NEW Substance related disordersATI Nclex Complehensive Exam With Rationales 2024

NEW Substance
related disordersATI Nclex
Complehensive
Exam With
Rationales 2024
A nurse is interviewing a client in an outpatient
substance-abuse clinic. To promote success in the
recovery process, which outcome should the nurse
expect the client to initially accomplish?
A. The client will identify one person to turn to for
support.
B. The client will give up all old drinking buddies.
C. The client will be able to verbalize the effects of
alcohol on the body.
D. The client will correlate life problems with
alcohol use. - ANSWER-ANS: D
To promote the recovery process the nurse should
expect that the client would initially correlate life
problems with alcohol use. Acceptance of the
problem is the first step of the recovery process.
A nurse evaluates a client's patient-controlled
analgesia (PCA) pump and notices 100 attempts
within a 30-minute period. Which is the best
rationale for assessing this client for substance
dependence?
A. Narcotic pain medication is contraindicated for
all clients with active substance-abuse problems.
B. Clients who are dependent on alcohol or
benzodiazepines may have developed crosstolerance to analgesics and require increased doses
to achieve effective pain control.
C. There is no need to assess the client for
substance dependence. There is an obvious PCA
malfunction.
D. The client is experiencing symptoms of
withdrawal and needs to be accurately assessed for
lorazepam (Ativan) dosage. - ANSWER-ANS: B
The nurse should assess the client for substance
dependence because clients who are dependent on
alcohol or benzodiazepines may have developed
cross-tolerance to analgesics, and require increased
doses to achieve effective pain control. Crosstolerance occurs when one drug lessened the
client's response to another drug.
A mother who has a history of chronic heroin use
has lost custody of her children due to abuse and
neglect. She has been admitted to an inpatient
substance-abuse program. Which client statement
should a nurse associate with a positive prognosis
for this client?
A. "I'm not going to use heroin ever again. I know
I've got the willpower to do it this time."
B. "I cannot control my use of heroin. It's stronger
than I am."
C. "I'm going to get all my children back. They need
their mother."
D. "Once I deal with my childhood physical abuse,
recovery should be easy." - ANSWER-ANS: B
A positive prognosis is more likely when a client
admits that he or she is addicted to a substance and
has a loss of control. One of the first steps in
accepting treatment is for the client to admit
powerlessness over the substance.
On the first day of a client's alcohol detoxification,
which nursing intervention should take priority?
A. Strongly encourage the client to attend 90
Alcoholics Anonymous meetings in 90 days.
B. Educate the client about the biopsychosocial
consequences of alcohol abuse.
C. Administer ordered chlordiazepoxide (Librium) in
a dosage according to protocol.
D. Administer vitamin B1 to prevent WernickeKorsakoff syndrome. - ANSWER-ANS: C
The priority nursing intervention for this client
should be to administer ordered chlordiazepoxide
(Librium) in a dosage according to protocol.
Chlordiazepoxide (Librium) is a benzodiazepine and
is often used for substitution therapy in alcohol
withdrawal. Substitution therapy may be required
to reduce life-threatening effects of the rebound
stimulation of the central nervous system that
occurs during withdrawal.
Which client statement indicates a knowledge
deficit related to substance abuse?
A. "Although it's legal, alcohol is one of the most
widely abused drugs in our society."
B. "Tolerance to heroin develops quickly."
C. "Flashbacks from LSD use may reoccur
spontaneously."
D. "Marijuana is like smoking cigarettes. Everyone
does it. It's essentially harmless." - ANSWER-ANS: D