A nurse is caring for a client who reports frequent social use of alcohol. The client tells the nurse that they have been reprimanded at work for being late several times after they had been out late drinking. Which of the following statements by the client might indicate that the client has developed a substance use disorder?

Correct Answer: A

Rationale: The correct answer is option A) "I have lost 15 pounds! I just don't want to eat lately." This statement indicates a potential substance use disorder because weight loss and loss of appetite are common symptoms of substance abuse, particularly alcohol. This change in eating habits, coupled with the client's reported frequent social use of alcohol and negative consequences at work due to drinking, raises concern for a substance use disorder. Option B) "I am so focused right now. I have a lot of goals." is incorrect because it does not directly relate to the symptoms or consequences of a substance use disorder. While substance use can sometimes lead to increased focus or euphoria initially, this statement does not align with the typical signs of a problem. Option C) repeats the same statement as option A) and is incorrect due to this repetition. Option D) "I am taking art lessons to relieve stress." is incorrect as it suggests a healthy coping mechanism for stress. While individuals with substance use disorders may use substances to cope with stress, engaging in positive activities like art lessons is not indicative of a substance use disorder. In an educational context, it is crucial for healthcare providers, including nurses, to be able to recognize the signs and symptoms of substance use disorders in their clients. Understanding these cues can help in early intervention, appropriate referrals, and providing support for individuals struggling with substance abuse issues. It is essential for nurses to approach these situations with empathy, understanding, and evidence-based interventions to promote the health and well-being of their clients.

Correct Answer: C

Rationale: In the context of behavioral nursing and mental health care, a patient should be considered for involuntary commitment when they exhibit behaviors that pose a serious risk to themselves or others. Threatening to harm oneself or others (Option C) is a clear indication of imminent danger and justifies the need for involuntary commitment to ensure safety and provide necessary treatment. Option A, nonadherence to treatment, while concerning, does not necessarily warrant involuntary commitment as it may require a different approach to address the underlying issues and improve treatment compliance. Option B, selling and distributing illegal drugs, is a criminal behavior that should be addressed through legal channels rather than involuntary commitment for psychiatric care. Option D, fraudulent bankruptcy filing, is a financial issue that does not directly relate to the need for immediate psychiatric intervention. In an educational context, understanding the criteria for involuntary commitment is crucial for behavioral health professionals to make informed and ethical decisions when dealing with patients who may pose a risk to themselves or others. This knowledge helps ensure the safety and well-being of patients and the community while respecting the rights and autonomy of individuals receiving mental health care.

Correct Answer: A

Rationale: The correct answer is A) Go to the nearest emergency department immediately. This patient is experiencing symptoms of antidepressant withdrawal, known as discontinuation syndrome. Amitriptyline, as a tricyclic antidepressant, can cause withdrawal symptoms if stopped abruptly after long-term use. The patient's symptoms of cold sweats, nausea, rapid heartbeat, and nightmares are indicative of withdrawal and require immediate medical attention to manage potential complications. Option B is incorrect as it trivializes the situation and does not address the severity of the symptoms. Taking aspirin and fluids will not alleviate withdrawal symptoms. Option C is incorrect because restarting the antidepressant without medical guidance can be dangerous and may not address the immediate symptoms effectively. The patient needs urgent evaluation by a healthcare provider. Option D is incorrect as it advises the patient to resume and then discontinue the medication again without medical supervision. This approach can worsen withdrawal symptoms and is not a recommended practice in managing antidepressant withdrawal. In an educational context, this question highlights the importance of understanding and managing antidepressant withdrawal symptoms. Nurses need to be vigilant in recognizing such symptoms and providing appropriate guidance to patients to ensure their safety and well-being. Immediate medical attention is crucial in such situations to prevent complications and provide necessary support to the patient.

Correct Answer: C

Rationale: In the treatment of alcohol use disorder, the medication commonly used is Disulfiram (option C). Disulfiram works by causing unpleasant effects such as nausea, vomiting, and palpitations when alcohol is consumed, thus acting as a deterrent to drinking. This medication helps individuals maintain sobriety by creating a negative association with alcohol consumption. Methadone (option A) is used in the treatment of opioid dependence, not alcohol use disorder. Bromocriptine (option B) is a medication used for conditions like Parkinson's disease and hyperprolactinemia, not alcohol use disorder. Naltrexone (option D) is also used in the treatment of alcohol use disorder, but it works differently from Disulfiram. Naltrexone reduces alcohol cravings and the pleasurable effects of alcohol, while Disulfiram causes unpleasant reactions if alcohol is consumed. In an educational context, understanding the pharmacological interventions for alcohol use disorder is crucial for healthcare professionals working in behavioral nursing. Knowing the mechanisms of action of different medications helps in providing appropriate and effective treatment to individuals struggling with alcohol use disorder. By grasping the rationale behind the correct medication, healthcare providers can make informed decisions to support their patients in achieving and maintaining sobriety.

Correct Answer: D

Rationale: In working with a patient diagnosed with PTSD, the most appropriate intervention is option D: helping the patient identify triggers and develop coping strategies. This approach is grounded in evidence-based practice for PTSD management. By identifying triggers, the patient gains awareness of what may lead to distress or flashbacks, empowering them to implement coping strategies to manage these triggers effectively. Option A, encouraging avoidance of talking about the trauma, is not recommended as it may perpetuate avoidance behaviors, worsen symptoms, and hinder the patient's ability to process and heal from the traumatic experience. Option B, exposure therapy, although effective for some individuals with PTSD, may not be appropriate for all patients, especially if they are not ready or willing to confront the trauma directly. Option C, offering sedating medications during flashbacks, only addresses the symptoms temporarily without addressing the underlying triggers or providing the patient with long-term coping skills. In an educational context, it is crucial for nurses to understand the principles of trauma-informed care and evidence-based interventions for PTSD. By choosing option D, nurses can actively engage in supporting patients to develop resilience and regain control over their lives in a safe and empowering manner.