Which are general warning signs of substance abuse that a nurse should be alert for in coworkers?
- A. Poor work performance
- B. Frequent absenteeism
- C. Unusual behavior
- D. Slurred speech
- E. Isolation from peers
- F. Substance abuse is not a problem in health professionals
Correct Answer: A,B,C,D,E
Rationale: Warning signs include poor performance, absenteeism, unusual behavior, slurred speech, and isolation, as health professionals have higher substance abuse rates.
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A client with alcohol dependence is admitted to the hospital with pancreatitis. Which intervention should be included in the client's plan of care?
- A. Fluid restriction of 1000 ml per 24 hours
- B. Glucometer checks b.i.d.
- C. High-protein diet
- D. Protective isolation precautions
Correct Answer: B
Rationale: Pancreatitis from alcohol dependence can elevate glucose levels, necessitating glucometer checks, unlike fluid restriction, high-protein diets, or isolation.
A client is admitted for a drug overdose with a Barbiturate. Which is the priority nursing action when planning care for this client?
- A. Check the client's belongings for additional drugs.
- B. Pad the side rails of the bed because seizures are likely.
- C. Prepare a dose of ipecac, an emetic.
- D. Monitor respiratory function.
Correct Answer: D
Rationale: Barbiturate overdose depresses respiratory function, making monitoring the priority to ensure safety, over checking belongings, padding rails, or using ipecac.
A peer reports for work looking unkempt and disheveled. Her movements are uncoordinated, and her breath smells like mouthwash. Another nurse suspects this peer is intoxicated. What should be the action of the nurse who suspects that a peer is intoxicated?
- A. Immediately call the supervisor to report the peer's behavior.
- B. Ask the peer if she feels alright and express concern.
- C. Give the peer some information about the hospital's employee assistance program.
- D. Ignore the situation until someone else validates the observations.
Correct Answer: B
Rationale: Expressing concern ensures client safety and opens dialogue, followed by reporting to a supervisor, unlike premature reporting, EAP distribution, or ignoring the issue.
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.
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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