Chapter 46: Care of Patients with Substance Abuse Disorders |DeWit: Medical-Surgical Nursing: Concepts & Practice, 3rd Edition

MULTIPLE CHOICE 1. The alcoholic patient says to the nurse, “I am not an alcoholic. I can quit any time I want to.” The nurse recognizes that the patient is using which defense mechanism? a. Repression b. Denial c. Rationalization d. Intellectualization ANS: B Denial is ignoring reality in spite of hard evidence. Denial is a mechanism frequently used by substance abusers. Repression refers to unconsciously blocking an unwanted thought or memory from open expression. Rationalization attempts to justify a behavior or action by making an excuse or an explanation. Intellectualization is the excessive reasoning and logic to counter emotional distress. PTS:1 DIF: Cognitive Level: Comprehension REF: 1074 OBJ:4 (theory) TOP: Alcoholism: Defense Mechanism KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation 2. The wife of an alcoholic tells the nurse, “My husband only drinks on the weekends to relax. He has a very stressful job.” The nurse recognizes that the patient’s wife is using which defense mechanism? a. Repression b. Denial c. Rationalization d. Identification ANS: C Rationalization is a justification for an unreasonable act to make it appear reasonable. Rationalization is used by many families to allay their own anxiety about the substance abuse of a family member. Repression refers to unconsciously blocking an unwanted thought or memory from open expression. Denial is ignoring reality in spite of hard evidence. Denial is a mechanism frequently used by substance abusers. Identification refers to modeling behaviors after another individual. PTS: 1 DIF: Cognitive Level: Application REF: 1074 OBJ: 5 (theory) TOP: Family Reaction to Substance Abuse: Rationalization KEY: Nursing Process Step: Assessment MSC: NCLEX: Psychosocial Integrity 3. Which statement accurately explains the difference between an enabler and a co- dependent? a. A codependent covers up the substance abuser’s behavior. b. A codependent rationalizes the substance abuser’s behavior. c. An enabler uses the substance abuser’s behavior to build up his or her own self-esteem. d. An enabler is also a substance abuser. ANS: A The codependent “fixes” things by overcompensating to prevent the abuser from facing reality. Enabling refers to “helping” a person so that the person’s consequences from unhealthy behavior are less severe; thus enabling “helps” the unhealthy behavior to continue. PTS:1 DIF: Cognitive Level: Application REF: 1075 OBJ:5 (theory) TOP: Codependent vs. Enabler KEY: Nursing Process Step: Implementation MSC: NCLEX: Psychosocial Integrity 4. How long does it take the body to metabolize a single can of beer? a. 20 minutes b. 30 minutes c. 40 minutes d. 60 minutes