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A peer reports for work looking unkempt and disheveled. Her movements are uncoordinated, and her breath smells like mouthwash. Another nurse suspects this peer is intoxicated. What should be the action of the nurse who suspects that a peer is intoxicated?
- A. Immediately call the supervisor to report the peer's behavior.
- B. Ask the peer if she feels alright and express concern.
- C. Give the peer some information about the hospital's employee assistance program.
- D. Ignore the situation until someone else validates the observations.
Correct Answer: B
Rationale: Expressing concern ensures client safety and opens dialogue, followed by reporting to a supervisor, unlike premature reporting, EAP distribution, or ignoring the issue.
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A client is being discharged on disulfiram (Antabuse). Which instruction for Antabuse should the client receive?
- A. Take disulfiram with food to avoid stomach upset.
- B. Skip the daily dose of disulfiram on days when consumption of alcoholic beverages is likely.
- C. Read products labels carefully to avoid all products containing alcohol.
- D. Disulfiram will prevent the desire to drink alcoholic beverages.
Correct Answer: C
Rationale: Avoiding all alcohol-containing products prevents severe reactions, unlike taking with food, skipping doses, or expecting reduced cravings, which are incorrect.
Which of the following neurochemical influences is a probable cause of substance abuse?
- A. Imbalances of serotonin and norepinephrine in the brain
- B. Inhibition of GABA in the brain
- C. Excessive serotonin activity in the CNS
- D. Stimulation of dopamine pathways in the brain
Correct Answer: D
Rationale: Stimulating dopamine pathways in the limbic system produces reinforcing pleasurable effects, driving substance abuse, unlike serotonin, norepinephrine, or GABA imbalances.
A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, he tells the nurse, 'I am so ashamed.' What should the nurse reply?
- A. I really thought you would make it.
- B. Tell me what has happened since your last admission.
- C. You have nothing to be ashamed of.
- D. Why did you start drinking again?
Correct Answer: B
Rationale: Asking about recent events encourages therapeutic discussion of the client's situation, unlike judgmental, dismissive, or confrontational responses.
Which reasons make it necessary for the nurse to examine his or her beliefs and attitudes about substance abuse?
- A. The nurse may be overly harsh and critical of the client.
- B. The nurse may unknowingly act out old family roles and engage in enabling behavior.
- C. The nurse or close friends and family of the nurse may abuse substances.
- D. The nurse may have different attitudes about various substances of abuse.
- E. The nurse is not likely to have had any experience with substance abuse.
Correct Answer: A,B,C,D
Rationale: Examining beliefs prevents harshness, enabling, or bias from personal or familial substance abuse experiences, as nurses are likely affected given its prevalence.
When interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency?
- A. Being flexible but angry
- B. Blaming themselves for the family's problems
- C. Expressing thoughts and feelings openly
- D. Taking pleasure in self-accomplishments
Correct Answer: B
Rationale: Self-blame is a hallmark of codependency, reflecting maladaptive coping, unlike flexibility, open expression, or self-accomplishment.