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During the third week of treatment, the spouse of a patient in an alcoholism rehabilitation program says, 'After discharge, I think everything will be just fine.' Which remark by the nurse will be most helpful to the spouse?
- A. It is good that you're supportive of your spouse's sobriety and want to help maintain it.'
- B. Although sobriety solves some problems, new ones may emerge as one adjusts to living without alcohol.'
- C. It will be important for you to structure life to avoid as much stress as possible. You will need to provide social protection.'
- D. Remember that alcoholism is a disorder of self-destruction. You will need to observe your spouse's behavior carefully.'
Correct Answer: B
Rationale: This response provides anticipatory guidance about challenges in sobriety, helping the spouse prepare for new issues.
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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.
In what significant ways is the therapeutic environment different for a patient who has ingested lysergic acid diethylamide (LSD) than for a patient who has ingested phencyclidine (PCP)?
- A. For LSD ingestion, one person stays with the patient and provides verbal support. For PCP ingestion, a regimen of limited contact with staff members is maintained, and continual visual monitoring is provided.
- B. For PCP ingestion, the patient is placed on one-on-one intensive supervision. For LSD ingestion, a regimen of limited interaction and minimal verbal stimulation is maintained.
- C. For LSD ingestion, continual moderate sensory stimulation is provided. For PCP ingestion, continual high-level stimulation is provided.
- D. For LSD ingestion, the patient is placed in restraints. For PCP ingestion, seizure precautions are implemented.
Correct Answer: A
Rationale: LSD patients benefit from verbal support, while PCP patients require minimal stimulation due to violent tendencies.
Which question has the highest priority when assessing a newly admitted patient with a history of alcohol abuse?
- A. Have you ever had blackouts?'
- B. When did you have your last drink?'
- C. Has drinking caused you any problems?'
- D. When did you decide to seek treatment?'
Correct Answer: B
Rationale: Knowing the last drink time is critical to anticipate withdrawal symptoms.
While caring for a patient with a methamphetamine overdose, which tasks are the priorities of care?
- A. Administration of naloxone (Narcan)
- B. Vitamin B12 and folate supplements
- C. Restoring nutritional integrity
- D. Prevention of seizures
- E. Reduction of fever
Correct Answer: D,E
Rationale: Hyperpyrexia and convulsions are life-threatening in methamphetamine overdose, making these priorities.
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.