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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.
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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.
The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply.
- A. Slight diaphoresis
- B. Hand tremors
- C. Intermittent confusion
- D. Heart rate of 135 beats/min
- E. Normal blood pressure
Correct Answer: A,B,E
Rationale: Stage 1 alcohol withdrawal (6?24 hours post-last drink) includes slight diaphoresis (A), hand tremors (B), and normal blood pressure (E). Intermittent confusion (C) and heart rate of 135 (D) are more typical of later stages like delirium tremens.
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).
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 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.