Chapter 46 Flashcards
The alcoholic patient says to the nurse, “I am not an alcoholic. I can quit any time I want to.”
The nurse recognizes that the patient is using which defense mechanism?
a. Repression
b. Denial
c. Rationalization
d. Intellectualization
ANS: B
Denial is ignoring reality in spite of hard evidence. Denial is a mechanism frequently used by substance abusers. Repression refers to unconsciously blocking an unwanted thought or memory from open expression. Rationalization attempts to justify a behavior or action by making an excuse or an explanation. Intellectualization is the excessive reasoning and logic to counter emotional distress.
The wife of an alcoholic tells the nurse, “My husband only drinks on the weekends to relax. He has a very stressful job.” The nurse recognizes that the patient’s wife is using which NURSINGTB.COM defense mechanism?
a. Repression
b. Denial
c. Rationalization
d. Identification
The wife of an alcoholic tells the nurse, “My husband only drinks on the weekends to relax. He has a very stressful job.” The nurse recognizes that the patient’s wife is using which NURSINGTB.COM defense mechanism?
a. Repression
b. Denial
c. Rationalization
d. Identification
Which statement accurately explains the difference between an enabler and a co-dependent?
a. A codependent covers up the substance abuser’s behavior.
b. A codependent rationalizes the substance abuser’s behavior.
c. An enabler uses the substance abuser’s behavior to build up his or her own
self-esteem.
d. An enabler is also a substance abuser.
ANS: A
The codependent “fixes” things by overcompensating to prevent the abuser from facing reality. Enabling refers to “helping” a person so that the person’s consequences from unhealthy behavior are less severe; thus enabling “helps” the unhealthy behavior to continue.
How long does it take the body to metabolize a single can of beer?
a. 20 minutes
b. 30 minutes
c. 40 minutes
d. 60 minutes
ANS: D
The metabolization of any amount of alcohol takes approximately 1 hour.
A person in jail for public intoxication has been without alcohol for 12 hours. Which finding indicates that the patient may be withdrawing from alcohol?
a. Irritability
b. Nausea and vomiting
c. Hallucinations
d. Seizures
ANS: A
Marked irritability is the early sign (6 to 12 hours after last drink) of alcohol withdrawal.
An intoxicated patient is admitted to a treatment center for detoxification. The nurse understands that his withdrawal will be supported with which method?
a. Psychotherapy support
b. Large doses opioids to ensure sedation for 72 hours
c. Symptomatic relief until the substance clears his symptoms
d. Titrated amounts of alcohol until severe withdrawal resolves
ANS: C
The alcoholic in withdrawal is supported with symptomatic relief for nausea and vomiting, cramps, and possible seizure.
After detoxification from substance abuse, the patient says, “I feel better than I have in years! All I needed was some rest. I am not an alcoholic.” Which response is best for the nurse to make?
a. “What were you doing that got you admitted to the detoxification center?”
b. “Alcoholism has many definitions. What is yours?”
c. “Admitting to alcoholism is hard.”
d. “Alcoholism has ruined your life. How can you say you are not an alcoholic?”
ANS: A
Confronting denial and encouraging self-diagnosis is the point of the treatment phase after detoxification. Asking for the patient’s definition of alcoholism allows for the patient to intellectualize the problem. Stating that alcoholism is “hard” is a sympathetic and unhelpful response. “Alcoholism has ruined your life” is accusatory and counterproductive.
The nurse explains that an alternative to disulfiram (Antabuse) is the drug naltrexone (ReVia).
Which information should the nurse include in the teaching plan?
a. Naltrexone (ReVia) causes severe headaches if alcohol is consumed while using
the drug.
b. Naltrexone (ReVia) can cause a dependence on the medication itself if taken
improperly. NURSINGTB.COM
c. Naltrexone (ReVia) releases endorphin-like enzymes that mimic intoxication.
d. Naltrexone (ReVia) blocks craving and prevents relapse.
ANS: D
Naltrexone (ReVia) can be used to block the craving for alcohol and to prevent relapse in the recovery phase.
The nurse encourages the recovering alcoholic to participate in group therapy. Which benefit is most important for the nurse to mention?
a. Development of improved social skills
b. Progression toward sobriety
c. Provision of a sense of belonging
d. Increasing self-discipline
ANS: D
The learning of the skill of self-discipline is the long-lasting benefit from group therapy. The other options are also benefits, but the major one is self-discipline, a skill a drug abuser must acquire for successful rehabilitation.
The nurse is aware that when Korsakoff syndrome is suspected from behavioral cues, the syndrome can be confirmed by which diagnostic test?
a. Liver biopsy
b. Brain scan
c. Magnetic resonance imaging
d. Spinal tap
ANS: B
The individual with Korsakoff syndrome has grossly impaired memory and gait disturbance. Confabulation (making up stories) frequently is seen as an attempt to communicate. A brain scan will show brain atrophy; currently there is no treatment to reverse the condition.
The nurse uses the CAGE challenge to alcoholics who persist in denial. What does the “G” in the set of questions from CAGE represent?
a. Get: “Do you feel like you must get alcohol?”
b. Go: “Do you go out to drink?”
c. Gone: “Is memory of drinking episodes gone?”
d. Guilty: “Do you feel guilty about your drinking?”
ANS: D
A commonly used screening tool for alcohol abuse is the CAGE assessment. Two or more “yes” answers have a 90% correlation with an alcohol abuse problem. The “G” stands as a reminder for the question, “Do you feel guilty about your drinking?”
The nurse is caring for a patient who was admitted for a lorazepam (Ativan) overdose. Which assessment finding indicates that the patient is experiencing withdrawal?
a. Lethargy
b. Urine output of 40 mL/hr
c. Heart rate of 48 beats/min
d. Blood pressure of 140/90
ANS: D
Elevated blood pressure is consistent with withdrawal from a central nervous system (CNS) depressant like lorazepam (Ativan), a benzodiazepine. If an individual has been abusing drugs that depress the CNS and goes through withdrawal, other symptoms would include an elevation in pulse, nervousness, and heightened anxiety. The patient would likely be agitated rather than lethargic and tachycardic. Urine output of 40 mL/hr is a normal finding.
The nurse is concerned about a coworker who she suspects is abusing amphetamines. Which behavior best validates the nurse’s concern?
a. Frantic, excited speech
b. Poor attention to detail
c. Poor personal hygiene
d. Insatiable hunger
ANS: A
Excited speech, euphoric behavior, increased alertness, and anorexia are indications of abuse of amphetamines.
Why do many people who abuse Cannabis (marijuana) rationalize their use?
a. Cannabis sedates them.
b. Cannabis expands their senses.
c. Cannabis heightens sexual pleasure.
d. Cannabis may be obtained legally for therapeutic purposes.
ANS: B
Many young people offer the increased sensitivity to sound, colors, and other environmental elements as a rationale for using the nonaddicting drug.
A patient is admitted after abusing an inhalant. Which safety precaution is most important for the nurse to take?
a. Check the patient’s temperature hourly.
b. Place the patient on seizure precautions.
c. Monitor carefully for changes in urine output.
d. Ensure that respiratory support equipment is present at the bedside.
ANS: D
Medical treatment and intervention for both hallucinogens and inhalants include provision of safety for the individual who may be experiencing a bad “trip.” Emergency measures may be necessary to provide respiratory support for an individual who has impaired gas exchange as a result of inhalants.
