The nurse is caring for a client with a substance use disorder. The client states to the
nurse, "I really appreciate all of your care. Can we meet for a cup of coffee
sometime?" Which statement made by the nurse provides the most therapeutic
response?
A."When you have completed yourtreatment, we most certainly can meet for a cup of
coffee."
B."I would love to meet you for a cup ofcoffee."
C."Thank you, but I will not be able to. It is important that we maintain a therapeutic
relationship."
D."You are myclient, and it is unethical for me to dothat."
Give this one a try later!
C."Thank you, but I will not be able to. It is important that we maintain a
therapeuticrelationship."
Rationale: Often, substance users have an unhealthy sense of personal
boundaries and frequently cross them. Clinicians need to be aware of
professionalboundaries, which the client can violate or exploit. The
statement that provides the most therapeutic responseis, "Thankyou, but I
will not be able to. It is important that we maintain a therapeutic
, relationship." The statement acknowledges the client and reinforces the
therapeutic boundaries. Telling theclient, "I would love to meet you for a
cup ofcoffee," is unethical and violates the professional boundaries.
Stating to theclient, "You are my client and it is unethical for me to dothat,"
does not acknowledge theclient's personal feelings. Stating to theclient,
"When you have completed yourtreatment, we most certainly can meet for
a cup ofcoffee," promotes an ambiguous relationship that is not
therapeutic for the client.
While practicing at an outpatient addiction clinic, the nurse summarizes a diagram in
the orientation handbook for another nurse who is new to the clinic. That diagram is
reproduced below. Which of the following statements on the part of the new nurse
would reflect an appropriate understanding of this diagram?
A) "Most abused substances either imitate or block the action of neurotransmitters."
B) "In order to be addictive, a substance must cause the release of excess
neurotransmitters."
C) "Substances that exert antagonistic effects can be used to counteract the addictive
tendencies of substances that exert agonistic effects."
D) "People with addictive personalities process neurotransmitters differently than
people who are less prone to addiction."
Give this one a try later!
A) Explanation: A) Most abused substances either mimic or block
neurotransmitters at critical receptor sites. These drugs exert agonistic
effects if they boost neurotransmitter synthesis, increase neurotransmitter
release, or activate receptors that normally respond to neurotransmitters
(as illustrated in the top half of the diagram). Conversely, they exert
antagonistic effects if they interfere with neurotransmitter release, occupy
receptor sites that are normally sensitive to neurotransmitters, or cause
leakage of neurotransmitters from synaptic vesicles (as shown in the
bottom half of the diagram). Both drugs with agonistic effects and those
with antagonistic effects can be addictive, and administering one class of
drug will not counteract the addictive tendencies of the other class.
Researchers have not identified an addictive personality type.
,A client is admitted for the fourth time in 4 years for opioid detoxification. When
planning care for this client, the nurse should consider which pathophysiologic aspect
of substance abuse because of its impact on care?
A) Aging can impact the body's ability to handle detoxification from alcohol and
drugs.
B) The client's withdrawal may be greater this time than during past detoxifications.
C) The client's dependency might have been greater this time than during past
periods of abuse.
D) Increased difficulty with opioid detoxification is likely the result of an addiction to
another substance at the same time.
Give this one a try later!
B
The emergency department nurse is providing care to a client who admits to
substance abuse. Which physical symptoms should the nurse assess during the
physicalexamination? (Select all thatapply.)
A.Inflamed nasal mucosa
B.Poor nutritional status
C.Staggering gait
D.Dilated pupils
E.Complaints of cough
Give this one a try later!
A, B, C, D
Rationale: Dilatedpupils, poor nutritionalstatus, inflamed nasalmucosa,
and staggering gait may all be physical signs of substance abuse.
Complaints of a cough are not a typical physical sign of substance abuse.
, A public health nurse is presenting a teaching session about alcohol use to a group of
college seniors. During the session, one of the students admits to frequent alcohol
use. What is the nurse's priority action?
A) Initiate a community assessment of the campus
B) Contact the campus nurse and refer the student for services
C) Notify campus security that the student may be driving while intoxicated
D) Complete a crisis assessment with the student
Give this one a try later!
Answer: D Explanation: The student should be assessed to determine the
extent of crisis he or she is facing as the result of frequent alcohol use. This
crisis assessment will allow the nurse to determine the appropriate course
of action. A community assessment is not necessary at this time because the
issue appears to be limited to this particular student. Contacting the
campus nurse is not advised without the student's permission. There is no
evidence that the student is driving while intoxicated.
A college student attends a seminar on alcohol abuse. Which statement would alert
the nurse that the student needs more education?
A) "The children of alcoholics have a lower risk of becoming alcoholic."
B) "Native Americans are at higher risk of becoming alcoholic."
C) "Married college graduates are less likely to become alcoholics."
D) "Childless people are more likely than parents to become alcoholics."
Give this one a try later!
