Lippincott NCLEX Personality and Substance-Related Disorders

The client is fidgeting and has trouble sitting still. He has difficulty concentrating and is tangential. Which of the following interventions should help decrease the client's level of anxiety? Select all that apply 1. Refocusing attention 2. Allowing ventilation 3. Suggesting a time-out 4. Giving IM medication 5. Assisting with problem solving

1. Refocusing attention 2. Allowing ventilation 5. Assisting with problem solving

The friend of a client brought to the ED states "I guess she had some bad heroin today". The client is drowsy and verbally non-responsive. Which of the following assessment findings is of immediate concern for the nurse? 1. Respiratory rate of 9 2. Urinary retention 3. Hypotension 4. Reduced pupil size

1. Respiratory rate of 9

Before hospitalization, a client needed increasingly larger doses of barbiturates to achieve the same euphoria as when he began using. The nurse develops a plan of care take takes into account that the client is likely suffering from which of the following? 1. Tolerance 2. Addiction 3. Abuse 4. Dependence

1. Tolerance

Which of the following should the nurse expect to assess for a client who is exhibiting late stages of heroin withdrawal? 1. Vomiting/diarrhea 2. Yawning/diaphoresis 3, Lacrimation and rhinorrhea 4. Restlessness and irritability

1. Vomiting/diarrhea

Which of the following is an accurate response when a client asks the nurse about requirements to become a members of AA? 1. You must be sober for at least a month before joining 2. AA is open to anyone who wants sobriety 3. The members will interview you and decide if you can join the groups 3. AA requires daily attendance at meetings

2. AA is open to anyone who wants sobriety

Which of the following foods should the nurse eliminate from the diet of a client in alcohol withdrawal? 1. Milk 2. Regular coffee 3. Orange juice 4. Eggs

2. Regular coffee

A client is entering the chemical dependency unit for treatment of alcohol dependency. Which of the clients possessions should the nurse place in a locked area? 1. Toothpaste 2. Dental floss 3. Shaving cream 4. Antiseptic mouthwash

4. Antiseptic mouthwash

When planning care for a client diagnosed with schizotypal personality disorder, which of the following helps the client become involved with others? 1. Participating solely in group activities 2. Being involved with primarily one-to-one activities 2. Leading a sing-along in the afternoon 4. Attending an activity with the nurse

4. Attending an activity with the nurse

An intoxicated client is admitted to the hospital for alcohol withdrawal. Which of the following should the nurse do to help the client become sober? 1. Give the client black coffee to drink 2. Walk the client around the unit 3. Have the client take a cold shower 4. Provide the client with a quiet room to sleep in

4. Provide the client with a quiet room to sleep in

Which of the following nursing actions is contraindicated for the client who is experiencing severe symptoms of alcohol withdrawal? 1. Helping the client walk 2. Monitoring intake and output 3. Assessing vital signs 4. Using short, concrete statements

1. Helping the client walk

When developing the plan of care for a client diagnosed with a personality disorder, the nurse plans to assist the client primarily with which of the following? 1. Specific dysfunctional behaviors 2. Psychopharmacologic compliance 3. Examination of developmental conflicts 4. Manipulation of the environment

1. Specific dysfunctional behaviors

While meeting with the nurse, a client's wife states "I don't know what else to do to make him stop drinking". The nurse should refer the wife to which of the following? 1. Alateen 2. Al-Anon 3. Employee assistance program 4. Alcoholics Anonymous

2. Al-Anon

While taking Antabuse, the client becomes nauseated and vomits severely. Which of the following questions should the nurse ask first? 1. How long have you been taking Antabuse? 2. Do you feel like you have the flu? 3. How much alcohol did you drink today? 4. Have you eaten any foods cooked in wine?

