Question 1

A client reports that the narcotic she took for pain on a regular basis made her feel bad and that when she tried an alternative analgesic, she experienced withdrawal symptoms. What is this client suffering from?
A) Drug abuse
B) Drug addiction
C) Drug dependence
D) Substance abuse

Accepted Answer

The terms drug dependence and drug addiction often are used interchangeably, but they are not synonymous. Drug dependence is a state of neuroadaptation caused by the chronic, regular use of a drug. People who are dependent on drugs must continue using them to prevent withdrawal symptoms. Drug addiction, in contrast, is a pattern of abuse characterized by an overwhelming preoccupation with the use (compulsive use) of a drug and securing its supply, and a high tendency to relapse if the drug is removed.

Question 2

At a district board meeting, the CHN requests funding for an after-school recreation program that promotes healthy, fun activities in an effort to decrease substance abuse. Which level of prevention does this exemplify?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Primary and secondary prevention

Accepted Answer

Primary prevention includes the promotion of healthy lifestyles and resiliency factors. The harm reduction approach to the issue of substance abuse focuses on health promotion and disease prevention.

Question 3

Which statement made by a parent indicates a need for more education about child abuse?
A) "I have stopped slapping my child, and I am learning to count to 10 before reacting."
B) "I never spank or hit my children; I yell at them to stop being stupid, and if they don't, I tell them that the boogeyman will steal them away at night if they don't obey."
C) "I use 'time out' when my child acts out or is naughty. Sometimes, my child doesn't cope well with this, but I am persistent."
D) "When my child misbehaves, I distract him and try to focus his attention on other things. If he throws a tantrum, I just pick him up and leave the store or show or wherever we may be."

Accepted Answer

Emotional abuse involves extreme debasement of feelings and may result in the child feeling inadequate, inept, uncared for, and worthless. A parent is emotionally abusing the children by yelling at them ("to stop being stupid") and frightening them ("boogeyman will steal them away at night").

Question 4

What action is the best example of enabling in a family with an alcoholic father?
A) The father asks the CHN to explain why his continued drinking is dangerous.
B) The son threatens to leave the home because he finds his father's behaviour embarrassing.
C) The teenage daughter turns to a favourite teacher for support.
D) The wife tells her husband's boss that her husband is sick when he is actually inebriated.

Accepted Answer

Enabling is the act of shielding or preventing the addict from experiencing the consequences of his or her addiction.

Question 5

Which action by a case manager would be classified as primary prevention?
A) Advocating for the client whose values conflict with those of the medical service provider
B) Collaborating between nursing and occupational health personnel
C) Educating a group regarding community services that are available if they are ever needed
D) Resolving conflict between a primary care clinic and a tertiary care facility

Accepted Answer

Primary prevention involves the use of the information exchange process to increase the client's understanding of the health care system. Remember that primary prevention occurs at a point before an illness or a problem occurs. In all of the other options, the client's health concern already exists and interventions have been employed.

Question 6

A CHN suspects that a new client may have a substance use disorder. When getting the health history of the client, the CHN needs to keep in mind that the client may not admit to drug use. What is a primary symptom of substance use disorder?
A) Confusion
B) Denial
C) Forgetfulness
D) Mental status changes

Accepted Answer

A primary symptom of substance use disorder involves a refusal to acknowledge that a substance use problem exists.

Question 7

During a group counselling session for perpetrators of intimate partner violence, which client statement indicates a lack of insight into his violent behaviour?
A) "I have been taking out my frustrations about work on my girlfriend."
B) "I love my girlfriend and didn't want to hurt her; it was an accident."
C) "It might be a good idea for me to temporarily leave the house when I feel I am getting angry."
D) "When I drink alcohol, I become more abusive toward my girlfriend."

Accepted Answer

Violence is defined as those nonaccidental acts that result in physical or psychological injury. Although the client may now be feeling remorse, at the time that the violent act was committed against the girlfriend, his intent was to inflict harm.

