NCLEX substance abuse

A client who abused alcohol for more than 20 years is diagnosed with cirrhosis of the liver. The nurse determines that teaching about the disease has been successful when the client makes which statement? 1. " If I decide to stop drinking, I won't kill myself." 2. " If I watch my blood pressure, I should be okay." 3. " If I take vitamins, I can undo some liver damage." 4. " If I use nutritional supplements, I won't have problems."

1.

1. Family members of an alcoholic client ask the nurse to help them intervene. Which action is essential for a successful intervention? 1. All family members must tell the client they're powerless. 2. All family members must describe how the addiction affects them. 3. All family members must come up with their share of financial support. 4. All family members must become caregivers during the detoxification period.

2.

25. A nurse is working with a client on recognizing the relationship between alcohol abuse and interpersonal problem. Which of the following is the priority intervention? 1. Help the client identify personal strengths. 2. Help the client decrease compulsive behaviors. 3. Examine the client's use of defense mechanisms. 4. Have the client work with peers who can serve as role models.

3.

A client says, "I started using cocaine as a recreational drug, but now I can't seem to control the use." The nurse interprets the client's statement as most consistent with which drug behavior? 1. Toxic dose 2. Dual diagnosis 3. Cross-tolerance 4. Compulsive use

4.

46. A client has been admitted to the emergency department and states he just used cocaine. The nurse monitors the client for which condition? 1. Tachycardia 2. Hyperthermia 3. Hypotension 4. Bradypnea

1.

The nurse is caring for a client with a history of chronic alcoholism and is aware that the client may be predisposed to which of the following? 1. Arteriosclerosis 2. Heart failure 3. Heart valve damage 4. Pericarditis

2. Heart failure

A client who has been drinking alcohol for 30 years asks a nurse if permanent damage has occurred to his immune system. What is the best response by the nurse? 1. " There is often less resistance to infections." 2. " Sometimes, the body's metabolism will increase." 3. " Put your energies into maintaining sobriety for now." 4. " Drinking puts you at high risk for disease later in life."

1.

A client who smoked marijuana daily for 10 years tells a nurse, "I don't have any goals, and I just don't know what to do." What is the most appropriate nursing intervention for this client? 1. Focus the interaction. 2. Use nonverbal methods. 3. Use reflection techniques. 4. Ask open-ended questions.

1.

When assessing a client with prolonged, chronic alcohol intake, the nurse would expect to find which of the following? 1. Enlarged liver 2. Nasal irritation 3. Muscle wasting 4. Limb paresthesia

1.

14. The nurse determines further teaching about nutrition is necessary when an alcoholic client makes which statement? 1. " I should avoid foods high in fat." 2. " I should eat only one balanced meal per day." 3. " I should take vitamin and mineral supplements." 4. " I should eat large portions of food containing fiber."

2.

16. A nurse is caring for a client undergoing treatment for acute alcohol dependence. The client tells the nurse, "I don't have a problem. My wife made me come here." Which defense mechanism does the nurse interpret the client's statement as representing? 1. Projection and suppression 2. Denial and rationalization 3. Rationalization and repression 4. Suppression and denial

2.

18. What is the most important short-term goal for a client with a knowledge deficit about the effects of alcohol on the body? 1. Test blood chemistries daily. 2. Verbalize the results of substance use. 3. Talk to a pharmacist about the substance. 4. Attend a weekly aerobic exercise program.

2.

The nurse is assessing a client who repeatedly abuses cocaine. It is important for the nurse to observe the client for which of the following? 1. Panic attacks 2. Bipolar cycling 3. Attention deficits 4. Expressive aphasia

2.

8. A client who is withdrawing from alcohol is being given lorazepam (Ativan). The client's family asks the nurse about the medication. What is the best response by the nurse? 1. " Short-term use of lorazepam can lead to dependence." 2. " The lorazepam will reduce the symptoms of withdrawal." 3. " The lorazepam will make him forget about symptoms of withdrawal." 4. " The lorazepam will also help with his heart disease."

2. Lorazepam

64. A client discusses with the nurse how drug addiction has made life unmanageable. The nurse determines that information to assist the client with coping would include: 1. how peers have committed to sobriety. 2. how to accomplish family of origin work. 3. the addiction process and tools for recovery. 4. how environmental stimuli serve as drug triggers.