3. How much alcohol did you drink today?

A client with alcohol dependency has peripheral neuropathy. The nurse should develop a teaching plan that emphasizes 1. Washing and drying the feet daily 2. Massaging the feet with lotion 3. Trimming toenails carefully 4. Avoiding use of an electric blanket

4. Avoiding use of an electric blanket

One evening the client takes the nurse aside and whispers "Don't tell anybody but I'm going to call in a bomb threat to this hospital tonight. Which of the following actions is the priority? 1. Warning the client that his telephone privileges will be taken away if he abuses them 2. Offering to disregard the clients plan if he does not go through with it 3. Notifying the proper authorities after saying nothing until the client has actually completed the call 4. Explaining to the client that this information will have to be shared immediately with the staff and the PCP

4. Explaining to the client that this information will have to be shared immediately with the staff and the PCP

A client is brought to the ED after overdosing on barbiturates is comatose. The nurse should assess the client for 1. Kidney failure 2. CVA 3. Status epilepticus 4. Respiratory failure

4. Respiratory failure

Which of the following statements by the nurse participating in a group confrontation of a coworker is most helpful in reducing the coworkers denial about alcohol being a problem? 1. Your behavior is unprofessional 2. As a nurse, you should have sought help earlier 3. Nurse are the worse when it comes to asking for help 4. You have alcohol on your breath

4. You have alcohol on your breath

A client diagnosed with paranoid personality disorder is being admitted to a 24-hour hold after a physical altercation with a police officer who was investigating the clients threatening phone calls to his neighbors. He states that his neighbors are spying on him for Homeland Security. "I want them to stop and leave me alone. Now they have you nurses and doctors involved in their conspiracy". Which of the following nursing approaches are most appropriate? Select all that apply 1. Approach the client in a professional, matter-of-fact manner 2. Avoid intrusiveness in interactions with the client 3. Gently present reality to counteract the clients current paranoid beliefs 4. Develop trust consistently with the client 5. Do not pressure the client to attend any groups

1. Approach the client in a professional, matter-of-fact manner 2. Avoid intrusiveness in interactions with the client 4. Develop trust consistently with the client 5. Do not pressure the client to attend any groups

The client sees no connection between her liver disorder and her alcohol intake. She believes that she drinks very little and that her family is making something out of nothing. The nurse interprets these behaviors as indicative of the clients use of which of the following defense mechanisms? 1. Denial 2. Displacement 3. Rationalization 4. Reaction formation

1. Denial

The nurse is assessing a client who has fallen twice in the last 2 days. The client has been diagnosed with delirium tremens following withdrawal from alcohol use. The should should further evaluate the client for which of the following? Select all that apply 1. Disorientation 2. Paralysis 3. Elevated temperature 4. Diaphoresis 5. Visual or auditory hallucinations

1. Disorientation 3. Elevated temperature 4. Diaphoresis 5. Visual or auditory hallucinations

The nurse is talking with a client who has been diagnosed with antisocial personality disorder about how to socialize during activities without being seductive. The nurse should focus the discussion on which of the following areas? 1. Explaining the negative reactions of others toward his behavior 2. Suggesting he apologize to others for his behavior 3. Asking him to explain the reasons for his behavior 4. Discussing his relationship with his mother

1. Explaining the negative reactions of others toward his behavior

Which of the following statements indicates to the nurse that the client needs further teaching about Antabuse? 1. I can drink one or two beers and not get sick while taking Antabuse 2. I can take Antabuse at bedtime if it makes me sleepy 3. A metallic or garlic taste in my mouth is normal when starting on Antabuse 4. I'll read the labels on cough syrup and mouthwash for possible alcohol content

1. I can drink one or two beers and not get sick while taking Antabuse

Which of the following behaviors indicates to the nurse that the client diagnosed with avoidant personality disorder is improving? 1. Interacting with two other clients 2. Listening to music with headphones 3. Sitting at a table and painting 3. Talking on the phone

1. Interacting with two other clients

When assessing a client with possible alcohol poisoning, the nurse should investigate the client's use of which of the following substances while drinking alcohol? 1. Marijuana 2. LSD 3. Peyote 4. Psilocybin

1. Marijuana

A school nurse is planning a program from parents on "Drugs Commonly Abused by Teens". Which of the following information should be included? Select all that apply 1. Monitor for paper bags and rags that may have been used for breathing inhalants 2. Brain damage in unlikely with the use of inhalants 3. Use of inhalants by teens is on the decline 4. Death from inhalants occur from asphyxiation, suffocation, and aspiration of vomit 5. Inhalants usually cause depression of the CNS 6. The basic groups of inhalants are hydrocarbon solvents such as glue, aerosol propellants, from spray cans and anesthetics/gases

