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
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. A serum lithium level of 1.6 mEq/L is above the therapeutic range, indicating lithium toxicity. Manifestations of lithium toxicity can include neurological symptoms such as blurred vision and jerking motor movements. Other symptoms may include nausea, vomiting, diarrhea, tremors, confusion, drowsiness, and muscle weakness.
B. Fever and fluctuating blood pressure are not typical manifestations of lithium toxicity.
C GI discomfort, such as nausea, vomiting, and diarrhea, is a common symptom of lithium toxicity. Poor coordination, along with tremors and muscle weakness, can also occur due to the effects of lithium on the central nervous system.
D. Lip smacking and tongue thrusting are repetitive and involuntary movements associated with certain types of seizures or seizure disorders, but they are not typically observed in lithium toxicity.
Correct Answer is A
Explanation
A. Dissociative amnesia involves difficulty remembering important personal information, usually of a traumatic or stressful nature, that is inconsistent with ordinary forgetting. In the case of a client who has been sexually assaulted and is having difficulty remembering events related to the assault, dissociative amnesia is the likely experience.
B. Depersonalization/derealization disorder involves persistent feelings of detachment from oneself or one's surroundings. While this condition can occur in response to trauma, it typically involves a sense of detachment rather than memory loss.
C. Dissociative identity disorder (DID) involves the presence of two or more distinct personality states, each with its own pattern of perceiving and interacting with the world.
D. Factitious disorder involves the deliberate falsification or exaggeration of physical or psychological symptoms in oneself. It is not directly related to memory loss or difficulty remembering events.
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