Practice and Learn: Alcohol Use Disorder
S20 Rina shows improvement, could be discharged. Says she's too busy for follow-up alcohol abuse program because she has to take care of her daughter and find a job. Which response is the most appropriate to encourage Rina to continue with the rehab program?
"Tell me your concerns about participating in rehab."
S10 Rina states that she is a failure because of her habitual drinking. Which of the following statements should the nurse emphasize to the client to reinforce cognitive restructuring?
"You are a good and competent person. You can do your job as well or better than anyone else."
S11 The nurse must assess Rena's overall health. What are potential physical complications of alcohol use disorder?
- GI problems such as esophagitis and pancreatitis - Cardiovascular problems such as hypertension and dysrhythmias - High risk of cancer - Hematopoietic complications such as decreased WBC production
S24 What criteria can the nurse use to evaluate if Rina has met her goals?
- Has she remained safe...? - Has she refrained from using alcohol? - Has she acknowledged her alcohol use? - Does she use healthy stress management techniques? - Has she identified alternative activities to drinking, such as exercise programs? - Is she participating in the treatment plan?
S6 A nurse strongly suspects alcohol use in a client who denies the problem, the nurse can use the CAGE questionnaire to ID the problem. Which questions from CAGE questionnaire might the nurse ask Rina?
- Have you ever felt guilty about your drinking? - Have people annoyed you by criticizing your drinking? - Have you ever felt you should cut down on your drinking?
S4 Rena wakes up in a hospital after drinking too much, unaware of where she is. She says, "yeah I drink, but I've never been in trouble because of it. I don't need to stay here because there is no problem at all." How should the nurse respond to Rina's denial of the existence of a substance abuse disorder?
- I respect your viewpoint but I suggest treatment because it is affecting your health and relationships." - I understand what you are going through must be difficult. However your drinking has adversely affected... - I can understand why you feel that way. However your heavy alcohol intake is not just a habitual activity, but a disorder that needs treament."
S22 With support from her husband Rina agrees to participate in long-term rehab. after 12 weeks she has improved, comes to hospital with Arush for a follow-up. Thanks nurse for support, assures her that she will continue with program. What are realistic goals for Rina?
- She will accept responsibility for her problem and take required action toward her own recovery to attain physical stability - she will undergo behavioral changes that will lead to greater personal enrichment, such as improved self-image and emotional stability
S17 Nursing Dx includes risk for injury related substance withdrawal. Which outcomes indicate that the nursing goal for successful management of alcohol withdrawal has been met?
- The client show in tact sensorium - The client exhibits normal vital signs - The client participates in health screening
S25 Which questions can the nurse suggest to reinforce cognitive restructuring in clients who face a fear of relapse in stressful situations?
- are other around me being negative? What can I do to avoid them affecting me? - What can I do to take responsibility for my feelings and myself? - What assertive, positive action can I take to make the situation less stressful to me?
S19 During hospitalization Rena shows signs of anger, sadness, anxiety Which interventions should the nurse use to alleviate clinical manifestations?
- be available to talk during rough patches - encourage client's discussions with supporting loved ones - encourage the client to learn deep breathing or relaxation techniques
S16 Which of the following can be used with alcohol withdrawal
- chlordiazepoxide - diazepam - lorazepam
S13 The nurse also assesses Rina's liver function. Which of the following are the symptoms of liver cirrhosis cause by alcohol abuse?
- contractures in the fingers - redness of the palms - clubbing of the fingers and nails
S5 Rena gets defensive...What are the two most common defense mechanisms seen in clients with alcohol use disorder?
- denying alcohol abuse - rationalizing their drinking behavior
S18 Which measures would the nurse implement if RIna shows evidence of withdrawal-related sensory alterations?
- maintain a comfortable, quiet and non-threatening environment - speak to the client in a low, calm, reassuring voice - provide reassurance about the client's safety
S12 Rina shows signs of deteriorating health, including esophageal varices, underweight status, and gum disease. Which of the following nursing interventions would contribute most to restoring the client's physical health?
- oral health restoration - nutrition management - exercise promotion
S15 symptoms of alcohol withdrawal delirium
- precordial pain - delusions - diaphoresis
S7 What are key assessment findings in this case?
- regularly drinking alcohol in progressively increasing amounts - needing more alcohol to attain a consistent level of numbness - switching to substances with a higher alcohol concentration - not being able to sleep without drinking - having blackout episodes - denying problem - experiencing strained personal relationships
S23 What are nursing interventions that can help Rina meet her goals?
- replace negative self talk with positive, kind, optimism - set realistic goals and take pride in achievements - examine values and beliefs and make actions congruent with those values - find personally rewarding activities - avoid comparing self with others
S9 Rina is diagnosed with AUD. Which of the following are the signs of alcohol use disorder?
- using alcohol to avoid or relieve withdrawal symptoms - spending significant time using or trying to obtain alcohol - drinking increased quantities of alcohol to achieve a consistent effect
S8 Which corresponds with signs and symptoms Rina is exhibiting?
alcohol use disorder
S21 Which program would help Rena in her recovery?
alcoholics anonymous (AA)
S2 What is the most accurate method for obtaining Rina's blood alcohol level
laboratory blood test
A client has been abusing alcohol for 9 years. During assessment, he complains of redness of palms and frequent nausea, vomiting, and abdominal pain. Which of the following problems may be indicate by these symptoms?
liver damage
When a client with alcohol use disorder states, "I usually don't drive after I drink, but a friend needed a ride home. And I couldn't say no." What kind of denial is exhibited?
rationalizing
S3 In addition to obtaining the client's BAL, it's important to gather assessment data about current and past alcohol and drug use. This provides necessary info. for planning care and treatment of client with a substance abuse disorder. Early signs of alcohol withdrawal are
seem within a few hours after the client has stopped drinking answer: TRUE
S14 Rina complains of headache and nausea, reports "someone is hammering my head, I can't take this anymore, please help me." She suddenly fears her friends will take her away. Her blood pressure has increased, she is sweating, agitated, increased anxiety, feels bugs crawling on her skin. Delirium tremens (DTs) occurs
within 48 hours for as long as 1 week after cessation of prolonged heavy drinking. answer: FALSE
