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Substance Abuse, Eating disorders

and Impulse control
disorders
1. An unemployed woman, age 24,
seeks help because she feels
depressed and abandoned and doesn't
know what to do with her life.
She says she has quit her last five
jobs because her coworkers didn't
like her and didn't train her
adequately. Last week, her boyfriend
broke up with her after she drove his
car into a tree after an
argument. The client's initial diagnosis
is borderline personality
disorder. Which nursing observations
support this diagnosis?
A. Flat affect, social withdrawal, and
unusual dress
B. Suspiciousness, hypervigilance, and
emotional coldness
C. Lack of self-esteem, strong
dependency needs, and
impulsive behavior
D. Insensitivity to others, sexual
acting out, and violence
2.In a toddler, which of the following
injuries is most likely the result
of child abuse?
A. A hematoma on the occipital region
of the head
B. A 1-inch forehead laceration
C. Several small, dime-sized circular
burns on the child's back
D. A small isolated bruise on the right
lower extremity
3. A client is admitted to the
emergency department after being
found
unconscious. Her blood pressure is
82/50 mm Hg. She is 5′ 4" (1.6 m)
tall, weighs 79 lb (35.8 kg), and
appears dehydrated and emaciated.
After regaining consciousness, she
reports that she has had trouble

eating lately and can't remember what
she ate in the last 24 hours.
She also states that she has had
amenorrhea for the past year. She is
convinced she is fat and refuses food.
The nurse suspects that she
has:
A. bulimia nervosa.
B. anorexia nervosa.
C. depression.
D. schizophrenia.
4. A 15-year-old girl with anorexia has
been admitted to a mental
health unit. She refuses to eat. Which
of the following statements is
the best response from the nurse?
A. "You don't have to eat. It's your
choice."
B. "I hope you'll eat your food by
mouth. Tube feedings and
I.V. lines can be uncomfortable."
C. "Why do you think you're fat?
You're underweight. Here — look in
the mirror."
D. "You really look terrible at this
weight. I hope you'll eat."
5. A client with a history of substance
abuse has been attending
Alcoholics Anonymous meetings
regularly in the psychiatric unit. One
afternoon, the client tells the nurse,
"I'm not going to those meetings
anymore. I'm not like the rest of those
people. I'm not a drunk. "What
is the most appropriate response?
A. "If you aren't an alcoholic, why do
you keep drinking and ending up
in the hospital?"
B. "It's your decision. If you don't
want to go, you don't have to."
C. "You seem upset about the
meetings."
D. "You have to go to the meetings.
It's part of your treatment plan."

Intensive inpatient treatment 12. Weekly outpatient therapy C. C. Instituting behavioral modification therapy as ordered C. structural changes in basal ganglia and caudate nucleus. Which of the following etiologic factors predispose a client to Tourette syndrome? A. by the client alone. Prealcoholic phase B. Addressing the client's low selfesteem D. Abnormalities in the structure and function of the ventricles D. jointly by the client and nurse. A client tells the nurse that he is having suicidal thoughts every day.3 kg). A client who's actively hallucinating is brought to the hospital by friends. and genetics C.1kg) weight loss in the last month. Paranoia D. She is 5′ 7" (1. B. Always tie restraints to side rails. Chronic phase 8. In conferring with the treatment team. Environmental factors and birthrelated trauma . Her history includes anorexia nervosa and a 20-lb (9. Have three staff members present. the contract should be written: A. B. During which phase of alcoholism is loss of control and physiologic dependence evident? A. one for each side of the body and one for the head. To best promote compliance. Early alcoholic phase C. Have an organized. A client is admitted to the inpatient adolescent unit after being arrested for attempting to sell cocaine to an undercover police officer. Crucial phase D. D. Which of the following is important when restraining a violent client? A. the nurse should make which of the following recommendations? A. Abnormalities in brain neurotransmitters. Which of the following common assessment findings indicates that the client may have ingested PCP? A. 7. Dilated pupils B. Which nursing intervention takes highest priority? A. D. Regularly monitoring vital signs and weight 11. Nystagmus C.6. Initiating caloric and nutritional therapy as ordered B.7 m) tall and weighs 80 lb (36. abstractly. No known etiology B. A severely dehydrated teenager admitted to the hospital with hypotension and tachycardia undergoes evaluation for electrolyte disturbances. 9. Altered mood 10. A second psychiatric opinion D. C. They say that the client used either lysergic acid diethylamide (LSD) or angel dust (phencyclidine [PCP]) at a concert. jointly by the physician and nurse. efficient team approach after the decision is made to restrain the client. A no-suicide contract B. Secure restraints to the gurney with knots to prevent escape. The nurse plans to write a behavioral contract.

