A nurse is providing counseling to a client who has substance use disorder.
The nurse is discussing the client's concerns regarding relapse. Which of the following client statements indicates the client is adhering to the relapse prevention plan? (Select all that apply)
“I can manage it if I just cut down on the drinking.”
“I was angry at my friends for putting me in that situation, but called my sponsor.”
“I just don't feel like myself and I don’t know who this new person is.”
“I’m not sure I can manage staying sober."
“I’ve quit drinking plenty of times before. I don’t want to give it up for good."
The Correct Answer is B
A. "I can manage it if I just cut down on the drinking." This statement reflects denial and a lack of commitment to sobriety. Controlled drinking is not a realistic goal for someone with substance use disorder, as the focus should be on complete abstinence.
B. "I was angry at my friends for putting me in that situation, but I called my sponsor." This statement demonstrates adherence to the relapse prevention plan. Calling a sponsor is a key coping strategy in 12-step programs like Alcoholics Anonymous (AA), helping the client seek support instead of relapsing.
C. "I just don't feel like myself and I don’t know who this new person is." This reflects emotional distress and uncertainty about sobriety, which can indicate a higher risk of relapse. While it is a common feeling in early recovery, it does not show active commitment to relapse prevention.
D. "I’m not sure I can manage staying sober." This expresses doubt and lack of confidence in long-term sobriety, suggesting the client may still be struggling with commitment to change. This is a warning sign rather than an indicator of relapse prevention success.
E. "I’ve quit drinking plenty of times before. I don’t want to give it up for good." This statement shows ambivalence about quitting alcohol permanently, which contradicts the goal of maintaining sobriety. A relapse prevention plan focuses on long-term abstinence, not temporary cessation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Refer the client to a support group for survivors of suicide. While a support group can be beneficial, this is not the first priority. The client is in immediate distress, and the nurse must first assess their emotional state and understanding of the event before providing referrals.
B. Offer to contact the client's family or support system. While involving the client's support system is important, the nurse should first assess the client’s immediate emotional and psychological response before reaching out to others.
C. Inform the client that feelings of guilt are often felt by survivors of suicide. While guilt is a common reaction, offering this information too early may seem dismissive or overwhelming. The nurse should first assess the client's thoughts and feelings before discussing expected emotional responses.
D. Determine the client's understanding of the suicide event. Assessing the client’s perception of the event is the first priority. This helps the nurse gauge emotional distress, risk of self-harm, and the need for immediate crisis intervention. Understanding the client's reaction allows for appropriate emotional support and guidance.
Correct Answer is D
Explanation
A. Urinary retention. While urinary retention can occur with both diazepam (a benzodiazepine) and hydromorphone (an opioid) due to their effects on the nervous system, it is not immediately life-threatening. This side effect should be monitored and managed, but it is not the priority concern.
B. Blurred vision. Blurred vision is a possible side effect of both medications, particularly diazepam, which can cause central nervous system (CNS) depression. However, it is not as critical as respiratory depression, which can be fatal if left untreated.
C. Headache. Headaches are a less serious side effect and do not indicate an urgent risk to the client’s safety. Other symptoms, such as bradypnea, should take precedence in immediate care.
D. Bradypnea. Respiratory depression is the most serious concern when benzodiazepines and opioids are used together. Both medications depress the CNS and can lead to severe respiratory compromise, coma, or even death. Bradypnea (slow breathing) is a priority finding because it indicates a potential overdose or dangerously suppressed respiratory drive, requiring immediate medical intervention.
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