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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 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.
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.
A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include?
- A. Success usually involves more than one type of intervention.
- B. Relapse is fairly rare within the first year of quitting.
- C. Ear acupressure is a highly proven method for quitting.
- D. Education is key for smoking cessation.
Correct Answer: A
Rationale: Smoking cessation success typically requires multiple interventions (A), such as behavioral therapy, medications, and support groups. Relapse is common in the first year (B), ear acupressure (C) lacks strong evidence, and education alone (D) is insufficient.
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.