Psych: Substance Abuse, Eating Disorders, Impulse Control Disorders ?s

A client with alcohol dependency is prescribed a B-complex vitamin. The client states, "Why do I need a vitamin? My appetite is just fine." Which of the following responses by the nurse is most appropriate? A. "Your doctor wants you to take it for at least 4 months." B. "You've been drinking alcohol and eating very little." C. "The vitamin is a nutritional supplement important to your health." D. "The amount of vitamins in the alcohol you drink is very low."

Correct response: "The vitamin is a nutritional supplement important to your health." Explanation: Stating that the vitamin is a nutritional supplement important to the client's health is the best response. The client is nutritionally depleted, and the B-complex vitamins produce a calming effect on the irritated central nervous system and prevent anemia, peripheral neuropathy, and Wernicke's encephalopathy. Although the statements about drinking alcohol and eating very little and that there is a low amount of vitamins in the alcohol consumed may be true, they fail to address the client's concerns directly and fail to provide the necessary information, as does telling the client that the doctor wants the client to take the vitamin for 4 months.

A 26-year-old is being treated for delirium due to acute alcohol intoxication. The client is restless, does not want to stay seated, and has a staggering gait. What should the nurse do first? A. Place the client in a chair with a waist restraint. B. Provide one-to-one supervision of the client until detoxification treatment can begin. C. Ask the client to sit in a chair next to the nurses' station. D. Decrease stimuli by putting the client in bed with the room door closed.

Correct response: B. Provide one-to-one supervision of the client until detoxification treatment can begin. Explanation: One-to-one supervision provides safety until appropriate detoxification can be given. Restraints are the last intervention after less restrictive alternatives have been tried. It is unlikely that the client can cooperate with staying in a chair. Putting the client in bed in his room puts him at risk for falling and a closed door prevents close observation.

Which finding indicates that the victim of an automobile accident is comatose as a result of a toxic drug overdose? hypertension fever constricted pupils warm, dry skin

Correct response: constricted pupils Explanation: Equal, normally reactive pupils indicate adequate neurologic functioning. An overdose of opioids or depressants can cause constricted pupils.Blood pressure is regulated by various factors. A finding of hypertension would not pinpoint a toxic disorder.Fever is related either to infection or dehydration.Clients with a drug overdose have cold, clammy skin.

A client is being given naltrexone as part of an alcohol treatment program. When the client asks the nurse to explain the intended effects of the drug, the nurse should state that the drug: prevents withdrawal symptoms. reduces compulsions to drink. treats peripheral neuropathy. manages symptoms of anxiety.

Correct response: reduces compulsions to drink. Explanation: The mechanism of action of naltrexone isn't fully understood. The drug blocks opiate receptors and is believed to help diminish the compulsion to drink. Naltrexone doesn't prevent withdrawal symptoms, treat peripheral neuropathy, or manage symptoms of anxiety.

For the client who has difficulty falling asleep at night because of withdrawal symptoms from alcohol, which are abating, which nursing intervention is likely to be most effective? A. inviting the client to play a board game with the nurse B. allowing the client to sit in the community room until the client feels sleepy C. advising the client to take multiple short naps during the day until symptoms improve D. teaching the client relaxation exercises to use before bedtime

Correct response: teaching the client relaxation exercises to use before bedtime Explanation: The best action by the nurse to help a client who has difficulty falling asleep would be to teach the client relaxation exercises to use before bedtime to reduce anxiety and promote relaxation. This activity will also be useful for the client when out of the hospital. Inviting the client to play a board game is inappropriate because this activity can be competitive and thus stimulate the client. Allowing the client to sit in the community room until feeling sleepy is inappropriate because it does nothing to help the client relax. Taking frequent naps can worsen the ability to fall asleep at night.