MSII Quiz 14

A nurse is reinforcing teaching about alcohol withdrawal with a client who has a history of alcohol use disorder. Which of the following client statements indicates an understanding?

"I should expect hand tremors to start less than 24 hours after I stop drinking."

A nurse is caring for a client whose partner asks to speak with the nurse. The client's partner relates that she is concerned because her partner abuses alcohol and has difficulty maintaining employment. Which of the following responses should the nurse make?

"What have you done in the past to cope with this issue?"

The nurse is monitoring a client who abuses alcohol for signs of alcohol withdrawal delirium. The nurse should monitor for which?

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A nurse is assisting in the care of an adolescent client who has been diagnosed with schizophrenia. The client's parents are tearful and express feelings of guilt. Which of the following responses should the nurse make? A. "You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way." B. "You should not feel guilty about your daughter's diagnosis. Schizophrenia is unpreventable." C. "I'm sure your daughter's diagnosis is very difficult to deal with, but everything will be alright once she receives the proper treatment." D. "Your provider has explained the causes of schizophrenia. Why do you feel guilty about your daughter's diagnosis?"

A. "You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way."

A LPN is assisting with the development of a nursing care plan for a client who has been using cocaine for 5 years. What should the nurse consider would most commonly need to be dealt with in this patient? A. Depression B. Violent behavior C. Nasal erosion D. Suicide attempts

A. Depression Cocaine users can be depressed for as long as 2 years after quitting drug use. An antidepressant such as bupropion (Wellbutrin) is helpful in treating the depression.

A nurse is caring for a client who has depressive disorder, is in alcohol withdrawal and reports a recent job loss. Which of the following should be the priority nursing intervention? A. Determine the presence and degree of suicide risk B. Assist the client to identify negative effects of chemical dependency C. Identify support groups in the community for long-term treatment D. Refer the client to a mental health care provider for evaluation and treatment

A. Determine the presence and degree of suicidal risk

A nurse is a community clinic is collecting data from a client who is withdrawing from heavy cocaine use. When collecting data from the client, which of the following manifestations should the nurse expect to observe?

Apathy

The nurse is caring for a client who is suspected of being dependent on drugs. Which question should be appropriate for the nurse to ask when collecting data from the client regarding drug abuse? A. "Why did you get started on these drugs?" B. "How much do you use and what effect does it have on you?" C. "How long did you think you could take these drugs without someone finding out?" D. The nurse does not ask any questions because of fear that the client is in denial and will throw the nurse out of the room.

B. "How much do you use and what effect does it have on you?" Whenever the nurse collects data from a client who is dependent on drugs, it is best for the nurse to attempt to elicit information by being nonjudgmental and direct. Option A is incorrect because it is judgmental, off focus, and reflects the nurse's bias. Option C is incorrect because it is judgmental, insensitive, and aggressive, which is nontherapeutic. Option D is incorrect because it indicates passivity on the nurse's part and uses rationalization to avoid the therapeutic nursing intervention.

The nurse determines that the wife of an alcoholic client is benefitting from attending an Al-Anon group when the nurse hears the wife say which statement? A. "My attendance at the meetings has helped me to see that I provoke my husband's violence." B. "I no longer feel that I deserve the beatings my husband inflicts on me." C. "I can tolerate my husband's destructive behavior now that I know they are common with alcoholics." D. "I enjoy attending the meetings because they get me out of the house and away from my husband."

B. "I no longer feel that I deserve the beatings my husband inflicts on me." Al-Anon support groups are protected, supportive opportunity for spouses and significant others to learn what to expect and to obtain excellent pointers about successful behavior changes. Option 2 is the most healthy response because is exemplifies and understanding that the alcoholic partner is responsible for his behavior and cannot be allowed to blame family members for loss of control.

A nurse explains that according to the intrapersonal theory, addiction is caused by early childhood rejection. These substance abusers are thought to have common characteristics. What do these characteristics include? A. Open-boundary approach to life that likes to party frequently B. Attention seeking, need for control, and self-centeredness C. Shyness and anxiety D. Stress and eagerness to be a part of the in-group

B. Attention seeking, need for control, and self-centeredness The intrapersonal theory identifies the common personality traits of self-centeredness, need for control, and attention seeking as parts of the addictive personality.

