What is the most important factor for the nurse to assess when doing an admission assessment of a client with a history of alcoholism?

d. When the client last had a drink of alcohol

Explanation of Choices

Choice A Reason: If the Client Has a History of Addictive Behaviors

Assessing whether the client has a history of addictive behaviors is important as it provides insight into the client’s overall pattern of substance use and potential risk for relapse. However, while this information is valuable for developing a comprehensive treatment plan, it is not the most immediate concern during the initial admission assessment. The primary focus should be on identifying any immediate risks or needs, such as the potential for alcohol withdrawal.

Choice B Reason: Whether the Client Has Had Previous Rehabilitation for Alcoholism

Knowing whether the client has had previous rehabilitation for alcoholism can help the nurse understand the client’s treatment history and any previous interventions that may have been effective or ineffective. This information is useful for planning ongoing care and support. However, it is not the most critical factor to assess during the initial admission, as it does not directly address the client’s current physical and mental state.

Choice C Reason: Their Previous and Current Coping Skills

Evaluating the client’s previous and current coping skills is essential for understanding how they manage stress and triggers related to their alcoholism. This assessment can inform the development of personalized coping strategies and support mechanisms. Nonetheless, while important for long-term treatment planning, it is not the most urgent factor to assess during the initial admission.

Choice D Reason: When the Client Last Had a Drink of Alcohol

Determining when the client last had a drink of alcohol is the most important factor to assess during the initial admission. This information is crucial for predicting the onset of alcohol withdrawal symptoms, which can begin as early as 4 to 6 hours after the last drink. Early identification of potential withdrawal allows the healthcare team to implement appropriate monitoring and interventions to manage withdrawal symptoms and prevent complications. Alcohol withdrawal can be life-threatening if not properly managed, making this assessment a top priority.

The correct answer is b.

Choice A Reason:

Expect hyperactivity as a common adverse effect. This statement is incorrect. Atomoxetine is a non-stimulant medication used to treat ADHD and does not typically cause hyperactivity. Instead, it helps improve attention and reduce hyperactivity and impulsiveness. Common side effects of atomoxetine include nausea, vomiting, upset stomach, constipation, dry mouth, loss of appetite, mood changes, feeling tired, dizziness, urination problems, or impotence.

Choice B Reason:

Give the dose in the morning to help prevent insomnia. This statement is correct. Atomoxetine should be taken in the morning to help prevent insomnia, as taking it later in the day can interfere with sleep. The medication can be taken with or without food, and if a second dose is prescribed, it is typically taken in the late afternoon or early evening.

Choice C Reason:

Avoid crowds due to the increased risk for infection. This statement is incorrect. Atomoxetine does not increase the risk of infection, and there is no need to avoid crowds while taking this medication3. Common side effects do not include an increased risk of infection.

Choice D Reason:

Limit caloric intake to prevent excessive weight gain. This statement is incorrect. Atomoxetine is more likely to cause weight loss rather than weight gain. It can decrease appetite, which may lead to weight loss in some patients. Therefore, limiting caloric intake is not necessary while taking atomoxetine.