SOLUTIONS MANUAL
** All Chapters included
** Latest accurate solutions
,Table of Contents are given below
Module 22: Addiction
Module 23: Cognition
Module 24: Culture and Diversity
Module 25: Development
Module 26: Family
Module 27: Grief and Loss
Module 28: Mood and Affect
Module 29: Self
Module 30: Spirituality
Module 31: Stress and Coping
Module 32: Trauma
Module 33: Reproduction
Module 34: Assessment
Module 35: Caring Interventions
Module 36: Clinical Decision Making
Module 37: Collaboration
Module 38: Communication
Module 39: Managing Care
Module 40: Professionalism
Module 41: Teaching and Learning
Module 42: Accountability
Module 43: Advocacy
Module 44: Ethics
Module 45: Evidence-Based Practice
Module 46: Healthcare Systems
Module 47: Health Policy
Module 48: Informatics
Module 49: Legal Issues
Module 50: Quality Improvement
Module 51: Safety
, MODULE 22: CONCEPT OF ADDICTION
Case Study: Parts 1, 2, & 3
Case Study, Part 1
Paul is the 19-year-old son of Mark and Susan John. The Johns have been married for 20
years. Mrs. Johns is a full-time stay-at-home mom. Paul’s dad is a corporate attorney who has
always been somewhat demanding of his wife and children. He drinks alcohol daily, but has
always been employed and has maintained a middle-class lifestyle for his family. Paul has two
younger sisters: Mara, the younger of the two, has been treated for anorexia since the age of
12. His 15-year-old sister, Jess, is doing well in high school. Paul did well in high school,
where he played varsity soccer and did fairly well academically.
Paul has just returned home from his first full year at college. His mother is concerned because
he doesn’t seem like his old self; he shows no interest in his old friends or in getting a summer
job. On the other hand, he seems secretive and has left the house on many occasions claiming
that he has new friends who “get it.” He is very short tempered with his sisters, constantly
irritable and discontent. He is very evasive when asked about his grades or any college
activities. He has noticeable weight loss and appears unkempt. His father is intolerant of his
behavior. His mother is concerned and has arranged to accompany him on a visit to his
primary care provider. She is hoping to find out what his problem is so it can be treated before
his father becomes angrier with him and his behavior. You are the nurse who is assessing Paul.
Question 1
Describe the elements of the interview/assessment environment that you should consider before
beginning Paul’s patient assessment.
Answer 1
A. The physical environment should be calm, quiet, and private.
B. Confidentiality is essential; you will need to explain to Paul’s mother that you need to
spend some time alone with Paul to get some information and get to know him.
C. Plan for enough time to establish rapport with Paul.
D. Review the steps of beginning a therapeutic relationship.
Question 2
What questions would be appropriate in assessing Paul’s physiologic, emotional, and psychologic
status? From the cues displayed in the history (change in a family interactions, weight loss,
evasiveness about activities, etc.), what are some tentative hypotheses you can make about his
problems?
Answer 2
Paul might have alcohol and/or substance abuse (possibly addiction) or depression or other mental
illness that could be causing his personality changes, lethargy, and lack of interest in normal
activities; trauma history, including recent events that could have happened during his first year at
college; and impaired family communication and interactions. Screening and focused questioning
will help yield more information.
Question 3
What cues in the family history might indicate a potential for substance use or abuse in Paul?
, Answer 3
A. Paul’s dad drinks alcohol daily.
B. There is evidence of ineffective or maladaptive coping in the home; for example, his
father’s anger and his sister’s eating disorder.
C. His mom demonstrates codependent behaviors.
Question 4
If substance abuse is suspected, how should you proceed to address any defense
mechanisms displayed?
Answer 4
Confront the observations calmly, clearly, and without blame. For example, denial is common.
If Paul denies that there is anything wrong, concretely point out his amount of weight loss and
indications of his lack of hygiene.
Question 5
What diagnostic measures might be needed based on your assessment?
Answer 5
A. A complete history and physical examination to assess state of health.
B. Ask about use of all substances, legal and illegal. If alcohol abuse is suspected, use the
CAGE questionnaire.
C. Complete family history related to any history of addiction. Include all forms of substance
addictions including drugs, alcohol, caffeine, and nicotine. Explore family history of eating
disorders, including obesity, and history of process addictions such as sex, gambling,
shopping, and work.
D. Laboratory studies include routine CBC, blood chemistry, and urinalysis. Appropriate
toxicology studies and serum blood levels may be ordered. Urine, saliva, and serum testing
may be orders to identify some metabolites. Hair testing may also be ordered to assess the
for specific substance use in the past 90 days.
Question 6
If depression is suspected, what further assessments would you perform?
Answer 6
A. The nurse should ask specific questions related to mood and affect. Ask how Paul has been
feeling at home, at school, with friends, with specific family members.
B. Ask specific questions about substance use at school and home. Use the CAGE
questionnaire.
C. The nurse should always perform a lethality screening during the initial interview if the
patient is suspected to be a danger to himself or others. A simple question such as, “Have
you thought about hurting yourself?” can start the process.
D. Information obtained on initial assessment should be promptly discussed with the
primary care provider and addressed in the treatment plan.
E. Most college campuses offer free counseling to students. Encourage Paul to seek
counseling at school or at home.