1. Monitor for paper bags and rags that may have been used for breathing inhalants 4. Death from inhalants occur from asphyxiation, suffocation, and aspiration of vomit 5. Inhalants usually cause depression of the CNS 6. The basic groups of inhalants are hydrocarbon solvents such as glue, aerosol propellants, from spray cans and anesthetics/gases

A new client on the psyc unit has been diagnosed with depression and OCPD. During visiting hours her husband share to the nurse that he does not understand what OCPD is and what can be done about it. What information by the nurse should she share with the client and her husband? Select all that apply 1. Perfectionism and overemphasis on tasks usually interfere with friendships and leisure time 2. It will help to interrupt her tasks and tell her you are going out for the evening 3. There are medications, such as clomipramine or fluoxetine that may help 4. Remind your wife that it is okay to be human and make mistakes 5. Reinforce with her that she is not allowed to expect the whole family to be perfect too 6. This disorder typically involves inflexibility and a need to be in control

1. Perfectionism and overemphasis on tasks usually interfere with friendships and leisure time 3. There are medications, such as clomipramine or fluoxetine that may help 4. Remind your wife that it is okay to be human and make mistakes 6. This disorder typically involves inflexibility and a need to be in control

A client states to the nurse, "I'm not going to any more NA meetings. I felt out of place there". Which response by the nurse is best? 1. Try attending a meeting in a different location; you may feel more comfortable there 2. Maybe it just wasn't good day for you; everybody has bad days now and then 3. Perhaps you weren't paying close enough attention to what they were saying 4. Sometimes the meetings ca seem like a waste of time but you need to attend to stay clean

1. Try attending a meeting in a different location; you may feel more comfortable there

When developing a teaching plan for a group of middle school children about Ecstasy, what information should the nurse expect to use? Select all that apply 1. Using Ecstasy is similar to using speed 2. Ecstasy is used at all-night parties 3. Teeth grinding is seen with cocaine, not Ecstasy 4. It can cause death 5. It reduces self-consciousness

1. Using Ecstasy is similar to using speed 2. Ecstasy is used at all-night parties 4. It can cause death 5. It reduces self-consciousness

A client with an Axis II diagnosis of antisocial personality disorder has a potential for violence and aggressive behavior. Which of the following client outcomes to be accomplished in the short term is most appropriate for the nurse to include in the plan of care? 1. Use humor when expressing anger 2. Discuss feelings of anger with staff 3. As the nurse for mediation when upset 4. Use indirect behaviors to express anger

2. Discuss feelings of anger with staff

A client is complaining to other clients about not being allowed by staff to keep food in her room. The nurse should 1. Ignore the clients behavior 2. Set limits on the clients behavior 3. Reprimand the client 4. Allow the snack to be kept in her room

2. Set limits on the clients behavior

Which of the following should the nurse use as the best measure to determine a clients progress in rehabilitation? 1. The kinds of friends he has 2. The number of drug-free days he has 3. The way he gets along with his parents 4. The amount of responsibility his job entails

2. The number of drug-free days he has

A client diagnosed with borderline personality disorder has self-inflicted cuts on her arms. The nurse is assessing the client for the risk of suicide. What should the nurse ask the client first? 1. About medications she has taken recently 2. If she is taking antidepressants 3. If she has a suicide plan 4. Why she cut herself

3. If she has a suicide plan

A client diagnosed with paranoid personality disorder is hospitalized for physically threatening his wife because he suspects her of having an affair with a coworker. Which of the following approaches should the nurse employ with this client? 1. Authoritarian 2. Parental 3. Matter-of-fact 3. Controlling

3. Matter-of-fact

A client with a cocaine dependency is irritable, anxious, highly sensitive to stimuli, and over reactive to clients and staff. Which of the following nursing actions is the most therapeutic? 1. Secluding and restraining the client as needed 2. Telling the client to stay in his room until he can control himself 3. Providing the client with time-outs 4. Confronting the client about his behaviors

