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A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, he tells the nurse, 'I am so ashamed.' What should the nurse reply?
- A. I really thought you would make it.
- B. Tell me what has happened since your last admission.
- C. You have nothing to be ashamed of.
- D. Why did you start drinking again?
Correct Answer: B
Rationale: Asking about recent events encourages therapeutic discussion of the client's situation, unlike judgmental, dismissive, or confrontational responses.
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The nurse is coleading a family therapy group with a client addicted to alcohol. Which statement made by the wife indicates the need for additional education regarding alcoholism as a family illness?
- A. I have to call in sick for my husband when he is too hung over to go to work.
- B. Last time he got arrested, I just let him sit in jail.
- C. We have separated our finances so that I will not go broke.
- D. I take my kids with me to Al-anon meetings every week.
Correct Answer: A
Rationale: Calling in sick enables the addiction, indicating a need for education on avoiding codependent behaviors, unlike jail time, financial separation, or Al-anon attendance.
A client is readmitted to the detox unit for the fourth time in 3 years. The nurse states in the morning report, 'Not again! Why should we keep trying to help this guy? He obviously doesn't want it.' What does this statement reflect?
- A. The nurse lacks the self-awareness to work effectively with this addicted client.
- B. The nurse understands the cycle of remission and relapse characteristic of addiction.
- C. The nurse has repressed negative emotions from past experiences with addiction.
- D. The nurse is trying to conceal his or her own addictions.
Correct Answer: A
Rationale: The nurse's cynical statement reflects a lack of self-awareness about addiction's chronic nature, hindering effective care, unlike understanding relapse or concealing personal issues.
Which of the following groups could benefit most from prevention programs?
- A. Children, prior to first use
- B. Adults who have already engaged in substance abuse
- C. Older adults
- D. Infants
Correct Answer: A
Rationale: Children before first use benefit most from prevention due to their impressionability and lack of addiction, unlike adults, older adults, or infants.
A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms?
- A. Alcohol withdrawal syndrome
- B. Continuing intoxication
- C. Delirium tremens
- D. Wernicke-Korsakoff syndrome
Correct Answer: A
Rationale: Symptoms like tremors, weakness, and sweating 24 hours after the last drink indicate alcohol withdrawal, not intoxication, delirium tremens, or Wernicke-Korsakoff syndrome.
The nurse is assessing the drinking history of a client being admitted for alcohol abuse. Which statement would the nurse expect the client to make?
- A. I really need some help. My drinking is tearing my family apart.
- B. I have tried so many times to stop drinking. It is so hard.
- C. I don't really have a problem with alcohol. I've just been having a streak of bad luck lately.
- D. I have no intention to stop drinking. I like the way it makes me feel.
Correct Answer: C
Rationale: Clients with alcohol abuse often use denial, minimizing their problem or blaming external factors, rather than admitting the full impact or expressing readiness to quit.