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A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drug?s purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug?
- A. Causes itching if alcohol is consumed
- B. Produces the euphoria of alcohol
- C. Reduces the appeal of alcohol
- D. Improves appetite and nutritional status
Correct Answer: C
Rationale: Naltrexone (C) reduces the appeal of alcohol by blocking opioid receptors, decreasing the rewarding effects of drinking. It does not cause itching (A), produce euphoria (B), or directly improve appetite/nutrition (D).
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A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you can?t make me stop drinking. Which response by the nurse would be most appropriate?
- A. You have to stop drinking and driving; you could kill someone.
- B. You?re right; you?re not an alcoholic.
- C. You should consider what you are doing to your marital relationship.
- D. You?re the only one who can make yourself stop drinking.
Correct Answer: D
Rationale: Motivational interviewing emphasizes autonomy, making the response that only the client can choose to stop drinking (D) most appropriate. Confronting about driving (A) or relationships (C) may increase resistance, and agreeing with denial (B) is non-therapeutic.
A nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies?
- A. Low self-esteem
- B. Genetic predisposition
- C. Dysfunctional family
- D. Peer influence
Correct Answer: A
Rationale: Low self-esteem (A) is a psychological etiology for substance abuse, contributing to vulnerability. Genetic predisposition (B) is biological, and dysfunctional family (C) and peer influence (D) are social, not primarily psychological.
A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply.
- A. Substance refusal skills
- B. Problem solving
- C. Anger awareness
- D. Emergency planning
- E. Social support networking
Correct Answer: B,C
Rationale: Intrapersonal coping skills for substance abuse include problem solving (B) and anger awareness (C), which focus on internal emotional and cognitive management. Substance refusal (A) and social support (E) are interpersonal, and emergency planning (D) is situational.
A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following?
- A. Asking the client questions about alcohol use
- B. Negotiating a conversation with the client to reduce use
- C. Pointing out the inconsistencies in thoughts, feelings, and action
- D. Helping the client change the way he thinks about a situation
Correct Answer: B
Rationale: Brief interventions for alcohol abuse involve negotiating a conversation to reduce use (B), using motivational techniques to encourage change. Asking questions (A) is part of assessment, pointing out inconsistencies (C) is confrontational, and changing thinking (D) is more cognitive therapy.
A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include?
- A. Success usually involves more than one type of intervention.
- B. Relapse is fairly rare within the first year of quitting.
- C. Ear acupressure is a highly proven method for quitting.
- D. Education is key for smoking cessation.
Correct Answer: A
Rationale: Smoking cessation success typically requires multiple interventions (A), such as behavioral therapy, medications, and support groups. Relapse is common in the first year (B), ear acupressure (C) lacks strong evidence, and education alone (D) is insufficient.