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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.
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A new patient in 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 a few drinks in the evening.' Which response by the nurse will help the patient view the drinking more honestly?
- A. I see,' and use interested silence.
- B. I think you may be drinking more than you report.'
- C. Being a social drinker involves having a drink or two once or twice a week.'
- D. You describe drinking steadily throughout the day and evening. Am I correct?'
Correct Answer: D
Rationale: This response summarizes and validates the patient's report in an accepting manner, encouraging honesty.
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.
A graduate nurse worked at a hospital for several months, resigned, and then took a position at another hospital. In the new position, the nurse often volunteers to be the medication nurse. After several serious medication errors, an investigation reveals that the nurse was diverting patient narcotics for self-use. What early indicator of the nurse's drug use was evident?
- A. Changing employment after only several months
- B. Seeking to be assigned as a medication nurse
- C. Frequent socializes with unit staff after work
- D. Recent graduate
Correct Answer: B
Rationale: Seeking access to medications is a drug-seeking behavior.
A patient asks for information about the goals of Alcoholics Anonymous (AA). Which is the nurse's best response?
- A. It is a self-help group with the goal of sobriety.'
- B. It is a form of group therapy led by a psychiatrist.'
- C. It is a group that learns about drinking from a group leader.'
- D. It is a network that advocates strong punishment for drunk drivers.'
Correct Answer: A
Rationale: AA is a peer support group for recovering alcoholics with the goal of maintaining sobriety.
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.