Behavior Study Qs
The probability of occurrence of withdrawal symptoms in a patient with a long-term history of alcohol abuse is most accurately assessed by Question 7 options: 1) drinking history, quantity consumed and time of last drink. 2) experiences following previous cessation of drinking. 3) the blood alcohol at the time of admission. 4) the kind of alcoholic beverage last consumed.
1
A patient with paranoid schizophrenia and cocaine abuse tells the nurse, "I don't think I'll ever be well and maybe I don't want to. The voices insult me, but when I use cocaine I like the good feelings I get. Which nursing diagnosis is most appropriate? Question 8 options: 1) Disturbed Thought Processes related to use of mood-altering substances. 2) Impaired Adjustment related to lack of intention to change maladaptive behavior. 3) Risk for Violence related to poor impulse control. 4) Spiritual Distress related to delusions of grandeur.
2
The optimal time to begin group therapy for a patient with a dual diagnosis is Question 6 options: 1) at the point of transfer to outpatient treatment. 2) during inpatient treatment. 3) never. Group therapy is not effective for patients with dual diagnosis. 4) when the patient begins physical withdrawal from the substance.
2
When intervening with a patient who is intoxicated from alcohol, the nurse should first Question 5 options: 1) allow the patient to sober up. 2) ask what drugs other than alcohol the patient has recently used. 3) decide on mutually agreed upon patient care goals. 4) gain a therapeutic relationship by sharing one's own personal alcohol use with the patient.
2
Without early intervention for alcohol withdrawal, symptoms will most likely become more severe and gradually progress to Question 3 options: 1) coma 2) heart failure 3) intracranial hemorrhage 4) seizures
2
Repeated cycles of alcohol intoxication followed by withdrawal result in a phenomenon called Question 2 options: 1) dependence 2) enabling 3) kindling 4) toxicity
3
A patient is hospitalized for treatment of pneumonia and has a history of substance abuse. Twenty-four hours after admission, the patient shows: tremulousness, anorexia, hypertension, and confusion. The nurse should recognize these as signs of Question 9 options: 1) acute alcohol intoxication. 2) alcohol hallucinosis. 3) alcohol withdrawal delirium. 4) Wernicke-Korsakoff syndrome.
4
One of the three medications most commonly used to manage alcohol withdrawal is Question 4 options: 1) clonidine (Catapres) 2) disulfiram (Antabuse) 3) lorazepam (Ativan) 4) naltrexone (Revia)
4
The nurse is caring for a client admitted to the hospital for detoxification from alcohol. What is the primary nursing intervention for this client upon admission? Question 1 options: 1) Administer medication so withdrawal symptoms won't occur. 2) Insure the client becomes involved in the therapeutic milieu. 3) Monitor the client's physical and medical status for symptoms of withdrawal. 4) Provide the patient with a safe environment.
4
A client was in an automobile accident and while there is the odor of alcohol on his breath, his speech is clear, and he is alert and answers questions posed to him. His blood alcohol level is determined to be 0.30 mg%. What conclusion can be drawn? A. The client has a high tolerance to alcohol. B. The client ate a high-fat meal before drinking. C. The client has a decreased tolerance to alcohol. D. The client's blood alcohol level is within legal limits.
A
A client who is dependent on alcohol tells the nurse, "Alcohol is no problem for me. I can quit anytime I want to." The nurse can assess this statement as indicating A. denial. B. projection. C. rationalization. D. reaction formation.
A
Nursing assessment of an alcohol-dependent client 6 to 12 hours after the last drink would most likely reveal the presence of A. tremors. B. seizures. C. blackouts. D. hallucinations.
A
Symptoms that would signal opioid withdrawal include A. lacrimation, rhinorrhea, dilated pupils, and muscle aches. B. illusions, disorientation, tachycardia, and tremors. C. fatigue, lethargy, sleepiness, and convulsions. D. synesthesia, depersonalization, and hallucinations.
A
The only class of commonly abused drugs that has a specific antidote is the A. opiates. B. hallucinogens. C. amphetamines. D. benzodiazepines.
A
The provision of optimal care for patients withdrawing from substances of abuse is facilitated by the nurse's understanding that severe morbidity and mortality are often associated with withdrawal from: a. Alcohol and CNS depressants. b. CNS stimulants and hallucinogens. c. Narcotic antagonists and caffeine. d. Opiates and inhalants.
