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A group of nursing students are reviewing information about co-occurring disorders and risks for substance abuse. The students demonstrate understanding of the information when they identify which psychiatric disorder as being associated with the highest risk for substance abuse?
- A. Mania
- B. Panic disorder
- C. Antisocial personality disorder
- D. Phobias
Correct Answer: C
Rationale: Antisocial personality disorder (C) has the highest risk for substance abuse due to impulsivity and disregard for consequences. Mania (A) and panic disorder (B) carry risks but are less associated, and phobias (D) have minimal direct correlation.
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The parents of a client with schizophrenia who also abuses alcohol asks the nurse, 'What can we do to help our son from relapsing after he is discharged from the hospital?' Which response by the nurse would be most appropriate?
- A. There?s really not much you can do; your son is responsible for maintaining his own sobriety.
- B. Avoid letting him take any mood-altering chemicals because they may trigger his delusional thinking.
- C. Make sure he goes to at least two Alcoholics Anonymous meetings a week, gets a sponsor, and calls his sponsor on a daily basis.
- D. Report any side effects he develops so they can be treated and therefore won?t tempt him to stop taking his prescribed medications.
Correct Answer: D
Rationale: Reporting side effects (D) helps ensure medication adherence, a key factor in preventing relapse in schizophrenia and alcohol abuse, as side effects often lead to discontinuation. Option A dismisses family involvement, option B is overly restrictive, and option C is specific to AA but less critical than medication management.
The nurse is reviewing a client?s medical record and finds that he has received treatment for his co-occurring disorders in the primary health care setting. The nurse interprets this as which quadrant of care?
- A. Category I
- B. Category II
- C. Category III
- D. Category IV
Correct Answer: A
Rationale: Category I (A) refers to low-severity mental health and substance use disorders treated in primary care settings. Categories II?IV involve higher severity or specialized care settings.
A nurse is working with a client with depression and substance abuse on ways to promote recovery. Which of the following would be most important for the nurse to include? Select all that apply.
- A. A positive social network
- B. Compliance to treatment
- C. Avoidance of hospitalization
- D. Supportive housing
- E. Community vocational rehabilitation
Correct Answer: A,B,D,E
Rationale: A positive social network (A), treatment compliance (B), supportive housing (D), and vocational rehabilitation (E) promote recovery by addressing social, medical, and practical needs. Avoiding hospitalization (C) is not a goal, as it may be necessary for stabilization.
When describing the relapse cycle to a group of families of clients experiencing co-occurring disorders, which of the following would the nurse identify as occurring first?
- A. Hospitalization
- B. Decompensation
- C. Stabilization
- D. Discharge
Correct Answer: B
Rationale: Decompensation (B) occurs first in the relapse cycle, as psychiatric symptoms worsen, leading to substance use, hospitalization (A), stabilization (C), and discharge (D).
The nurse is caring for a female adolescent client diagnosed with depression and substance abuse. Which of the following would be most appropriate for the nurse to do?
- A. Determine if the client is experiencing hyperactivity.
- B. Ask her if she is having thoughts of harming herself.
- C. Determine if the client is exhibiting Wernicke?s syndrome.
- D. Ask the client if she has had problems with excessive anxiety.
Correct Answer: B
Rationale: Asking about suicidal thoughts (B) is most appropriate, as depression in adolescents with substance abuse significantly increases suicide risk, requiring immediate assessment. Hyperactivity (A) is less relevant, Wernicke?s syndrome (C) is specific to thiamine deficiency in alcoholism, and anxiety (D) is secondary to suicide risk.