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 A

Explanation

Rationale:

A. History of severe menorrhagia: A copper IUD can increase menstrual bleeding and cramping. Clients with a history of severe menorrhagia are at higher risk for exacerbated bleeding and anemia, making this a contraindication to IUD insertion. Alternative contraceptive methods should be considered for these clients.

B. Desire to become pregnant in 1 to 2 years: While the client’s future fertility plans may influence contraceptive choice, it is not a medical contraindication. The IUD can be removed at any time, allowing fertility to return quickly, so this does not preclude insertion.

C. Takes antiretroviral therapy for HIV: HIV infection or antiretroviral therapy is not a contraindication to IUD use. Clients with HIV can safely use intrauterine contraception, provided there are no active pelvic infections.

D. Report of unprotected sex in the past 24 hr: Recent unprotected intercourse is not a contraindication, but the nurse should assess the risk of pregnancy and consider emergency contraception if appropriate. It does not medically prevent IUD insertion.

A. Respiratory rate B. Pain level C. Blood pressure D. LDL E. Weight F. Hemoglobin A1c

Correct Answer is ["A","C","D","E","F"]

Explanation

Rationale:

A. Respiratory rate: The client’s respiratory rate decreased from 20/min to 18/min, indicating improved cardiopulmonary function and reduced physiological stress, which reflects overall improvement in health status.

B. Pain level: The client’s pain level remains at 0/10 both at baseline and follow-up, showing no change. Pain was not a concern initially, so this does not indicate improvement.

C. Blood pressure: Blood pressure decreased from 164/92 mm Hg to 138/84 mm Hg, demonstrating better hypertension management through lifestyle modifications and/or medications, indicating cardiovascular improvement.

D. LDL: LDL cholesterol improved significantly from 220 mg/dL to 90 mg/dL, reflecting effective hyperlipidemia management and reduced risk for cardiovascular disease.

E. Weight: The client’s weight decreased from 88.6 kg to 83.2 kg, reducing BMI from 30.5 to 28.7. This weight loss indicates successful lifestyle modifications and improvement in overall metabolic health.

F. Hemoglobin A1c: HbA1c decreased from 7% to 6%, showing improved long-term glycemic control and reduced risk for diabetes-related complications, reflecting an overall improvement in metabolic health.

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System	Findings
General	Adult child accompanying parent reports decline in client, expressing concern over memory and thought process, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that would help but it has not. I found the title to the car today, signed over to me."
Physical	Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month. Heart rate 68/min
Affect	Client says, "Why don't you just leave me? I am of no use."

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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A client requests to have a copper intrauterine device (IUD) inserted for contraception. Which of the following should the nurse recognize as a contraindication to IUD insertion?

Correct Answer is A

Explanation

The nurse has reviewed the Nurses' Notes, Vital Signs, and Laboratory Results from 3 months ago. Exhibits The nurse is reviewing the client's plan of care. Which of the following findings indicate the client's condition has improved? Select all that apply.

Correct Answer is ["A","C","D","E","F"]

Explanation

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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?