What is the nurse's best response? A. euphoria and constricted pupils. During a private conversation. "Tell me what type of instrument you used. domestic violence and abuse span all socioeconomic classes. The nurse is providing care for a client undergoing opiate withdrawal. a client plans to take disulfiram (Antabuse) as prescribed. violence usually results from a power struggle. a single-parent family 15. B. the nurse emphasizes the need to: A." D. Assessment findings in a client abusing opiates such as morphine include: A. I'm concerned about infection. benzodiazepines. 17. "That's it! You're on suicide precautions. adhere to concomitant vitamin B therapy. a client with borderline personality disorder asks the nurse to keep his secret and then displays multiple. opiate users are commonly detoxified with: A.13. C. C. C. B. An 16-year-old boy is admitted to the facility after acting out his aggressions inappropriately at school. self-inflicted. Opiate withdrawal causes severe physical discomfort and can be life-threatening." B. passive parents. Denial 14. D. Logical thinking C. dilated pupils and agitation. The nurse caring for this client understands that: A. a prominent attorney. dilated pupils and slurred speech. violent behavior is a genetic trait passed from one generation to the next. but let's talk about it first. B. D. barbiturates. When teaching the client about this drug. On discharge after treatment for alcoholism. Predisposing factors to the expression of aggression include: A. . amphetamines. D. B. avoid all products containing alcohol. open boundaries are common in violent families. The client tells the nurse that he frequently uses cocaine but he can control his use if he chooses. 19. A client is admitted for detoxification after a cocaine overdose. an internal locus of control. 16. Repression D." 18. limit alcohol consumption to a moderate level. A client is brought to the emergency department after being beaten by her husband. The nurse is caring for a client who she believes has been abusing opiates. To minimize these effects. Do you want to tell me why you did that?" C. violence on television. C. methadone. "The team needs to know when something important occurs in treatment. D. superficial lacerations on the forearms. rapid speech and agitation. "I'm going to tell your physician. C. B. return for monthly blood drug level monitoring. D. I need to tell the others. Withdrawal B. Which coping mechanism is he using? A.

I can quit whenever I want. dry skin D. Attendance at Alcoholics Anonymous meetings every day will cure alcoholism. Constricted pupils 21. C. For treatment to be successful. nitroglycerin (Nitro-Bid IV). The nurse is working with a client who abuses alcohol. Helping the client identify and express feelings of anxiety and anger B. Which nursing action is best when trying to diffuse a client's impending violent behavior? A. incoherent speech. the nurse expects the physician to prescribe: A. "I don't have a drug problem. Other assessment findings include an enlarged liver. . Placing the client in seclusion 23. The electrocardiogram (ECG) shows a 1mm ST-segment elevation the anteroseptal leads and T-wave inversion in leads V3 to V5. Hot." Which defense mechanism is the client using? A.V. Obsession C. Which of the following signs should the nurse expect in a client with known amphetamine overdose? A. A history of schizophrenia in the family D. No other information about the client is available. Considering the client's history of drug abuse. lidocaine (Xylocaine). Which psychosocial influence has been causally related to the development of aggressive behavior and conduct disorder? A. what is the first priority? A. An occasional social drink is acceptable behavior for the alcoholic 24. and recording fluid intake and output B. C.20. Which of the following facts should the nurse communicate to the client? A. Tachycardia C. lethargy. A client with a history of cocaine addiction is admitted to the coronary care unit for evaluation of substernal chest pain. Rationalization 26. Checking the client's medical records for health history information C. Instituting seizure precautions. D. Compensation D. Low socioeconomic status 25. Denial B. An overbearing mother B. procainamide (Pronestyl). A client is admitted to the psychiatric unit with a diagnosis of alcohol intoxication and suspected alcohol dependence. Restricting fluids and leaving the client alone to "sleep off" the episode 22. jaundice. In group therapy. After the nurse completes the initial assessment. Involving the client in a quiet activity to divert attention C. family members must participate. heroin every day for the past 14 years says. obtaining frequent vital signs. Attempting to contact the client's family to obtain more information about the client D. Abstinence is the basis for successful treatment. I've done it before. B. and rambling. Rejection by peers C. Hypotension B. B. a client who has used I. Leaving the client alone until the client can talk about feelings D.

