Nokea
An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include?
- A. Tremors and CNS arousal
- B. Enhanced normal heart rhythms
- C. Enhanced attention focus and memory
- D. Brain damage and cognitive abnormalities
Correct Answer: D
Rationale: Long-term inhalant use, such as sniffing glue, causes brain damage and cognitive abnormalities (D) due to neurotoxicity. Tremors and CNS arousal (A) are acute effects, heart rhythms (B) are disrupted, and attention/memory (C) are impaired, not enhanced.
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A nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies?
- A. Low self-esteem
- B. Genetic predisposition
- C. Dysfunctional family
- D. Peer influence
Correct Answer: A
Rationale: Low self-esteem (A) is a psychological etiology for substance abuse, contributing to vulnerability. Genetic predisposition (B) is biological, and dysfunctional family (C) and peer influence (D) are social, not primarily psychological.
A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you can?t make me stop drinking. Which response by the nurse would be most appropriate?
- A. You have to stop drinking and driving; you could kill someone.
- B. You?re right; you?re not an alcoholic.
- C. You should consider what you are doing to your marital relationship.
- D. You?re the only one who can make yourself stop drinking.
Correct Answer: D
Rationale: Motivational interviewing emphasizes autonomy, making the response that only the client can choose to stop drinking (D) most appropriate. Confronting about driving (A) or relationships (C) may increase resistance, and agreeing with denial (B) is non-therapeutic.
A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply.
- A. Euphoria
- B. Seizures
- C. Cardiac arrhythmia
- D. Paranoia
- E. Dilated pupils
Correct Answer: B,C,D,E
Rationale: Cocaine overdose can cause seizures (B), cardiac arrhythmia (C), paranoia (D), and dilated pupils (E) due to excessive CNS and sympathetic stimulation. Euphoria (A) is more typical of use, not overdose.
A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply.
- A. Substance refusal skills
- B. Problem solving
- C. Anger awareness
- D. Emergency planning
- E. Social support networking
Correct Answer: B,C
Rationale: Intrapersonal coping skills for substance abuse include problem solving (B) and anger awareness (C), which focus on internal emotional and cognitive management. Substance refusal (A) and social support (E) are interpersonal, and emergency planning (D) is situational.
A 52-year-old male client who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mm Hg, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which nursing diagnosis would be the priority?
- A. Disturbed Thought Processes
- B. Risk for Injury
- C. Ineffective Coping
- D. Ineffective Denial
Correct Answer: B
Rationale: The client?s symptoms (tremors, anxiety, elevated vitals, diaphoresis) indicate early alcohol withdrawal, making Risk for Injury (B) the priority due to potential progression to seizures or delirium. Thought processes (A), coping (C), and denial (D) are secondary concerns.