3. Providing the client with time-outs

The client diagnosed with borderline personality disorder is admitted to the unit after having attempted to cut her wrists with a pair of scissors. The client has several scars on both arms from self-mutilation and suicide gestures. A staff member states to the nurse "it's just attention that she wants, she is not going to kill herself". The nurse should respond to the staff member by saying: 1. She's here now and we have to do our best 2. She needs to be here until she can control her behavior 3. I'm ashamed of you; you know better than to say that 4. Any attempt at self-harm is serious and safety is a priority

4. Any attempt at self-harm is serious and safety is a priority

When teaching a client who is to receive methadone therapy for opioid addiction the nurse should instruct the client that methadone is useful primarily for which of the following reasons? 1. It is not an addictive substance 2. A maintenance dose is taken twice a day 3. The client will no longer be addicted to opioids 4. The client may work and live normally

4. The client may work and live normally

A client is being admitted to the addictions unit for a confirmed and long-term addiction to Xanax. She continues to strongly deny her addiction stating that she was prescribed Xanax to control her panic attacks. Which of the following procedures would be the most important during the admission process? Select all that apply 1. Assess the client for suicide, escape, and aggression with risks 2. With the client present, search the client's clothes and belongings for contraband and restricted items 3. Initiate withdrawal precautions 4. Explain the unit routine and types of groups 5. Obtain a urine specimen for a drug screen

1. Assess the client for suicide, escape, and aggression with risks 2. With the client present, search the client's clothes and belongings for contraband and restricted items 3. Initiate withdrawal precautions 5. Obtain a urine specimen for a drug screen

The client is admitted to the hospital for alcohol detox. Which of the following interventions should the nurse use? Select all that apply 1. Taking vital signs 2. Monitoring input and output 3. Placing the client in restraints as a safety measure 4. Reinforcing reality if the client is disoriented or hallucinating 5. Explaining to the client that the symptoms of withdrawal are temporary

1. Taking vital signs 2. Monitoring input and output 4. Reinforcing reality if the client is disoriented or hallucinating 5. Explaining to the client that the symptoms of withdrawal are temporary

A client who has experienced the loss of her husband through divorce, the loss of her job and apartment, and the development and drug dependency is suffering situational low self-esteem. Which of the following outcomes is most appropriate? 1. The client will discuss her feelings related to her loses 2. the client will identify two positive qualities 3. The client will explore her strengths 4. The client will prioritize problems

1. The client will discuss her feelings related to her loses

When teaching a nursing assistant new to the unit about the principles for the care of a client diagnosed with a personality disorder, the nurse should explain that 1. The clients are accepted although their behavior may not be 2. Clients need limits on their behavior 3. The staff members are the primary ones left to care about these clients 4. The staff should use minimal humor when working with these clients

1. The clients are accepted although their behavior may not be

A client diagnosed with schizophrenia and alcohol abuse decides to drink alcohol with his friends. The nurse recognizes which of the following as the underlying dynamic of the clients alcohol use? 1. The decision to use alcohol is a wish to feel accepted by others 2. The decision to drink increases the clients guilt and shame 3. The client abused alcohol before developing a mental illness 4. The client is compelled to drink because of cognitive difficulties

1. The decision to use alcohol is a wish to feel accepted by others

The client diagnosed with borderline personality disorder tells the nurse "You're the best nurse here. I can talk to you and you listen. You're the only one here that can help me" Which of the following responses by the nurse is most therapeutic? 1. Thank you; you're a good person 2. All of the nurses here provide good care 3. Other clients have told me that too 4. Mary and Sam are good nurses too

2. All of the nurses here provide good care

A client states the her life has gone down the tubes since her divorce 6 months ago. She tells the nurse that after she lost her job and apt, she took an overdose or barbiturates so she could go to sleep and never wake up. Which of the following statements by the nurse should be made first? 1. It seems as if your self-esteem has been affected by all your loses 2. I know you took an overdose. Are you thinking of suicide now? 3. Helplessness is common after losing a job. Are you having trouble making decisions? 4. You sound hopeless about the future since your divorce