A
The treatment team meets to discuss Cody's plan of care. Which of the following factors will be priorities when planning interventions? A. Readiness to change and support system B. Current college performance C. Financial ability D. Availability of immediate family to come to meetings
A
Which assessment data would be most consistent with a severe opiate overdose? A. Blood pressure, 80/40 mm Hg; pulse, 120 beats/min; respirations, 10 breaths/min B. Blood pressure, 120/80 mm Hg; pulse, 84 beats/min; respirations, 20 breaths/min C. Blood pressure, 140/90 mm Hg; pulse, 76 beats/min; respirations, 24 breaths/min D. Blood pressure, 180/100 mm Hg; pulse, 72 beats/min; respirations, 28 breaths/min
A
The nurse is assessing a patient using the CAGE (Cut, Annoyed, Guilty, and Eye Opener) questionnaire. The nurse suspects possible alcoholism when the patient states: (Select all that apply): A. The patient states, "My wife keeps nagging me about my drinking." B. The patient states, "I am going to try to cut down on drinking. I have been partying too much." C. The patient states, "I go to meetings once or twice a week but continue to drink." D. The patient states, "I usually have a Bloody Mary or Mimosa with breakfast." E. The patient says to the nurse, "I am ashamed of how much I have been drinking lately." F. The patient states, "I can quit whenever I want to."
A,B,D,E
A patient is being treated for drug addiction. The nurse understands that the treatment may include which of the following? (Select all that apply): A. A motivational interview. B. Observing for stress reaction. C. Converting narcotic use from an illicit to a legally controlled drug. D. Observing for delirium tremens. E. Encouraging involvement in Narcotics Anonymous.
A,B,E
Primary prevention activities a nurse can perform related to substance abuse include (Select all that apply): A. Education to prevent substance abuse. B. Focusing on relapse prevention. C. Identification of risk factors for abuse. D. Medical detoxification. E. Referral to a self-help group for stress relief and meditation.
A,C,E
A patient who is in pain is concerned about becoming addicted to pain medication and asks the nurse, "Can I become addicted to this medication?" Which of the following would be the nurse's best response? (Select all that apply): A. "You may develop a tolerance for the medication and need more of it in order for it to be therapeutic." B. "You will likely experience euphoria from the medication." C. "You will likely become dependent on this medication and require other medications to control your pain." D. "Before stopping the medication, you may need to taper it so you do not suffer from withdrawal." E. "You will not become physically addicted, but you may develop a physiological addiction."
A,D
A person who covertly supports the substance-abusing behavior of another is called a(n) A. patsy. B. enabler. C. participant. D. minimizer.
B
Cocaine exerts which of the following effects on a client? A. Stimulation after 15 to 20 minutes B. Stimulation and anesthetic effects C. Immediate imbalance of emotions D. Paranoia
B
A client brought to the emergency department after phenylcyclohexylpiperidine (PCP) ingestion is both verbally and physically abusive, and the staff is having difficulty keeping him and themselves safe. The nursing intervention that would be most therapeutic is A. taking him to the gym on the psychiatric unit. B. obtaining an order for seclusion and close observation. C. assigning a psychiatric technician to "talk him down." D. administering naltrexone as needed per hospital protocol.
B
Cody is a 19-year-old college sophomore who has been using cocaine and alcohol heavily for 5 months. He is admitted for observation after admitting to suicidal ideation with a plan to the college counselor. What would be an appropriate priority outcome for Cody's treatment plan while in the hospital? A. Cody will return to a predrug level of functioning within 1 week. B. Cody will be medically stabilized while in the hospital. C. Cody will state within 3 days that he will totally abstain from drugs and alcohol. D. Cody will take a leave of absence from college to alleviate stress.
B
Erik is a 26-year-old patient who abuses heroin. He states to you, "I've been using more heroin lately. I told my provider about it and she said I need more and more heroin to feel the effect I want." You know this describes: A. intoxication. B. tolerance. C. withdrawal. D. addiction.
B
You are caring for Mick, a 32-year-old patient with chemical addiction who will soon be preparing for discharge. A principle of counseling interventions that should be observed when caring for a patient with chemical addiction is to: a. Praise the patient for compliant behavior. b. Communicate that relapses are always possible. c. Confirm that the patient's recovery is considered complete after discharge. d. Encourage Mick to resume his former friendships to regain a sense of normalcy.
B
A young woman reports that although she has no memory of the event, she believes that she was raped. This raises suspicion that she unknowingly ingested A. LAAM B. GHB C. ReVia D. Clonidine
B The drugs most frequently used to facilitate a sexual assault (rape) are flunitrazepam (Rohypnol, "roofies"), a fast-acting benzodiazepine, and gamma-hydroxybutyrate (GHB) and its congeners. These drugs are odorless, tasteless, and colorless; mix easily with drinks; and can render a person unconscious in a matter of minutes. Perpetrators use these drugs because they rapidly produce disinhibition and relaxation of voluntary muscles; they also cause the victim to have lasting anterograde amnesia for events that occur.
