Nokea
A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply.
- A. Euphoria
- B. Seizures
- C. Cardiac arrhythmia
- D. Paranoia
- E. Dilated pupils
Correct Answer: B,C,D,E
Rationale: Cocaine overdose can cause seizures (B), cardiac arrhythmia (C), paranoia (D), and dilated pupils (E) due to excessive CNS and sympathetic stimulation. Euphoria (A) is more typical of use, not overdose.
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A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client asks the nurse, How will this drug help me? Which response by the nurse would be most appropriate?
- A. It will help to cure your alcoholism.
- B. It can help to prevent you from drinking.
- C. It makes the withdrawal symptoms less troublesome.
- D. It helps to clear the alcohol out of your body.
Correct Answer: B
Rationale: Disulfiram (B) prevents drinking by causing unpleasant reactions (e.g., nausea) if alcohol is consumed, acting as a deterrent. It does not cure alcoholism (A), reduce withdrawal symptoms (C), or clear alcohol from the body (D).
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 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 talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so she?d remember to get well. The nurse suspects that the client may be experiencing which of the following?
- A. Wernicke?s syndrome
- B. Delirium tremens
- C. Korsakoff?s psychosis
- D. Malignant hyperthermia
Correct Answer: C
Rationale: The client?s confabulation (fabricated story about the stethoscope) and insomnia suggest Korsakoff?s psychosis (C), a chronic condition from alcohol-related thiamine deficiency causing memory deficits. Wernicke?s syndrome (A) involves ataxia and confusion, delirium tremens (B) includes severe autonomic symptoms, and malignant hyperthermia (D) is unrelated to alcohol.
An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include?
- A. Tremors and CNS arousal
- B. Enhanced normal heart rhythms
- C. Enhanced attention focus and memory
- D. Brain damage and cognitive abnormalities
Correct Answer: D
Rationale: Long-term inhalant use, such as sniffing glue, causes brain damage and cognitive abnormalities (D) due to neurotoxicity. Tremors and CNS arousal (A) are acute effects, heart rhythms (B) are disrupted, and attention/memory (C) are impaired, not enhanced.