2. I know you took an overdose. Are you thinking of suicide now?

A client has been taking increased amounts of Xanax for about 6 months for anxiety. She asks the nurse how she can "get off the Xanax". The most accurate answer by the nurse is which of the following? 1. There will be an immediate discontinuation of the Xanax and Haldol will be available if needed 2. Instead of Xanax, you will take Ativan in decreasing doses and frequency over a period of 3-4 days 3. The Xanax will be tapered down over a period of 4 hours 4. The Xanax will be available on a PRN basis for 4-5 days

2. Instead of Xanax, you will take Ativan in decreasing doses and frequency over a period of 3-4 days

A client who is experiencing alcohol withdrawal exhibits tremors, diaphoresis, and hyperactivity. Blood pressure is 190/87 and pulse is 92. Which of the following medications should the nurse expect to administer? 1. Haloperidol (haldol) 2. Lorazepam (ativan) 3. Benxtropine (congentin) 4. Naloxone (narcan)

2. Lorazepam (ativan)

While caring for a client who has a dual diagnosis of bipolar disorder and alcohol dependency, which of the following areas is the priority for daily assessment? 1. Sleep pattern 2. Mental status 3. Eating habits 4. Self-care ability

2. Mental status

A client who chronically snorts cocaine is brought to the ED due to a cocaine overdose. The client is experiencing delusions, hallucinations, mild respiratory distress, and mild tachycardia initially. The nurse should do which of the following? Select all that apply 1. Induce vomiting 2. Place seizure pads on bed 3. Administer PRN Haldol as prescribed 4. Monitor for respiratory acidosis 5. Encourage deep breathing 6. Monitor for metabolic acidosis

2. Place seizure pads on bed 3. Administer PRN Haldol as prescribed 4. Monitor for respiratory acidosis 5. Encourage deep breathing 6. Monitor for metabolic acidosis

Which of the following client statements indicates an understanding of the signs of alcohol relapse? 1. I know I can stay dry if my wife keeps alcohol out of the house 2. Stopping AA and not expressing my feelings can lead to relapse 3. I'll have my sponsor at AA keep the list of symptoms for me 4. If someone tells me I'm about to relapse, I'll be sure to do something about it

2. Stopping AA and not expressing my feelings can lead to relapse

Which of the following approaches is the most appropriate to use with a client diagnosed with a narcissistic personality disorder when discrepancies exist between what the clients says and what actually exists? 1. Limit setting 2. Supportive confrontation 3. Consistency 4. Rationalization

2. Supportive confrontation

The nurse asses a client to be at risk for self-mutilation and implements a safety contract with the client. Which of the following client behaviors indicates that the contract is working? 1. The client withdraws to his room when feeling overwhelmed 2. The client notifies staff when anxiety is increasing 3. The client suppresses his feelings when angry 4. The client displaces his feelings onto the PCP

2. The client notifies staff when anxiety is increasing

The client is to be discharged from the hospital after a safe, medically supervised withdrawal from alcohol. Which of the following outcomes indicate the client readiness for an outpatient treatment program? Select all that apply 1. The client states the need to cut down on his alcohol intake 2. The client verbalizes the damaging effects of alcohol on his body 3. The client plans to attend AA meetings 4. The client takes ReVia daily 5. The client says he is indestructible

2. The client verbalizes the damaging effects of alcohol on his body 3. The client plans to attend AA meetings 4. The client takes ReVia daily

A client is returning to the PCP office for follow-up on his diagnosis of CAD. After all the exams and paperwork are completed, the nurse asks the client about how well he is sleeping. The client states "Oh, that's not my problem anymore. I take couple of my wife's Valium and sleep like a baby". Which of the following information should the nurse obtain? Select all that apply 1. The reason the client's wife is taking Valium 2. The dose of Valium he is taking and how long he has been taking it 3. Exactly how many Valiums he takes at night and during the day 4. Whether he intends to stop the Valium use 5. What was interfering with his sleep prior to starting the Valium

2. The dose of Valium he is taking and how long he has been taking it 3. Exactly how many Valiums he takes at night and during the day 5. What was interfering with his sleep prior to starting the Valium

