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A patient undergoing alcohol rehabilitation decides to accept disulfiram therapy to avoid impulsively responding to drinking cues. Which information should be included in the discharge teaching for this patient?
- A. Avoid aged cheeses.
- B. Read labels of all liquid medications.
- C. Wear sunscreen and avoid bright sunlight.
- D. Maintain an adequate dietary intake of sodium.
- E. Avoid breathing fumes of paints, stains, and stripping compounds.
Correct Answer: B,E
Rationale: Disulfiram reacts with alcohol, so patients must avoid hidden alcohol sources like liquid medications and alcohol-laden fumes.
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Select the most appropriate outcome for a patient completing the fourth alcohol detoxification program in 1 year. Before discharge, what will the patient do?
- A. Use rationalization in healthy ways.
- B. State, 'I see the need for ongoing treatment.'
- C. Identify constructive outlets for expression of anger.
- D. Develop a trusting relationship with one staff member.
Correct Answer: B
Rationale: Recognizing the need for ongoing treatment is key to preventing relapse.
A patient in an alcohol treatment program says, 'I have been a loser all my life. I'm so ashamed of what I have put my family through. Now, I'm not even sure I can succeed at staying sober.' Which nursing diagnosis applies?
- A. Chronic low self-esteem
- B. Situational low self-esteem
- C. Disturbed personal identity
- D. Ineffective health maintenance
Correct Answer: A
Rationale: Lifelong feelings of inadequacy indicate chronic low self-esteem.
A patient with a history of daily alcohol use says, 'Drinking helps me cope with being a single parent.' Which response by the nurse would help the individual conceptualize the drinking more objectively?
- A. Sooner or later, alcohol will kill you. Then what will happen to your children?'
- B. I hear a lot of defensiveness in your voice. Do you really believe this?'
- C. If you were coping so well, why were you hospitalized again?'
- D. Tell me what happened the last time you drank.'
Correct Answer: D
Rationale: This response helps the patient see alcohol as a cause of problems, not a solution, and encourages receptivity to change.
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.
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.