Progressive Care Nursing Certification (PCCN) Practice Exam

What is the first clinical sign of alcohol withdrawal that a nurse should monitor for?

1. Seizures

2. Tremors

3. Hallucinations

4. Tachycardia

The correct answer is: Tachycardia

The first clinical sign of alcohol withdrawal that a nurse should monitor for is typically tremors. In the context of alcohol withdrawal, tremors, also known as "shakes," are usually one of the earliest manifestations, often occurring within 6 to 12 hours after the last drink. They are a direct result of the central nervous system's reaction to decreased alcohol levels, as alcohol acts as a central nervous system depressant. As the body adapts to the absence of alcohol, it can lead to hyperactivity of the nervous system, manifesting as tremors. Monitoring for tremors is essential during the withdrawal process, as they often indicate the progression of withdrawal symptoms and help guide treatment decisions. Early identification of this sign allows for timely interventions that may include benzodiazepines, which can alleviate symptoms and prevent the development of more severe complications that typically manifest later, such as seizures or delirium tremens. While tachycardia can occur in alcohol withdrawal due to sympathetic nervous system overstimulation, it is usually not the very first sign. Seizures and hallucinations are more associated with later stages of withdrawal and may occur a bit later in the timeline. Therefore, focusing on tremors first in monitoring is crucial for effective management of patients