While admitting a client to the alcohol treatment program, the nurse asks how long the client has been drinking, how much, and when she had her last drink. The client replies that she has been drinking about a liter of vodka a day for the past week and her last drink was about an hour ago. This information helps the nurse to determine which of the following? 1. The severity of the disease 2. The severity of withdrawal symptoms 3. The possibility of hallucinations 4. The occurrence of delirium tremens

2. The severity of withdrawal symptoms

When caring for a client who has overdosed on PCP, the nurse should be especially cautious about which of the following client behaviors? 1. Visual hallucinations 2. Violent behavior 3. Bizarre behavior 4. Loud screaming

2. Violent behavior

Which of the following liquids should the nurse administer to a client who is intoxicated on PCP to hasten excretion of the chemical? 1. Water 2. Milk 3. Cranberry juice 4. Grape juice

3. Cranberry juice

The husband of a nurse who is being confronted by a group about her problem with alcohol asks the nurse acting as the group leader what he should say to his wife during the meeting. The nurse leader directs the husband to use which of the following statements to facilitate his wifes entrance into treatment? 1. The children and I want you to get help 2. If your parents were alive, they would be extremely disappointed in you 3. Either you get help or the kids and I will move out of the house 4. You need to enter treatment now or be a drunk if that is what you want

3. Either you get help or the kids and I will move out of the house

The wife of a client with alcohol dependency tells the nurse she is tired of making excuses for him to his boss and coworkers when he can't make it into work. She believes him every time he tells her she is going to quit. The nurse recognizes the wife's statement as indicating which of the following behaviors? 1. Helpfulness 2. Self-defeat 3. Enabling 4. Masochism

3. Enabling

The client who has a history of using angry outbursts when frustrated begins to curse at the nurse during an appointment after being informed that she will have to wait to have her medication refilled. Which of the following response by the nurse is most appropriate? 1. You're being very childish 2. I'm sorry if you can't wait 3. I will not continue to talk with you if you curse 4. Come back tomorrow and your medication will be ready

3. I will not continue to talk with you if you curse

Which of the following measures should the nurse include in the plan of care for a client with alcohol withdrawal delirium? 1. Using restraints continuously 2. Touching the client before saying anything 3. Remaining with the client when she is confused or disoriented 4. Informing the client about alcohol treatment programs

3. Remaining with the client when she is confused or disoriented

The nurse is speaking to a 6th grade class about drugs. A students says "I know someone who smokes marijuana and he says its safe". The nurse should tell the student 1. Marijuana is not safe and is illegal 2. Do you really believe him? 3. That drug causes more damage to your body than regular cigarettes 4. Marijuana usage can lead to using other chemicals

3. That drug causes more damage to your body than regular cigarettes

A client diagnosed with major depression and substance dependence is being admitted to the Dual Diagnosis Unit. In explaining the focus of the program, the nurse should tell the client? 1. The addiction will be treated first, then the depression 2. The depression will be treated first, then the addiction 3. There will be simultaneous treatment of the addiction and depression 4. As the addiction is treated, the depression will clear up on its own

3. There will be simultaneous treatment of the addiction and depression

Which of the following assessments provides the best information about the clients physiologic response and the effectiveness of the medication prescribed specifically for alcohol withdrawal? 1. Nutritional status 2. Evidence of tremors 3. Vital signs 4. Sleep pattern

3. Vital signs

A nurse working in an alcohol rehab program is teaching staff how to give clients constructive feedback. Which of the following statements given as an example illustrates that the staff member understands the nurses teaching regarding the use of constructive feedback 1. I think you're a real con artist 2. You're dominating the conversation 3. You interrupted Terry twice in 4 minutes 4. You don't give anyone a chance to finish talking

3. You interrupted Terry twice in 4 minutes

A 19 year old client is admitted to the psych unit with an Axis I diagnosis of alcohol abuse and an Axis II diagnosis of personality disorder not otherwise specified. The clients mother states "He's always in trouble, just like when he was a boy. Now hes just a bigger prankster and out of control". In view of the clients history which of the following is most important initially? 1. Letting the client know the staff has the authority to subdue him if he gets unruly 2. Keeping the client isolated from other clients until he is better known by the staff 3. Emphasizing to the client that he will have to pay for any damage he causes 4. Closely observing the clients behavior to establish a baseline pattern of functioning