temperature above 101° F (38. diarrhea. and pruritus C. paroxetine (Paxil) 29. B. "Tell me how you feel about the accident. 27. Vomiting. haloperidol (Haldol) D. "I recommend that you attend an Alcoholics Anonymous meeting. He confesses that he drinks 1 qt or more of vodka each day and uses cocaine occasionally. This client has a long history of initiating fights and abusing animals and recently was arrested for setting a neighbor's dog on fire. Dehydration. The client will drink plenty of fluids daily.3° C). C. fluvoxamine (Luvox) C. Diaphoresis. I just need to keep my weight down because I'm a cheerleader. "You should know better than to drink and drive. A 15-year-old client is brought to the clinic by her mother. "Why didn't you get someone else to drive you?" B. the nurse expects the physician to prescribe: A." D. What are some early signs of this condition? A. When evaluating this . Hypertension. Which of the following goals is a priority? A. nifedipine (Procardia) and lidocaine. the nurse notes sudden increases in the arterial blood pressure and heart rate. I eat plenty of fast food when I'm out with my friends. tremors. B." 28. "I do diet around my periods." C. and bradycardia B. A client is admitted to a psychiatric facility by court order for evaluation for antisocial personality disorder. fluoxetine (Prozac) B. nifedipine and esmolol 32.D. epinephrine. "I just can't seem to get down to the weight I want to be. A client voluntarily admits himself to the substance abuse unit. The nurse conducts a health history interview. D. To correct these problems." D. I'm so fat compared to other girls. What would be the most therapeutic response from the nurse? A." 30. "I like the way I look. The client will commit to a drugfree lifestyle." B. D. and nervousness 31. When monitoring a client recently admitted for treatment of cocaine addiction. Later that afternoon. nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc). otherwise. diaphoresis. Her mother expresses concern about her daughter's weight loss and constant dieting. norepinephrine (Levophed) and lidocaine (Xylocaine). I just get so bloated. Which of the following comments indicates that the client may be suffering from anorexia nervosa? A. The client will make a personal inventory of strengths 33. and seizures D. he begins to show signs of alcohol withdrawal. Which is the drug of choice for treating Tourette syndrome? A. A client experiencing alcohol withdrawal is upset about going through detoxification. C." C. The client tells the nurse he was involved in a car accident while he was intoxicated. "I don't like the food my mother cooks. The client will work with the nurse to remain safe.

B. A rigid posture. The nurse notes a rise in the client's arterial blood pressure and a heart rate of 144 beats/minute." 35. The nurse concludes that the client is at high risk for which complication of cocaine use? A. "I only spend half of my paycheck at the bar. begin anytime within the next 1 to 2 days. A client is brought to the psychiatric clinic by family members. substernal chest pain suddenly complains of palpitations. As part of the intake interview. In fact. C. the nurse should assess for which behavioral clues? A. Providing one-on-one supervision during meals and for 1 hour afterward B. Situational low self-esteem related to feelings of loss of control." B.client for the potential for violence. Silence and noncompliance D. begin after 7 days. not occur at all because the time period for their occurrence has passed. which statement by the client most strongly supports a diagnosis of psychoactive substance abuse? A. B. restlessness. Initially. A client is being admitted to the substance abuse unit for alcohol detoxification. During an interview with the nurse." D. Neurobehavioral deficits D. Based on this finding. Based on this response. The nurse is assigned to care for a client with anorexia nervosa. "I'm not addicted to alcohol. Bradyarrhythmias C. 38. but the police are just trying to hassle me. the nurse asks him when he had his last alcoholic drink. 36. C. Letting the client eat with other clients to create a normal mealtime atmosphere . Panic disorder 37. Depression and physical withdrawal C. the nurse should formulate a nursing diagnosis of: A. Hypervigilance and talk of past violent acts 34. A client recently admitted to the hospital with sharp. I can drink more than I used to without being affected. Initial nursing assessment reveals that the client's wrists are scratched from a recent suicide attempt. Ineffective individual coping related to feelings of guilt. On further questioning. "I know I've been arrested three times for drinking and driving. A client with borderline personality disorder is admitted to the psychiatric unit. and glaring B. the nurse should expect early withdrawal symptoms to: A. Risk for violence: Directed toward others related to verbal threats. D. who tell the admitting nurse that the client repeatedly drives while intoxicated despite their pleas to stop." C. He says that he had his last drink 6 hours before admission. "I just drink to relax after work. Risk for violence: Self-directed related to impulsive mutilating acts. D. which nursing intervention is most appropriate for this client? A. Coronary artery spasm B. the client admits to having used cocaine recently after previously denying use of the drug. begin within 2 to 7 days.

