Nokea
A nurse is working with a client with co-occurring disorders who is in the early stages of recovery. The client has been abstained from using alcohol for the past 3 weeks. During a follow-up visit, the nurse is working on teaching the client about the effects of alcohol on his body. Which of the following would be most important for the nurse to keep in mind about the client?
- A. The client will be highly suggestible to information, being unable to reason critically.
- B. The alcohol abuse has destroyed the brain cells that are necessary for learning.
- C. Some cognitive impairment may be present that hinders his ability to learn new things.
- D. The underlying effects of the substance abuse will prevent him from being able to learn.
Correct Answer: C
Rationale: Some cognitive impairment (C) may persist in early recovery from alcohol abuse, affecting learning ability, so teaching should be simplified. Options A, B, and D overestimate or mischaracterize the extent of cognitive impact.
You may also like to solve these questions
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.
A nurse is readmitting a client with a co-occurring diagnoses of schizophrenia and alcohol abuse who has relapsed. The client says, 'I?m just a failure. I?ll never be anything but just a drunk.' Which response by the nurse would be most appropriate?
- A. Relapse is a normal part of recovery; you can learn from this experience so it will be easier to avoid it or a similar one in the future.
- B. Face it, you will always be an alcoholic, and relapse is inevitable because it is part of the illness.
- C. If you didn?t have disturbed thoughts from your schizophrenia, you wouldn?t be tempted to drink.
- D. Please clarify something for me. When you say, ?just a drunk,? what exactly are you trying to say?
Correct Answer: A
Rationale: Stating that relapse is a normal part of recovery (A) is therapeutic, offering hope and framing the relapse as a learning opportunity. Option B is defeatist, option C oversimplifies the relationship between disorders, and option D avoids addressing the client?s feelings directly.
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.
A client has a co-occurring diagnosis of alcoholism and bipolar disorder. He was brought to the emergency department by two policemen who had broken up a fight that the client had gotten into in a neighborhood bar. The client is intrusive and verbose about having diplomatic immunity and his pressing need to tour the bistate area to promote his bid for the presidency. The client has had multiple admissions to the hospital?s psychiatric unit, and he has almost always experienced alcohol withdrawal syndrome immediately after his previous admissions. Which of the following would be a priority for this client?
- A. Administering prescribed mood-stabilizing medications to control his delusional thinking because doing so will curtail his desire to drink
- B. Taking baseline vital signs and then monitoring them on an ongoing basis to ascertain if the client is exhibiting early signs of alcohol withdrawal
- C. Suggesting that client refrain from being intrusive and annoying others with his constant chatter about his delusional thinking
- D. Referring the client to an outpatient community substance abuse treatment center because his addiction has to be adequately addressed before his bipolar problems can be effectively treated
Correct Answer: B
Rationale: Monitoring for alcohol withdrawal syndrome (B) is the priority due to its potential for life-threatening complications, given the client?s history. Administering mood stabilizers (A) is important but secondary to immediate safety. Suggesting behavioral changes (C) is ineffective during acute mania, and outpatient referral (D) is premature during an acute crisis.
A client with schizophrenia and substance abuse disorder is admitted to a detoxification program. The client has been prescribed neuroleptic medications for schizophrenia. When caring for this client, the nurse would implement interventions to reduce the client?s risk for relapse, integrating knowledge that relapse frequently is secondary to which of the following?
- A. Poor social skills
- B. Lack of vocational skills
- C. Medication non-adherence
- D. Dysfunctional family systems
Correct Answer: C
Rationale: Medication non-adherence (C) is a primary cause of relapse in schizophrenia, as neuroleptics control symptoms, and stopping them often leads to symptom recurrence and substance use. Poor social skills (A), lack of vocational skills (B), and dysfunctional family systems (D) contribute but are less directly linked to relapse than non-adherence.