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A patient admitted to an alcoholism rehabilitation program says, 'I'm just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and several drinks during the evening.' The patient is using which defense mechanism?
- A. Rationalization
- B. Introjection
- C. Projection
- D. Denial
Correct Answer: D
Rationale: Minimizing drinking is a form of denial of alcoholism.
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A patient admitted for a heroin overdose received naloxone. The patient's breathing pattern improved. Two hours later, the patient reports muscle aches, abdominal cramps, gooseflesh and says, 'I feel terrible.' Which analysis is correct?
- A. The patient is exhibiting a prodromal symptom of seizures.
- B. An idiosyncratic reaction to naloxone is occurring.
- C. Symptoms of opiate withdrawal are present.
- D. The patient is experiencing a relapse.
Correct Answer: C
Rationale: Naloxone precipitates opiate withdrawal, causing flulike symptoms.
A patient admitted yesterday for injuries sustained in a fall while intoxicated believes snakes are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis?
- A. Disturbed sensory perception
- B. Ineffective coping
- C. Ineffective denial
- D. Risk for injury
Correct Answer: D
Rationale: Clouded sensorium, agitation, sensory perceptual distortions, and poor judgment increase the risk for injury. Safety has a higher priority.
A nurse is called to the home of a neighbor and finds an unconscious person still holding a medication bottle labeled 'lorazepam.' What is the nurse's first action?
- A. Test reflexes.
- B. Check pupils.
- C. Initiate vomiting.
- D. Establish a patent airway.
Correct Answer: D
Rationale: Maintaining a patent airway is the priority for an unconscious patient to prevent aspiration.
A nurse can assist a patient diagnosed with addiction and the patient's family in which aspects of relapse prevention?
- A. Rehearsing techniques to handle anticipated stressful situations
- B. Advising the patient to accept residential treatment if relapse occurs
- C. Assisting the patient to identify life skills needed for effective coping
- D. Isolating self from significant others and social situations until sobriety is established
- E. Teaching the patient about the physical changes to expect as the body adapts to functioning without substances
Correct Answer: A,C,E
Rationale: Nurses can help with skill-building, stress management, and education on physiological changes to prevent relapse.
Which medication is the nurse most likely to see prescribed as part of the treatment plan for both a patient in an alcoholism treatment program and a patient in a program for the treatment of opioid addiction?
- A. Methadone
- B. Bromocriptine
- C. Disulfiram
- D. Naltrexone
Correct Answer: D
Rationale: Naltrexone blocks opioid action and reduces alcohol craving, useful for both addictions.