A nurse on the medical unit is admitting a client with a history of alcohol use disorder. The nurse is aware that which of the following are potential physical symptoms of alcohol withdrawal? (Select all that apply.).

Tachycardia.

Tremors.

Hallucinations.

Hypotension.

Seizures.

Answer and Explanation

Correct Answer : A,B,C,E

Choice A rationale:

Tachycardia (rapid heart rate) is a potential physical symptom of alcohol withdrawal. When alcohol-dependent individuals suddenly stop or reduce their alcohol intake, it can lead to increased sympathetic nervous system activity, resulting in elevated heart rate.

Choice B rationale:

Tremors (shakes) are common during alcohol withdrawal due to the suppression of the central nervous system by alcohol. Abrupt cessation of alcohol can lead to overactivity in the nervous system, resulting in tremors.

Choice C rationale:

Hallucinations can occur during alcohol withdrawal and are usually visual or tactile in nature. These hallucinations are often referred to as alcoholic hallucinosis and can be distressing for the individual experiencing them.

Choice E rationale:

Seizures can be a severe consequence of alcohol withdrawal. Known as alcohol withdrawal seizures, these episodes can occur within the first 48 hours after cessation of heavy alcohol consumption and are attributed to the hyperexcitability of the central nervous system.

Choice D rationale:

Hypotension (low blood pressure) is not typically associated with alcohol withdrawal. In fact, alcohol withdrawal often leads to an increase in blood pressure and heart rate due to the hyperactivity of the sympathetic nervous system.

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Correct Answer is ["A","B","D"]

Explanation

The correct answer is choicea. Low self-esteem,b. Family history of addiction, andd. Personality disorders.

Choice A rationale:

Low self-esteem is considered a risk factor for addictive disorders.Individuals with low self-esteem may use substances as a coping mechanism to deal with negative feelings about themselves.

Choice B rationale:

A family history of addiction is a significant risk factor.Genetic predisposition plays a crucial role in the development of addictive behaviors.

Choice C rationale:

Asian ethnicity is not typically considered an etiological factor for addictive disorders.In fact, some studies suggest that certain genetic factors in Asian populations may reduce the risk of alcohol addiction.

Choice D rationale:

Personality disorders, such as borderline personality disorder or antisocial personality disorder, are associated with a higher risk of substance use disorders.These disorders can lead to behaviors that increase the likelihood of addiction.

Choice E rationale:

Being female is not a direct etiological factor for addictive disorders.However, gender can influence the patterns and consequences of substance use, with males generally having a higher prevalence of substance use disorders.

A. Ask the client for permission to take photographs. B. Provide community sexual assault support contacts. C. Document the client's verbatim statements. D. Determine any physical signs of injury.

Correct Answer is C

Explanation

Answer: c. Document the client's verbatim statements.

Here's why the other options are wrong:

a. Ask the client for permission to take photographs:While photographs may be collected as evidence later, it should not be the first priority. The priority is to focus on patient care and emotional well-being.
b. Provide community sexual assault support contacts:Offering support resources is important, but documenting the details of the assault is crucial for forensic and legal purposes, and should come first.
d. Determine any physical signs of injury:Looking for physical injuries is important, but documenting the client's account should come first. This ensures the client's narrative is captured accurately and can be referred to later.

Documenting the client's verbatim statements is the most important initial action because:

It preserves the client's account of the assault in their own words.
It allows for accurate reporting and investigation.
It can be used as evidence in legal proceedings.

Here are some supporting points:

The Rape, Abuse & Incest National Network (RAINN):"Law enforcement will need to take a detailed statement about the assault, and a medical professional will likely perform a physical exam. Be prepared to answer questions about what happened." [1]
The National Sexual Assault Hotline:"Law enforcement will want to get a statement from you as soon as possible after the assault. Try to remember the details of the assault as clearly as you can." [2]

In conclusion, while all the other options are important aspects of caring for a sexual assault survivor, documenting the client's verbatim statements is the most critical initial action for a nurse to take in the emergency department setting.

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A nurse on the medical unit is admitting a client with a history of alcohol use disorder. The nurse is aware that which of the following are potential physical symptoms of alcohol withdrawal? (Select all that apply.).

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A charge nurse is preparing an educational session about addictive disorders for the nursing staff. Which of the following should the nurse include as etiological factors of addictive disorders? (Select all that apply).

Correct Answer is ["A","B","D"]

Explanation

A nurse in an emergency department is performing an assessment on a client who reports being sexually assaulted. Which of the following actions should the nurse take first?

Correct Answer is C

Explanation

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