Nokea
A client with alcohol dependence is admitted to the hospital with pancreatitis. Which intervention should be included in the client's plan of care?
- A. Fluid restriction of 1000 ml per 24 hours
- B. Glucometer checks b.i.d.
- C. High-protein diet
- D. Protective isolation precautions
Correct Answer: B
Rationale: Pancreatitis from alcohol dependence can elevate glucose levels, necessitating glucometer checks, unlike fluid restriction, high-protein diets, or isolation.
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The nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam (Valium) when the injections are given by a particular nurse. This nurse returns from lunch exhibiting slurred speech and euphoria. Which is the best action for the nurse to take?
- A. Ask other nurses if they have noticed anything unusual.
- B. Call the manager and report the observations.
- C. Observe the nurse as injections are prepared and administered.
- D. Tell the nurse, 'I know you've been stealing Valium.'
Correct Answer: B
Rationale: Reporting to the manager addresses suspected diversion and ensures client safety, unlike asking others, observing further, or confronting directly.
A client reports drinking one to two drinks when drinking behavior first began. Now the client reports drinking at least six drinks with every episode in order to have a good time. Which term would best describe this phenomenon?
- A. Dependence
- B. Intoxication
- C. Tolerance
- D. Withdrawal
Correct Answer: C
Rationale: Tolerance describes needing more alcohol to achieve the same effect, unlike intoxication (maladaptive behavior), withdrawal (symptoms upon cessation), or dependence (addiction with multiple symptoms).
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.
Which of the following neurochemical influences is a probable cause of substance abuse?
- A. Imbalances of serotonin and norepinephrine in the brain
- B. Inhibition of GABA in the brain
- C. Excessive serotonin activity in the CNS
- D. Stimulation of dopamine pathways in the brain
Correct Answer: D
Rationale: Stimulating dopamine pathways in the limbic system produces reinforcing pleasurable effects, driving substance abuse, unlike serotonin, norepinephrine, or GABA imbalances.
The wife of a client who is alcoholic asks the nurse how to respond to him in a helpful way when he is disruptive in family life. Which is the nurse's best response?
- A. Help him avoid embarrassment by supporting him when he makes excuses for failing to meet obligations.
- B. Include him in family outings even when he is drinking.
- C. Search the house regularly for alcohol.
- D. Try to maintain a normal home environment for yourself and the children.
Correct Answer: D
Rationale: Maintaining a normal home environment breaks codependency, unlike enabling excuses, including him while drinking, or searching for alcohol.