** All Chapters included
** Latest accurate solutions
,Table of Contents are given below
Module 22: Addiction
Module 23: Cognition
Module 24: Culture and Diversity
Module 25: Development
Module 26: Family
Module 27: Grief and Loss
Module 28: Mood and Affect
Module 29: Self
Module 30: Spirituality
Module 31: Stress and Coping
Module 32: Trauma
Module 33: Reproduction
Module 34: Assessment
Module 35: Caring Interventions
Module 36: Clinical Decision Making
Module 37: Collaboration
Module 38: Communication
Module 39: Managing Care
Module 40: Professionalism
Module 41: Teaching and Learning
Module 42: Accountability
Module 43: Advocacy
Module 44: Ethics
Module 45: Evidence-Based Practice
Module 46: Healthcare Systems
Module 47: Health Policy
Module 48: Informatics
Module 49: Legal Issues
Module 50: Quality Improvement
Module 51: Safety
, MODULE 22: CONCEPT OF ADDICTION
Case Study: Parts 1, 2, & 3
Case Study, Part 1
Paul is the 19-year-old son of Mark and Susan John. The Johns have been married for 20
years. Mrs. Johns is a full-time stay-at-home mom. Paul’s dad is a corporate attorney who has
always been somewhat demanding of his wife and children. He drinks alcohol daily, but has
always been employed and has maintained a middle-class lifestyle for his family. Paul has two
younger sisters: Mara, the younger of the two, has been treated for anorexia since the age of
12. His 15-year-old sister, Jess, is doing well in high school. Paul did well in high school,
where he played varsity soccer and did fairly well academically.
Paul has just returned home from his first full year at college. His mother is concerned because
he doesn’t seem like his old self; he shows no interest in his old friends or in getting a summer
job. On the other hand, he seems secretive and has left the house on many occasions claiming
that he has new friends who “get it.” He is very short tempered with his sisters, constantly
irritable and discontent. He is very evasive when asked about his grades or any college
activities. He has noticeable weight loss and appears unkempt. His father is intolerant of his
behavior. His mother is concerned and has arranged to accompany him on a visit to his
primary care provider. She is hoping to find out what his problem is so it can be treated before
his father becomes angrier with him and his behavior. You are the nurse who is assessing Paul.
Question 1
Describe the elements of the interview/assessment environment that you should consider before
beginning Paul’s patient assessment.
Answer 1
A. The physical environment should be calm, quiet, and private.
B. Confidentiality is essential; you will need to explain to Paul’s mother that you need to
spend some time alone with Paul to get some information and get to know him.
C. Plan for enough time to establish rapport with Paul.
D. Review the steps of beginning a therapeutic relationship.
Question 2
What questions would be appropriate in assessing Paul’s physiologic, emotional, and psychologic
status? From the cues displayed in the history (change in a family interactions, weight loss,
evasiveness about activities, etc.), what are some tentative hypotheses you can make about his
problems?
Answer 2
Paul might have alcohol and/or substance abuse (possibly addiction) or depression or other mental
illness that could be causing his personality changes, lethargy, and lack of interest in normal
activities; trauma history, including recent events that could have happened during his first year at
college; and impaired family communication and interactions. Screening and focused questioning
will help yield more information.
Question 3
What cues in the family history might indicate a potential for substance use or abuse in Paul?
, Answer 3
A. Paul’s dad drinks alcohol daily.
B. There is evidence of ineffective or maladaptive coping in the home; for example, his
father’s anger and his sister’s eating disorder.
C. His mom demonstrates codependent behaviors.
Question 4
If substance abuse is suspected, how should you proceed to address any defense
mechanisms displayed?
Answer 4
Confront the observations calmly, clearly, and without blame. For example, denial is common.
If Paul denies that there is anything wrong, concretely point out his amount of weight loss and
indications of his lack of hygiene.
Question 5
What diagnostic measures might be needed based on your assessment?
Answer 5
A. A complete history and physical examination to assess state of health.
B. Ask about use of all substances, legal and illegal. If alcohol abuse is suspected, use the
CAGE questionnaire.
C. Complete family history related to any history of addiction. Include all forms of substance
addictions including drugs, alcohol, caffeine, and nicotine. Explore family history of eating
disorders, including obesity, and history of process addictions such as sex, gambling,
shopping, and work.
D. Laboratory studies include routine CBC, blood chemistry, and urinalysis. Appropriate
toxicology studies and serum blood levels may be ordered. Urine, saliva, and serum testing
may be orders to identify some metabolites. Hair testing may also be ordered to assess the
for specific substance use in the past 90 days.
Question 6
If depression is suspected, what further assessments would you perform?
Answer 6
A. The nurse should ask specific questions related to mood and affect. Ask how Paul has been
feeling at home, at school, with friends, with specific family members.
B. Ask specific questions about substance use at school and home. Use the CAGE
questionnaire.
C. The nurse should always perform a lethality screening during the initial interview if the
patient is suspected to be a danger to himself or others. A simple question such as, “Have
you thought about hurting yourself?” can start the process.
D. Information obtained on initial assessment should be promptly discussed with the
primary care provider and addressed in the treatment plan.
E. Most college campuses offer free counseling to students. Encourage Paul to seek
counseling at school or at home.
