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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.
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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 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 client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess?
- A. Rhinorrhea
- B. Lacrimation
- C. Dilated pupils
- D. Dysphoria
Correct Answer: A,B,C,D
Rationale: Moderate opioid withdrawal includes rhinorrhea (A), lacrimation (B), dilated pupils (C), and dysphoria (D) due to autonomic and psychological distress. All are characteristic symptoms.
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).
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).