Vsim Andrew Davis Mental Health
Which nursing interventions are directly associated with the primary goals of the
management of a patient, like Mr. Davis, who is currently experiencing alcohol
withdrawal? (select all that apply)
A. implement seizure precautions
B. assess and record heart rate every 4 hours
C. keep SpO2 probe at bedside
D. provide information regarding AA support groups
E. identifying triggers for alcohol consumption - ✔️✔️ABC
A patient with a history of chronic alcohol abuse has begun to demonstrate signs and
symptoms of delirium tremens (DTs). The nurse demonstrates an understanding of the
seriousness of the patient's risk for injury when implementing which intervention?
A. orienting for time, place and person as needed
B. assessing for auditory and visual hallucinations frequently
C. observing seizure precautions
D. restricting patient to the room - ✔️✔️C
Which nursing interventions would best assess Mr. Davis's safety issues if his CIWA-Ar
score were to rise to 8 or above? (select all that apply)
A. minimize all sources of noise in his room
B. dim the lighting in his room
C. suction equipment is kept at the bedside
D. institute falls precautions
E. provide him with high protein, low fat meals - ✔️✔️ABCD
How can the nurse caring for Mr. Davis best provide the appropriate emotional care
during his alcohol withdrawal?
A. remind him frequently that the signs and symptoms will lessen in severity
B. ensure that his needs are met in a nonjudgmental manner
C. assure him that the withdrawal process generally lasts no more than 96 hours
D. encourage his family to spend time at his bedside - ✔️✔️B
What symptom of alcohol withdrawal syndrome would be the most urgent for the nurse
to address?
,A. hallucinations
B. grand mal seizures
C. anxiety
D. insomnia - ✔️✔️B
Which assessment finding confirms that a patient is experiencing moderate alcohol
withdrawal?
A. nausea and vomiting
B. profuse sweating
C. restless sleep
D. total wakefulness - ✔️✔️A
What request of the patient being assessed for possible alcohol withdrawal should the
nurse make to determine the presence of tremors?
A. "please touch your thumb to your little finger"
B. "pease extend your arms and spread your fingers apart"
C. "please interlock the fingers of both hands"
D. "please make a tight fit and hold it for 5 seconds" - ✔️✔️B
What nursing intervention would most likely improve the therapeutic relationship
between the nurse and a patient experiencing alcohol withdrawal by increasing the
nurse's self-awareness?
A. providing prompt, effective nursing care for the patient with a history of alcohol abuse
B. monitoring one's own biases and reactions regarding alcoholism
C. providing empathetic care for the patient in alcohol withdrawal
D. regularly reviewing research results regarding the triggers for chronic alcoholism -
✔️✔️B
Which class of medication is regularly prescribed to provide a gradual withdrawal from
alcohol?
A. tranquilizer
B. stimulant
C. anticonvulsant
D. antidepressant - ✔️✔️A
A client with a blood alcohol level of 0.20 mg% is at high risk for injury related to the
impairment of which function?
A. motor
B. respiratory
C. consciousness
D. orientation - ✔️✔️A
, Symptoms of alcohol withdrawal begin within what time period after the cessation or
marked reduction of alcohol intake by the chronic alcohol drinker?
A. 120 minutes
B. 1 week
C. 3 days
D. 12 hours - ✔️✔️D
What term refers to the collection of symptoms that are associated with untreated
alcohol withdrawal?
A. korsakoff syndrome
B. cardiac myopathy
C. delirium tremens
D. wernicke's encephalopathy - ✔️✔️C
Which clinical manifestations confirm that a patient is experiencing Stage I (mild) of
alcohol withdrawal syndrome? (select all that apply)
A. hypotension
B. course hand tremors
C. disorientation
D. diaphoresis
E. anxiety - ✔️✔️BDE
Which factor is most likely to decrease the severity of Mr. Davis's alcohol withdrawal
signs and symptoms?
A. never experiencing alcohol withdrawal signs and symptoms before
B. having the emotional support of his strong religious faith and beliefs
C. having been consuming vodka for only 5 years
D. being only 56 years of age - ✔️✔️A
Mr. Davis reported having consumed his last drink around 4 pm, and he was admitted to
the facility's detoxification unit shortly thereafter. What clinical manifestations of alcohol
withdrawal should the nurse expect him to demonstrate by 10 pm that night?
