Exam 2 PrepU Chapter 31
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? "How many siblings do you have?" "How much alcohol do you consume?" "Which substances do you routinely use?" "Did your parents consume alcohol when you were growing up?"
"Did your parents consume alcohol when you were growing up?"
A client with alcohol use disorder is admitted for treatment. Which statement indicates that the nurse has an issue with the client's condition? "Tell me how you are feeling right now." "I have family members with the same problem." "Explain to me when you started using alcohol." "So you attended Alcoholics Anonymous meetings for how long?"
"I have family members with the same problem."
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." "I will avoid operating heavy machinery or driving." "I will have weekly blood alcohol levels drawn." "I will limit alcohol consumption to a moderate level."
"I will avoid all products containing alcohol."
The nurse is teaching a client admitted with acute alcohol withdrawal about medications used to prevent complications during the withdrawal from alcohol. The nurse recognizes that teaching has been effective when the client makes which statement? "I will be given a benzodiapine over several days as a substitution for alcohol." "A narcotic antagonist will be given to me to block the alcohol in my system." "Antipsychotic medications will be given to me gradually for my withdrawal." "By taking a disulfide, I will be able to start my recovery process sooner."
"I will be given a benzodiapine over several days as a substitution for alcohol."
The nurse is educating a client with alcoholism that has been in rehabilitation for two weeks to prepare for discharge. Which statement made by the client indicates that education was effective and the client is best prepared for discharge? "In order to give myself the best chance for sobriety, I will abstain from alcohol." "Now that I have completed rehab, I can safely return to life as it was before." "I will be able to maintain sobriety by looking at the long-term outcomes." "This is a good time to make a lot of serious changes in my life such as a new job."
"In order to give myself the best chance for sobriety, I will abstain from alcohol."
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? "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." "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."
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? "You need to really commit to this process." "I don't understand why you keep going back to using the drug." "Sometimes it takes a few times before relapses stop occurring." "There has to be a reason rehabilitation is not working for you."
"Sometimes it takes a few times before relapses stop occurring."
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? "I know it's a problem." "They only drink after work." "My partner needs to stop going to the club." "I will encourage my spouse to go to meetings."
"They only drink after work."
The nurse is caring for a client who consumes an excessive amount of alcohol. The client abruptly stopped drinking at 1300 today. What is the latest time the nurse expects the onset of delirium tremens? 0100, tomorrow 0400, tomorrow 0800, tomorrow 1000, tomorrow
0100, tomorrow
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 18 hours 24 hours 48 hours
12 hours
Disulfiram should not be administered until a client has abstained from alcohol for at least how long? 12 hours 4 hours 8 hours 16 hours
12 hours
The client is brought to the emergency room with opioid overdose. After the initial assessment for central nervous system (CNS) function, what will be the nurse's priority action? Administer naloxone. Inquire as to what opioid was taken. Monitor condition with frequent vital signs. Focus on cognition and ability to arouse.
Administer naloxone.
A client with alcohol abuse is to receive disulfiram. The client's last drink was at 4 PM. The client should receive the medication no earlier than at which time? 8 PM 12 midnight 4 AM 8 AM
4 AM
A client's history reveals that he continues to use cocaine despite the negative consequences. The nurse identifies this as which of the following? Addiction Abuse Use Withdrawal
Addiction
The nurse is caring for a client with alcohol use disorder that is acutely intoxicated. Which action will the nurse perform to treat the Wernicke-Korsakoff syndrome the client is experiencing? Administer Vitamin B1. Administer folic acid. Administer cyanocobalamin. Administer naloxone.
Administer Vitamin B1.
A client is brought to the emergency department by law enforcement after suspicion of driving under the influence. A blood alcohol level is drawn and is found to be 0.10 mg%. Which of the following would the nurse expect to assess? Difficulty coordinating movements Impaired judgment Giddiness Mood changes
Difficulty coordinating movements
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 Several trusting relationships with friends Went back to college to complete a degree in nursing Divorced 3 times with tumultuous relationships with spouses States that they hold on to bad relationships due to fear of being alone
Drinks alcohol to excess 3 days a week Divorced 3 times with tumultuous relationships with spouses States that they hold on to bad relationships due to fear of being alone
A client has a blood alcohol level of 0.05%. The nurse would expect which behavior to occur? Impaired judgment Difficulty driving Stupor Coma
Impaired judgment
Which of the following is the best description of the term substance use disorders, according to the American Psychiatric Association? Indicates that the client experiences tolerance and withdrawal symptoms Is an umbrella term for substance abuse and substance dependence Indicates that the client does not experience tolerance and withdrawal symptoms Indicates that the client has a medical reason for taking the substance
Is an umbrella term for substance abuse and substance dependence
When discussing methadone treatment with a client, the nurse should include what? It decreases the severity of heroin withdrawal symptoms. The cure rate is extremely high. It takes 1 to 2 years to cure an opiate addict. It is a nonaddictive treatment.
It decreases the severity of heroin withdrawal symptoms.
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. Heart rate around 72 beats/min Marked diaphoresis Auditory hallucinations Gross uncontrollable tremors Increased appetite
Marked diaphoresis Auditory hallucinations Gross uncontrollable tremors
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. Prepare for lumbar puncture for viral encephalopathy. Administer B12 deficiency injection using Z-track method. Determine if the client is having episodes of cognitive dementia.
Monitor for Korsakoff syndrome from long-term effects of alcohol use.
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? Vital signs and medications as prescribed Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered Suicide precautions because suicide attempts are frequent during withdrawal Seizure precautions and vital signs
Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered
A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition? Motor vehicle accidents Substance abuse disorders Falls Mood disorders
Substance abuse disorders
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. Families can expect the client to seek treatment independently upon relapse. It is possible to refrain from substance abuse through personal motivation. Beer and wine are less problematic in substance abuse. Substance abuse is an illness like any other. An individual with substance abuse issues typically cannot use drugs socially.
Substance abuse is an illness like any other. An individual with substance abuse issues typically cannot use drugs socially.
Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder? The client has a demonstrated family history of alcoholism. The client engages in binge drinking a few times a week rather than drinking consistently each day. The client uses marijuana in addition to alcohol. The client had six drinks a few hours ago.
The client had six drinks a few hours ago.
The nurse is planning the care of a client with bipolar disorder and addiction to heroin that is in a rehabilitation facility. Which outcome(s) will the nurse assign in the immediate phase after withdrawal symptoms are over? Select all that apply. The client will initiate interactions with at least two other people in the facility. The client will assess strengths and weaknesses realistically. The client will share feelings openly within 48 hours. The client will receive only prescribed medications. The client will verbalize plans to join a community support group.
The client will share feelings openly within 48 hours. The client will receive only prescribed medications.
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 recognize their own beliefs, backgrounds, and attitudes related to substance use disorder. 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 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.
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. Marijuana interferes with coordination and balance. Marijuana has cardiovascular effects. Some active ingredients in marijuana have been approved for medical uses.
Users of marijuana always experience relaxation and euphoria.
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? use of medication actions to prevent relapse recognizing levels of tolerance value of spontaneous remission
actions to prevent relapse
A client with alcohol use disorder refuses to attend Alcoholics Anonymous (AA) meetings. Which information would the nurse locate in the medical record that would explain the client's decision? client does not want anyone to know about the disorder denies having a problem with alcohol does not believe that they are needed cannot find a meeting at a convenient time
client does not want anyone to know about the disorder
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 increased BUN and creatinine decreased iron level increased TSH
decreased thiamine level
