatory hemorrhagic, degenerative condition of the brain caused by a thiamine deficiency.

The nurse is talking with a client that grew up in a home where both parents were alcoholics. Which behavior(s) does the nurse identify when assessing this client that correlate with this home life? Select all that apply. Drinks alcohol to excess 3 days a week Went back to college to complete a degree in nursing States that they hold on to bad relationships due to fear of being alone Divorced 3 times with tumultuous relationships with spouses Several trusting relationships with friends

Drinks alcohol to excess 3 days a week States that they hold on to bad relationships due to fear of being alone Divorced 3 times with tumultuous relationships with spouses Many people growing up in homes with parental alcoholism believe their problems will be solved when they are old enough to leave and escape the situation. They may begin to have problems in relationships such as maintaining a marriage, have low self-esteem, and have excessive fears of abandonment or insecurity as adults. Difficulty with problem-solving and using maladaptive coping mechanisms such as substance use. Going back to college and achieving goals and having several trusting friendships are not behaviors that are maladaptive and indicate parenteral alcohol use.

An older adult client with liver disease is experiencing alcohol withdrawal. Based on the nurse's understanding of drug therapy, which of the following would the nurse expect to be prescribed? Diazepam Chlordiazepoxide Lorazepam Fluoxetine

Lorazepam Antianxiety and sedating drugs, such as benzodiazepines, are titrated downwardly over several days as a substitution for the alcohol. Chlordiazepoxide (Librium) and diazepam (Valium) have longer half-lives and smoother tapers. Lorazepam (Ativan) is better for the older adult and people with liver impairment. Fluoxetine is not used.

A client with a long history of alcohol abuse is hospitalized. The client's last drink was at noon. The nurse would anticipate symptoms of withdrawal beginning no later than what time? 8:00 p.m. midnight 4:00 a.m. 4:00 p.m.

midnight In patients with alcoholism and in chronic drinkers, the alcohol withdrawal syndrome usually begins 4 to 12 hours after abrupt discontinuation or attempt to decrease consumption. Since the last drink was at noon, withdrawal symptoms could appear as early as 4:00 p.m. but would almost certainly begin no later than midnight.

A client with a history of alcohol use disorder is participating in a 12-step Alcoholics Anonymous (AA) program. A nurse determines that the client is at step 2 based on what statement by the client? "I realize that there is a higher power that can help me." "I am making amends to all those who I've harmed." "I've admitted to myself and others the wrongdoings I've done." "I know now that I am powerless over alcohol."

"I realize that there is a higher power that can help me." Coming to believe that a power greater than oneself could help restore sanity reflects the second step of AA. Admitting to one's self and others about wrongdoings reflects step 5 of AA. Admitting powerlessness over alcohol is step 1. Making amends is part of step 9.

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, a nurse determines that the education was successful when the client makes which statement? "I should take the drug on an empty stomach." "I should eat small frequent meals if I get nauseated." "I might experience diarrhea with this drug." "I can have a glass of wine with dinner if I choose."

"I should eat small frequent meals if I get nauseated." A client receiving methadone maintenance therapy may experience nausea. Therefore, the client should eat small, frequent meals to treat the nausea and loss of appetite and should take the drug with food and lie quietly to minimize the nausea. Alcohol should be avoided. Constipation may occur, necessitating the use of a mild laxative.

The nurse is talking with a client regarding their addiction to opioids. The client states, "I am unhappy in my job. My spouse is always nagging at me to make more money. The kids want more expensive toys." Which is the most therapeutic response by the nurse? "Let's talk about your behaviors and how you are responsible for your addiction." "If you are unhappy with your job, you should find something else you enjoy?" "So are you placing all of the blame for your addiction on everyone else?" "It sounds as though your spouse and children really want a lot from you."

"Let's talk about your behaviors and how you are responsible for your addiction." The most therapeutic response is to facilitate the client's acceptance and responsibility for their own behavior by talking about it so this can lead to identification of responsibilities. The client may deny or lack insight into the relationship between their problems or behaviors. Consistently redirect the client's focus to their own problems and to what they can do about them. The nurse is only scratching surface issues related to being unhappy with the job. By reinforcing the perceived issues with family, the nurse is preventing the client from accepting responsibility for the addiction.