One who tells others that he or she might do something if life doesn't get better soon D. Heart rate of 120 to 140 beats/minute B. what would be the most desirable outcome? A. Make Today Count C. clozapine (Clozaril) B. D. The student accepts a referral to a substance abuse counselor. weigh the client daily. severely restrict the client's physical activities.C. A client who reportedly consumes 1 qt of vodka daily is admitted for alcohol detoxification. Restraining the client and measuring blood pressure every 30 minutes 40. Emotions Anonymous D. Cancer C. . One who talks about wanting to die 42. the physician is most likely to prescribe which drug? A. Alcoholics Anonymous 46. Blood pressure of 140/80 mm Hg 41. Blood pressure of 100/70 mm Hg D. lithium carbonate (Eskalith) 45. A client is being treated for alcoholism. A high school student is referred to the school nurse for suspected substance abuse. Heart rate of 50 to 60 beats/minute C. lorazepam (Ativan) D. Which assessment finding is most consistent with early alcohol withdrawal? A. A client begins to experience alcoholic hallucinosis. Following the nurse's assessment and interventions. Diabetes mellitus D. Trying to persuade the client to eat and thus restore nutritional balance D. One who appears depressed. thiothixene (Navane) C. the nurse should plan to: A. frequently thinks of dying. To promote the client's physical health. 44. One who plans a violent death and has the means readily available C. After a family meeting. The nurse should suggest that the family join which organization? A. Al-Anon B. after the evening meal. the client's spouse asks the nurse about ways to help the family deal with the effects of alcoholism. Which client is at highest risk for suicide? A. C. Allergies B. Hepatitis A 43. A client is admitted to the psychiatric clinic for treatment of anorexia nervosa. Checking the client's blood pressure every 15 minutes and offering juices C. To try to prevent alcohol withdrawal symptoms. The student reports increased comfort with making choices. Providing a quiet environment and administering medication as needed and prescribed D. and gives away all personal possessions B. B. The student discusses conflicts over drug use. The student agrees to inform his parents of the problem. Keeping the client restrained in bed B. B. Which of the following medical conditions is commonly found in clients with bulimia nervosa? A. Giving the client as much time to eat as desired 39. What is the best nursing intervention at this time? A.

has only moderate impulse control. 49. Anxiety D. A client whose husband just left her has a recurrence of anorexia nervosa. Flumazenil (Romazicon) has been ordered for a client who has overdosed on oxazepam (Serax). has learned violence as an acceptable behavior. D. 50. the nurse should be prepared for which common adverse effect? A. He dropped out of school at age 16 and has been living on his own since then. A husband and wife seek emergency crisis intervention because he slapped her repeatedly the night before. D. feels secure in his relationship with his wife. obsessive-compulsive personality disorder. Seizures B. 48. C. When intervening with this couple. B. 51. C. The nurse should tell the client that the only effective treatment for alcoholism is: A. psychotherapy. commit suicide. repeatedly discuss previous suicide attempts with the client. borderline personality disorder. B. gain control of one part of her life. control eating impulses. and acid-base balance. A client who's at high risk for suicide needs close supervision. 47. A young man is remanded by the courts for psychiatric treatment. C. auto theft. instruct the client to keep an accurate record of food and fluid intake. includes delinquency.C. 53. manipulate her husband. The most appropriate initial goal for a client diagnosed with bulimia is to: A. the nurse knows they are at risk for repeated violence because the husband: A. identify anxiety-causing situations. B. Shivering C. Chest pain 52. Before administering the medication. His police record. C. The nurse caring for her realizes that this exacerbation of anorexia nervosa results from the client's effort to: A. D. monitor vital signs. assure the client that the nurse will hold in confidence anything the client says. A client has approached the nurse asking for advice on how to deal with his alcohol addiction. the nurse should: A. His history suggests maladaptive coping. avoid shopping for large amounts of food. Alcoholics Anonymous (AA). which dates to his early teenage years. which is associated with: A. serum electrolyte levels. B. To best ensure the client's safety. check the client frequently at irregular intervals throughout the night. C. denies feelings of jealousy or possessiveness. live up to her mother's expectations. D. C. D. aversion therapy. running away. B. B. eat only three meals per day. The nurse is caring for a client diagnosed with bulimia. narcissistic personality disorder. D. . The husband indicates that his childhood was marred by an abusive relationship with his father. antisocial personality disorder. total abstinence. and vandalism.

