# A client with alcohol use disorder says, ‘I want help, but I am not ready to promise lifelong abstinence.’ For each proposed action, select the best classification. > source: MyMerci (mymerci.kr) > url: https://mymerci.kr/pages/nclex_q.php?qn_id=395594&lang=en > language: en > subject: Chemical/Substance Use Disorder > category: PSI ## Question A client with alcohol use disorder says, ‘I want help, but I am not ready to promise lifelong abstinence.’ For each proposed action, select the best classification. | | Supports person-centered engagement | Requires immediate safety assessment or escalation | Creates a treatment barrier | | --- | --- | --- | --- | | Ask what change matters most to the client and offer evidence-based treatment options without demanding a lifelong-abstinence promise | | | | | Use nonstigmatizing language and explain that alcohol use disorder is a treatable health condition | | | | | Assess recent alcohol use, current intoxication, prior withdrawal seizures or delirium, overdose risk, and self-harm thoughts | | | | | Arrange prompt medical evaluation when findings suggest severe withdrawal or another immediate danger | | | | | Require documented abstinence before allowing the client to schedule an assessment | | | | | Label recurrence of alcohol use as misconduct and automatically discharge the client from care | | | | ## Explanation Substance use disorder is a treatable health condition, and engagement is strengthened by nonjudgmental, person-centered care that explores the client's own goals and offers accessible treatment options. Immediate safety still comes first: the nurse assesses current intoxication, overdose risk, self-harm risk, and the possibility of severe alcohol withdrawal, including prior withdrawal seizures or delirium. Requiring abstinence before an assessment, using stigmatizing labels, or threatening discharge after recurrence creates barriers and can drive the client away from effective care. ## In-depth explanation Correct Answer Use collaborative, nonstigmatizing engagement; assess urgent intoxication, withdrawal, overdose, and self-harm risks; and revise rules or language that make abstinence or flawless recovery a condition of access. Why It Fits Person-centered substance use care meets the client at the current stage of change while preserving safety. Ambivalence is information for a collaborative conversation, not a reason to deny assessment or treatment. Clinical Picture The client is stable enough to participate in goal setting, but alcohol withdrawal can become medically dangerous. A focused history of recent use, prior severe withdrawal, seizures, delirium, co-occurring symptoms, and self-harm risk determines whether urgent medical escalation is needed. Memory Link Welcome the person, ask the goal, check immediate danger, remove the barrier. NCLEX Rule Therapeutic care protects both autonomy and safety. Do not confuse a client's uncertainty about abstinence with refusal of all care, and do not use shame or punishment as a clinical intervention. Why the Alternatives Fail Stigmatizing labels weaken trust. An abstinence prerequisite delays assessment and treatment. Automatic discharge after recurrence treats a chronic condition as misconduct and breaks continuity instead of revising the care plan. Source 1SAMHSA Breaking Down Barriers to Treatment 2SAMHSA Treatment Options for Substance Use Disorder 32026 NCLEX-RN Test Plan ## Clinical scenario The client is alert, medically stable, and able to participate in decisions. The nurse uses nonstigmatizing language, explores the client's goals, screens for immediate behavioral and withdrawal risk, and connects the client with treatment without using readiness for abstinence as a prerequisite for care. ## Key concepts - **Person-centered care** — Care that builds the plan around the client's goals, preferences, strengths, circumstances, and informed choices. - **Low-barrier care** — An approach that reduces unnecessary access requirements and provides welcoming, nonjudgmental entry to substance use treatment. - **Severe alcohol withdrawal** — A potentially life-threatening withdrawal state that may include seizures or delirium and requires prompt medical assessment and treatment. ## Related questions - [Stage 2 — Analyze cues. Complete the statements about timing, assessment-tool selection, a…](https://mymerci.kr/pages/nclex_q.php?qn_id=372478&lang=en) - [Stage 4 — Generate solutions. 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