Question 8

A mother confides to the CHN that her live-in boyfriend pushed her 2-year-old child because he was crying too much. She begs the CHN not to tell anyone because her boyfriend has agreed to take anger management classes. What should the CHN do?
A) Abide by the mother's wishes because this information was provided in confidence.
B) Arrange for the earliest available counselling for the boyfriend.
C) Advise the mother to take the child away from the boyfriend and find alternative housing right away.
D) Report the incident to the child protection agency.

Accepted Answer

All individuals in Canada who suspect child abuse are required to report it to the proper child protection agencies as mandated by law. First Nations peoples also have access to specific child protection agencies. All of the other options put the child's welfare at risk.

Question 9

A client who abuses intravenous (IV) drugs admits to the CHN that he has no desire to change this behaviour, so the CHN counsels him on the importance of sterilizing his needles to prevent infection and transmission of blood-borne diseases. Which level of prevention does this action represent?
A) Primary prevention
B) Secondary prevention
C) Tertiary prevention
D) Primary and tertiary prevention

Accepted Answer

Tertiary prevention is implemented in people who already have a health concern or problem (in this instance, someone who is already misusing substances) to prevent complications (harm reduction). In this instance, because the client does not plan to stop the drug abuse, the CHN is trying to prevent complications arising from use of contaminated needles. Emphasis is placed on reducing the trAnswermission of blood-borne diseases through contaminated needles. Giving up the addiction is the best solution but is unrealistic for many addicts. Using the harm reduction model, the CHN should provide education on cleaning needles with bleach between uses and about needle exchange programs to decrease the spread of blood-borne pathogens.

Question 10

A CHN is asked by a parent group to explain the risk factors for alcoholism. What statement should the CHN include in the explanation?
A) Alcoholism is determined solely by environment.
B) Alcoholism is determined partly by genes.
C) Alcoholism is higher in women.
D) Persons born with fetal alcohol syndrome are alcoholics from birth.

Accepted Answer

Research has shown conclusively that alcoholism is, at least in part, genetic and not just the result of family environment.

Question 11

Which characteristics observed in a teenage boy should always alert the CHN to the possibility of suicide?
A) Age between 15 and 19 years
B) Questioning sexual orientation and history of depression
C) Threatening to cause harm to peers
D) A history of torturing and abusing animals

Accepted Answer

Depression, homosexuality, and questioning gender identity are among the leading risk factors for adolescent suicide. Those who threaten peers or torture and abuse animals are more likely to cause harm to others than to themselves.

Quiz 15: Working With Vulnerable Populations

A client reports that the narcotic she took for pain on a regular basis made her feel bad and that when she tried an alternative analgesic, she experienced withdrawal symptoms. What is this client suffering from?

At a district board meeting, the CHN requests funding for an after-school recreation program that promotes healthy, fun activities in an effort to decrease substance abuse. Which level of prevention does this exemplify?

Which statement made by a parent indicates a need for more education about child abuse?

What action is the best example of enabling in a family with an alcoholic father?

Which action by a case manager would be classified as primary prevention?

A CHN suspects that a new client may have a substance use disorder. When getting the health history of the client, the CHN needs to keep in mind that the client may not admit to drug use. What is a primary symptom of substance use disorder?

During a group counselling session for perpetrators of intimate partner violence, which client statement indicates a lack of insight into his violent behaviour?

A mother confides to the CHN that her live-in boyfriend pushed her 2-year-old child because he was crying too much. She begs the CHN not to tell anyone because her boyfriend has agreed to take anger management classes. What should the CHN do?

A client who abuses intravenous (IV) drugs admits to the CHN that he has no desire to change this behaviour, so the CHN counsels him on the importance of sterilizing his needles to prevent infection and transmission of blood-borne diseases. Which level of prevention does this action represent?

A CHN is asked by a parent group to explain the risk factors for alcoholism. What statement should the CHN include in the explanation?

Which characteristics observed in a teenage boy should always alert the CHN to the possibility of suicide?