A nurse is caring for a client who was admitted for alcohol detoxification. Which of the following findings should the nurse expect to observe that indicate the client is experiencing alcohol withdrawal?

Decreased blood pressure and nausea

Constipation and pupil constriction

Bone and muscle aches

Increased heart rate and vomiting

Answer and Explanation

The Correct Answer is D

D. Alcohol withdrawal is characterized by a range of symptoms that can vary in severity. Some common symptoms include increased heart rate (tachycardia), sweating, tremors, anxiety, nausea, vomiting, and agitation.

A. Alcohol withdrawal is more commonly associated with increased blood pressure rather than decreased blood pressure. Nausea can be a symptom of alcohol withdrawal, particularly in the early stages, but it is not necessarily a defining characteristic.

B. Constipation and pupil constriction are not typically associated with alcohol withdrawal. These symptoms are more commonly seen with opioid withdrawal.

C Bone and muscle aches are common symptoms of alcohol withdrawal. They can occur as a result of the body's reaction to the sudden cessation of alcohol intake and the associated changes in neurotransmitter levels.

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Correct Answer is D

Explanation

D. The immune system plays a crucial role in the body's response to infections and inflammation. Research suggests that dysregulation of the immune system, including chronic inflammation and autoimmune disorders, may contribute to the development or exacerbation of certain mental health disorders.

A. Adverse effects of treatment for mental health disorders can impact the client's well-being and quality of life but they are not typically considered risk factors for developing mental illness. B Medication adherence refers to the extent to which a client follows the prescribed treatment regimen. Poor adherence does not increase the risk for mental illness

C. Allergic reactions primarily affect the respiratory or immune systems and are not typically linked to mental health outcomes.

A. A. history of self-injurious behavior B. History of trauma during the developmental years C. Borderline personality disorder D. A history of schizophrenia

Correct Answer is B

Explanation

B. Trauma during the developmental years, especially in early childhood, is considered a significant risk factor for the development of DID. Trauma disrupts normal psychological development and can lead to the fragmentation of identity as a coping mechanism to dissociate from overwhelming or traumatic experiences.

A. A history of self-injurious behavior is often associated with various mental health conditions, such as borderline personality disorder, post-traumatic stress disorder (PTSD), or depression but it is not a primary risk factor for dissociative identity disorder (DID).

C. Individuals with BPD may experience dissociative symptoms, particularly during times of stress or intense emotional arousal but BPD itself is not considered a primary risk factor for dissociative identity disorder (DID).

D. Individuals with schizophrenia may experience dissociative symptoms, such as depersonalization or derealization but these symptoms are typically secondary to psychotic experiences rather than being indicative of dissociative identity disorder (DID).

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A nurse is caring for a client who was admitted for alcohol detoxification. Which of the following findings should the nurse expect to observe that indicate the client is experiencing alcohol withdrawal?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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