The parents are argumentative and demanding with emergency department personnel. deferoxamine mesylate (Desferal) B. The client will make a contract with the nurse that sets a target weight. but I'll monitor you for 90 minutes after you eat. Which of the following drugs should the nurse prepare to administer to a client with a toxic acetaminophen (Tylenol) level? A. "You can sit with me. The mother and father tell different stories regarding what happened." Which of the following is the most appropriate response? A. a client with bulimia nervosa tells the nurse. flumazenil (Romazicon) D. Today. acetylcysteine (Mucomyst) 55. The client will establish adequate daily nutritional intake. C. "If you continue to talk like that. For a client with anorexia nervosa. For a client with anorexia nervosa." B. my goal is to do it twice." D." What is the nurse's best response? A. D. magnesium sulfate D. "How are you purging and when do you do it?" C. naloxone (Narcan) B. "I know it's important for you to feel in control. The client will identify selfperceptions about body size as unrealistic. the nurse plans to include the parents in therapy sessions along with the client. 54. disregard decreased communication by the client because this is common in suicidal clients. A client is admitted to the substance abuse unit for alcohol detoxification. The family is poor. haloperidol (Haldol) C. 59. The client will verbalize the possible physiological consequences of self-starvation. "Don't you know it's illegal to use drugs?" 58." B. During postprandial monitoring. When interviewing the parents of an injured child. The injury isn't consistent with the history or the child's age. I'm going to stop speaking to you. A client admitted to the psychiatric unit for treatment of substance abuse says to the nurse. "I trust you not to purge. What fact should the nurse remember to be typical of parents of clients with anorexia nervosa? . succimer (Chemet) C. C.D. "You told me you got fired from your last job for missing too many days after taking drugs all night." 57." C. chlordiazepoxide (Librium) 56. "It felt so wonderful to get high. B. I was still able to purge. D. "Tell me more about how it felt to get high. B." D. 60. I won't allow you to purge today. After you sat with me yesterday. which goal takes the highest priority? A. which of the following is the strongest indicator that child abuse may be a problem? A. "Don't worry. Which of the following medications is the nurse most likely to administer to reduce the symptoms of alcohol withdrawal? A. but you're just wasting your time.

B. Remaining with the client and staying calm B. Determining why the husband feels so angry 62. 63. B. Let the client choose her own food. The nurse is developing a plan of care for a client with anorexia nervosa. They usually have a history of substance abuse. 65. the nurse teaches the client that he must read labels carefully on which of the following products? A. They tend to overprotect their children. In the emergency department. They alternate between loving and rejecting their children. C. Provide objective data and feedback regarding the client's weight and attractiveness. Before initiating therapy with disulfiram (Antabuse). "When I look in the mirror. They maintain emotional distance from their children. a client with facial lacerations states that her husband beat her with a shoe. Calling a security guard and another staff member for assistance C. Telling the client's husband that he must leave at once D. Cheese 66. which is the nurse's highest care priority? A. Fill out the client's menu and make sure she eats at least half of what is on her tray. D.A. shouting that he wants to "finish the job. A client with anorexia nervosa tells the nurse. I hate what I see. Let the client eat her meals in private. The nurse is caring for a client with bulimia. Aftershave lotion C. Suddenly the client's husband arrives. Then engage her in social activities for at least 2 hours after each meal." Which strategy should the nurse use to deal with the client's distorted perceptions and feelings? A. Initially. C. The nurse is caring for a client being treated for alcoholism. Focus discussions on food and weight. B. Exploring the nurse's own feelings about suicide C. she waits to be seen by the crisis intake nurse. but she should keep a strict calorie count. C. Let the client eat food brought in by the family if she chooses. Avoid discussing the client's perceptions and feelings. Referring the client to a clergyperson to discuss the moral implications of suicide 64. After the health care team repairs her lacerations. Assessing the client's home environment and relationships outside the hospital B. who will evaluate the continued threat of violence. Toothpaste D. D. Avoid discussing unrealistic cultural standards regarding weight. Discussing the future with the client D. Carbonated beverages B. D. I look so fat and ugly. Strict management of dietary intake is necessary. The nurse is assigned to care for a suicidal client. 61. If she eats everything she orders. Which intervention is also important? A. Which action should the nurse include in the plan? . then stay with her for 1 hour after each meal." What is the first priority of the health care worker who witnesses this scene? A.