The nurse is caring for a client with Wernicke encephalopathy. The nurse determines that teaching has been effective when the client makes which statement? "My condition is a degenerative brain disorder caused by nutrient deficiency." "There is swelling of my brain that is caused by alcohol consumption." "Toxins from the alcohol I drank have caused my brain to swell." "The inability of my liver to metabolize the alcohol caused this condition."

"My condition is a degenerative brain disorder caused by nutrient deficiency." The nurse determines that teaching is effective when the client states that Wernicke encephalopathy is a degenerative brain disorder caused by deficiency of folic acid and thiamine (and other B vitamins). It is characterized by vision impairment, ataxia, hypotension, confusion, and coma. The statement about swelling of the brain due to alcohol consumption is not a true statement. The statement of metabolism of alcohol in the liver causing this condition is also incorrect and would require futher education. The alcohol toxin statement is not accurate.

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? "This has been a difficult situation for all of us and disturbing to the entire family." "My sibling is so proud and happy to be able to attend the kids' ball games." "My sibling would not drink as much if their spouse was more understanding." "We can meet whenever we need to, but it really is inconvienent!"

"My sibling would not drink as much if their spouse was more understanding." The nurse determines that the statement indicating codependence, also described as "enabling," is when an individual in a relationship with a person who abuses alcohol inadvertently reinforces the drinking behavior of the abuser. Excusing the client's substance abuse problem suggests codependency, as with the statement of the sibling's spouse not being understanding. Being flexible but angry, as in the statement of meeting anytime but it not being convenient; and expressing thoughts and feelings openly as in the client's condition being a difficult situation, indicates identification of the problem, not codependency or enabling. Taking pleasure, as in the statement of the sibling being proud and happy, demonstrates positive coping, not enabling behavior.

The nurse is providing support to a client's child regarding the parent's alcohol use disorder. When integrating the disease concept treatment approach about this type of disorder, which statement by the nurse would be most effective? "Your parent wants to stop drinking but the parent is addicted to the alcohol." "With your parent's cooperation, your parent can go through the detoxification process." "A brief intervention for alcohol use problems is very effective." "Your parent's alcohol use problem is a chronic disease but can be treated."

"Your parent's alcohol use problem is a chronic disease but can be treated." According to the Disease Concept, alcoholism is considered a chronic disease with modalities in place to help manage it. Thus, the most assuring response by the nurse is, "Your parent's alcohol use disorder is a chronic disease that can be treated." The other statements do not address this concept.

A client can expect symptoms of alcohol withdrawal to begin how many hours after the last drink? 2 24 16 8

8 Symptoms of withdrawal usually begin 4 to 12 hours after cessation or marked reduction of alcohol intake.

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 naloxone. Administer Vitamin B1. Administer cyanocobalamin. Administer folic acid.

Administer vitamin B1. For clients whose primary substance is alcohol, vitamin B1 (thiamine) is often prescribed to prevent or to treat Wernicke-Korsakoff syndrome, which are neurologic conditions that can result from heavy alcohol use. Folic acid and cyanocobalamin are used to treat the nutritional deficiencies the client likely has from the chronic alcohol use and poor nutrition. Naloxone is used in the reversal of opioid overdose.

The mental health nurse is preparing a presentation about prescription drug abuse to a local community group. When describing the incidence, which age group would the nurse identify as experiencing an increase? Middle-age males Chronically ill females Cognitively impaired older adults Adolescents

Adolescents Alcohol, tobacco, marijuana, and illegal prescription drug use have reached epidemic proportions in the United States, with the incidence rising in younger age groups, particularly among adolescents and young adults.

While conducting an admission interview with a client, the nurse suspects the client may be in alcohol withdrawal. Which screening tool can help the nurse identify the severity of withdrawal symptoms? CIWA-Ar PERSONS MSE CAGE

CIWA-Ar Once alcohol withdrawal is suspected, a screening tool such as the CIWA-Ar can assist nurses to identify the severity of symptoms.

Clonidine is most effective for which symptom of opioid withdrawal? Restlessness Muscle aches Diarrhea Anxiety

Diarrhea Clonidine is most effective against nausea, vomiting, and diarrhea but produces modest relief from muscle aches, anxiety, and restlessness.