3.

A 20-year-old client is admitted with bone marrow depression. He tells the nurse he's been abusing drugs since age 13. The nurse reviews the client's history for use of which drug? 1. Amphetamines 2. Cocaine 3. Inhalants 4. Marijuana

3.

A client who abuses alcohol tells a nurse, "I'm sure I can become a social drinker." What is the most appropriate response by the nurse? 1. " When do you think you can become a social drinker?" 2. " What makes you think you'll learn to drink normally?" 3. " Does your alcohol use cause major problems in your life?" 4. " How many alcoholic beverages can a social drinker consume?"

3.

A group of teenagers tell the school nurse they used cocaine because they were bored. What is the most important goal for the nurse? 1. Prepare a drug lecture. 2. Restrict school privileges. 3. Establish an activity schedule. 4. Report the incident to their parents.

3.

The family of an adolescent who smokes marijuana asks a nurse if the use of marijuana leads to abuse of other drugs. What is the most appropriate response by the nurse? 1. " Use of marijuana is a stage your child will go through." 2. " Many people use marijuana and don't use other street drugs." 3. " Use of marijuana can lead to abuse of more potent substances." 4. " It's difficult to answer that question as I don't know your child."

3.

78. A client with an alcohol addiction requests a prescription for disulfiram (Antabuse). To determine the client's ability to take the drug appropriately, the nurse should assess which of the following? 1. Whether the client will take a prescription drug 2. Whether the client's family accepts the use of this treatment strategy 3. Whether the client is willing to follow the necessary dietary restrictions 4. Whether the client is motivated to stay sober .

4.

A client asks a nurse not to tell his parents about his alcohol problem. What is the most appropriate response by the nurse? 1. " How can you not tell them? Is that being honest?" 2. " Don't you think you'll need to tell them someday?" 3. " Do alcohol problems run in either side of your family?" 4. " What do you think will happen if you tell your parents?"

4.

A client recovering from alcohol addiction asks the nurse how to talk to his children about the impact of addiction on them. What is the best response by the nurse? 1. " Try to limit references to the addiction and focus on the present." 2. " Talk about all the hardships you've had in working to remain sober." 3. " Tell them you're sorry and emphasize that you're doing so much better now." 4. " Talk to them by acknowledging the difficulties and pain your drinking caused."

4.

A client who abuses alcohol tells the nurse that everyone in his family has an alcohol problem and nothing can be done about it. What is the most appropriate response by the nurse? 1. " You're right; it's much harder to become a recovering person." 2. " This is just an excuse for you so you don't have to work on becoming sober." 3. " Sometimes, nothing can be done, but you may be the exception in this family." 4. " Alcohol problems can occur in families, but you can decide to take the steps to become and stay sober."

4.

A client who uses cocaine denies that drug use is a problem. What is the best intervention by the nurse? 1. State ways to cope with stress. 2. Repeat the drug facts as needed. 3. Identify the client's ambivalence. 4. Use open-ended, factual questions.

4.

A client with a history of cocaine abuse exhibits behavior changes following return from an inpatient treatment facility. The nurse anticipates that the physician will order which test? 1. Antibody screen 2. Glucose screen 3. Hepatic screen 4. Urine screen

4.

A nurse is assessing a client with a history of cocaine abuse. The nurse is aware that the assessment may include which finding? 1. Glossitis 2. Pharyngitis 3. Bilateral ear infections 4. Perforated nasal septum

4.

A young, depressed adult woman with a history of alcohol abuse is admitted to the hospital after a motor vehicle accident. The nurse performs the admission assessment of the client and anticipates that the history will include which of the following? 1. Defiant responses 2. Infertility 3. Memory loss 4. Sexual abuse

4.

The nurse is developing interventions to prevent a client who abused alcohol from relapsing. What is the most important intervention for the client? 1. Avoid taking over-the-counter medications. 2. Limit monthly contact with the family of origin. 3. Refrain from becoming involved in group activities. 4. Avoid people, places, and activities from the former lifestyle.

4.

The nurse is preparing a client with the diagnosis of alcohol dependency for discharge from the hospital. What is the most important goal for the client? 1. Find a way to drink socially. 2. Allow self to grieve recent losses. 3. Work to bring others into treatment. 4. Develop relapse-prevention strategies.

