Question: A patient was admitted 1 day ago with a hip fracture sustained in a fall while intoxicated. The patient points to the Buck’s traction and screams, “Somebody tied me up with ropes.” The patient’s response is described by what term?
Answer Choices: a. An illusion b. A delusion c. Hallucinations d. Hypnagogic phenomenon
Answer: a. An illusion
Question: A patient was admitted 48 hours ago for injuries sustained while intoxicated. The patient is shaky, irritable, anxious, and diaphoretic. The pulse rate is 130 beats/min. The patient shouts, “Snakes are crawling on my bed. I’ve got to get out of here.” What is the most accurate assessment of the situation?
Answer Choices: a. The patient is attempting to obtain attention by manipulating staff. b. The patient may have sustained a head injury before admission. c. The patient has symptoms of alcohol withdrawal delirium. d. The patient is having a recurrence of an acute psychosis.
Answer: c. The patient has symptoms of alcohol withdrawal delirium.
Question: 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?
Answer Choices: a. Disturbed sensory perception b. Ineffective coping c. Ineffective denial d. Risk for injury
Answer: d. Risk for injury
Question: A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe?
Answer Choices: a. Monoamine oxidase inhibitor, such as phenelzine b. Phenothiazine, such as thioridazine c. Benzodiazepine, such as lorazepam d. Narcotic analgesic, such as morphine
Answer: c. Benzodiazepine, such as lorazepam
Question: A hospitalized patient, injured in a fall while intoxicated, believes spiders are spinning entrapping webs in the room. The patient is anxious, agitated, and diaphoretic. Which nursing intervention has priority?
Answer Choices: a. Check the patient every 15 minutes. b. Rigorously encourage fluid intake. c. Provide one-on-one supervision. d. Keep the room dimly lit.
Answer: c. Provide one-on-one supervision.
Question: A patient with a history of daily alcohol use says, “Drinking helps me cope with being a single parent.” Which response by the nurse would help the individual conceptualize the drinking more objectively?
Answer Choices: a. “Sooner or later, alcohol will kill you. Then what will happen to your children?” b. “I hear a lot of defensiveness in your voice. Do you really believe this?” c. “If your wife were coping so well, why were you hospitalized again?” d. “Tell me what happened the last time you drank.”
Answer: d. “Tell me what happened the last time you drank.”
Question: A patient asks for information about the goals of Alcoholics Anonymous (AA). Which is the nurse’s best response?
Answer Choices: a. “It is a self-help group with the goal of sobriety.” b. “It is a form of group therapy led by a psychiatrist.” c. “It is a group that learns about drinking from a group leader.” d. “It is a network that advocates strong punishment for drunk drivers.”
Answer: a. “It is a self-help group with the goal of sobriety.”
Question: 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?
Answer Choices: 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.
Answer: b. The patient has a high tolerance to alcohol.
Question: 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?
Answer Choices: a. Rationalization b. Introjection c. Projection d. Denial
Answer: d. Denial
Question: 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?
Answer Choices: 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?”
Answer: d. “You describe drinking steadily throughout the day and evening. Am I correct?”
Question: During the third week of treatment, the spouse of a patient in an alcoholism rehabilitation program says, “After discharge, I think everything will be just fine.” Which remark by the nurse will be most helpful to the spouse?
Answer Choices: a. “It is good that you’re supportive of your spouse’s sobriety and want to help maintain it.” b. “Although sobriety solves some problems, new ones may emerge as one adjusts to living without alcohol.” c. “It will be important for you to structure life to avoid as much stress as possible. You will need to provide social protection.” d. “Remember that alcoholism is a disorder of self-destruction. You will need to observe your spouse’s behavior carefully.”
Answer: b. “Although sobriety solves some problems, new ones may emerge as one adjusts to living without alcohol.”
Question: The treatment team plans care for a person diagnosed with schizophrenia and cannabis abuse. The team plans to address both problems concurrently. Which principle applies?
Answer Choices: a. The person must first detoxify from cannabis. b. The person will benefit from treatment in a residential treatment facility. c. Withdraw the person from cannabis, and then treat the schizophrenia. d. Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
Answer: a. The person must first detoxify from cannabis.
Question: When working with a patient beginning treatment for alcohol abuse, what is the nurse’s most therapeutic approach?
Answer Choices: a. Empathetic, supportive b. Strong, confrontational c. Skeptical, guarded d. Cool, distant
Answer: a. Empathetic, supportive
Question: A patient comes to an outpatient appointment obviously intoxicated. The nurse should implement what intervention?
Answer Choices: a. Exploring the patient’s reasons for drinking today b. Arranging admission to an inpatient psychiatric unit c. Coordinating emergency admission to a detoxification unit d. Telling the patient, “We cannot see you today because you’ve been drinking”
Answer: d. Telling the patient, “We cannot see you today because you’ve been drinking”
Question: When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After 1 year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur?
Answer Choices: a. Tolerance develops. b. The alcohol is less potent. c. Learned behavior occurs. d. Hypomagnesemia develops.
Answer: a. Tolerance develops.
Question: Which statement most accurately describes substance addiction?
Answer Choices: a. A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance. b. A disorder associated with tolerance to a substance as well as withdrawal symptoms if use is abruptly discontinued. c. Behaviors associated with habitual use of a substance for the single purpose of altering one’s mood, emotion, or state of consciousness. d. A behavioral disorder associated with selected personality features.
Answer: a. A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance.
Question: A patient admitted for a heroin overdose received naloxone. The patient’s breathing pattern improved. Two hours later, the patient reports muscle aches, abdominal cramps, gooseflesh, and says, “I feel terrible.” Which analysis is correct?
Answer Choices: a. The patient is exhibiting a prodromal symptom of seizures. b. An idiosyncratic reaction to naloxone is occurring. c. Symptoms of opiate withdrawal are present. d. The patient is experiencing a relapse.
Answer: c. Symptoms of opiate withdrawal are present.