A nurse in a substance abuse clinic is assessing a client who is prescribed disulfiram (Antabuse). The client states he stopped the medication after developing severe nausea and vomiting. Which of the following does the nurse realize is most likely the cause of the client's symptoms?
The client took an overdose of the medication.
The client demonstrated an allergic response to the medication.
The client experienced a common side effect of the medication.
The client consumed alcohol while taking the medication.
The Correct Answer is D
Choice A Reason:
An overdose of disulfiram can cause symptoms such as nausea and vomiting, but it is less likely to be the cause in this scenario. Overdoses typically present with more severe symptoms, including seizures and coma in rare cases¹. The client's symptoms are more consistent with a disulfiram-alcohol reaction.
Choice B Reason:
An allergic response to disulfiram can cause symptoms such as rash, itching, and swelling, but severe nausea and vomiting are not typical allergic reactions². Allergic reactions would also likely present with other symptoms such as difficulty breathing or hives, which are not mentioned in this case.
Choice C Reason:
While nausea and vomiting can be common side effects of disulfiram, the severity described by the client suggests a more significant reaction. Common side effects are usually milder and do not typically cause the client to stop the medication abruptly.
Choice D Reason:
The most likely cause of the client's severe nausea and vomiting is the consumption of alcohol while taking disulfiram. Disulfiram works by inhibiting the enzyme acetaldehyde dehydrogenase, leading to an accumulation of acetaldehyde when alcohol is consumed. This results in unpleasant effects such as severe nausea, vomiting, headache, and flushing. The client's symptoms align with this reaction, making it the most probable cause.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason:
This statement reflects anger and distrust towards the physician rather than denial. It indicates a belief that the doctor's incompetence is the reason for the poor prognosis, which is a common reaction in the anger stage of grief.
Choice B reason:
This response suggests a lack of energy, which could be associated with depression, another stage of grief. It does not indicate denial, as the client is not refusing the reality of the diagnosis but expressing feelings of lethargy and possible sadness.
Choice C reason:
This statement is a classic example of denial, one of the first stages of grief identified by Elisabeth Kübler-Ross. The client is refusing to accept the reality of the prognosis, which is a defense mechanism to protect oneself from the initial shock and pain of a distressing diagnosis.
Choice D reason:
This response indicates acceptance, the final stage of grief, where the individual acknowledges the reality of the situation and is at peace with the impending outcome.
Correct Answer is B
Explanation
Choice A Reason:
The statement "Your provider has explained the causes of schizophrenia. Why do you feel guilty about your daughter's diagnosis?" is not the most appropriate response. While it acknowledges the parents' feelings, it can come across as dismissive and may make the parents feel defensive. It does not provide a supportive environment for them to express their emotions and concerns.
Choice B Reason:
The statement "You said that you feel guilty about your daughter's diagnosis. Let's talk about what is causing you to feel this way." is the most appropriate response. It acknowledges the parents' feelings and invites them to share their thoughts and emotions. This approach fosters open communication and provides an opportunity for the nurse to offer support and reassurance. It helps the parents feel heard and understood, which is crucial in addressing their feelings of guilt.
Choice C Reason:
The statement "You should not feel guilty about your daughter's diagnosis. Schizophrenia is unpreventable." is factual but not therapeutic. It dismisses the parents' feelings of guilt without addressing the underlying emotions. While it is important to provide accurate information, it is equally important to validate the parents' feelings and offer emotional support.
Choice D Reason:
The statement "I'm sure your daughter's diagnosis is very difficult to deal with, but everything will be all right once she receives the proper treatment." is well-intentioned but overly reassuring. It may come across as minimizing the parents' concerns and does not provide an opportunity for them to express their feelings. It is important to balance reassurance with empathy and active listening.
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