Nokea
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.
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A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply.
- A. Headache
- B. Fatigue
- C. Yawning
- D. Flushing
- E. Diuresis
Correct Answer: A,B,C
Rationale: Abrupt reduction in caffeine intake can cause withdrawal symptoms like headache (A), fatigue (B), and yawning (C) due to CNS and adenosine receptor changes. Flushing (D) and diuresis (E) are not typical caffeine withdrawal symptoms.
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 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.
A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following?
- A. Difficulty with coordination
- B. Stupor
- C. Emotional lability
- D. Ataxia
Correct Answer: A
Rationale: A BAL of 0.10 mg % (0.10 g/dL) typically causes difficulty with coordination (A), such as impaired motor skills. Stupor (B) occurs at higher levels (e.g., >0.30), emotional lability (C) is less specific, and ataxia (D) is more severe and less common at this level.
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.