Nokea
The nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam (Valium) when the injections are given by a particular nurse. This nurse returns from lunch exhibiting slurred speech and euphoria. Which is the best action for the nurse to take?
- A. Ask other nurses if they have noticed anything unusual.
- B. Call the manager and report the observations.
- C. Observe the nurse as injections are prepared and administered.
- D. Tell the nurse, 'I know you've been stealing Valium.'
Correct Answer: B
Rationale: Reporting to the manager addresses suspected diversion and ensures client safety, unlike asking others, observing further, or confronting directly.
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The nurse is discussing the principles of 12-step program for recovery with a client. Which statement is consistent with the principles of 12-step programs?
- A. The client will need to abstain from all substances for successful recovery.
- B. Once sober, the person can safely return to life as it was before becoming addicted.
- C. The prognosis for recovery is enhanced with the aid of maintenance medications.
- D. Recovery requires adherence to a plan of achieving long-term goals.
Correct Answer: A
Rationale: The 12-step program emphasizes total abstinence and support from others, unlike returning to pre-addiction life, relying on medications, or focusing solely on long-term goals.
The nurse is coleading a family therapy group with a client addicted to alcohol. Which statement made by the wife indicates the need for additional education regarding alcoholism as a family illness?
- A. I have to call in sick for my husband when he is too hung over to go to work.
- B. Last time he got arrested, I just let him sit in jail.
- C. We have separated our finances so that I will not go broke.
- D. I take my kids with me to Al-anon meetings every week.
Correct Answer: A
Rationale: Calling in sick enables the addiction, indicating a need for education on avoiding codependent behaviors, unlike jail time, financial separation, or Al-anon attendance.
A client is readmitted to the detox unit for the fourth time in 3 years. The nurse states in the morning report, 'Not again! Why should we keep trying to help this guy? He obviously doesn't want it.' What does this statement reflect?
- A. The nurse lacks the self-awareness to work effectively with this addicted client.
- B. The nurse understands the cycle of remission and relapse characteristic of addiction.
- C. The nurse has repressed negative emotions from past experiences with addiction.
- D. The nurse is trying to conceal his or her own addictions.
Correct Answer: A
Rationale: The nurse's cynical statement reflects a lack of self-awareness about addiction's chronic nature, hindering effective care, unlike understanding relapse or concealing personal issues.
When interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency?
- A. Being flexible but angry
- B. Blaming themselves for the family's problems
- C. Expressing thoughts and feelings openly
- D. Taking pleasure in self-accomplishments
Correct Answer: B
Rationale: Self-blame is a hallmark of codependency, reflecting maladaptive coping, unlike flexibility, open expression, or self-accomplishment.
The client asks the nurse, 'What will happen if I drink while taking Antabuse?' What should be the nurse's reply?
- A. You will not want to drink while taking Antabuse, it reduces the cravings.
- B. You will not get any effect from the alcohol you drink.
- C. Antabuse will reverse the effects of alcohol.
- D. You will experience a severe reaction, including a throbbing headache and vomiting.
Correct Answer: D
Rationale: Drinking on Antabuse causes severe symptoms like headache and vomiting, not reduced cravings, no alcohol effect, or reversal of alcohol effects.