Nokea
A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe?
- A. Monoamine oxidase inhibitor, such as phenelzine
- B. Phenothiazine, such as thioridazine
- C. Benzodiazepine, such as lorazepam
- D. Narcotic analgesic, such as morphine
Correct Answer: C
Rationale: Benzodiazepines are the drugs of choice for alcohol withdrawal delirium due to their high therapeutic safety index and anticonvulsant properties.
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The treatment team plans care for a person diagnosed with schizophrenia and cannabis abuse. The person has recently used cannabis daily and is experiencing increased hallucinations and delusions. Which principle applies to care planning?
- A. Consider each disorder primary and provide simultaneous treatment.
- B. The person will benefit from treatment in a residential treatment facility.
- C. Withdraw the person from cannabis, and then treat the schizophrenia.
- D. Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
Correct Answer: A
Rationale: Dual diagnosis guidelines suggest treating both substance and psychiatric disorders as primary with simultaneous treatments.
In the emergency department, a patient's vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats/min (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone. What is the priority outcome for this patient?
- A. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
- B. The patient will be able to describe a plan for home care and achieve a drug-free state before being released from the emergency department.
- C. The patient will attend daily meetings of Narcotics Anonymous within 1 week of beginning treatment.
- D. The patient will identify two community resources for the treatment of substance abuse by discharge.
Correct Answer: A
Rationale: Stabilizing vital signs is the priority for an opiate overdose.
A nurse with a history of narcotic abuse is found unconscious in the hospital locker room after overdosing. The nurse is transferred to an inpatient substance abuse unit for care. Which attitudes or behaviors by nursing staff may be enabling?
- A. Conveying understanding that pressures associated with nursing practice underlie substance abuse
- B. Pointing out that work problems are the result, but not the cause, of substance abuse
- C. Conveying empathy when the nurse discusses fears of disciplinary action by the state board of nursing
- D. Providing health teaching about stress management
Correct Answer: A
Rationale: Enabling denies the seriousness of the problem or shifts responsibility from the individual.
Which question has the highest priority when assessing a newly admitted patient with a history of alcohol abuse?
- A. Have you ever had blackouts?'
- B. When did you have your last drink?'
- C. Has drinking caused you any problems?'
- D. When did you decide to seek treatment?'
Correct Answer: B
Rationale: Knowing the last drink time is critical to anticipate withdrawal symptoms.
Which documentation indicates that the treatment plan for a patient in an alcohol treatment program was effective?
- A. Is abstinent for 10 days and states, 'I can maintain sobriety one day at a time.' Spoke with employer, who is willing to allow the patient to return to work in 3 weeks.
- B. Is abstinent for 15 days and states, 'My problems are under control.' Plans to seek a new job where coworkers will not know history.
- C. Attends AA daily; states many of the members are 'real' alcoholics and says, 'I may be able to help some of them find jobs at my company.'
- D. Is abstinent for 21 days and says, 'I know I can't handle more than one or two drinks in a social setting.'
Correct Answer: A
Rationale: This reflects AA principles and practical steps toward sobriety, indicating treatment effectiveness.