BIOLOGY 102 Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition P CHAPTER 6

Medical-Surgical Nursing Critical Thinking in Client Care, 4th Edition Priscilla LeMon

CHAPTER 6

Chapter 6

1. During a class for teens, a participant states she frequently “overindulges” in numerous activities, including eating. She questions her likelihood for becoming addicted to alcohol as a result of her “addictive personality.” What information should be provided to the client?

a. There are no data to support the existence of an addictive personality, although individuals who become addicted to substances frequently display an affinity for engaging in risky behaviors.

b. It is true the addictive personality does have a greater incidence of becoming addicted to a variety of substances.

c. There is no relationship between addiction and personalities who are prone to “overindulgence.”

d. The client is not at an advanced enough age to make this determination.

2. After surgery, the nurse notes a client is unable to achieve pain relief from the analgesics prescribed. A review of the client’s medical records reveals a history of alcohol abuse. What inferences can the nurse make?

1. The client has an unreported addiction to the pain medication being prescribed.

2. The client has a history of using this medication at home.

3. The client is likely cross-tolerant to the prescribed analgesic.

4. The client has a dual diagnosis relating to alcohol and drug addiction.

3. A client is being treated for alcohol dependency. During the treatment, the client reports having been treated and undergone detoxification three times in the past. The client states that this time has been more difficult than the previous detoxification experiences. What information can be provided to the client?

1. Aging can impact the ability of the body to handle detoxification from alcohol and drugs.

2. Increased difficulty with alcohol detoxification is likely the result of an addiction to another substance at the same time.

3. The dependency might have been greater this time.

4. With each subsequent episode, detoxification becomes more difficult.

4. During a routine physical, the nurse asks the client about alcohol use. The client denies alcohol use. The client reports having alcoholic parents, and wonders about the likelihood of becoming an alcoholic as well. What response by the nurse is most correct?

1. “You are right to avoid alcohol use.”

2. “You will likely become an alcoholic.”

3. “There are studies that support a genetic link for developing alcoholism.”

4. “You should be fine to drink.”

5. A client involved in a minor accident reports having used “crank” an hour ago. The client denies having used the drug before. Based upon your knowledge, what manifestations can be anticipated?

1. The client might report feelings of increased strength and intelligence.

2. The client will display increased strength and cognition.

3. The client will be drowsy.

4. The client will exhibit hallucinations and paranoia.

6. A teen client is brought to the Emergency Department by parents. The client’s mother reports the client reported taking goofballs and hootch before refusing to communicate further. Based upon your knowledge, which of the following will be the greatest concern for this client?

1. The client will require close observation for seizure activity.

2. The client will require close observation for respiratory depression.

3. The client will require close observation for signs of withdrawal.

4. The client will require close observation for signs of hallucinations.

7. A client is admitted to the Emergency Department after taking PCP (phencyclidine piperidine). The physician has determined that the client overdosed on the drug. You are anticipating the care that will be provided to this client. What actions can be anticipated? Select all that apply.

1. Induce vomiting.

2. Obtain materials to assist with lavage.

3. Initiate seizure precautions.

4. Initiate an IV.

5. Administer Narcan as prescribed.

8. The nurse is colleting data from a client regarding past alcohol use history. What question will provide the greatest amount of information?

1. Are you a heavy drinker?

2. How often do you use alcohol?

3. Drinking doesn’t cause any problems for you, does it?

4. Is alcohol use a concern for you?

9. A new nurse orienting to the unit is preparing to assist with obtaining data for a screening tool to review the likelihood that a client is addicted to methamphetamine. Based upon your knowledge, which of the following tools will be used?

1. B-DAST

2. The CAGE questionnaire

3. MAST

4. CIWA-ar

10. The client with a history of alcohol abuse is being discharged. The physician has prescribed disulfiram (Antabuse). The client asks about the action of the medication. Which of the following statements by the nurse is most correct?

1. “The medication will help curb your craving for alcohol.”

2. “The medication will reduce the anxiety you might experience during this difficult time.”

3. “The medication will prevent seizures and other symptoms of withdrawal.”

4. “The medication will prevent your body from breaking down alcohol.”

11. A nurse is concerned about potential substance abuse by a coworker. Which of the following behaviors warrants further investigation?

1. The nurse in question frequently requests the largest patient care assignment for the shift.

2. The nurse in question prefers not to be the “medication nurse” on the shift.

3. The nurse in question declines to take scheduled breaks.

4. The nurse in question frequently wastes medications.

12. A formerly homeless client has been treated for alcoholism. The client’s physical examination reveals the client is underweight and malnourished. Which of the following medications prescribed by the physician is intended to manage the client’s nutritional status?

1. Folic acid

2. Magnesium sulfate

3. Methadone

4. Sertraline (Zoloft)

13. The client reports to the Emergency Department with signs of drug use. The client reports having ingested “mellow yellows.” Which of the following medications will be indicated to manage a potential overdose?

1. Narcan

2. Diazepam

3. Haldol

4. Vitamin B₁₂