4.

The nurse is preparing a teaching plan for a client who abused alcohol. What is the most important information for the nurse to include? 1. Personal needs 2. Illness exacerbation 3. Cognitive distortions 4. Communication skills

4.

A client has received chlordiazepoxide (Librium) to control the symptoms of alcohol withdrawal. The chlordiazepoxide has been ordered as needed. The nurse assesses the client and determines an additional dose of medication is needed when the client displays which symptoms? Select all that apply. 1. Tachycardia 2. Mood swings 3. Elevated blood pressure and temperature 4. Piloerection 5. Tremors 6. Increasing anxiety

1, 3, 5, and 6.

A nurse has developed a relationship with a client who has an addiction problem. The nurse determines that the therapeutic interaction is in the working stage when the client does what? Select all that apply. 1. The client addresses how the addiction has contributed to family distress. 2. The client reluctantly shares the family history of addiction. 3. The client verbalizes difficulty identifying personal strengths. 4. The client discusses financial problems related to the addiction. 5. The client expresses uncertainty about meeting with the nurse. 6. The client acknowledges the addiction's effects on the children.

1, 3, and 6.

17. During a family therapy session, an alcoholic client tells a family member, "You made it easy for me to use alcohol. You always made excuses for my behavior." What should the nurse encourage the family to do? 1. Give up enabling behaviors 2. Manage the client's self-care 3. Deal with negative behaviors 4. Evaluate the home environment

1.

4. The nurse is caring for a client who is experiencing alcohol withdrawal. The nurse would be most concerned if the client exhibited which of the following? 1. Hallucinations 2. Nervousness 3. Diaphoresis 4. Nausea

1.

61. The family of a client in rehabilitation following heroin withdrawal asks a nurse why the client is receiving naltrexone (ReVia). What is the best response by the nurse? 1. To help reverse withdrawal symptoms 2. To keep the client sedated during withdrawal 3. To take the place of detoxification with methadone 4. To decrease the client's memory of the withdrawal experience

1.

7. A client who abuses alcohol tells a nurse, "Alcohol helps me sleep." What is the most appropriate response by the nurse? 1. " Alcohol doesn't help promote sleep." 2. " Continued alcohol use causes insomnia." 3. " One glass of alcohol at dinnertime can induce sleep." 4. " Sometimes, alcohol can make one drowsy enough to fall asleep."

1.

A client addicted to alcohol is scheduled to begin individual therapy with the nurse. What is the most important nursing intervention for the client? 1. Learn to express feelings. 2. Establish new roles in the family. 3. Determine strategies for socializing. 4. Decrease preoccupation with physical health.

1.

A client addicted to alcohol tells a nurse, "Making friends used to be hard for me." The nurse determines that client teaching about relationships has been successful when the client makes which statement? 1. " I've set limits on my behaviors toward others." 2. " I need to be judgmental of others." 3. " I won't become intimately involved with others." 4. " I can't bear to see myself hurt again in a relationship."

1.

A client is receiving chlordiazepoxide (Librium) as needed for signs and symptoms of alcohol withdrawal. The nurse assesses the client and determines the need for medication when the client displays: 1. mild tremors, hypertension, tachycardia. 2. bradycardia, hyperthermia, sedation. 3. hypotension, decreased reflexes, drowsiness. 4. hypothermia, mild tremors, slurred speech.

1.

A client tells the nurse that he used amphetamines to be productive at work. The nurse is aware that abrupt discontinuation of the drug will produce which symptom? 1. Severe anxiety 2. Increased yawning 3. Altered perceptions 4. Amotivational syndrome

1.

A client tells the nurse, "I have been drinking ever since they told me I had learning disabilities." How does the nurse interpret this response? 1. The client is self-medicating. 2. The client has an excuse to drink. 3. The client isn't a productive person. 4. The client will be unable to stop drinking.

1.

A client who uses cocaine finally admits he also abused other drugs to equalize the effect of cocaine. The nurse is aware that the client's drug history may include which substance? 1. Alcohol 2. Amphetamines 3. Caffeine 4. Phencyclidine

1.

A nurse is assessing a client with a history of substance abuse who has pinpoint pupils, a heart rate of 56 beats/ minute, a respiratory rate of 6 breaths/ minute, and temperature of 96.4 ° F. The nurse determines that which is the most likely cause of the client's symptoms? 1. Opioids 2. Amphetamines 3. Cannabis 4. Alcohol

1.

