Ch 57 (DT for Substance Abuse Disorders
A nurse is providing health education for the family of a patient who has a substance use disorder. How should the nurse best explain the etiology of this disorder? A. "Substance abuse is a complex phenomenon, and science has not yet begun to truly understand the phenomenon." B. "Substance abuse is multifactorial and involves genetics, personality, and culture." C. "Many different factors contribute to substance abuse, but the primary ones are lack of willpower and impaired coping." D. "Substance abuse is considered to be primarily a cultural concept, since definitions vary widely across time and place."
"Substance abuse is multifactorial and involves genetics, personality, and culture."
A patient is admitted to the hospital for treatment of a stasis ulcer of the right leg. The patient's history indicates he has abused alcohol in the past, and he typically consumes at least eight alcoholic beverages daily. What symptoms should the nurse assess the patient for? A. Confusion, hallucination, agitation, tremors B. Denial, manipulation, combativeness C. Suspicion, mania, stubbornness, fear D. Depression, remorse, withdrawal from reality
A. Confusion, hallucination, agitation, tremors
A patient with a well-known history of heroin use has begun addiction treatment. The nurse had administered the patient's daily dose of methadone. The nurses should know that this medication aids in treating opioid addiction because it does which of the following? A. Acts as an opioid antagonist and causes unpleasant symptoms if the patient uses opioids B. Acts as an agonist at opioid receptors and prevents withdrawal symptoms C. Acts on the limbic system and the reticular system to suppress brain activity associated with addiction D. Depresses the CNS to a similar degree as opioids, aiding in detoxification
Acts as an agonist at opioid receptors and prevents withdrawal symptoms
A patient who suffers from alcoholism is prescribed disulfiram (Antabuse). How does this medication assist the patient in refraining from ingestion of alcohol? A. Increases the level of serotonin B. Decreases stimulation of the CNS C. Increases the level of acetylcholine D. Allows the accumulation of acetaldehyde
Allows the accumulation of acetaldehyde
A 77-year-old patient is admitted for the treatment of a fracture, and the nurse has identified that the patient has a history of heavy alcohol use. At what point should the care team administer pharmacologic treatments for alcohol withdrawal? A. After cognitive behavioral therapy has begun B. After skeletal muscle relaxants have taken effect C. As soon as the patient shows signs of withdrawal D. After treatment for the patient's acute injuries has been completed
As soon as the patient shows signs of withdrawal
A patient has a long history of heavy alcohol use and has been admitted to the hospital for traumatic injuries after a motor vehicle accident. How should the nurse best assess the patient for physical dependence on alcohol? A. Assess the patient for signs and symptoms of alcohol withdrawal. B. Assess the patient's typical alcohol intake. C. Assess the patient's perceptions of his coping strategies. D. Assess whether the patient ever feels guilty about his drinking.
Assess the patient for signs and symptoms of alcohol withdrawal.