lack of financial autonomy and isolation) B. Which outcome criteria would be appropriate for a child diagnosed with oppositional defiant disorder? A. A parent brings a preschooler to the emergency department for treatment of a dislocated shoulder. which allegedly happened when the child fell down the stairs. C. D. The child doesn't cry when the shoulder is examined. Enter the room quietly and move beside her to assess her injuries. Reasons they stay in the abusive relationship (for example. thiamine deficiency. During hospitalization. C. Which action should make the nurse suspect that the child was abused? A. triglyceride buildup. D. 72. Client's physical needs B. The nurse realizes that these symptoms probably result from: A. D. calling . Laboratory tests reveal a blood alcohol level of 0. B. How should the nurse approach her initially? A. Victims of domestic violence should be assessed for what important information? A. 67. Police suspect the client was intoxicated at the time of the accident. Call for staff back-up before entering the room and restraining her.2% (200 mg/dl). Approach her slowly while speaking in a calm voice. The child pulls away from contact with the physician. acetate accumulation. Surrounded by broken glass. Move as much glass away from her as possible and sit next to her quietly. Readiness to leave the perpetrator and knowledge of resources C. C. 70. which of the following is the highest priority? A.A. Encourage the client to exercise. A client is hospitalized with fractures of the right femur and right humerus sustained in a motorcycle accident. Accept responsibility for own behaviors. which will reduce her anxiety. Client's medical needs 71. Allow the child to establish his own limits and boundaries. a below-normal serum potassium level 69. The child cries uncontrollably throughout the examination. A client is found sitting on the floor of the bathroom in the day treatment clinic with moderate lacerations on both wrists. Restrict visits with the family until the client begins to eat. The client later admits to drinking heavily for years. B. Client's safety needs C. Be able to verbalize own needs and assert rights. When planning care for a client who has ingested phencyclidine (PCP). Client's psychosocial needs D. she sits staring blankly at her bleeding wrists while staff members call for an ambulance. B. Provide privacy during meals. History of previous victimization 68. The child doesn't make eye contact with the nurse. B. B. D. Use of drugs or alcohol D. Set up a strict eating plan for the client. C. Set firm and consistent limits with the client. the client periodically complains of tingling and numbness in the hands and feet. C. D.

pneumonia. 75.7 m) tall and weighs only 90 lb (40. "Your physician must refer you to this program. the nurse should respond: A. The nurse knows that the client's behavior most likely represents the use of which defense mechanism? A. the nurse's assessment reveals that the client is 5′ 8" (1. The client exhibits gross hand tremors and is screaming for someone to kill the bugs in the bed. 73. scheduled during each shift D. Opiate withdrawal D. The nurse should suspect: A. a client with a reported history of social drinking displays these vital signs: temperature." B.her name. 77.6° F (38. The client drinks 4 L of fluid per day. One of the goals for a client with anorexia nervosa is that the client will demonstrate increased individual coping by responding to stress in constructive ways. Projection . heart rate. C. Confronting the client about her actual appearance during one-onone sessions. Which of the following actions is the best indicator that the client is working toward meeting the goal? A. For which of the following conditions might the drug be administered? A. 140/96 mm Hg. Cocaine withdrawal 76. Telling the client of the nurse's concern for her health and desire to help her make decisions to keep her healthy 74. Asking the client to compare her figure with magazine photographs of women her age B. C. "You must bring along a friend who will support you. "You must first stop drinking. and telling her that the nurse is here to help her. D. D." D. When the client asks the nurse what he must do to become a member. acute sepsis. The client talks almost constantly with friends by telephone. alcohol withdrawal.8 kg). Assigning the client to group therapy in which participants provide realistic feedback about her weight C. Alcohol withdrawal C." 78. B. respiratory rate. 24 breaths/minute. 101." C. Eighteen hours after undergoing an emergency appendectomy. Clonidine (Catapres) can be used to treat conditions other than hypertension. "Admit you're powerless over alcohol and that you need help. a postoperative infection. Regression B. Considering the client's unrealistic body image. The client paces around the unit most of the day. B. The nurse in the substance abuse unit is trying to encourage a client to attend Alcoholics Anonymous meetings." However. which intervention should be included in the plan of care? A. An attorney who throws books and furniture around the office after losing a case is referred to the psychiatric nurse in the law firm's employee assistance program. A client with anorexia nervosa describes herself as "a whale.7° C). Phencyclidine (PCP) intoxication B. The client keeps a journal and discusses it with the nurse. and blood pressure. 126 beats/minute.

