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Difficulty: MediumHigh Risk Behaviors

During a routine visit at a university health center, a young adult client confides in the practical nurse (PN) about using a friend's prescription dextroamphetamine to help stay awake and study for upcoming midterms. Which of the following actions are appropriate for the PN to implement? Select all that apply.

  1. Document the specific substance, amount, and frequency of use in the client's medical record.Answer
  2. B
    Ask the client, "Why would you take a medication that was not prescribed to you?"
  3. Reinforce education regarding the cardiovascular risks associated with unprescribed stimulant use.Answer
  4. D
    Report the medication diversion to the university's academic disciplinary committee.
  5. E
    Formulate a comprehensive nursing diagnosis related to ineffective coping and substance abuse.
  6. Gather additional data regarding the client's current sleep habits and academic stressors.Answer

Answer

The practical nurse should document the specific details of the substance use, reinforce education about the cardiovascular risks of stimulants, and gather more data about the client's sleep habits and stressors.
The correct actions align with the practical nurse's role in providing safe, effective care for a client engaging in high-risk behaviors. Documenting the specific substance use establishes an accurate clinical record. Gathering further information about sleep and stress acts as focused data collection to help the health care team understand the root cause. Reinforcing the known cardiovascular risks of stimulants serves as a vital, scope-appropriate harm reduction strategy.

Step-by-Step Solution

1
Identify the high-risk behavior and the clinical setting.
The client is misusing unprescribed prescription stimulants in a college setting due to academic stress.
Understanding the context helps determine which interventions are appropriate and legally sound.
2
Evaluate each option against the practical nurse (PN) scope of practice.
Data collection (gathering stress/sleep data), documentation, and reinforcing education fall within the PN scope.
The PN must act within legal boundaries, leaving independent analysis and initial care planning to the RN.
3
Identify and eliminate options that violate therapeutic communication or confidentiality.
Options involving asking 'why' or reporting to the university committee are eliminated.
Therapeutic communication avoids judgment, and health care professionals must maintain strict client confidentiality.

Key Concept

Practical Nursing Scope of Practice and Harm Reduction in Substance Misuse
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Topics

High Risk Behaviors

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