A patient has smoked two packs of cigarettes daily for many years. When the patient does not smoke or tries to cut back, anxiety, craving, poor concentration, and headache result. What does this scenario describe?

Correct Answer: C

Rationale: The correct answer is C: Substance dependence. This scenario describes a pattern of symptoms indicative of substance dependence, which includes tolerance, withdrawal symptoms when trying to cut back, unsuccessful attempts to quit, and continued use despite negative consequences. The patient's reliance on cigarettes to manage anxiety, craving, poor concentration, and headache indicates a psychological and physical dependence on nicotine. A: Substance abuse typically involves harmful use of a substance but does not necessarily include physiological dependence. B: Substance intoxication refers to the immediate effects of a substance in the body, not the long-term pattern of dependence. D: Recreational use of a social drug implies occasional and non-regular use, which does not align with the described scenario of chronic, daily smoking leading to withdrawal symptoms.

Correct Answer: A

Rationale: The correct answer is A because it demonstrates a positive change in behavior and mindset. The patient has been abstinent for 10 days, shows commitment to sobriety, and has a supportive employer. This indicates progress and readiness to reintegrate into work. Choice B shows longer abstinence but still relies on external factors for control. Choice C focuses on helping others rather than personal progress. Choice D mentions limitations on alcohol consumption, which may not reflect true recovery.

Correct Answer: B

Rationale: The correct answer is B because it demonstrates reflective practice by focusing on self-awareness and identifying potential barriers to effective care. This approach allows the nurse to address personal biases, limitations, and areas for growth, leading to improved nurse-client relationships. Choice A is incorrect as it suggests suppressing negative feelings, which may hinder self-awareness and authenticity in the relationship. Choice C is incorrect as it avoids self-analysis and seeks external solutions, which may not address the root of the issue. Choice D is incorrect as it prioritizes avoiding conflict over establishing healthy boundaries, which is essential for therapeutic relationships.

Correct Answer: C

Rationale: The correct answer is C because the goal of crisis intervention is to help the individual cope with the crisis and move towards a positive resolution. In this case, the mother describing her new job as better than the old one indicates that she has successfully transitioned from the crisis of losing her job to a positive outcome. Choice A is incorrect because just beginning a job search does not guarantee a successful resolution. Choice B is incorrect as resolving anger towards the employer is not the primary goal of crisis intervention. Choice D is incorrect because accepting a job that requires moving may not necessarily mean it is a better job than the previous one.

Correct Answer: B

Rationale: The correct answer is B because reassigning a client's activity level based on his demonstration of disregard of appropriate social boundaries demonstrates using outcome measurements effectively in mental health care. This shows that the nurse is monitoring the client's behavior and adjusting the care plan accordingly to promote positive outcomes. A is incorrect because requiring a caregiver to attend a discharge planning meeting does not directly relate to outcome measurements for the client's mental health progress. C is incorrect because providing clean linen according to a schedule does not demonstrate the use of outcome measurements for mental health assessment and intervention. D is incorrect because permitting the son to bring ethnic foods does not directly relate to monitoring and adjusting the client's care plan based on observed behaviors.