and a balanced diet. suppression. calories. Intellectualization 79. I'm not making any promises. underestimate the amount consumed. 81. D. C. D. She complains of nausea and vomiting 24 hours after admission. a client is being prepared for discharge. When the nurse asks about alcohol use." C. A 38-year-old client is admitted for alcohol withdrawal. Cannibis withdrawal C. B. Which clinical manifestation is the nurse most likely to find? A. this client is most likely to: A. Which additional assessment finding would suggest that the woman has an eating disorder? A. Coarse hair growth 82. The nurse is caring for an adolescent female who reports amenorrhea. A client with a history of polysubstance abuse is admitted to the facility. 83. Wearing tight-fitting clothing B. "I will substitue crack for something else" 80. Tachycardia B. . Excessive and ritualized exercise 84. accurately describe the amount consumed. The nurse is assessing a 15-yearold female who's being admitted for treatment of anorexia nervosa. Parotid gland tenderness D. Establish a trusting relationship with the client. flushed extremities C. deny any consumption of alcohol. Which remark by the client indicates a realistic view of the future? A. Teach the client about nutrition. After completing chemical detoxification and a 12-step program to treat crack addiction. Cocaine withdrawal D. A client is admitted to the psychiatric unit with a diagnosis of anorexia nervosa. manipulating behavior." D.C. I have to limit my crack use. Reaction-formation D. and depression.7 kg). Warm.7 m) tall and weighs only 103 lb (46. The nurse is assessing a client on admission to the chemical dependency unit for alcohol detoxification. weight loss." B. The nurse assesses the client and notes piloerection. The most common early sign or symptom that this client is likely to experience is: A. Oily skin D. B. C. "I know what I have to do. and lacrimation. Although she is 5′ 8" (1. Which measure should the nurse take first when caring for this client? A. Alcohol withdrawal B. perceptual disorders. she talks incessantly about how fat she is. overestimate the amount consumed. "I'm going to take 1 day at a time. B. The nurse suspects that the client is going through which of the following withdrawals? A. pupillary dilation. Increased blood pressure C. impending coma. "I'm never going to use crack again. Opioid withdrawal 85.

B. Tourette syndrome is characterized by the presence of multiple motor and vocal tics. C. the nurse should expect to see: A. Which of the following groups are considered to be at highest risk for suicide? A. B. divorced persons.C. palilalia. and substance abusers C. Which of the following drugs may be abused because of tolerance and physiologic dependence. . 86. D. tension and irritability. B. Explore the reasons why the client doesn't eat. and young married men D. clozapine (Clozaril) and amitriptyline (Elavil) 88. physicians. When assessing this client. Alcohol abusers. Adolescents. C. hypotension. A vocal tic that involves repeating one's own sounds or words is known as: A. and persons who have made previous suicide attempts B. constipation. apraxia. slow pulse. Teachers. Discuss cultural stereotypes regarding thinness and attractiveness. and persons living in rural areas 89. A client is admitted for an overdose of amphetamines. 87. A. echolalia. Depressed persons. D. aphonia. widows. alprazolam (Xanax) and phenobarbital (Luminal) D. D. verapamil (Calan) and chlorpromazine (Thorazine) C. men over age 45. lithium (Lithobid) and divalproex (Depakote).