A nurse is interviewing a patient and assessing the patient's readiness to change. Which statements by the patient in the motivational interview reflect this willingness? (Select all that apply): A. The patient states, "I don't think my body will recover from the drinking." B. The patient states, "I will watch the game at my friend's house instead of at the bar." C. The patient states, "I now realize that the drinking has affected my family life." D. The patient states, "I am glad that I did not drag others into my drinking." E. The patient states, "I have been attending a meeting a day."
B,C,E
A teaching need is revealed when a client taking disulfiram (Antabuse) states, A. "I usually treat heartburn with antacids." B. "I take ibuprofen or acetaminophen for headache." C. "Most over-the-counter cough syrups are safe for me to use." D. "I have had to give up using aftershave lotion."
C
An appropriate long-term goal/outcome for a recovering substance abuser would be that the client will A. discuss the addiction with significant others. B. state an intention to stop using illegal substances. C. abstain from the use of mood-altering substances. D. substitute a less addicting drug for the present drug.
C
In helping an addicted individual plan for ongoing treatment, which intervention is the first priority for a safe recovery? A. Ongoing support from at least two family members must be secured. B. The client needs to be employed. C. The client must strive to maintain abstinence. D. A regular schedule of appointments with a primary care provider must be set up.
C
The most helpful message to transmit about relapse to the recovering alcoholic client is that lapses A. are an indicator of treatment failure. B. are caused by physiological changes. C. result from lack of good situational support. D. can be learning situations to prolong sobriety.
C
When intervening with a patient who is intoxicated from alcohol, it is useful to first: a. Let the patient sober up. b. Decide immediately on care goals. c. Ask what drugs other than alcohol the patient has recently used. d. Gain adherence by sharing your personal drinking habits with the patient.
C
Which of the drugs used by a polysubstance abuser is most likely to be responsible for withdrawal symptoms requiring both medical intervention and nursing support? A. Opiates B. Marijuana C. Barbiturates D. Hallucinogens
C
Which of the following is true regarding substance addiction and medical comorbidity? A. Most substance abusers do not have medical comorbidities. B. There has been little research done regarding substance addiction disorders and medical comorbidity. C. Conditions such as hepatitis C, diabetes, and HIV infection are common comorbidities. D. Comorbid conditions are thought to positively affect those with substance addiction in that these patients seek help for symptoms earlier.
C
A client has been using cocaine intranasally for 4 years. When brought to the hospital in an unconscious state, nursing measures should include A. induction of vomiting. B. administration of ammonium chloride. C. monitoring of opiate withdrawal symptoms. D. observation for hyperpyrexia and seizures.
D
A syndrome that occurs after stopping the long-term use of a drug is called A. amnesia. B. tolerance. C. enabling. D. withdrawal.
D
As you evaluate a patient's progress, which treatment outcome would indicate a poor general prognosis for long-term recovery from substance abuse? a. Patient demonstrates improved self-esteem. b. Patient demonstrates enhanced coping abilities. c. Patient demonstrates improved relationships with others. d. Patient demonstrates positive expectations for ongoing drug use.
D
Benzodiazepines are useful for treating alcohol withdrawal because they A. block cortisol secretion. B. increase dopamine release. C. decrease serotonin availability. D. exert a calming effect.
D
Cody is preparing for discharge. He tells you, "Dr. Jacobson is putting me on some medication called naltrexone. How will that help me?" Which response is appropriate teaching regarding naltrexone? A. "It helps your mood so that you don't feel the need to do drugs." B. "It will keep you from experiencing flashbacks." C. "It is a sedative that will help you sleep at night so you are more alert and able to make good decisions." D. "It helps prevent relapse by reducing drug cravings."
D
The term tolerance, as it relates to substance abuse, refers to A. the use of a substance beyond acceptable societal norms. B. the additive effects achieved by taking two drugs with similar actions. C. the signs and symptoms that occur when an addictive substance is withheld. D. the need to take larger amounts of a substance to achieve the same effects.
D
What is the ethical obligation of the nurse who sees a peer divert a narcotic, compared with the ethical obligation when the nurse observes a peer who is under the influence of alcohol? A. The nurse should immediately report the peer who is diverting narcotics and should defer reporting the alcohol-using nurse until a second incident takes place. B. Neither should be reported until the nurse has collected factual evidence. C. No report should be made until suspicions are confirmed by a second staff member. D. Supervisory staff should be informed as soon as possible in both cases.
D
You are caring for Leah, a 26-year-old patient who has been abusing CNS stimulants. Which statement provides a basis for planning care for a patient who abuses CNS stimulants? a. Symptoms of intoxication include dilation of the pupils, dryness of the oronasal cavity, and excessive motor activity. b. Medical management focuses on removing the drugs from the body. c. Withdrawal is simple and rarely complicated. d. Postwithdrawal symptoms include fatigue and depression.
D
