Nokea
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 obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply.
- A. Headache
- B. Fatigue
- C. Yawning
- D. Flushing
- E. Diuresis
Correct Answer: A,B,C
Rationale: Abrupt reduction in caffeine intake can cause withdrawal symptoms like headache (A), fatigue (B), and yawning (C) due to CNS and adenosine receptor changes. Flushing (D) and diuresis (E) are not typical caffeine withdrawal symptoms.
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 nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following?
- A. Using bleach solution to disinfect dirty needles
- B. Problem solving
- C. Healthy coping skills
- D. Proper use of naltrexone (Trexan)
Correct Answer: A
Rationale: Harm reduction in heroin addiction includes teaching needle disinfection with bleach (A) to reduce infection risk. Problem solving (B) and coping skills (C) are broader interventions, and naltrexone (D) is more relevant for alcohol or opioid relapse prevention.
A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following?
- A. Difficulty with coordination
- B. Stupor
- C. Emotional lability
- D. Ataxia
Correct Answer: A
Rationale: A BAL of 0.10 mg % (0.10 g/dL) typically causes difficulty with coordination (A), such as impaired motor skills. Stupor (B) occurs at higher levels (e.g., >0.30), emotional lability (C) is less specific, and ataxia (D) is more severe and less common at this level.
A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following?
- A. I?ve admitted to myself and others the wrongdoings I?ve done.
- B. I realize that there is a higher power that can help me.
- C. I know now that I am powerless over alcohol.
- D. I am making amends to all those that I?ve harmed.
Correct Answer: B
Rationale: Step two of the AA 12-step program involves recognizing a higher power that can aid recovery (B). Step one is admitting powerlessness (C), step four involves admitting wrongdoings (A), and step eight involves making amends (D).