Mental Health Chapter 19

The nurse is caring for a client who began drinking a six-pack of beer every day in freshman year of college. By sophomore year, the client was drinking two six-packs to get the same effect. After educating the client on the chronic use of alcohol, the nurse determines education has been effective when the client makes which statement describing this phenomena?

decreased thiamine level

The nurse is caring for a client with chronic alcohol use disorder that is experiencing an alteration in memory function. Which laboratory result will the nurse correlate with this assessment finding?

decreased thiamine level

During an assessment, a client states the inability to have long-term relationships and fears being abandoned. Which question would the nurse ask to help identify the reason for the client's feelings?

"Did your parents consume alcohol when you were growing up?"

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

The nurse is teaching a client about addiction. Which client statement indicates the education has been effective?

"A tolerance is built up over time, so more is needed to get the same effect."

A nurse is caring for a client with substance use disorder. The nurse determines that education was successful when the client makes which statement?

"I am not alone with addiction because it affects every class and gender."

A client is prescribed disulfiram as part of the alcohol treatment program to prevent relapse. The client asks a nurse, "How will this drug help me?" Which response by a nurse would be most appropriate?

"It can help to prevent you from drinking."

An adult client is being discharged home after detoxing from alcohol use. The client is prescribed disulfiram. Which statement made by the client would indicate the need for further client teaching?

"I need to wait 5 to 7 days after stopping this medication to use products with alcohol in it."

The nurse is preparing to discharge a client recovering from an addiction to an opioid. Which statement indicates to the nurse that teaching was effective?

"I plan to attend the group meetings."

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 eat small frequent meals if I get nauseated."

The nurse is educating a client regarding the use of disulfiram as treatment for alcohol use disorder. Which statement made by the client indicates that teaching is effective?

"I will avoid all products containing alcohol."

The nurse is caring for a client who has has been inhaling solvents to receive a "high." After the nurse provides education on the effects of inhaling solvents, which statement from the client indicates understanding of the teaching?

"Inhalants are central nervous system (CNS) depressants similar to alcohol."

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 meeting with the family of a client who uses alcohol. Which statement indicates to the nurse that the family believes a myth about alcohol use?

"They only drink after work."

The family of a client admitted for substance use disorder is being taught about enabling behaviors. Which statement(s) by the family demonstrates their understanding of the information provided by the nurse? Select all that apply.

"We can no longer make excuses or lie for them." "We will have to be more assertive and less passive." "We are not responsible for their money failures."

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?

"What negative consequences have resulted from your drinking?"

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

An outpatient clinic nurse is caring for a client diagnosed with an alcohol use disorder. Which treatment program will the client be referred to for recovery?

12-step program

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 with a suspected heroin overdose. Which is the priority action by the nurse?

Administer naloxone 0.4 mg IV.

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

The mental health nurse recognizes that genetic intolerance of alcohol has been documented among which ethnic group?

Asians

The mental health nurse should focus on preventative efforts including educational interventions related to the abuse of prescription drugs on which client group?

Both genders between the age of 12 and 17

Which group could benefit most from prevention programs?

Children, prior to first use

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?

Delirium tremens

Clonidine is most effective for which symptom of opioid withdrawal?

Diarrhea

A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as belonging to what class?

Hallucinogen

A nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance?

Hallucinogen

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.

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is acting in a therapeutic role when doing what?

Helping the client identify positive coping mechanismsThe ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?

A 47-year-old client has been admitted to the hospital after being found unconscious in a park. Upon regaining consciousness, the client admits to heavy alcohol use over many years. Assessment reveals a low body mass index, low electrolyte levels, and impaired skin integrity. Vital signs are within normal ranges. What nursing diagnosis should be prioritized in the care of this client?

Imbalanced nutrition: less than body requirements related to chronic alcohol intake

When discussing methadone treatment with a client, the nurse should include what?

It decreases the severity of heroin withdrawal symptoms.

Which characteristic of the 12-step program distinguishes it from other programs?

It is a self-help group that focuses on total abstinence.

A client is being treated for chronic alcohol use disorder. A nurse notes the client is wearing a stethoscope, and asks the client where the stethoscope came from. The client gives a rambling response that the nurse knows is not accurate. The nurse suspects that the client may be experiencing which condition(s)? Select all that apply.

Korsakoff amnestic syndrome

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?

Lorazepam

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

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

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?

Monday morning

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 arrives at the emergency department by ambulance. The client is unconscious, with slow respirations and pinpoint pupils. The friend who came with the client reports that the client had just "shot up" heroin and then became unconscious. Which medication would a nurse most likely expect to administer?

Naloxone

A group of nursing students is reviewing information about nutritional supplementation used during alcohol detoxification. The students demonstrate the need for additional review when they identify which of the following as being used?

Naloxone

The nurse is visiting the home of a client with a substance use disorder. Which observation indicates to the nurse that the client's behavior is being enabled?

Parent tells the client that attending an Alcoholics Anonymous meeting is not necessary.

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.

A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which condition(s) would a nurse document as evidence of cocaine overdose? Select all that apply.

Seizures Cardiac arrhythmia

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

Substance abuse disorders

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.

Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder?

The client had six drinks a few hours ago.

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 most likely has a dual diagnosis since she has both a substance dependence and depression.

A client with opioid addiction is prescribed methadone maintenance therapy. When explaining this treatment to the client, which of the following would the nurse need to keep in mind?

The drug helps to satisfy the craving for the opioid.

A nurse is caring for a client with an acute substance intoxication. The client's pupils are dilated, and the nurse notes the client's blood pressure is 166/108 mm Hg. Which substance is the most likely cause of the client's symptoms?

cocaine

A client with chronic alcoholism has been found to have Wernicke encephalopathy. This irreversible complication is characterized by what?

Thiamine, or vitamin B1, deficiency

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?

This is an indication of long-term use of alcohol for this client

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

Tolerance break

A nurse is conducting a class for a group of high school students about marijuana use and abuse. The nurse determines that the class needs further discussion when they state which of the following?

Users of marijuana always experience relaxation and euphoria.

An appropriate goal for a client newly admitted to the unit for alcohol withdrawal is what?

Verbalize feeling safe and comfortable.

High doses of alcohol produce which effect?

Vomiting

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

A client is experiencing alcohol withdrawal symptoms. Which will the nurse expect to be prescribed to assist with the withdrawal symptoms, acting as a substitute for the alcohol?

benzodiazepines

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

A client has been brought to the emergency room by the police after they were trying to walk down a six-lane interstate highway. Witnesses state the client was seen smoking marijuana a few hours earlier at a park nearby. Which element(s) will the nurse likely find during assessment?

conjunctival redness increased heart rate reports of dry mouth request for food

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 an adult client that has been admitted to the detoxification unit. Due to acute withdrawal, what cues will the nurse likely assess?

flushed face, headache, and tremors

The nurse is teaching a community awareness group about opioids. Which drugs should the nurse include in the discussion? Select all that apply.

heroin morphine codeine hydrocodone

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

prevention

A nurse observes a fellow nurse colleague who has an unsteady gait and slurred speech. The nurse suspects that the colleague is impaired. Which would be the appropriate action to take?

report the nurse colleague's behavior to the supervisor on the floor

A nurse is performing an assessment for a client brought in by a family member, who tells the nurse they think the client has been using inhalants today. Which effect(s) does the nurse observe that indicates the client has likely used inhalants? Select all that apply.

stumbling gait euphoria aggressiveness dizziness