A nurse is preparing an educational session for family members affected by substance abuse. Which point should the nurse include in the session? Select all that apply. An individual with substance abuse issues typically cannot use drugs socially. Substance abuse is an illness like any other. It is possible to refrain from substance abuse through personal motivation. Families can expect the client to seek treatment independently upon relapse. Beer and wine are less problematic in substance abuse.

An individual with substance abuse issues typically cannot use drugs socially. Substance abuse is an illness like any other. When providing family education about substance abuse, it is important for the nurse to ensure that families understand substance abuse is an illness like any other. Families should also be aware that it is not possible for people with substance abuse issues to use drugs socially, there is no minimal amount that can be used without the potential for relapse. Feedback from families about relapse signs, for example, a return to previous maladaptive coping mechanism, is vital.

Suspicion that a nursing professional is impaired by a substance abuse problem is most supported by which situation? Frequently calling off work for undefined illnesses Having several clients complain that their pain medication is not working Spending a considerable amount of shift time off the unit Asking to be scheduled for weekend shifts as much as possible

Having several clients complain that their pain medication is not working Suspicion that a nursing professional is impaired by a substance abuse problem is most supported by having several clients complain that their pain medication is not working. An additional risk factor for health care providers and chemical dependency is access to and availability of drugs, training in the administration and injection of drugs, and a familiarity with and a frequency of administering drugs. A nurse who is chemically dependent may divert clients' pain medication to self-administer it; the clients then believe that their medication is not working when in fact they did not receive it. The other situations listed may also indicate a substance abuse problem, but there may be other explanations, whereas a pattern of client complaints that pain medication is not working is strong evidence for a substance abuse problem among the staff.

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? Remind them that substance dependency is a disease, not a mental disorder. Ask them to make a list of all the people they harmed during their addictions. Help them to identify appropriate diversional activities. Suggest that they try to confront other issues in their lives, such as estranged relationships or financial issues.

Help them to identify appropriate diversional activities. Clients in recovery typically have devoted much time to their addiction. Substance use is integral to their existence and occupies most of their leisure time. In some cases, it also takes up work and family time. During treatment, clients may find themselves lonely, bored, idle, or conflicted about what to do with so much "free" time. They need to plan activities to minimize the temptation to revert to alcohol or drug use.

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is acting in a therapeutic role when doing what? Discussing the pros and the cons of alcohol abuse Providing education to the client's family Helping the client identify positive coping mechanisms Monitoring the effects of treatment

Helping the client identify positive coping mechanisms When a client is working toward the prevention of an alcohol abuse relapse, the nurse is most therapeutic when helping the client identify positive coping mechanisms.

Which statements identify positive aspects of methadone as a substitute for heroin? Select all that apply. It is controlled by a health care provider. It is available in tablet form. It is a legal medication. It is available in IV form.

It is controlled by a health care provider. It is available in tablet form. It is a legal medication. Methadone is safer than heroin because it is legal, controlled by a health care provider, and available in tablet form. It is not available in IV form.

Which medication is used to prevent alcohol withdrawal symptoms? Lorazepam (Ativan) Clonidine (Catapres) Folic acid (Folate) Naltrexone (ReVia)

Lorazepam (Ativan) Safe withdrawal usually is accomplished with the administration of benzodiazepines, such as lorazepam, chlordiazepoxide, or diazepam, to suppress the withdrawal symptoms.63

A client is admitted to the detoxification unit on Sunday evening. The client discloses that the client's last alcoholic drink was just before the client was admitted to the unit. When can the nurse expect that the client's alcohol withdrawal symptoms will begin? Tuesday evening Friday evening Wednesday morning Monday morning

Monday morning Symptoms of withdrawal usually begin within 12 hours after cessation or marked reduction of alcohol intake.

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? Prepare for lumbar puncture for viral encephalopathy. Administer B12 deficiency injection using Z-track method. Monitor for Korsakoff syndrome from long-term effects of alcohol use. Determine if the client is having episodes of cognitive dementia.

Monitor for Korsakoff syndrome from long-term effects of alcohol use. The nurse must monitor for Korsakoff syndrome, which is a physiologic effect of long-term alcohol use and manifests with hallucinations and making up or confabulating stories to mask the fact that there is significant memory loss. Wernicke encephalopathy is seen in some individuals with history of alcohol abuse. This problem is associated with long-term heavy alcohol use. Chronic alcohol consumption can lead to a variety of nutritional deficiencies such as folic acid and thiamine (not B12), but these deficiencies can be caused by conditions other than alcohol abuse and be present before cognitive impairment. Cognitive dementia can be seen in a number of other conditions but does not relate specifically to alcohol abuse.

