A nurse is teaching a client who has a history of substance abuse about prevention and education strategies. Which of the following statements by the client indicates a need for further teaching?

Correct answer: c) Assess the client's vital signs and level of consciousness.

Rationale: The first action that the nurse should take when using the nursing process is to assess the client. Assessing the client's vital signs and level of consciousness is essential to determine the severity of the overdose and the need for immediate interventions. The nurse should also monitor the client for signs of respiratory depression, cardiac arrhythmias, seizures, or other complications.

Incorrect choices:
a) Notify the health care provider and request an order for a urine drug screen.: This is an important action, but not the first one. The nurse should notify the health care provider and request an order for a urine drug screen after assessing the client and stabilizing their condition. A urine drug screen can help to identify the type and amount of drugs that the client has ingested and guide the treatment plan.

b) Administer naloxone as prescribed to reverse the effects of opioids.: This is an important action, but not the first one. The nurse should administer naloxone as prescribed to reverse the effects of opioids after assessing the client and confirming that they have signs of opioid toxicity, such as pinpoint pupils, decreased respiratory rate, and decreased level of consciousness. Naloxone is an opioid antagonist that can rapidly restore normal respiration and alertness in opioid overdose cases. However, naloxone has no effect on other types of drugs and may precipitate withdrawal symptoms in opioid-dependent clients.

d) Educate the client about the risks and consequences of drug abuse.: This is an important action, but not the first one. The nurse should educate the client about the risks and consequences of drug abuse after assessing the client and ensuring their safety and stability. The nurse should also provide emotional support and refer the client to appropriate resources for substance abuse treatment and recovery.

Correct answer: d) "I should use over-the-counter drugs instead of prescription drugs if I have pain."

Rationale: This statement indicates a need for further teaching, as over-the-counter drugs can also be abused or misused and cause harm to the client. The client should consult with their provider before taking any medications for pain and follow the directions carefully. The client should also use nonpharmacological methods for pain relief, such as relaxation techniques, massage, or ice packs.

Incorrect choices:

a) "I should avoid situations or people that trigger my urge to use drugs.": This statement indicates an understanding of the teaching, as avoiding triggers is one of the prevention and education strategies for substance abuse.

b) "I should seek professional help if I have signs of depression or anxiety.": This statement indicates an understanding of the teaching, as seeking professional help is one of the prevention and education strategies for substance abuse. Depression and anxiety are common co-occurring disorders with substance abuse and can increase the risk of relapse.

c) "I should join a support group or a 12-step program to stay sober.": This statement indicates an understanding of the teaching, as joining a support group or a 12-step program is one of the prevention and education strategies for substance abuse. Support groups and 12-step programs can provide peer support, guidance, and accountability for clients who are recovering from substance abuse.