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: Persistent pain after Herpes zoster suggests postherpetic neuralgia (PHN), a neuropathic condition from varicella-zoster virus damaging sensory nerves. Assessing pain intensity, location, and characteristics guides treatment with analgesics or anticonvulsants like gabapentin. This step differentiates PHN from other causes, ensuring targeted therapy to alleviate nerve pain and improve quality of life.

Choice B reason: Checking shingles vaccination status is irrelevant for current pain, as the client already had Herpes zoster. Vaccination prevents initial infection but does not treat PHN, which results from nerve damage during active infection. Pain assessment is critical to address neuropathic symptoms caused by viral-induced sensory nerve dysfunction, making this less urgent.

Choice C reason: A mental status exam evaluates cognition but is not indicated for PHN, a physiological condition from nerve damage, not a cognitive issue. Pain is neuropathic, driven by damaged sensory neurons, not psychological factors. Assessing pain directly addresses the client’s complaint, guiding treatment for nerve-related discomfort, making this action inappropriate.

Choice D reason: Teaching about phantom pain is incorrect, as phantom pain occurs post-amputation, not after shingles. PHN involves persistent nerve pain in the affected dermatome due to viral nerve damage. Misdiagnosing this could delay proper management, as pain assessment is needed to confirm PHN and initiate therapies like gabapentin, not phantom pain education.

A. Palpitations and shortness of breath. B. Lethargy and lack of appetite. C. Muscle cramping and dry, flushed. D. Bradycardia and constipation.

Correct Answer is A

Explanation

Choice A reason: Excessive levothyroxine causes hyperthyroidism, increasing T3/T4, stimulating beta-adrenergic receptors, leading to palpitations (tachycardia) and shortness of breath from heightened cardiac workload and oxygen demand. These indicate overdose, risking atrial fibrillation, requiring immediate dose adjustment to prevent cardiovascular complications in this thyroid-treated client.

Choice B reason: Lethargy and lack of appetite suggest hypothyroidism, indicating low thyroid hormone levels from insufficient levothyroxine. These are opposite to overdose symptoms like palpitations, driven by excessive metabolism. High doses cause hyperthyroid effects, making this incorrect for identifying excessive dosing in goiter treatment.

Choice C reason: Muscle cramps and dry, flushed skin are not typical of levothyroxine overdose. Hyperthyroidism causes warm, moist skin from increased metabolism, not dryness. Cramps relate to electrolytes. Palpitations and shortness of breath are hallmark overdose signs, reflecting thyroid-driven cardiovascular overstimulation, making this less accurate.

Choice D reason: Bradycardia and constipation indicate hypothyroidism from low thyroid hormones, reducing heart rate and metabolism. This suggests inadequate levothyroxine, not overdose. Excessive doses cause hyperthyroidism, with palpitations and dyspnea from metabolic hyperactivity, making these symptoms incorrect for high-dose levothyroxine effects.

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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

Five months following treatment for Herpes zoster (shingles), an older adult client tells the home health nurse of continuing to experience pain where the rash occurred. Which action should the nurse implement?

Correct Answer is A

Explanation

A client is admitted to the hospital for treatment of a simple goiter, and levothyroxine sodium is prescribed. Which symptoms indicate to the nurse that the prescribed dosage is too high for this client?

Correct Answer is A

Explanation

The nurse is reviewing the recommended preventative care for clients with asthma, chronic bronchitis, and emphysema. Which health care measure is most important for the nurse to recommend to these clients?

The nurse is teaching a client with newly diagnosed glaucoma about the condition. Which statement by the client indicates a need for further teaching?

On the second postoperative day, a client reports increasing abdominal pain. Assessment findings include a distended abdomen with absent bowel sounds. Which intervention should the nurse anticipate implementing?

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

Which serum laboratory test is most important for the nurse to monitor when administering enoxaparin to a client?

Which client information indicates the need for the nurse to use the CAGE questionnaire during the admission interview?