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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
- B. being unable to reason critically.
- C. The alcohol abuse has destroyed the brain cells that are necessary for learning.
- D. Some cognitive impairment may be present that hinders his ability to learn new things.
Correct Answer: D
Rationale: The correct answer is D. In clients with co-occurring disorders in early recovery, cognitive impairment from alcohol use may hinder their ability to learn new things. This is crucial to consider as it directly impacts the client's learning process. Option A is incorrect as suggestibility is not the main concern in this scenario. Option B is incorrect as critical reasoning ability is not the primary focus. Option C is incorrect as brain cells can regenerate, and not all are destroyed by alcohol abuse. Therefore, understanding and addressing potential cognitive impairment is key for effective teaching and support in the client's recovery journey.
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What behavior is a client with a diagnosis of antisocial personality disorder demonstrating when they engage in binge drinking?
- A. a defiant personality
- B. emotional regulation
- C. maladaptive behavior
- D. self-determination
Correct Answer: C
Rationale: The correct answer is C: maladaptive behavior. Clients with antisocial personality disorder often engage in maladaptive behaviors, such as binge drinking, to cope with their emotions and impulsivity. Binge drinking is a harmful coping mechanism that can lead to negative consequences, reflecting maladaptive behavior. Choice A (defiant personality) is incorrect as it does not directly relate to the behavior of binge drinking. Emotional regulation (Choice B) is also incorrect as individuals with antisocial personality disorder typically struggle with regulating their emotions, leading to impulsive behaviors like binge drinking. Self-determination (Choice D) is not the most appropriate answer as it does not directly address the maladaptive nature of binge drinking in individuals with antisocial personality disorder.
A patient has come to the clinic to discuss the stress she is experiencing because of failing two exams at school. Initially, she described her failures as 'the worst thing that has ever happened to me,' and she stated, 'There is absolutely nothing I can do to pass this course now.' In response to the nurse's questions, the nurse finds out there are three more equally weighted exams scheduled for the course in question. The nurse and patient collaborate and decide to use interventions to facilitate emotion-focused coping. Which additional comment from the patient would the nurse identify as providing support for this decision?
- A. You've got to figure out something for me to do to get me out of this situation!
- B. This is a waste of time because absolutely nothing you or I can do will make it any better.
- C. I overreacted; surely together we can figure out something for me to do.
- D. This is the worst thing that could ever happen to me. I'm nothing but a failure.
Correct Answer: C
Rationale: The correct answer is C because the patient's statement shows a shift in perspective from hopelessness to a willingness to collaborate and problem-solve. By acknowledging the possibility of working together to find a solution, the patient demonstrates openness to coping strategies. Choice A displays frustration without a willingness to participate actively. Choice B reinforces hopelessness and a defeatist attitude. Choice D reinforces negative self-perception without any indication of openness to change. In summary, choice C aligns with emotion-focused coping by showing a willingness to explore solutions collaboratively.
The history of a child newly diagnosed with ADHD reveals that the child is experiencing sleeping difficulties. Which agent would the nurse most likely use?
- A. Methylphenidate
- B. Atomoxetine
- C. Bupropion
- D. Clonidine
Correct Answer: B
Rationale: The correct answer is B: Atomoxetine. Atomoxetine is the preferred agent for ADHD in children with sleeping difficulties as it does not typically affect sleep patterns. Methylphenidate (A) may worsen sleep issues due to its stimulant properties. Bupropion (C) can also cause insomnia. Clonidine (D) may help with sleep but is not the first-line choice for ADHD without comorbid conditions like tics or aggression.
When alprazolam is prescribed for a patient who experiences acute anxiety, health teaching should include instructions to
- A. report drowsiness.
- B. eat a tyramine-free diet.
- C. avoid alcoholic beverages.
- D. adjust dose and frequency based on anxiety level.
Correct Answer: C
Rationale: The correct answer is C: avoid alcoholic beverages. This is because alprazolam is a central nervous system depressant, and alcohol also has depressant effects. Combining the two can potentiate sedation and respiratory depression. Reporting drowsiness (A) is important but not specific to alprazolam. Eating a tyramine-free diet (B) is relevant for certain medications like MAOIs, not alprazolam. Adjusting dose and frequency based on anxiety level (D) is not recommended as it can lead to misuse or dependence.
Based on assessment data, the nurse formulates the nursing diagnosis for a patient as sleep pattern disturbance. After teaching the patient how to relax before bedtime, the nurse determines that the teaching was effective by which outcome?
- A. Discusses feelings about not being able to fall asleep
- B. Reports feeling rested on awakening in the morning within 3 days
- C. Requests sleeping medication each night before bedtime
- D. Is able to sleep for short intervals throughout the night
Correct Answer: B
Rationale: The correct answer is B because feeling rested upon awakening indicates improved sleep quality, reflecting effective teaching on relaxation techniques. Choice A does not directly measure the effectiveness of the teaching intervention. Choice C indicates reliance on medication rather than improved sleep hygiene. Choice D, sleeping for short intervals, does not necessarily signify improved sleep quality.