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An adult in the emergency department states, 'I feel restless. Everything I look is wavy. Sometimes I'm outside my body looking at myself. I hear colors. I think I'm losing my mind.' Vital signs are slightly elevated. The nurse should suspect what triggered these reports?
- A. Cocaine overdose
- B. Schizophrenic episode
- C. Phencyclidine (PCP) intoxication
- D. Lysergic acid diethylamide (LSD) ingestion
Correct Answer: D
Rationale: LSD ingestion causes synesthesia, depersonalization, and concerns about losing sanity.
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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.
A patient was admitted 1 day ago with a hip fracture sustained in a fall while intoxicated. The patient points to the Buck's traction and screams, 'Somebody tied me up with ropes.' The patient's response is described by what term?
- A. An illusion
- B. A delusion
- C. Hallucinations
- D. Hypnagogic phenomenon
Correct Answer: A
Rationale: The patient is misinterpreting a sensory perception when seeing a rope instead of traction. Illusions are common in early withdrawal from alcohol.
When working with a patient beginning treatment for alcohol abuse, what is the nurse's most therapeutic approach?
- A. Empathetic, supportive
- B. Strong, confrontational
- C. Skeptical, guarded
- D. Cool, distant
Correct Answer: A
Rationale: Support and empathy help the patient feel safe to address problems.
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 patient is admitted in a comatose state after ingesting five capsules of lorazepam. A friend of the patient says, 'Often my friend drinks, along with taking more of the drug than is prescribed.' What is the effect of the use of alcohol with this drug?
- A. The drug's metabolism is stimulated.
- B. The drug's effect is diminished.
- C. A synergistic effect occurs.
- D. There is no effect.
Correct Answer: C
Rationale: Alcohol and lorazepam, both CNS depressants, have synergistic effects, potentiating each other.