IGNOU PB Bsc Nsg Entrance-2017
Mental Health Nursing
Medium
Alcohol dependence is indicated by?
Appeared in: IGNOU PB Bsc Nsg Entrance-2017
Explanation
- The presence of a physiological withdrawal state is a core diagnostic criterion for alcohol dependence, as defined by major classification systems like ICD-11.
- Withdrawal symptoms occur because the central nervous system adapts to the constant presence of alcohol (a depressant) by increasing its own excitatory signaling.
- When alcohol is suddenly removed, this unopposed excitatory activity leads to a specific syndrome including tremors, autonomic hyperactivity, anxiety, and potentially seizures.
- This demonstrates that the body has become physically dependent on the substance to maintain homeostasis.
Why Other Options Were Wrong
- Option A: A blackout is a form of anterograde amnesia caused by rapid, high levels of blood alcohol. It is a sign of acute, heavy intoxication, not a defining criterion for physiological dependence.
- Option B: Early morning drinking is a behavior performed to relieve or prevent withdrawal symptoms that emerge overnight. While it is a very strong indicator of dependence, the withdrawal syndrome itself is the underlying physiological phenomenon.
- Option D: This term is too vague and non-specific. Alcohol withdrawal causes a very specific type of physical discomfort, but many other conditions can also cause physical discomfort.
Related Visual
Clinical Relevance
- Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Indicators of Alcohol Dependence as background academic context rather than a clinical decision trigger.
- Recognizing the signs of alcohol dependence, especially withdrawal, is critical for patient safety. Unmanaged alcohol withdrawal can be life-threatening, leading to seizures and delirium tremens.
- Nurses use standardized tools like the Clinical Institute Withdrawal Assessment for Alcohol, Revised (CIWA-Ar) scale to objectively measure the severity of withdrawal and guide treatment with benzodiazepines.
- What if? If a patient reports daily heavy drinking and early morning drinking but denies any tremors, anxiety, or nausea upon stopping, the nurse should still have a high suspicion for dependence. The patient may be minimizing symptoms or may not have gone long enough without alcohol to experience significant withdrawal. The priority is to educate the patient on the risks and plan for a medically supervised withdrawal if they decide to stop.
How to Approach the Question
- First, understand the question is asking for a defining indicator of alcohol dependence, which is a specific clinical syndrome.
- Analyze each option to see how it relates to dependence. Ask yourself: Is this a cause, a consequence, or a core feature?
- Recognize that 'black-out' relates to the amount of alcohol consumed at one time (intoxication), not necessarily the long-term pattern of dependence.
- Identify 'early morning drinking' as a behavior to cope with an underlying problem.
- Identify 'withdrawal symptoms' as the underlying physiological problem that the behavior is trying to solve. This makes it the most fundamental indicator of physical dependence.
- Eliminate 'physical discomfort' as too general and non-specific for a clinical diagnosis.
Concept Tested & Keywords
- Concept Tested: Indicators of Alcohol Dependence
- Stem keywords: Alcohol dependence, indicated by
- Lead-in keywords: BEST, MOST RELEVANT CLUE
- Negative lead-in flag: false
Question ID
Q0B9dk-GLLcnMOYQzrrzYU
Reference Book
E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani— Part 2 (pp 290-564 of 579) p. 2
E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 888-890
E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4228-4230
Practise the full IGNOU PB Bsc Nsg Entrance-2017
Attempt every question from this paper in a timed mock, then review the full solution for each one.
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