The CAGE questionnaire asks four questions and is a widely used tool to screen for alcoholism. Which of the four questions included in the CAGE questionnaire is most indicative of alcoholism?

Have you ever felt guilty about drinking?

Do you need a drink in the morning to get rid of a hangover?

Have people annoyed you by criticizing your drinking?

Have you ever felt you needed to cut down on your drinking?

Answer and Explanation

The Correct Answer is B

Choice A reason: Feeling guilty about drinking (CAGE’s “G”) suggests awareness of problematic use, indicating psychological dependence. However, guilt is less specific than morning drinking, as it may occur in binge or social drinking without physical addiction. Morning drinking reflects physiological dependence, a stronger marker of chronic alcoholism.

Choice B reason: Needing a morning drink (CAGE’s “E” for eye-opener) indicates physical dependence, a hallmark of alcoholism. This reflects tolerance and withdrawal, where alcohol stabilizes GABA/glutamate imbalances to prevent symptoms like tremors. It’s the most specific indicator, showing the body’s reliance on alcohol, central to alcoholism’s pathophysiology.

Choice C reason: Annoyance at drinking criticism (CAGE’s “A”) suggests defensiveness, possibly indicating psychological dependence. It’s less specific than morning drinking, reflecting social dynamics rather than physical addiction. Alcoholism involves physiological changes, and morning drinking directly demonstrates the body’s need for alcohol to manage withdrawal, making this less indicative.

Choice D reason: Feeling the need to cut down (CAGE’s “C”) shows recognition of excessive drinking but is less specific than morning drinking, which signifies physical dependence from chronic alcohol-induced neurotransmitter changes. This question captures awareness but not the physiological addiction that morning drinking indicates, central to diagnosing alcoholism.

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Correct Answer is A

Explanation

Choice A reason: Increased JVD and pedal edema indicate fluid overload in heart failure, where reduced cardiac output causes venous congestion. Assessing breathing for dyspnea or crackles detects pulmonary edema, as fluid backs into alveoli, impairing gas exchange. This urgent finding guides interventions like diuretics, critical before reporting.

Choice B reason: Palpating pedal pulses assesses arterial flow, not fluid overload causing JVD and edema, which are venous issues in heart failure. Pulses may be normal despite congestion. Breathing changes indicate pulmonary edema, a life-threatening complication, making this assessment more critical for detecting acute decompensation.

Choice C reason: Assessing calf inflammation may detect thrombosis, a heart failure risk, but JVD and edema suggest fluid overload, not clotting. Breathing changes are more urgent, indicating pulmonary edema from alveolar fluid, requiring immediate intervention to prevent respiratory failure, unlike inflammation, which is less immediate.

Choice D reason: Inspecting peripheral vein distention confirms venous congestion but is less critical than breathing assessment. In heart failure, fluid overload risks pulmonary edema, where alveolar fluid causes dyspnea. Monitoring breathing detects this severe complication, prioritizing intervention to ensure oxygenation over additional venous assessment.

A. Discuss checking the time frequently. B. Ask the client why she checks the locks. C. Plan a list of activities to be carried out daily. D. Determine the type and size of the locks.

Correct Answer is C

Explanation

Choice A reason: Discussing time-checking does not address compulsive lock-checking, likely obsessive-compulsive disorder (OCD), driven by serotonin dysregulation causing intrusive fears. Time management is unrelated to compulsions. Planning activities reduces idle time, distracting from OCD behaviors, addressing the neurobiological basis more effectively.

Choice B reason: Asking why the client checks locks may heighten anxiety in OCD, as compulsions arise from irrational fears, not logic, via cortico-striatal-thalamic dysfunction. This may reinforce obsessions. Activity planning distracts from compulsions, offering a therapeutic approach to improve function, making questioning less effective.

Choice C reason: Planning daily activities structures time, reducing compulsive lock-checking in OCD, where obsessive fears disrupt function. Engaging tasks modulate serotonin, distracting from cortico-striatal overactivity, improving behavioral control. This addresses the disorder’s impact, enhancing functionality by minimizing compulsion opportunities, making it the best action.

Choice D reason: Determining lock type is irrelevant to OCD’s compulsive checking, rooted in neurobiological fear responses, not lock characteristics. This does not address serotonin imbalance. Activity planning redirects focus to structured tasks, reducing compulsions, making lock assessment ineffective for managing the client’s behavior.

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The CAGE questionnaire asks four questions and is a widely used tool to screen for alcoholism. Which of the four questions included in the CAGE questionnaire is most indicative of alcoholism?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with heart failure is receiving intravenous fluids at 125 mL/hour. The nurse observes an increase in jugular vein distention (JVD) and pedal edema. Which additional assessment should the nurse make before reporting to the healthcare provider?

Correct Answer is A

Explanation

A female client engages in repeated checks of door and window locks and behavior that prevents her from arriving on time and interfering with her ability to function effectively. Which action should the nurse take?

Correct Answer is C

Explanation

Following a total thyroidectomy, the nurse plans to observe a client for complications. Which finding indicates that the client has developed a complication?

When conducting discharge teaching for a client diagnosed with diverticulosis, which diet instruction should the nurse include?

The nurse attaches a pulse oximeter to a client’s finger and obtains an oxygen saturation reading of 91%. Which assessment finding most likely contributes to this reading?

In assessing tactile fremitus in the client with suspected pneumonia, the nurse should perform which action?

At 0800, the practical nurse (PN) reports to the registered nurse (RN) that a client’s blood pressure is 140/90 mm Hg. When the RN arrives to administer the 0900 antihypertensive medication, the client is oriented but lethargic, pale, and diaphoretic. Which action should the RN implement first?

When performing postural drainage on a client with chronic obstructive pulmonary disease (COPD), which approach should the nurse use?

An older male client reports nocturia with difficulty starting his urine stream. Which additional assessment should the nurse perform to obtain further data related to this information?

A client with chronic kidney disease (CKD) is prescribed a low-potassium diet. Which food choice indicates to the nurse that the client understands the dietary restrictions?