Nokea
Select the most appropriate outcome for a patient completing the fourth alcohol detoxification program in 1 year. Before discharge, what will the patient do?
- A. Use rationalization in healthy ways.
- B. State, 'I see the need for ongoing treatment.'
- C. Identify constructive outlets for expression of anger.
- D. Develop a trusting relationship with one staff member.
Correct Answer: B
Rationale: Recognizing the need for ongoing treatment is key to preventing relapse.
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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.
A patient admitted to 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 several drinks during the evening.' The patient is using which defense mechanism?
- A. Rationalization
- B. Introjection
- C. Projection
- D. Denial
Correct Answer: D
Rationale: Minimizing drinking is a form of denial of alcoholism.
Which treatment approach is most appropriate for a patient with poor social skills who has been treated several times for substance addiction but has relapsed?
- A. 1-week detoxification program
- B. Long-term outpatient therapy
- C. 12-step self-help program
- D. Residential program
Correct Answer: D
Rationale: Residential programs promote lifestyle changes and skill development, effective for those with poor social skills.
A patient admitted yesterday for injuries sustained in a fall while intoxicated believes snakes are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis?
- A. Disturbed sensory perception
- B. Ineffective coping
- C. Ineffective denial
- D. Risk for injury
Correct Answer: D
Rationale: Clouded sensorium, agitation, sensory perceptual distortions, and poor judgment increase the risk for injury. Safety has a higher priority.
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.