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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).
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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 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 is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following?
- A. I can have a glass of wine with dinner if I choose.
- B. I should eat small frequent meals if I get nauseated.
- C. I should take the drug on an empty stomach.
- D. I might experience diarrhea with this drug.
Correct Answer: B
Rationale: Methadone can cause nausea, and eating small, frequent meals (B) helps manage this side effect. Alcohol (A) should be avoided, methadone is taken without regard to food (C), and constipation, not diarrhea (D), is a common side effect.
A 20-year-old man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are tracks visible on his arms. The friend who came with him reports that the client had just shot up heroin when he became unconscious. Which medication would the nurse most likely expect to administer?
- A. Naloxone
- B. Naltrexone
- C. Bupropion
- D. Varenicline
Correct Answer: A
Rationale: Naloxone (A) is an opioid antagonist used to reverse heroin overdose, counteracting respiratory depression and unconsciousness. Naltrexone (B) is for maintenance, bupropion (C) is for depression/smoking cessation, and varenicline (D) is for smoking cessation.
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.