247SimpleTests
NCLEX · Substance Use Disorders

A client is admitted for alcohol withdrawal. Which symptom indicates the MOST life-threatening progression of withdrawal?

Correct answer

Delirium tremens (DTs) — characterised by confusion, agitation, hallucinations, hyperthermia, and autonomic instability (tachycardia, hypertension, diaphoresis); can progress to seizures and death if untreated

  1. A Mild tremors
  2. B Nausea and vomiting
  3. C Delirium tremens (DTs) — characterised by confusion, agitation, hallucinations, hyperthermia, and autonomic instability (tachycardia, hypertension, diaphoresis); can progress to seizures and death if untreated
  4. D Insomnia and irritability

Why this is the answer

ALCOHOL WITHDRAWAL PROGRESSION: MILD (6-12 hours): Tremors, anxiety, nausea, diaphoresis, palpitations; MODERATE (12-48 hours): Same plus headache, vomiting, transient hallucinations (often visual/auditory), seizures (peak 24-48 hours); SEVERE — DELIRIUM TREMENS (48-96 hours): Life-threatening; disorientation and confusion; agitation; auditory, visual, tactile hallucinations; severe autonomic instability (fever to 104°F+, HR>120, BP crisis); seizures; WITHOUT TREATMENT: DT mortality is 5-15%; WITH TREATMENT: <1%; TREATMENT: IV benzodiazepines (lorazepam, diazepam) — first-line; thiamine IV before any glucose (prevents Wernicke's encephalopathy); fluid/electrolyte replacement (hypomagnesemia, hypokalemia common); beta-blockers or clonidine for autonomic symptoms; CIWA-Ar scale monitors symptom severity to guide benzodiazepine dosing.
Source: NCLEX-RN Test Plan: Psychosocial — Substance Use, Alcohol Withdrawal Progression

Practice more questions

This question is from our NCLEX Practice Tests practice test. Take the full practice test to test your knowledge across all Substance Use Disorders and other topics.

Take the RN: Psychosocial Integrity practice test →

New to this exam? Our NCLEX exam guide explains the format, scoring, and how to prepare.

Related questions

Substance Use Disorders

What are the typical features of alcohol withdrawal?

 Substance Use Disorders

What are the typical symptoms of opioid withdrawal?

 Substance Use Disorders

What is the most effective response if a nurse suspects a colleague is impaired at work?

 Substance Use Disorders

A client in alcohol withdrawal is assessed using the CIWA-Ar scale. Which score range indicates SEVERE withdrawal requiring close monitoring and aggressive pharmacological treatment?

State-specific guides

Need information for your state? Our state guides cover local requirements, fees, and what to expect on exam day.

California Texas Florida New York Pennsylvania Illinois Ohio Georgia

Recommended study materials

Study guide

Saunders Comprehensive Review for NCLEX-RN 9th Ed. (Elsevier)

The gold standard for NCLEX-RN prep: 5,200+ practice questions, content review, test-taking strategy.

Check Price → Study guide

NCLEX-PN Prep Plus 2023 (Kaplan)

Targeted NCLEX-PN content review with hundreds of practice questions and video explanations.

Check Price → Study guide

Prioritization, Delegation & Assignment (Elsevier)

The leading resource for NCLEX questions on prioritization, delegation, and management of care.

Check Price →

As an Amazon Associate, CJ Affiliate, and AWIN publisher we earn from qualifying purchases. Links above are affiliate links. Full disclosure →