Addiction and Substance-Related Disorders

12. A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following? A) I can have a glass of wine with dinner if I choose. B) I should eat small frequent meals if I get nauseated. C) I should take the drug on an empty stomach. D) I might experience diarrhea with this drug.

12. B

13. A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step two when he states which of the following? A) Ive admitted to myself and others the wrongdoings Ive done. B) I realize that there is a higher power that can help me. C) I know now that I am powerless over alcohol. D) I am making amends to all those that Ive harmed.

13. B

14. A nurse is preparing an inservice program about substance abuse and its etiology. Which of the following would the nurse most likely include in the presentation when discussing possible psychologic etiologies? A) Low self-esteem B) Genetic predisposition C) Dysfunctional family D) Peer influence

14. A

15. A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following? A) Difficulty with coordination B) Stupor C) Emotional lability D) Ataxia

15. A

16. A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess? A) Rhinorrhea B) Lacrimation C) Dilated pupils D) Dysphoria

16. C

17. A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which of the following? A) Asking the client questions about alcohol use B) Negotiating a conversation with the client to reduce use C) Pointing out the inconsistencies in thoughts, feelings, and action D) Helping the client change the way he thinks about a situation

17. B

18. A client with a history of substance abuse is involved in a skills training group. Which of the following would the client be involved with to enhance intrapersonal coping skills? Select all that apply. A) Substance refusal skills B) Problem solving C) Anger awareness D) Emergency planning E) Social support networking

18. B, C, D

19. A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply. A) Euphoria B) Seizures C) Cardiac arrhythmia D) Paranoia E) Dilated pupils

19. B, C

1. A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drugs purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug? A) Causes itching if alcohol is consumed B) Produces the euphoria of alcohol C) Reduces the appeal of alcohol D) Improves appetite and nutritional status

1. C

10. A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply. A) Headache B) Fatigue C) Yawning D) Flushing E) Diuresis

10. A, B, C

11. A group of nursing students is reviewing information about substances that are abused. The students demonstrate understanding of the information when they identify which of the following as stimulants? Select all that apply. A) Alcohol B) Cocaine C) Heroin D) Nicotine E) Phencyclidine

11. B, D

2. An adolescent client tells the nurse that he or she occasionally sniffs airplane glue. When discussing the effects of long-term use of inhalants, which of the following would the nurse most likely include? A) Tremors and CNS arousal B) Enhanced normal heart rhythms C) Enhanced attention focus and memory D) Brain damage and cognitive abnormalities

2. D

20. A client is prescribed disulfiram as part of his alcohol treatment program to prevent relapse. The client asks the nurse, How will this drug help me? Which response by the nurse would be most appropriate? A) It will help to cure your alcoholism. B) It can help to prevent you from drinking. C) It makes the withdrawal symptoms less troublesome. D) It helps to clear the alcohol out of your body.

20. B

3. A client tells the nurse that he is committed to trying to quit smoking. When teaching the client about smoking cessation, which of the following would the nurse include? A) Success usually involves more than one type of intervention. B) Relapse is fairly rare within the first year of quitting. C) Ear acupressure is a highly proven method for quitting. D) Education is key for smoking cessation.

3. A

4. The nurse is completing the admission of a client who is seeking treatment for alcoholism. He tells the nurse that the last time he had any alcohol to drink was at 10:00 AM before he left for the hospital. The nurse closely monitors the client. Which of the following would lead the nurse to suspect that the client is experiencing stage 1 of alcohol withdrawal syndrome? Select all that apply. A) Slight diaphoresis B) Hand tremors C) Intermittent confusion D) Heart rate of 135 beats/min E) Normal blood pressure

4. A, B, E

5. A nurse is talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so shed remember to get well. The nurse suspects that the client may be experiencing which of the following? A) Wernickes syndrome B) Delirium tremens C) Korsakoffs psychosis D) Malignant hyperthermia

5. C

6. A nurse is using motivational therapy with a female client with alcoholism. The client, who is unwilling to consider changing her drinking behavior, emphatically states, I am not an alcoholic; you cant make me stop drinking. Which response by the nurse would be most appropriate? A) You have to stop drinking and driving; you could kill someone. B) Youre right; youre not an alcoholic. C) You should consider what you are doing to your marital relationship. D) Youre the only one who can make yourself stop drinking.

6. D

7. A 52-year-old male client who has a history of alcohol dependence is admitted to a detoxification unit. He has tremors, he is anxious, his pulse has risen from 98 to 110 beats/min, his blood pressure has risen from 140/88 to 152/100 mm Hg, and his temperature is six tenths of a degree above normal. He is slightly diaphoretic. Which nursing diagnosis would be the priority? A) Disturbed Thought Processes B) Risk for Injury C) Ineffective Coping D) Ineffective Denial

7. B

8. A nurse is working with a client who is addicted to heroin. The nurse engages in harm reduction by teaching the client about which of the following? A) Using bleach solution to disinfect dirty needles B) Problem solving C) Healthy coping skills D) Proper use of naltrexone (Trexan)

8. A

9. A 20-year-old man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are tracks visible on his arms. The friend who came with him reports that the client had just shot up heroin when he became unconscious. Which medication would the nurse most likely expect to administer? A) Naloxone B) Naltrexone C) Bupropion D) Varenicline

9. A