What might the positive effects of marijuana be used to treat? A. Diet control in morbidly obese patients B. Chemotherapy-induced nausea and vomiting C. Air hunger in patients with end-stage emphysema D. Early diabetic-induced cataracts

B. Chemotherapy-induced nausea and vomiting Marijuana has been studied for use to reduce nausea and vomiting in patients with cancer. Marinol (Dronabinol) is a marijuana derivative that is currently used to reduce chemotherapy-induced nausea and vomiting.

A patient who has alcoholism with a history of heavy drinking is brought into patient psychiatric unit saying that he does not know where he is or what day it is. What should the nurse suspect he is exhibiting?

Blackout

A nurse is caring for a client who is experiencing alcohol withdrawal. Which of the following findings should the nurse expect? A. Muscle aches and chills B. Fatigue and depression C. Anxiety and diaphoresis D. Arrhythmia and respiratory depression A. Bradycardia B. Increased somnolence C. Slurred speech D. Headache

C. Anxiety and diaphoresis D. Headache Headache is an expected finding in a client who is experiencing alcohol withdrawal. This can occur 4 to 12 hours following cessation of alcohol use. Other findings include hand tremors, nausea, vomiting, sweating, depression, or irritability.

Which implementation can be used to help prevent relapse in a patient who has had substance abuse problems? A. Self-hypnosis B. Imagery C. Stress management D. Blocking

C. Stress management Teaching stress management techniques to patients who have a substance abuse problem will assist them in managing the conflict and stress in their daily lives, which previously triggered the substance abuse.

During the taking of a medical history, a patient who is addicted to heroin reports he only uses the drug a few times a week. What is the nurse's best response when trying to disclose more precise information? A. "OK. You only use heroin two times a week?" B. "What do you mean when you say 'a few?'" C. "Are you saying that in a week's time would you use heroin only two times?" D. "Rate your weekly usage on a scale of 1 to 15."

D. "Rate your weekly usage on a scale of 1 to 15." When trying to get a health history on a patient with a substance abuse problem, the best method is an open discussion of the drug use. The discussion should be open and nonjudgmental. By requesting a scale, the patient's response will be more informative.

A hospitalized client with a history of alcohol abuse tells the nurse, "I'm leaving now. I have to go. I don't want anymore treatment. I have things I have to do right away." The client has not been discharged. In fact, the client is to be scheduled for an important diagnostic test in one hour. After the nurse discusses the client's concerns with the client, the client dresses and begins to walk out of the hospital room. The appropriate nursing action is what?

Notify the RN

A nurse is assisting with a court-ordered admission of a client to a substance abuse program. The client states, "You are all angry with me and wish you could go out and have a drink." The client's response is an example of which of the following defense mechanisms?

Projection

A nurse is collecting data from a client who is experiencing alcohol withdrawal. Which of the following is an expected finding?

Seizure activity

A nurse is collecting data from a client who is experiencing alcohol withdrawal delirium. Which of the following findings should the nurse expect? Select all that apply.

Visual hallucinations Paranoid delusions Tremors

Which syndrome of alcoholism is related to thiamine deficiency?

Wernicke-Korsakoff syndrome

The nurse is caring for a client who has a history of opioid abuse and is monitoring the client for signs of withdrawal. Which manifestations are specifically associated with withdrawal from opioids?

Yawning, irritability, diaphoresis, cramps and diarrhea

The nurse is assigned to care for a client at risk for alcohol withdrawal. The nurse monitors the client knowing that the early signs of withdrawal will usually develop within which time after cessation or reduction of alcohol intake? A. In 7 days B. In 14 days C. In 21 days D. Within a few hours

D. Within a few hours Early signs of alcohol withdrawal develop within a few hours after cessation or reduction of alcohol and peak after 24 to 48 hours.

A nurse is assisting in the development of a community education course about the physical complications related to substance abuse disorder. Which of the following physical complications should the nurse include about the use or heroin?

Dental caries

A nurse is reinforcing teaching with a client about Alcoholics Anonymous (AA). Which of the following statements by the nurse indicates an understanding of the program's basic concepts? A. "I am responsible for my alcoholism." B. "I need to identify things that cause me to be an alcoholic." C. "I am powerless against my addiction to alcohol." D. "I need to see a counselor who will be responsible for my recovery."

C. "I am powerless against my addiction to alcohol."

Which are appropriate interventions for caring for the client in alcohol withdrawal? Select all that apply.

Monitor vital signs. Provide a safe environment. Address hallucinations therapeutically. Provide reality orientation as appropriate.