A nurse is caring for a client who is withdrawing from a stimulant. Which of the following should be prioritized for safety in a client with stimulant withdrawal?
The client is experiencing withdrawal symptoms.
The client is experiencing hallucinations.
The client is at risk for traumatic re-experiencing.
The client is at risk for self-harm or harm to others.
The Correct Answer is D
Choice A reason:
The client experiencing withdrawal symptoms should be monitored, as these symptoms can range from mild to severe. Withdrawal symptoms may include fatigue, depression, and anxiety, which are significant but generally not life-threatening. The nurse should provide supportive care and monitor the client's vital signs and emotional state.
Choice B reason:
If the client is experiencing hallucinations, this indicates a more severe level of withdrawal and possibly the presence of a stimulant-induced psychotic disorder. While hallucinations can be distressing and require intervention, they are not the highest priority when compared to the risk of self-harm or harm to others.
Choice C reason:
The risk for traumatic re-experiencing, or flashbacks, is a concern during withdrawal, particularly if the client has a history of trauma. These experiences can be highly distressing and may lead to further psychological distress. However, the immediate physical safety of the client and others takes precedence.
Choice D reason:
The risk of self-harm or harm to others is the most critical safety concern and must be prioritized. Clients withdrawing from stimulants may exhibit increased agitation, aggression, or impulsivity, which can lead to dangerous behaviors. The nurse must take immediate action to ensure a safe environment, which may include close supervision, the use of restraints, or rapid pharmacological intervention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A reason:
Alcohol use disorder (AUD) is associated with various workplace problems. Individuals with AUD may experience a decline in their work performance due to cognitive, emotional, and behavioral impairments caused by alcohol use. This can manifest as frequent tardiness, absenteeism, and a decrease in productivity. Moreover, alcohol use can lead to workplace injuries and conflicts, which further affect an individual's ability to perform their job effectively. Therefore, asking about the impact of alcohol use on work performance can provide insights into the extent of the disorder's effect on the client's psychosocial behaviors.
Choice B reason:
The age at which an individual begins drinking alcohol is a significant factor in the development of AUD. Studies have shown that early onset of drinking increases the risk of developing alcohol dependence later in life. While this information is valuable for understanding the client's history with alcohol, it does not directly address the current impact of alcohol use on their psychosocial behaviors.
Choice C reason:
Previous treatment for substance use disorder can indicate the severity of the client's condition and their history of seeking help. Treatment history can also reveal patterns of relapse or recovery, which are important in the management of AUD. However, this choice does not specifically inquire about the current psychosocial impact of alcohol use.
Choice D reason:
Mental health disorders often co-occur with AUD, and the presence of such disorders can exacerbate the psychosocial impact of alcohol use. While it is crucial to understand the client's overall mental health, this question does not focus on the specific effects of alcohol use on work performance and other psychosocial behaviors.
Correct Answer is ["A","B"]
Explanation
Choice A reason:
This hypothesis aligns with the typical motivations seen in factitious disorder, where individuals intentionally produce or exaggerate symptoms of illness in themselves to receive attention, sympathy, and care from medical personnel¹. The nurse should prioritize understanding this behavior to manage the client's care effectively and to avoid unnecessary medical interventions.
Choice B reason:
Similar to choice A, individuals with factitious disorder may induce injury or illness to fulfill a psychological need for attention and validation. Recognizing this motivation is crucial for the nurse to provide appropriate psychological support and to prevent further self-harm.
Choice C reason:
While misdiagnosis or medical error can occur, this is not typically a hypothesis that should be prioritized in the care of a client with factitious disorder. The disorder involves intentional actions by the client, not errors by healthcare providers.
Choice D reason:
Seeking financial gain is more characteristic of malingering than factitious disorder. In factitious disorder, the primary motivation is psychological gratification from playing the patient role, rather than external incentives like financial gain.
Choice E reason:
Factitious disorder involves the intentional production of symptoms without an underlying medical condition. Therefore, this hypothesis would not be a priority in the care of a client with factitious disorder, as the symptoms are not related to a genuine medical condition but are self-induced.
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