4. Closely observing the clients behavior to establish a baseline pattern of functioning

A client recovering from a drug overdose is interacting with the nurse and recounting her exploits at numerous parties she's attended. Which of the following actions is the most therapeutic? 1. Allowing the client to continue with her stories 2. Telling the client you've heard the stories before 3. Questioning the client further about her exploits 4. Direction the conversation to realistic concerns

4. Direction the conversation to realistic concerns

The client diagnosed with borderline personality disorder who is to be discharged soon threatens to do something to herself if discharged. The nurse should first 1. Request that the clients discharge be cancelled 2. Ignore the clients statement as it is a sign of manipulation 3. Ask a family member to stay with the client at home temporarily 4. Discuss the meaning of the client's statement with her

4. Discuss the meaning of the client's statement with her

The nurse notices that a client recovering from a barbiturate overdose spends most of his time with other young adults who have substance related problems. This group of clients is a dominant force on the unit, keeping the nondrug users entertained with their stories of their "highs". Which of the following methods is best to use when dealing with this problem? 1. Providing additional recreation 2. Breaking up drug-oriented discussions 3. Speaking with the clients individually about their behaviors 4. Discussing the behavior at the daily community meeting

4. Discussing the behavior at the daily community meeting

A client is to be discharged from an alcohol rehab program. Which of the following should the nurse emphasize in the discharge plan a a priority? 1. Supportive friends 2. A list of goals 3. Family forgiveness 4. Follow-up care

4. Follow-up care

The client approaches various staff with numerous request and needs to the point of disrupting the staffs work with other clients. The nurse meets with the staff to decide on a consistent, therapeutic approach for the client. Which of the following approaches will be most effective? 1. Telling the client to stay in his room until staff approach him 2. Limiting the client to the day room and dining area 3. Giving the client a list of permissible requests 4. Having the client address needs to the staff person assigned

4. Having the client address needs to the staff person assigned

Which of the following should lead the nurse to suspect that a client is addicted to heroin? 1. Hilarity 2. Aggression 3. Labile mood 4. Hypoactivity

4. Hypoactivity

A 68 year old client is admitted to the addiction unit after treatment in the ED for an overdose of Percocet. Her son calls the unit and expresses intense anger that his mother is being treated as a "common street addict". He says that she has severe back pain and was just given that prescription by her doctor. He states she accidentally took a few too many pills last night. Which reply by the nurse is most therapeutic? 1. I understand that your mother may not have intentionally taken too many pills. This medication can cause one to forget how many have been taken 2. It may be appropriate for your mother to be referred to a pain management program 3. Unfortunately, it is fairly common for clients with pain to increase their use of pain pills overtime 4. I can hear how upset you are. You sound very concerned about your mother

4. I can hear how upset you are. You sound very concerned about your mother

A client is entering the alcohol treatment program for the 4th time in 5 years. Which of the following statements by the nurse will most help the client? 1. I hope you are serious about maintaining your sobriety this time 2. I'm Maria, a nurse here, I don't know you from past attempts, but you'll get it right this time 3. I know someone who was successful after the 5th program 4. I'm Maria, a nurse in the program. The staff and I will help you go through the program

4. I'm Maria, a nurse in the program. The staff and I will help you go through the program

The client with histrionic personality disorder is melodramatic and responds to others and situations in an exaggerated manner. The nurse should recommend which of the following activities for this client? 1. Party planning 2. Music group 3. Cooking class 4. Role-playing

4. Role-playing

The client has been diagnosed with dementia related to heavy alcohol consumption. In a family meeting with the client, discharge plans are being discussed. Which of the following points should the nurse share with the family and client? Select all that apply 1. The house and garage need to be searched and all the alcohol products destroyed 2. Without continued alcohol intake, the client will gradually get better 3. With the memory loss, answer the clients question one and the ignore that question when asked again 4. Safety alarms on the doors will help to keep the client from wandering 5. As the need for supervision increases, it may be necessary for the client to be placed in an extended care facility

