A nurse is teaching a client who has alcohol use disorder about disulfiram. Which of the following client statements indicates an understanding of the teaching?

"Taking disulfiram is an alternate therapy instead of joining Alcoholics Anonymous.

"I should avoid products containing alcohol, like mouthwash, while taking this medication."

"Disulfiram is mainly used for people who are at a high risk for a relapse of drinking alcohol.

"My sensitivity to alcohol will go away 24 hours after I stop taking this medication."

Answer and Explanation

The Correct Answer is B

Rationale:

A. "Taking disulfiram is an alternate therapy instead of joining Alcoholics Anonymous.": Disulfiram is a pharmacologic aid and should be used in combination with counseling or support groups like Alcoholics Anonymous. It is not a standalone treatment and does not replace behavioral therapies.

B. "I should avoid products containing alcohol, like mouthwash, while taking this medication.": Disulfiram causes a severe reaction when alcohol is ingested, even in small amounts found in products like mouthwash or cough syrup. Avoiding all alcohol-containing products demonstrates correct understanding of safety precautions while taking this medication.

C. "Disulfiram is mainly used for people who are at a high risk for a relapse of drinking alcohol.": Disulfiram is primarily used to maintain abstinence by causing unpleasant reactions with alcohol, but it is not limited to clients at high risk of relapse. It is important for all clients on disulfiram to understand adherence and alcohol avoidance.

D. "My sensitivity to alcohol will go away 24 hours after I stop taking this medication.": Disulfiram’s effects persist for up to 14 days after discontinuation, not just 24 hours. The client must continue to avoid alcohol for a longer period even after stopping the medication to prevent adverse reactions.

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Correct Answer is C

Explanation

Rationale:

A. "Can you tune out the voices by listening to music?": This question focuses on coping strategies, which is important, but it is not the immediate priority. The nurse must first assess the content of the hallucinations to determine potential risk.

B. "Are you also seeing unusual persons or things?": Assessing for visual hallucinations is useful, but the client is currently experiencing auditory command hallucinations. Immediate focus should be on the commands to ensure safety.

C. "What are the voices telling you to do?": Determining the content of the voices is the priority because command hallucinations may instruct the client to harm themselves or others. Assessing risk and ensuring safety comes before exploring coping or additional symptoms.

D. "Do the voices cause you to feel anxious?": Assessing emotional response is relevant, but it is secondary to understanding whether the hallucinations pose a safety risk to the client or others.

A. "Using this machine increases my risk of overdose.” B. “I can get pain medication any time as long as I press the button” C. "My partner can press my pain medication button for me if I am sleeping" D. "I will receive a limited amount of pain medication when I press the button."

Correct Answer is D

Explanation

Rationale:

A. "Using this machine increases my risk of overdose.": PCA pumps are designed with safety features, including dose limits and lockout intervals, which reduce the risk of overdose. Understanding this helps the client recognize that PCA is a safe method for self-administered pain control when used correctly.

B. “I can get pain medication any time as long as I press the button”: The client can only receive medication according to the programmed dose and lockout interval. Pressing the button repeatedly will not override the safety mechanism, so this reflects a misunderstanding of how PCA pumps function.

C. "My partner can press my pain medication button for me if I am sleeping": PCA pumps are intended for self-administration only. Allowing someone else to press the button (a practice called “PCA by proxy”) can cause overdose and is unsafe, especially if the client is sleeping or sedated.

D. "I will receive a limited amount of pain medication when I press the button.": PCA pumps deliver a preset dose with a lockout interval to prevent overdose. This statement shows the client understands the safety mechanisms in place, indicating correct comprehension of PCA use.

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A nurse is teaching a client who has alcohol use disorder about disulfiram. Which of the following client statements indicates an understanding of the teaching?

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