A. he is likely currently experiencing the peak of his signs and symptoms
B. his signs and symptoms will likely taper off in severity over the next 12 hours
C. the majority of his withdrawal will consist of signs and symptoms similar to the
current ones
D. the signs and symptoms are likely to increase in type and severity - ✔️✔️D
Which nursing interventions are directly associated with the primary goals of the
management of a patient, like Mr. Davis, who is currently experiencing alcohol
withdrawal? (select all that apply)
A. implement seizure precautions
B. assess and record heart rate every 4 hours
C. keep SpO2 probe at bedside
D. provide information regarding AA support groups
E. identifying triggers for alcohol consumption - ✔️✔️ABC
A patient with a history of chronic alcohol abuse has begun to demonstrate signs and
symptoms of delirium tremens (DTs). The nurse demonstrates an understanding of the
seriousness of the patient's risk for injury when implementing which intervention?
A. orienting for time, place and person as needed
B. assessing for auditory and visual hallucinations frequently
C. observing seizure precautions
D. restricting patient to the room - ✔️✔️C
Which nursing interventions would best assess Mr. Davis's safety issues if his CIWA-Ar
score were to rise to 8 or above? (select all that apply)
A. minimize all sources of noise in his room
B. dim the lighting in his room
C. suction equipment is kept at the bedside
D. institute falls precautions
E. provide him with high protein, low fat meals - ✔️✔️ABCD
How can the nurse caring for Mr. Davis best provide the appropriate emotional care
during his alcohol withdrawal?
A. remind him frequently that the signs and symptoms will lessen in severity
B. ensure that his needs are met in a nonjudgmental manner
C. assure him that the withdrawal process generally lasts no more than 96 hours
D. encourage his family to spend time at his bedside - ✔️✔️B
What symptom of alcohol withdrawal syndrome would be the most urgent for the nurse
to address?
,A. hallucinations
B. grand mal seizures
C. anxiety
D. insomnia - ✔️✔️B
Which assessment finding confirms that a patient is experiencing moderate alcohol
withdrawal?
A. nausea and vomiting
B. profuse sweating
C. restless sleep
D. total wakefulness - ✔️✔️A
What request of the patient being assessed for possible alcohol withdrawal should the
nurse make to determine the presence of tremors?
A. "please touch your thumb to your little finger"
B. "pease extend your arms and spread your fingers apart"
C. "please interlock the fingers of both hands"
D. "please make a tight fit and hold it for 5 seconds" - ✔️✔️B
What nursing intervention would most likely improve the therapeutic relationship
between the nurse and a patient experiencing alcohol withdrawal by increasing the
nurse's self-awareness?
A. providing prompt, effective nursing care for the patient with a history of alcohol abuse
B. monitoring one's own biases and reactions regarding alcoholism
C. providing empathetic care for the patient in alcohol withdrawal
D. regularly reviewing research results regarding the triggers for chronic alcoholism -
✔️✔️B
Which class of medication is regularly prescribed to provide a gradual withdrawal from
alcohol?
A. tranquilizer
B. stimulant
C. anticonvulsant
D. antidepressant - ✔️✔️A
A client with a blood alcohol level of 0.20 mg% is at high risk for injury related to the
impairment of which function?
A. motor
B. respiratory
C. consciousness
D. orientation - ✔️✔️A
, Symptoms of alcohol withdrawal begin within what time period after the cessation or
marked reduction of alcohol intake by the chronic alcohol drinker?
A. 120 minutes
B. 1 week
C. 3 days
D. 12 hours - ✔️✔️D
What term refers to the collection of symptoms that are associated with untreated
alcohol withdrawal?
A. korsakoff syndrome
B. cardiac myopathy
C. delirium tremens
D. wernicke's encephalopathy - ✔️✔️C
Which clinical manifestations confirm that a patient is experiencing Stage I (mild) of
alcohol withdrawal syndrome? (select all that apply)
A. hypotension
B. course hand tremors
C. disorientation
D. diaphoresis
E. anxiety - ✔️✔️BDE
Which factor is most likely to decrease the severity of Mr. Davis's alcohol withdrawal
signs and symptoms?
A. never experiencing alcohol withdrawal signs and symptoms before
B. having the emotional support of his strong religious faith and beliefs
C. having been consuming vodka for only 5 years
D. being only 56 years of age - ✔️✔️A
Mr. Davis reported having consumed his last drink around 4 pm, and he was admitted to
the facility's detoxification unit shortly thereafter. What clinical manifestations of alcohol
withdrawal should the nurse expect him to demonstrate by 10 pm that night?
A. he is likely currently experiencing the peak of his signs and symptoms
B. his signs and symptoms will likely taper off in severity over the next 12 hours
C. the majority of his withdrawal will consist of signs and symptoms similar to the
current ones
D. the signs and symptoms are likely to increase in type and severity - ✔️✔️D
