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Which characteristic of the 12-step program distinguishes it from other programs?
- A. The philosophy that it is possible to reduce the use of substances without abstaining.
- B. It is a self-help group that does not necessarily use health professionals as leaders.
- C. Persons who use this program are independent in their sobriety.
- D. Infrequent attendance is usually successful.
Correct Answer: B
Rationale: The 12-step program is distinguished by its self-help model, led by peers rather than professionals, emphasizing abstinence and regular attendance.
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Which of the following neurochemical influences is a probable cause of substance abuse?
- A. Imbalances of serotonin and norepinephrine in the brain
- B. Inhibition of GABA in the brain
- C. Excessive serotonin activity in the CNS
- D. Stimulation of dopamine pathways in the brain
Correct Answer: D
Rationale: Stimulating dopamine pathways in the limbic system produces reinforcing pleasurable effects, driving substance abuse, unlike serotonin, norepinephrine, or GABA imbalances.
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.
A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, he tells the nurse, 'I am so ashamed.' What should the nurse reply?
- A. I really thought you would make it.
- B. Tell me what has happened since your last admission.
- C. You have nothing to be ashamed of.
- D. Why did you start drinking again?
Correct Answer: B
Rationale: Asking about recent events encourages therapeutic discussion of the client's situation, unlike judgmental, dismissive, or confrontational responses.
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.
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.