Safety is the nursing priority for a client who is at risk for alcohol withdrawal. A care plan for the client who is in withdrawal must include which nursing interventions? Suicide precautions because suicide attempts are frequent during withdrawal Vital signs and medications as prescribed Seizure precautions and vital signs Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered

Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered Nursing care of the client experiencing withdrawal centers on safety first. The nurse must implement frequent vital sign assessment, seizure precautions, and fall precautions to ensure the client's safety. Withdrawal symptoms must be controlled with medications.

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? Unstable backgrounds Short history of drug use Multiple problems involving drug use High levels of dependence

Short history of drug use Brief intervention is most successful when working with individuals who are experiencing few problems with their drug use, have low levels of dependence, have a short history of drug use, and have stable backgrounds.

The psychiatric nurse managing the care of a client experiencing alcohol withdrawal instructs unit staff to anticipate that the client may experience which neurological response? Tactile hallucinations Nihilistic delusions Gustatory hallucinations Somatic delusions

Tactile hallucinations Alcohol withdrawal can be the origin of tactile hallucinations. Alcohol withdrawal is not usually the origin of gustatory hallucinations or delusions of any type.

Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder? The client engages in binge drinking a few times a week rather than drinking consistently each day. The client had six drinks a few hours ago. The client has a demonstrated family history of alcoholism. The client uses marijuana in addition to alcohol.

The client had six drinks a few hours ago. Disulfiram may not be administered to a client who is acutely intoxicated. A family history of alcoholism, marijuana use, and binge drinking do not preclude the use of the drug.

The client was diagnosed with cocaine abuse at age 30. When the client was 23, the client was diagnosed with major depressive episode, and has continued to have depression off and on since then. Which statement would reflect this situation? The client needs to address the cocaine abuse first before addressing her episodes of depression. The client is probably using cocaine in combination with her antidepressants to enhance the effects of the cocaine. The client's prognosis is very poor because discontinuing the cocaine use will exacerbate depressive symptoms. The client most likely has a dual diagnosis since she has both a substance dependence and depression.

The client most likely has a dual diagnosis since she has both a substance dependence and depression. The client has a dual diagnosis: a primary substance dependence and a mental health disorder. The client requires concurrent treatment of both disorders. Cocaine is a stimulant so it would counteract the action of the antidepressants. Prognosis is variable and dependent on the effectiveness of the treatment for both disorders.

A nurse is assessing a client with bizzare and aggressive behavior in the emergency department. Upon questioning, the client's partner discloses that the client had been smoking PCP. While in the emergency department, the client continues to exhibit signs of PCP-induced psychosis and has required physical restraints. What nursing outcome should the nurse prioritize in the care of this client? The client will be physically safe and without injury. The client will demonstrate appropriate social skills. The client will verbalize acceptance of responsibility for the behavior. The client will establish a balance of rest, sleep, and activity.

The client will be physically safe and without injury. While the client is actively psychotic and restrained, the need for safety is paramount and would be prioritized over establishing healthy routines, taking responsibility, or demonstrating social skills.

The nurse is working with a client with alcohol use disorder that has difficult behaviors to manage. Which action by the nurse is a priority to effectively care for this client? The nurse must attend substance use disorder training prior to taking care of clients with these issues. The nurse identifies that they retain their own ideas about how client's behavior is managed. The nurse must recognize their own beliefs, backgrounds, and attitudes related to substance use disorder. The nurse should inform the client that all negative behaviors will stop prior to their sessions.

The nurse must recognize their own beliefs, backgrounds, and attitudes related to substance use disorder. The nurse must examine their beliefs and attitudes about substance use disorder. A history of substance use disorder in the nurse's family can strongly influence interaction with clients. It is not a requirement that the nurse attend substance use disorder training although it may be helpful. The nurse may need to alter the thought process of how clients should be managed and seek other evidence-based practice regarding substance use disorder. It is an unrealistic expectation that negative behaviors from the client will stop. Substance use disorder has many behavioral layers and some behaviors may be perceived by the nurse as negative when in fact, these may be coping skills the client is using.

