Nokea
Police bring a patient to the emergency department after an automobile accident. The patient is ataxic with slurred speech and mild confusion. The blood alcohol level is 400 mg/dL. Considering the relationship between behavior and blood alcohol level, which conclusion can the nurse draw?
- A. The patient rarely drinks alcohol.
- B. The patient has a high tolerance to alcohol.
- C. The patient has been treated with disulfiram.
- D. The patient has recently ingested both alcohol and sedative drugs.
Correct Answer: B
Rationale: A nontolerant drinker would be in a coma with a blood alcohol level of 400 mg/dL. The patient's ability to walk and talk suggests tolerance.
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A patient with a history of daily alcohol use says, 'Drinking helps me cope with being a single parent.' Which response by the nurse would help the individual conceptualize the drinking more objectively?
- A. Sooner or later, alcohol will kill you. Then what will happen to your children?'
- B. I hear a lot of defensiveness in your voice. Do you really believe this?'
- C. If you were coping so well, why were you hospitalized again?'
- D. Tell me what happened the last time you drank.'
Correct Answer: D
Rationale: This response helps the patient see alcohol as a cause of problems, not a solution, and encourages receptivity to change.
A new patient in an alcoholism rehabilitation program says, 'I'm just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and a few drinks in the evening.' Which response by the nurse will help the patient view the drinking more honestly?
- A. I see,' and use interested silence.
- B. I think you may be drinking more than you report.'
- C. Being a social drinker involves having a drink or two once or twice a week.'
- D. You describe drinking steadily throughout the day and evening. Am I correct?'
Correct Answer: D
Rationale: This response summarizes and validates the patient's report in an accepting manner, encouraging honesty.
Which statement most accurately describes substance addiction?
- A. A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance.
- B. A disorder associated with tolerance to a substance as well as withdrawal symptoms if use is abruptly discontinued.
- C. Behaviors associated with habitual use of a substance for the single purpose of altering one's mood, emotion, or state of consciousness.
- D. A behavioral disorder associated with selected personality features.
Correct Answer: A
Rationale: Addiction involves a lack of control and craving, characteristic of a chronic brain disease.
When assessing a patient who has ingested flunitrazepam, what should the nurse expect?
- A. Acrophobia
- B. Hypothermia
- C. Hallucinations
- D. Anterograde amnesia
Correct Answer: D
Rationale: Flunitrazepam causes anterograde amnesia, disinhibition, and muscle relaxation.
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.