Substance Abuse, Eating Disorders, Impulse Control Disorders

A client with borderline personality disorder becomes angry when he is told that today's psychotherapy session with the nurse will be delayed 30 minutes because of an emergency. When the session finally begins, the client expresses anger. Which response by the nurse would be helpful in dealing with the client's anger? "If it had been your emergency, I would have made the other client wait." "I know it's frustrating to wait. I'm sorry this happened." "Can we talk about how this is making you feel right now?" "I really care about you and I'll never let this happen again."

"Can we talk about how this is making you feel right now?"

A client asks a nurse, "Why is it important to talk to my peers in group therapy?" Which response is most appropriate? "Group therapy provides a way to ask for support as well as to support others." "Group therapy acts as a defense against your disorganized behavior." "In group therapy, you can vent your frustrations and others will listen." "Group therapy lets you see what you're doing wrong in your life."

"Group therapy provides a way to ask for support as well as to support others."

A client with bulimia nervosa asks a nurse, "How can I ask for help from my family?" Which response is most appropriate? "Think about how you can handle this situation without help." "Ask family members to spend time with you at mealtime." "When you ask for help, make sure you really need it." "Have you ever asked your family for help in the past?"

"Have you ever asked your family for help in the past?"

The nurse is providing education about Tourette syndrome to a community group. Which participant statement indicates that further teaching is necessary? Select all that apply. "Barking is classified as a simple tic." "Hiccuping is classified as a simple tic." "Using different tones of words is classified as a simple tic." "Hopping is classified as a simple tic." "Palilalia is classified as a simple tic."

"Hopping is classified as a simple tic." "Palilalia is classified as a simple tic." "Using different tones of words is classified as a simple tic."

A client with anorexia nervosa has observed rectal bleeding. Which question by the nurse will help obtain more information about the problem? "Do you bleed before or after exercise?" "How often do you use laxatives?" "Are you eating anything that causes irritation?" "How many days ago did you stop vomiting?"

"How often do you use laxatives?"

The nurse is caring for a client asking for information about cocaine. Which statement by a client indicates that reinforcement of teaching about cocaine use has been effective? "I'm not going to be a chronic user. I only use it on holidays." "I wasn't using cocaine to feel better about myself." "I started using cocaine more and more until I couldn't stop." "I'm not addicted to cocaine because I don't use it every day."

"I started using cocaine more and more until I couldn't stop."

A client who frequently uses alcohol tells the nurse, "Everyone in my family is an alcoholic, so it's in my genes to be one, too." Which response is most appropriate? "I believe you are using this as an excuse to avoid the work it takes to become sober." "It is possible that you are the exception in your family." "When someone has a genetic predisposition to alcohol, very little can be done." "Problems with alcohol can occur in families, but it is your decision to become and stay sober."

"Problems with alcohol can occur in families, but it is your decision to become and stay sober."

A client with a history of alcohol use refuses to take the prescribed vitamin supplement. The client asks, "What good will that do me?" What teaching will the nurse provide? "Prolonged use of alcohol can cause vitamin depletion." "Your liver will heal more quickly if you take the supplement." "It's important to take vitamins to stop the craving for alcohol." "The health care provider wouldn't have prescribed the supplement if you didn't need it."

"Prolonged use of alcohol can cause vitamin depletion."

The parents of a client with anorexia nervosa ask the nurse about the risk factors for this disorder. After reinforcement of the education plan by the nurse, which statement by the parents best indicates that it has been effective? "Risk factors include a lack of life experiences and opportunities to learn life skills." "Risk factors include a high level of anxiety and disorganized behavior." "Risk factors include low self-esteem and problems with family relationships." "Risk factors include the inability to be still and emotional lability."

"Risk factors include low self-esteem and problems with family relationships."

