Chapter 27: Care of the Chemically Impaired

Chapter 27: Care of the Chemically Impaired

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1)   A client has been admitted for treatment of a compound fracture of the femur sustained when she fell while intoxicated. The nurse has cared for the client on previous admissions for similar problems. The nurse admits to feeling angry and frustrated at seeing the client in this condition. The action by the nurse that would be most beneficial for the client is to

ANS:   D

The nurse who uses the approach of honestly acknowledging feelings is able to maintain congruence between nonverbal and verbal communication. This approach shows the nurse’s concern for the client’s well-being. Option A, an avoidant approach by the nurse, would confirm for the client her lack of worth and the hopelessness of her situation. Option B is not an honest approach. The nurse’s true feelings would probably be conveyed nonverbally. Option C: This approach reveals the nurse’s feelings of helplessness.

DIF:    Cognitive Level: Application             REF:    Text Page: 559

TOP:    Nursing Process: Implementation

MSC:   NCLEX: Safe, Effective Care Environment;

2)   The blood alcohol level of a client admitted last night with a compound fracture of the femur sustained in a fall while intoxicated was not assessed at the time of admission. The nurse should

ANS:   D

These questions allow the nurse to gain vital information about the likelihood of withdrawal symptoms occurring and the general time of their onset. The blood alcohol level at the time of admission is useful for assessment purposes but is not a necessity. Options A and C: Information relevant for planning can be obtained with option D. Option B is not the best solution. Ascertaining if and when withdrawal symptoms may appear is important.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 554

TOP:    Nursing Process: Assessment

MSC:   NCLEX: Safe, Effective Care Environment;

3)   If an intoxicated client admitted for trauma treatment last night at 2 AM is going to have withdrawal symptoms, nurses should be alert for the symptoms to begin

ANS:   A

Alcohol withdrawal usually begins 6 to 8 hours after cessation or marked reduction of alcohol intake.

DIF:    Cognitive Level: Application             REF:    Text Page: 554

TOP:    Nursing Process: Assessment            MSC:   NCLEX: Physiologic Integrity

4)   The blood pressure and pulse rates for a client admitted last night with a compound fracture of the femur sustained in a fall while intoxicated, are recorded as follows: admission 2 AM, 122/80 mm Hg and 72 beats/min

4 AM, 126/78 mm Hg and 76 beats/min

6 AM, 124/80 mm Hg and 72 beats/min

8 AM, 132/88 mm Hg and 80 beats/min

10 AM, 148/88 mm Hg and 96 beats/min

The priority action for the nurse to take is to

ANS:   D

Elevated pulse and blood pressure may indicate that the client is going into withdrawal delirium and that additional sedation is warranted. None of the other options takes into account the possible need for sedation. Options B and C: No indication is present that the client may have a urinary tract infection or is presently in need of restraint. Option A is too nonspecific. Overhydration may bring on its own set of problems.

DIF:    Cognitive Level: Analysis                  REF:    Text Page: 554, Text Page: 555

TOP:    Nursing Process: Implementation      MSC:   NCLEX: Physiologic Integrity