The nurse is using the CAGE questionnaires as a screening tool for

a client who is seeking help because his wife said he had a

drinking problem. What information should the nurse explore

indepth with the client based on this screening tool?

A. Consumption, liver enzyme, gastrointestinal complains

and bleeding.

B. Minimizes drinking frequently misses family events, guilt

about drinking, and amount of daily intake.

C. Cancer screening results, anger, gastritis, daily alcohol intake.

D. Efforts to cut down, annoyance with questions, guilt, drinking as

an “Eye-opener”.

(Cutting down, annoyance, guilt and eye-opener drinking

are represented with the acronym of CAGE)

A client who is admitted with a closed head injury after a gall has a

blood alcohol level (BAL) of 0.28 (28%) and is difficult to arouse.

Which intervention during the first 6 hours following admission should

the nurse identify as the priority?

A. Place in a side-lying position with head of bed

elevated. B. Administer disulfram (Atabuse )

immediately

C. Give lorezapam (Ativan)PRN for signs of withdrawal.

D. Provide thiamine and folate supplements as prescribed.

The nurse leading a group session of adolescent clients give the

members handout about anger management. One of the male clients

is fidgety, interrupts peers when they try to talk, and talks about his

pets at home. What nursing action is best for the nurse to take?

A. Give the client permission to leave and return in 10 minutes.

B. Explore the client’s feeling about his pets and home life.

C. Encourage his peers to help involve him in the activity.

D. Redirect him by encouraging him to read from the handout.

The nurse is preparing medications for a client with bipolar disorder

and notices that the antipsychotic medication was discontinued several

day ago. Which medicati