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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.
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A nurse is working as part of an interdisciplinary treatment team for a client diagnosed with a mental illness and substance abuse disorder. As part of the recovery process, which of the following would be most important for the team to do initially?
- A. Provide a series of short-term hospitalizations that apply leverage to pressure the client into adhering to a prescribed treatment regimen.
- B. Establish rules that will enhance the client?s recognition of staff as authority figures who know what is best for the client?s care and well-being.
- C. Use heavy confrontation, intense emotional pressure, and discouragement of the use of medications since all medications have the potential to be addictive.
- D. Provide immediate help with a situational crisis the client is experiencing to promote trust in the client and have the client buy into the treatment process.
Correct Answer: D
Rationale: Providing immediate help with a situational crisis (D) builds trust, a critical first step for engaging clients with co-occurring disorders in treatment. Short-term hospitalizations (A) and establishing authority (B) are less effective initially, and heavy confrontation (C) is counterproductive and inappropriate.
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.
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 client with co-occurring disorders of schizophrenia and substance abuse is admitted for treatment. Which of the following would the nurse be least likely to identify as a priority for this client?
- A. Assessment
- B. Group therapy
- C. Control of psychiatric symptoms
- D. Treatment of withdrawal symptoms
Correct Answer: B
Rationale: Group therapy (B) is least likely to be a priority during acute admission, as assessment (A), controlling psychiatric symptoms (C), and treating withdrawal symptoms (D) address immediate safety and stabilization needs.
A client with major depression visits the mental health clinic and tells the nurse that he has recently started using marijuana quite frequently. The nurse determines that the manifestation of the client?s co-occurring disorder reflects which of the following?
- A. Primary mental illness with subsequent substance use
- B. Primary substance abuse disorder with psychopathologic sequelae
- C. Dual primary diagnoses
- D. A common etiology
Correct Answer: A
Rationale: The client?s major depression preceded the frequent marijuana use, suggesting primary mental illness with subsequent substance use (A) as a coping mechanism. Option B implies substance abuse came first, which is not indicated. Option C suggests equal primacy of both disorders, and option D implies a shared cause, both less likely given the sequence described.