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Which statements are important reasons for why the problem of substance abuse must be addressed?
- A. Increasing numbers of infants are suffering the physiologic and emotional consequences of prenatal exposure to alcohol or drugs.
- B. Chemical abuse results in increased violence.
- C. Drug abuse costs business and industry an estimated $102 billion annually.
- D. Alcohol abuse is a too frequent cause of or contributor to death.
- E. Substance abuse is decreasing.
Correct Answer: A,B,C,D
Rationale: Substance abuse causes prenatal harm, violence, economic losses, and death, but it is increasing, not decreasing, making it a critical issue to address.
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A client reports drinking one to two drinks when drinking behavior first began. Now the client reports drinking at least six drinks with every episode in order to have a good time. Which term would best describe this phenomenon?
- A. Dependence
- B. Intoxication
- C. Tolerance
- D. Withdrawal
Correct Answer: C
Rationale: Tolerance describes needing more alcohol to achieve the same effect, unlike intoxication (maladaptive behavior), withdrawal (symptoms upon cessation), or dependence (addiction with multiple symptoms).
A client will be taking disulfiram (Antabuse) after discharge from an alcohol treatment program. Which statement would indicate that teaching has been effective?
- A. Antabuse is safe to take with any over-the-counter cold medication.
- B. Antabuse will block my cravings for alcohol, so I'll have less desire to drink.
- C. Drinking alcohol while taking Antabuse can cause dangerous symptoms.
- D. If I drink while taking Antabuse, it will make me vomit before the alcohol affects me.
Correct Answer: C
Rationale: Understanding that Antabuse causes dangerous symptoms with alcohol indicates effective teaching, unlike misconceptions about cravings, vomiting timing, or OTC safety.
A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms?
- A. Alcohol withdrawal syndrome
- B. Continuing intoxication
- C. Delirium tremens
- D. Wernicke-Korsakoff syndrome
Correct Answer: A
Rationale: Symptoms like tremors, weakness, and sweating 24 hours after the last drink indicate alcohol withdrawal, not intoxication, delirium tremens, or Wernicke-Korsakoff syndrome.
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 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.