A client is in treatment for depression and alcohol abuse. The client is unwilling to confront substance abuse issues, stating the client uses alcohol to ease feelings of depression. The client's spouse reports that the spouse often has to care for the client when the client is hung over, calling in sick for the client and doing what the spouse can to help the client catch up with household or job responsibilities. The nurse diagnoses the client's family with dysfunctional family processes. The nurse and clients develop a plan of care. Which goal indicates an understanding of the family situation and the linkages between the diagnosis and the outcomes? The spouse will refrain from the enabling the client's drinking behaviors. The spouse will work through anger at the client. The client will admit that the client is an alcoholic. The client and spouse will develop better problem-solving techniques.

The spouse will refrain from the enabling the client's drinking behaviors. Codependency needs attention from staff and counselors to learn to adjust to the sober spouse and to develop a less vigilant, more interdependent relationship. The nurse recommends that family members begin their own recovery by attending support groups such as Al-Anon or Alateen.

A client with chronic alcoholism has been found to have Wernicke encephalopathy. This irreversible complication is characterized by what? Double vision and rapid eye movement Thiamine, or vitamin B1, deficiency Inability to learn new skills and short-term memory loss Hypothalamic and mammillary body lesions

Thiamine, or vitamin B1, deficiency Wernicke encephalopathy is associated with a deficiency in thiamine, or vitamin B1.

The nurse is assessing a client who is suspected of having an alcohol use disorder. The nurse asks about daily alcohol intake. The client replies, "The important point is that if I have 10 drinks, I don't get drunk." The nurse determines the client's response as what? Determines the client may drink frequently but does not have a problem The client is minimizing the consumption of alcohol and is in denial This is an indication of long-term use of alcohol for this client Suggests the client may pass out and have episodes of memory lapse

This is an indication of long-term use of alcohol for this client The nurse determines this statement made by the client is indicative of long-term use. Behavioral tolerance to alcohol is manifested by the ability to mask the behavioral effects. For example, the acquired ability not to slur words, to walk straight, and to function in ways that would not be possible in a nondependent person who drinks. The drinking history of alcoholics often reveals the ability to increase tolerance and to maintain this increase for a long time, perhaps several years. The statement does not indicate passing out or memory lapses. The statment does not indicate the client is in denial or that the client does not have a problem.

Which term describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking? Tolerance Intoxication Tolerance break Blackout

Tolerance break After continued heavy drinking, the person experiences a tolerance break, which means that very small amounts of alcohol intoxicate the person. A blackout is an episode during which the person continues to function but has no conscious awareness of his or her behavior at the time or any later memory of the behavior. Tolerance occurs when the person needs more alcohol to produce the same effect. Intoxication is use of a substance that results in maladaptive behavior.

Which statement about clients with a dual diagnosis is accurate? These clients represent a small percentage of hospitalized clients. Addictions and mental disorders should be treated separately. Chances for recovery for clients with a dual diagnosis are better than average. Traditional methods of treatment have not been very successful for these clients.

Traditional methods of treatment have not been very successful for these clients. Traditional methods of treatment for major psychiatric disorders and substance dependency (i.e., substance dependency programs) have not been successful in treating clients with dual diagnoses.

An appropriate goal for a client newly admitted to the unit for alcohol withdrawal is what? Make amends to people in his or her life that he or she has harmed. Verbalize feeling safe and comfortable. Demonstrate knowledge of the deleterious effects of alcohol. Attend two Alcoholics Anonymous meetings each week.

Verbalize feeling safe and comfortable. The client should verbalize feeling safe and comfortable. The other answer choices are goals for longer-term treatment—i.e., after the detoxification process has been successfully completed.

High doses of alcohol produce which effect? Increased inhibitions Vomiting Calmness Decreased muscle tension

Vomiting An overdose, or excessive alcohol intake in a short period, can result in vomiting, unconsciousness, and respiratory depression.

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? Alcohol dependence with memory impairment Alcoholic dementia Scurvy Wernicke-Korsakoff syndrome

Wernicke-Korsakoff syndrome Wernicke-Korsakoff syndrome is the coexistence of Wernicke's encephalopathy and Korsakoff's psychosis. Wernicke's encephalopathy is characterized by ataxia, nystagmus, ophthalmoplegia, and mental status changes. Korsakoff's psychosis involves gait disturbances, short-term memory loss, disorientation, delirium, confabulation, and neuropathy.


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