A
During visitation on the unit, a nurse is observing the family dynamics of an
adolescent client who has an addiction problem. In doing so, the nurse concludes
nurse, "I really appreciate all of your care. Can we meet for a cup of coffee
sometime?" Which statement made by the nurse provides the most therapeutic
response?
A."When you have completed yourtreatment, we most certainly can meet for a cup of
coffee."
B."I would love to meet you for a cup ofcoffee."
C."Thank you, but I will not be able to. It is important that we maintain a therapeutic
relationship."
D."You are myclient, and it is unethical for me to dothat."
Give this one a try later!
C."Thank you, but I will not be able to. It is important that we maintain a
therapeuticrelationship."
Rationale: Often, substance users have an unhealthy sense of personal
boundaries and frequently cross them. Clinicians need to be aware of
professionalboundaries, which the client can violate or exploit. The
statement that provides the most therapeutic responseis, "Thankyou, but I
will not be able to. It is important that we maintain a therapeutic
, relationship." The statement acknowledges the client and reinforces the
therapeutic boundaries. Telling theclient, "I would love to meet you for a
cup ofcoffee," is unethical and violates the professional boundaries.
Stating to theclient, "You are my client and it is unethical for me to dothat,"
does not acknowledge theclient's personal feelings. Stating to theclient,
"When you have completed yourtreatment, we most certainly can meet for
a cup ofcoffee," promotes an ambiguous relationship that is not
therapeutic for the client.
While practicing at an outpatient addiction clinic, the nurse summarizes a diagram in
the orientation handbook for another nurse who is new to the clinic. That diagram is
reproduced below. Which of the following statements on the part of the new nurse
would reflect an appropriate understanding of this diagram?
A) "Most abused substances either imitate or block the action of neurotransmitters."
B) "In order to be addictive, a substance must cause the release of excess
neurotransmitters."
C) "Substances that exert antagonistic effects can be used to counteract the addictive
tendencies of substances that exert agonistic effects."
D) "People with addictive personalities process neurotransmitters differently than
people who are less prone to addiction."
Give this one a try later!
A) Explanation: A) Most abused substances either mimic or block
neurotransmitters at critical receptor sites. These drugs exert agonistic
effects if they boost neurotransmitter synthesis, increase neurotransmitter
release, or activate receptors that normally respond to neurotransmitters
(as illustrated in the top half of the diagram). Conversely, they exert
antagonistic effects if they interfere with neurotransmitter release, occupy
receptor sites that are normally sensitive to neurotransmitters, or cause
leakage of neurotransmitters from synaptic vesicles (as shown in the
bottom half of the diagram). Both drugs with agonistic effects and those
with antagonistic effects can be addictive, and administering one class of
drug will not counteract the addictive tendencies of the other class.
Researchers have not identified an addictive personality type.
,A client is admitted for the fourth time in 4 years for opioid detoxification. When
planning care for this client, the nurse should consider which pathophysiologic aspect
of substance abuse because of its impact on care?
A) Aging can impact the body's ability to handle detoxification from alcohol and
drugs.
B) The client's withdrawal may be greater this time than during past detoxifications.
C) The client's dependency might have been greater this time than during past
periods of abuse.
D) Increased difficulty with opioid detoxification is likely the result of an addiction to
another substance at the same time.
Give this one a try later!
B
The emergency department nurse is providing care to a client who admits to
substance abuse. Which physical symptoms should the nurse assess during the
physicalexamination? (Select all thatapply.)
A.Inflamed nasal mucosa
B.Poor nutritional status
C.Staggering gait
D.Dilated pupils
E.Complaints of cough
Give this one a try later!
A, B, C, D
Rationale: Dilatedpupils, poor nutritionalstatus, inflamed nasalmucosa,
and staggering gait may all be physical signs of substance abuse.
Complaints of a cough are not a typical physical sign of substance abuse.
, A public health nurse is presenting a teaching session about alcohol use to a group of
college seniors. During the session, one of the students admits to frequent alcohol
use. What is the nurse's priority action?
A) Initiate a community assessment of the campus
B) Contact the campus nurse and refer the student for services
C) Notify campus security that the student may be driving while intoxicated
D) Complete a crisis assessment with the student
Give this one a try later!
Answer: D Explanation: The student should be assessed to determine the
extent of crisis he or she is facing as the result of frequent alcohol use. This
crisis assessment will allow the nurse to determine the appropriate course
of action. A community assessment is not necessary at this time because the
issue appears to be limited to this particular student. Contacting the
campus nurse is not advised without the student's permission. There is no
evidence that the student is driving while intoxicated.
A college student attends a seminar on alcohol abuse. Which statement would alert
the nurse that the student needs more education?
A) "The children of alcoholics have a lower risk of becoming alcoholic."
B) "Native Americans are at higher risk of becoming alcoholic."
C) "Married college graduates are less likely to become alcoholics."
D) "Childless people are more likely than parents to become alcoholics."
Give this one a try later!
A
During visitation on the unit, a nurse is observing the family dynamics of an
adolescent client who has an addiction problem. In doing so, the nurse concludes