A 15-year-old boy with a complex psychosocial history is being treated for inhalant abuse. When providing health education to this boy, the nurse should cite which of the following risks associated with inhalant abuse? A. Hyperactivity B. Psychological dependence C. Physiological dependence D. Organ damage
Organ damage
A patient has been brought to the emergency department by paramedics. The patient's known history and highly agitated state are suggestive of cocaine-induced psychosis. What assessment should the nurse prioritize prior to administering pharmacologic treatments? A. Lung auscultation B. Assessment of blood glucose levels C. Cardiovascular assessment D. Assessment of cranial nerve function
Cardiovascular assessment
A patient is admitted to the inpatient alcohol rehabilitation program. What medication will the patient most likely be prescribed to treat alcohol withdrawal syndromes? A. Clonidine (Catapres) B. Atenolol (Tenormin) C. Methyldopa (Aldomet) D. Chlordiazepoxide (Librium)
Chlordiazepoxide (Librium)
A patient was admitted to the emergency room with acute alcohol intoxication and has been diagnosed with alcohol abuse after subsequent assessment and treatment. What are the goals of long-term treatment of this patient's substance abuse disorder? A. Detoxification, abstinence, and prevention of relapse B. Withdrawal, abstinence, and accountability C. Assessment, planning, and intervention D. Withdrawal, reeducation, and compliance
Detoxification, abstinence, and prevention of relapse
A 22-year-old male is brought to the emergency room due to an overdose of diazepam (Valium). What drug will be administered in the emergency room to treat the overdose? A. Methadone (Dolophine) B. Naloxone (Narcan) C. Disulfiram (Antabuse) D. Flumazenil (Romazicon)
Flumazenil (Romazicon)
A patient is being treated for opioid abuse after many years of cocaine and heroin use. The nurse should anticipate that this patient will be treated with what drug? A. Naloxone (Narcan) B. Methadone (Dolophine) C. Flumazenil (Romazicon) D. Disulfiram (Antabuse)
Methadone (Dolophine)
A 33-year-old patient with a diagnosis of alcoholism is to be treated with chlordiazepoxide on an inpatient basis. When a nurse is administering this medication, he or she should do which of the following actions? A. Administer the oral form of the medication if the patient is combative B. Promptly stop administering the medication once status improvements are noted C. Monitor the patient's vital signs closely during IV administration D. Assess the patient's cardiac status prior to administering each dose
Monitor the patient's vital signs closely during IV administration
A patient with a diagnosis of endocarditis has been admitted, and the care team is aware that IV opioid use is the origin of the patient's infection. The patient is open to the idea of treatment for her substance abuse disorder. When planning this aspect of the patient's care, what goal should the nurse first address? A. Compliance with treatment B. Taking ownership of the problem C. Safe detoxification D. Adequate stimulation of the CNS
Safe detoxification
A patient is admitted to the emergency room suffering from symptoms of alcohol withdrawal. The nurse should plan care with the goal of preventing which of the following? A. Seizures B. Hypotension C. Gastrointestinal bleeding D. Bradycardia
Seizures
A man has asked the care team to consider the use of benzodiazepines to treat his wife's severe alcoholism. The use of benzodiazepines for this purpose may be contraindicated in what circumstances? A. The patient is also addicted to nicotine. B. The patient has previously been treated with benzodiazepines. C. The patient is acutely intoxicated. D. The patient denies the severity of her addiction.
The patient is acutely intoxicated.
A patient is being treated for addiction to cocaine and heroin and will begin treatment with naltrexone (ReVia). If the patient uses an opioid after taking this drug, the nurse should expect what effect? A. The patient will experience a decline in neurological function. B. The patient will experience visual disturbances and unpleasant hallucinations. C. The patient will not experience the usual physiological effects of opioids. D. The patient will experience a sudden onset of nausea and vomiting.
The patient will not experience the usual physiological effects of opioids.
A patient who has long abused alcohol is being treated with disulfiram (Antabuse). The patient currently takes phenytoin (Dilantin) for an underlying seizure disorder. Based on the interaction of these two medications, what will need to be adjusted in the medication administration? A. The patient will require phenytoin (Dilantin) to be administered twice daily. B. The patient will require a larger dose of disulfiram (Antabuse). C. The patient will require a reduced dose of phenytoin (Dilantin). D. The patient will require more frequent administration of disulfiram (Antabuse).
The patient will require a reduced dose of phenytoin (Dilantin).
A patient is taking disulfiram (Antabuse) and later consumes several shots of vodka. What effect will be produced from the combination of alcohol and disulfiram? A. Hyperalertness B. Hypertension C. Oral bleeding D. Vomiting
Vomiting
A patient was admitted with a diagnosis of a gastrointestinal bleed, the latest of several hospital admissions that have been attributed to his alcohol abuse. The addictions medicine specialist has prescribed disulfiram, which will A. prevent the patient from experiencing euphoria if he drinks alcohol. B. intensify the patient's CNS depression if he drinks alcohol. C. result in a depressed mood if he drinks alcohol. D. produce unpleasant reactions if the patient drinks alcohol.
produce unpleasant reactions if the patient drinks alcohol.