A client with a history of substance abuse has been attending Alcoholics Anonymous meetings regularly in the psychiatric unit. One afternoon, the client tells the nurse, "I'm not going to those meetings anymore. I'm not like the rest of those people. I'm not a drunk." What would be the most appropriate response by the nurse? "If you aren't an alcoholic, why do you keep drinking and ending up in the hospital?" "It's your decision. If you don't want to go, you don't have to." "You seem upset about the meetings." "You have to go to the meetings. It's part of your treatment plan"

"You seem upset about the meetings."

The mother of a client with bulimia nervosa asks a nurse if bulimia nervosa will stop her daughter from menstruating. Which response is best? "Your daughter may have a normal or abnormal menstrual cycle, depending on the severity of her problem." "When your daughter is bingeing and purging, she won't have normal periods." "The eating disorder must be ongoing for your daughter's menstrual cycle to change." "All women with anorexia nervosa or bulimia nervosa will have amenorrhea."

"Your daughter may have a normal or abnormal menstrual cycle, depending on the severity of her problem."

When reviewing medications for a pharmacology examination, the nursing student recognizes which drugs may be abused because of tolerance and physiologic dependence? Lithium and divalproex Clozapine and amitriptyline Verapamil and chlorpromazine Alprazolam and phenobarbital

Alprazolam and phenobarbital

A client is struggling with alcohol dependence. Which communication strategy is most effective for the nurse? Determine if nonverbal communication will be more effective. Speak briefly and directly. Confront feelings and examples of perfectionism. Avoid blaming or lecturing the client.

Avoid blaming or lecturing the client.

In group therapy, a client who has used intravenous (I.V.) heroin every day for the past year says, "I don't have a drug problem. I can quit whenever I want. I've done it before." The nurse determines that this statement is indicating which defense mechanism? Denial Compensation Rationalization Obsession

Denial

A nurse is working with a 23-year-old client with a history of alcohol abuse. The nurse uses the CAGE Screening Tool while performing her assessment. She begins explaining the significance of each letter contained in the acronym. The nurse should explain that the letter "A" represents which assessment question? Do you have an addiction disorder? Is alcohol your drug of choice? Have people annoyed you by criticizing your drinking? Are you a member of Alcoholics Anonymous?

Have people annoyed you by criticizing your drinking?

A nurse determines that a client who used alcohol has nutritional problems. Which strategy is best for addressing the client's nutritional needs? Encourage the client to eat a diet high in calories. Ask the client to monitor the calories consumed each day. Provide the client with liquid protein supplements daily. Help the client to recognize and follow a balanced diet.

Help the client to recognize and follow a balanced diet.

A 40-year-old client is admitted to the hospital for alcohol abuse for the third time in the past 9 months. The health care team recommends rehabilitative treatment for this client. Why was this treatment recommended? It's the only option for controlling alcohol consumption. It helps the client identify the relationship between his problems and alcohol consumption. It helps the client understand the effects of alcohol on his body. It helps the client identify a new group of friends.

It helps the client identify the relationship between his problems and alcohol consumption.

A 15-year-old client is admitted for treatment of bulimia nervosa. Which intervention is a critical component in the care plan? Assessing the client for insomnia Monitoring the client for purging behaviors Weighing the client daily Monitoring the client's vital signs every 2 hours

Monitoring the client for purging behaviors

The nurse is caring for a client who exhibits pinpoint pupils and decreased blood pressure, pulse, respirations, and temperature. These signs may indicate which disorder? Opiate intoxication Alcohol intoxication Amphetamine intoxication Cannabis intoxication

Opiate intoxication

A nurse is working with a client with anorexia nervosa who has acrocyanosis in the extremities. Which short-term goal is most important for the client? Check neurologic reflexes. Do daily range-of-motion exercises. Promote systemic circulation. Eat some fatty foods daily.

Promote systemic circulation

A client begins to experience alcoholic hallucinosis. Which appropriate nursing intervention does the nurse implement at this time? Providing a quiet environment and administering medication as needed and prescribed Restraining the client and measuring blood pressure every 30 minutes Keeping the client restrained in bed Checking the client's blood pressure every 15 minutes and offering juices

Providing a quiet environment and administering medication as needed and prescribed

A client with anorexia nervosa tells a nurse about always feeling fat. Which intervention is best for this client? Encourage the client to honestly evaluate him or herself in a mirror. Reinforce education about the dynamics of the disorder. Talk about how they are different from peers. Identify negative characteristics to boost self-esteem.

