Answer Options:
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 Options:
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: A patient diagnosed with schizophrenia and also diagnosed with alcoholism asks, “Shouldn’t I just stop drinking and then worry about the schizophrenia?” Which response by the nurse reflects current clinical practice guidelines?
Answer Options:
a. Dual diagnosis treatment will be too much for you to handle.
b. The person will benefit from treatment in a residential setting.
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: d. Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
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 Options:
a. An illusion
b. A delusion
c. Hallucinations
d. Hypnagogic phenomenon
Answer: a. An illusion
Question: A patient has smoked two packs of cigarettes daily for many years. When the patient does not smoke or tries to cut back, anxiety, craving, poor concentration, and headache result. What does this scenario describe?
Answer Options:
a. Substance abuse
b. Substance addiction
c. Substance intoxication
d. Recreational use of a social drug
Answer: b. Substance addiction
Question: A patient in an alcohol treatment program says, “I have been a loser all my life. I’m so ashamed of what I have put my family through. Now, I’m not even sure I can succeed at staying sober.” Which nursing diagnosis applies?
Answer Options:
a. Chronic low self-esteem
b. Situational low self-esteem
c. Disturbed personal identity
d. Ineffective health maintenance
Answer: a. Chronic low self-esteem
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 Options:
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.”
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: In the emergency department, a patient’s vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats/min (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone. What is the priority outcome for this patient?
Answer Options:
a. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
b. The patient will be able to describe his or her choice to use drugs.
c. The patient will deny pain to prevent further drug abuse.
d. The patient will admit to the seriousness of the overdose and agree to treatment for substance abuse by discharge.
Answer: a. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
Question: A clinic nurse interviews four patients between 70 and 80 years of age. Which patient should have further assessment regarding the risk of alcohol addiction?
a. One with a history of intermittent problems of alcohol misuse early in life and who now consumes one glass of wine nightly with dinner.
b. One with no history of alcohol-related problems until age 65 years, when the patient began to drink alcohol daily “to keep my mind off my arthritis.”
c. One who drank socially throughout adult life and continues this pattern, saying, “I’ve earned the right to do as I please.”
d. One who abused alcohol between the ages of 25 and 40 years but now abstains and occasionally attends Alcoholics Anonymous.
Answer: B
Question: The nurse caring for an older adult patient who is taking acetaminophen and alcohol should assess for what?
a. Inquiring about sleep disturbances caused by mixing alcohol and analgesic medications
b. Determining the safety of the daily acetaminophen dose the patient is ingesting
c. Advising the patient of harmful effects of alcohol and acetaminophen on the liver
d. Suggesting an increase in the acetaminophen dose because alcohol produces faster excretion
e. Assessing the patient for declining functional status associated with medication-induced dementia
Answer: B, C
Question: A patient asks for information about the goals of Alcoholics Anonymous (AA). Which is the nurse’s best response?
Answer Options:
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: 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 Options:
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 you 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.”