4. Safety alarms on the doors will help to keep the client from wandering 5. As the need for supervision increases, it may be necessary for the client to be placed in an extended care facility

A client walks into the clinic and tells the nurse she has run out of money for crack, has crashed, and wants something to help her feel better. Which of the following is most important for the nurse to assess? 1. Suspiciousness 2. Loss of appetite 3. Drug craving 4. Suicidal ideation

4. Suicidal ideation

For the client who has difficulty falling asleep at night because of withdrawal symptoms from alcohol, which are abating, which of the following nursing interventions are likely to be most effective? 1. Inviting the client to play a board game with the nurse 2. Allowing the client to sit in the community room until the client feels sleepy 3. Advising the client to sleep on the sofa in the day room 4. Teaching the client relaxation exercises before bedtime

4. Teaching the client relaxation exercises before bedtime

A client is entering a rehab for alcohol dependency as an alternative to going to jail for multiple DUI's. While obtaining the clients history, the nurse asks about the amount of alcohol he consumes daily. He responds, "I just have a few drinks with the guys after work". Which of the following response by the nurse is most therapeutic? 1. That's what all the clients here have to say at first 2. Then you should have had a designated driver for yourself 3. I guess you can't handle a few drinks 4. You say you have a few drinks, but you have had multiple arrests

4. You say you have a few drinks, but you have had multiple arrests

The client tells the nurse at the outpatient clinic that she doesn't like to attend groups because shes not regular like these other people here. The nurse should respond to the client by saying 1. Because you're not a regular client, sit in the hall when the others are in group 2. Your family wants you to attend and they will be very disappointed if you don't 3. I'll have to mark you absent from the clinic today and speak to the doctor about it 4. You say you're not a regular here, but you're experiencing what others are experiencing

4. You say you're not regular here, but you're experiencing what others are experiencing

A client ashamedly tells the nurse that he hit his wife while intoxicated and asks the nurse if his wife will ever forgive him. The nurse should reply to the client by saying 1. Perhaps you could ask her and find out 2. That is something you can explore in family therapy 3. It would depend on how much she really cares for you 4. You seem to have some feelings about hitting your wife

4. You seem to have some feelings about hitting your wife

Which of the following statements by the nurse is most appropriate when addressing a client with a barbiturate overdose who awakens in a confused state and exhibits stable vital signs? 1. I am here to help you beat your drug habit. But it is you who will need to work hard 2. It is time to get straight and stay clean and put and end to your torture 3. I am glad you pulled through; it was touch and go with you for awhile 4. You're in the hospital because of a drug problem; I'm one of the nurses who will help you

4. You;re in the hospital because of a drug problem; I'm one of the nurses who will help you

A client is being admitted to the hospital following an inadvertent overdose with Vicodin. He reveals that he has chronic back pain that resulted from an injury on a construction site. He states "I know I took too much Vicodin at once but I can't live with this pain without them. You can't take them away from me." Which of the following responses by the nurse is most appropriate? 1. Once you are tapered off the Vicodin, you will find that nonaddictive pain medicines will be enough to control your pain 2. You are going to be switched from the Vicodin to methadone for long-term pain management 3. The Vicodin will be stopped tomorrow, but you will have Ativan to help you with the withdrawal process 4. Your pain will be controlled by tapering doses of Vicodin with other pain management strategies and medications

4. Your pain will be controlled by tapering doses of Vicodin with other pain management strategies and medications

A 28 year old client with an Axis I diagnosis of major depression and an Axis II diagnosis of dependent personality disorder has been living at home with very supportive parents. The client is thinking about independent living on the recommendation of the treatment team. The client states to the nurse " I don't know if I can make it in an apartment without my parents." The nurse should respond by saying to the client: 1. You are a 28-year old adult now, not a child who needs to be cared for 2. Your parents won't be around forever. After all, they are getting older 3. Your parents need a break and you need a break from them 4. Your parents have been supportive and will continue to be even if you live apart

4. Your parents have been supportive and will continue to be even if you live apart