Nokea
A woman in the last trimester of pregnancy drinks 8 to 12 ounces of alcohol daily. The nurse plans for the delivery of an infant who presents with what related characteristic?
- A. Jaundice
- B. Dependent on alcohol
- C. Healthy but underweight
- D. Facial abnormalities and cognitive impairment
Correct Answer: D
Rationale: Fetal alcohol syndrome is the result of alcohol's inhibiting fetal development in the first trimester. The fetus of a woman who drinks that much alcohol will probably have this disorder.
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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.
When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After 1 year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur?
- A. Tolerance develops.
- B. The alcohol is less potent.
- C. Antagonistic effects occur.
- D. Hypomagnesemia develops.
Correct Answer: A
Rationale: Tolerance means needing higher doses to achieve the same effect.
A hospitalized patient, injured in a fall while intoxicated, believes spiders are spinning entrapping webs in the room. The patient is anxious, agitated, and diaphoretic. Which nursing intervention has priority?
- A. Check the patient every 15 minutes.
- B. Rigorously encourage fluid intake.
- C. Provide one-on-one supervision.
- D. Keep the room dimly lit.
Correct Answer: C
Rationale: One-on-one supervision is necessary to promote physical safety until sedation reduces the patient's feelings of terror.
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.
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.