1 . The client states, “I go out just about every weekend and drink pretty heavily
with my friends. Does that mean I’m dependent on alcohol?” Which is the best
response by the nurse?
A. “You’re not dependent on alcohol if you never drink to the point of intoxication.”
B. “It sounds like you feel guilty about how much you drink. Tell me more about this.”
C. “With dependence, you have a strong need to drink and feel uncomfortable if you don’t.”
D. “You could be dependent. Consuming alcohol pretty heavily every weekend is excessive.”
ANSWER: C
A. Intoxication is not necessarily an indication of dependence. A person can be dependent
without becoming intoxicated, or vice versa.
B. Dependence on alcohol is not defined by guilt or other feelings surrounding the drinking
behavior.
C. Dependence involves a compulsive or chronic requirement for a chemical. The need is
so strong as to generate physical or psychological distress if left unfilled.
D. Dependency is not defined by frequency.
2. The nurse is teaching home health aides about monitoring for alcohol abuse
in older adults. Which response by a home health aide indicates a need for
further teaching?
A. “Alcohol abuse is the largest category of substance abuse problems in older adults.”
B. “I should monitor more closely for alcohol abuse in single male clients who smoke.”
C. “Retirement and freedom from work and family pressures tend to decrease alcohol use.”
D. “Confusion, malnutrition, and self-neglect may be signs of alcohol abuse in the elderly.”
ANSWER: C
1. The use of alcohol is the largest category of substance abuse in the elderly; this is a correct
statement.
2. Being male and single, having less than a high school education, low income, and smoking
are risk factors for heavy drinking in older adults; this statement is correct.
3. This statement indicates more teaching is needed. Past work and family responsibilities may
have kept a potential abuser from drinking too much, whereas isolation due to retirement and
lack of family nearby can trigger alcohol abuse.
,4. Older clients abusing alcohol display vague geriatric signs or syndromes such as confusion,
malnutrition, and self-neglect.
3. Based on client statements, the nurse determines that the client has
enormous guilt about drinking and is using excessive rationalization and denial
of drinking. Place an X on the current phase of the client’s alcoholic drinking
progression.
,Jellinek (1952) outlined four phases through which the alcoholic’s pattern of drinking
progresses. During the early alcoholic phase (Phase II), the individual feels guilt and becomes
defensive. Excessive use of denial and rationalization be- comes evident. Phase 1 involves
using alcohol to relieve everyday stress. In Phase 111, control over alcohol is lost, and
physiological dependence is evident. Drinking has become the total focus. Phase IV involves
emotional and physical disintegration.
, 4. The nurse is preparing to lead a group therapy session with clients
recovering from alcohol and other substances. Which seating arrangement
would be most effective to facilitate group participation and discussion?
ANSWER: C
A. Clients facing forward with the nurse at the front of the room establishes a
communication barrier.
B. When the clients and nurse are seated in a circle around a conference table, the
conference table poses a physical barrier.
C. Clients and the nurse seated in chairs arranged in a circle is most effective for
promoting com- munication. The room is arranged so that there are no barriers
between members.
D. The teacher standing in front of the group establishes a power position and
poses a barrier to effective communication.
with my friends. Does that mean I’m dependent on alcohol?” Which is the best
response by the nurse?
A. “You’re not dependent on alcohol if you never drink to the point of intoxication.”
B. “It sounds like you feel guilty about how much you drink. Tell me more about this.”
C. “With dependence, you have a strong need to drink and feel uncomfortable if you don’t.”
D. “You could be dependent. Consuming alcohol pretty heavily every weekend is excessive.”
ANSWER: C
A. Intoxication is not necessarily an indication of dependence. A person can be dependent
without becoming intoxicated, or vice versa.
B. Dependence on alcohol is not defined by guilt or other feelings surrounding the drinking
behavior.
C. Dependence involves a compulsive or chronic requirement for a chemical. The need is
so strong as to generate physical or psychological distress if left unfilled.
D. Dependency is not defined by frequency.
2. The nurse is teaching home health aides about monitoring for alcohol abuse
in older adults. Which response by a home health aide indicates a need for
further teaching?
A. “Alcohol abuse is the largest category of substance abuse problems in older adults.”
B. “I should monitor more closely for alcohol abuse in single male clients who smoke.”
C. “Retirement and freedom from work and family pressures tend to decrease alcohol use.”
D. “Confusion, malnutrition, and self-neglect may be signs of alcohol abuse in the elderly.”
ANSWER: C
1. The use of alcohol is the largest category of substance abuse in the elderly; this is a correct
statement.
2. Being male and single, having less than a high school education, low income, and smoking
are risk factors for heavy drinking in older adults; this statement is correct.
3. This statement indicates more teaching is needed. Past work and family responsibilities may
have kept a potential abuser from drinking too much, whereas isolation due to retirement and
lack of family nearby can trigger alcohol abuse.
,4. Older clients abusing alcohol display vague geriatric signs or syndromes such as confusion,
malnutrition, and self-neglect.
3. Based on client statements, the nurse determines that the client has
enormous guilt about drinking and is using excessive rationalization and denial
of drinking. Place an X on the current phase of the client’s alcoholic drinking
progression.
,Jellinek (1952) outlined four phases through which the alcoholic’s pattern of drinking
progresses. During the early alcoholic phase (Phase II), the individual feels guilt and becomes
defensive. Excessive use of denial and rationalization be- comes evident. Phase 1 involves
using alcohol to relieve everyday stress. In Phase 111, control over alcohol is lost, and
physiological dependence is evident. Drinking has become the total focus. Phase IV involves
emotional and physical disintegration.
, 4. The nurse is preparing to lead a group therapy session with clients
recovering from alcohol and other substances. Which seating arrangement
would be most effective to facilitate group participation and discussion?
ANSWER: C
A. Clients facing forward with the nurse at the front of the room establishes a
communication barrier.
B. When the clients and nurse are seated in a circle around a conference table, the
conference table poses a physical barrier.
C. Clients and the nurse seated in chairs arranged in a circle is most effective for
promoting com- munication. The room is arranged so that there are no barriers
between members.
D. The teacher standing in front of the group establishes a power position and
poses a barrier to effective communication.