Reinforce education about the dynamics of the disorder.

The nurse is collecting data from a parent regarding the child's behavior. Which behavior is consistent with the diagnosis of conduct disorder in this child? The child has purposely hurt animals. The child has threatened suicide. The child has a fear of attending school. The child is wetting the bed at night.

The child has purposely hurt animals.

A nurse is caring for a client with anorexia nervosa. When assisting with the development of the client's plan of care, which goal would the nurse identify as the highest priority? The client will establish adequate daily nutritional intake. The client will make a contract with the nurse that sets a target weight. The client will identify self-perceptions about body size as unrealistic. The client will verbalize the possible physiological consequences of self-starvation.

The client will establish adequate daily nutritional intake.

A high school student is referred to the school nurse for suspected substance abuse. Following the nurse's assessment and interventions, what would be the most desirable outcome? The student accepts a referral to a substance abuse counselor. The student reports increased comfort with making choices. The student agrees to inform the parents of the problem. The student discusses conflicts over drug use.

The student accepts a referral to a substance abuse counselor.

On discharge after treatment for alcoholism, a client plans to take disulfiram as prescribed. When teaching the client about this drug, the nurse emphasizes the need to: limit alcohol consumption to a moderate level. adhere to concomitant vitamin B therapy. return for monthly blood drug level monitoring. avoid all products containing alcohol.

avoid all products containing alcohol.

In the emergency department, a client with facial lacerations states that the spouse beat the client with a shoe. After the lacerations are repaired, the client waits to be seen by the crisis intake nurse, who will evaluate the continued threat of violence the spouse represents. Suddenly the client's spouse arrives, shouting a desire to "finish the job." What is the first priority of the nurse who witnesses this scene? calling a security guard and another staff member for assistance remaining with the client and staying calm saying that the client's spouse must leave at once determining why the spouse feels so angry

calling a security guard and another staff member for assistance

A client is admitted to the inpatient treatment unit for detoxification after a cocaine overdose. The client tells the nurse. "Even though I frequently use cocaine, I can control my use if I want to." The nurse interprets this statement as indicating which defense mechanism? denial withdrawal repression logical thinking

denial

A nurse is caring for a client with anorexia nervosa who requires a high-protein, high-calorie diet. When offering appropriate choices for snacks, which snack would be best for this client? chicken soup and crackers a doughnut and orange juice egg salad and peanuts cashews and strawberries

egg salad and peanuts

An adolescent client ingests a large number of acetaminophen tablets in an attempt to commit suicide. Which laboratory result is most consistent with an acetaminophen overdose? metabolic acidosis increased white blood cell (WBC) count increased serum creatinine level elevated liver enzyme levels

elevated liver enzyme levels

The nurse is gathering data from a client with prolonged, chronic alcohol use. Which finding does the nurse expect? increased flatus colostomy enlarged liver spleen deterioration

enlarged liver

A client tells a nurse, "I've been clean from drugs for the past 5 years, but my life really hasn't changed." Which concept should be explored with this client? career development personal development conflict resolution further education

personal development

A nurse is assisting with the development of a plan of care for a client with anorexia nervosa. Which action would the nurse expect to implement as part of the plan? reinforcing a strict refeeding plan for the client providing client privacy during meals encouraging the client to exercise vigorously restricting family visits until the client begins to eat

reinforcing a strict refeeding plan for the client

Which finding does the nurse recognize is commonly associated with use of alcohol in a young, depressed adult woman? memory loss sexual abuse defiant responses infertility

sexual abuse

The nurse is caring for a client with a history of cocaine abuse. Which test might be ordered following a return to an inpatient treatment facility? urine screen glucose screen hepatic screen antibody screen

urine screen