A nurse is caring for a client who is experiencing amphetamine withdrawal. The nurse should assess the client for which of the following? 1. Disturbed sleep 2. Increased yawning 3. Psychomotor agitation 4. Inability to concentrate

1.

A nurse is performing a physical assessment on a client who uses heroin. It is most important for the nurse to assess the client for which of the following? 1. Hepatitis 2. Peptic ulcers 3. Hypertension 4. Chronic pharyngitis

1.

A nurse suggests to a client struggling with alcohol addiction that keeping a journal may be helpful. The goal of this nursing intervention is to help the client do what? 1. Identify stressors and responses to them. 2. Understand the diagnosis. 3. Help others by reading the journal to them. 4. Develop an emergency plan for use in a crisis.

1.

A polyaddicted client is hospitalized for withdrawal complications. What is the most important goal for this client? 1. The client will remain safe during the detoxification period. 2. The client will develop an accurate perception of his drug problem. 3. The client will abstain from mood-altering drugs. 4. The client will learn coping strategies to help him stop relying on drugs.

1.

What is the priority nursing intervention for a client recovering from cocaine addiction? 1. Help the client find ways to be happy and competent. 2. Foster the creative use of self in community activities. 3. Teach the client to handle stresses in the work setting. 4. Help the client acknowledge the current level of dependency.

1.

31. A client recovering from alcohol abuse tells the nurse, "I get nothing out of Alcoholics Anonymous (AA) meetings." What is the best response by the nurse? 1. " What were you told about going to AA meetings?" 2. " What do you want to get out of the AA meetings?" 3. " When do you think you'll stop going to the meetings?" 4. " Do you think you can control what happens in a meeting?"

2.

56. The nurse determines that teaching about cocaine has been effective when the client makes which statement? 1. " I wasn't using cocaine to feel better about myself." 2. " I started using cocaine more and more until I couldn't stop." 3. " I'm not addicted to cocaine because I don't use it every day." 4. " I'm not going to be a chronic user; I only use it on holidays."

2.

A client experiencing alcohol withdrawal tells the nurse she is upset about going through detoxification. What is the most important goal for this client? 1. The client will commit to a drug-free lifestyle. 2. The client will work with the nurse to remain safe. 3. The client will drink plenty of fluids on a daily basis. 4. The client will make a personal inventory of strengths.

2.

A client tells a nurse, "I'm not going to have problems from smoking marijuana." What is the most appropriate response by the nurse? 1. " Evidence shows it can cause major health problems." 2. " Marijuana can cause reproductive problems later in life." 3. " Smoking marijuana isn't as dangerous as smoking cigarettes." 4. " Some people have minor or no reactions to smoking marijuana." .

2.

A client who formerly used lysergic acid diethylamide (LSD) is seeking counseling. The nurse anticipates that the assessment of the client will include which finding? 1. Lack of trust 2. Panic attacks 3. Recurrent depression 4. Loss of ego boundaries

2.

A client with a history of alcohol abuse has been diagnosed with nutritional deficits. What is the best intervention for the nurse to implement? 1. Encourage the client to eat a diet high in calories. 2. Help the client recognize and follow a balanced diet. 3. Have the client drink liquid protein supplements daily. 4. Have the client monitor the calories consumed each day.

2.

A client with a history of alcohol abuse tells the nurse that he refuses to take his vitamins. What is the most appropriate response by the nurse? 1. " It's important to take vitamins to stop your craving." 2. " Prolonged use of alcohol can cause vitamin depletion." 3. " For every vitamin you take, you'll help your liver heal." 4. " By taking vitamins, you don't need to worry about your diet."

2.

A client withdrawing from alcohol tells the nurse that he is worried about periodic hallucinations. What is the most appropriate intervention by the nurse? 1. Point out that the sensation doesn't exist. 2. Allow the client to talk about the experience. 3. Encourage the client to wash the body areas well. 4. Determine if the client has a cognitive impairment.

2.

A family tells the nurse that they are concerned about a family member who stopped using amphetamines 3 months ago and is now acting paranoid. What is the best response by the nurse? 1. " A person gets symptoms of paranoia with polysubstance abuse." 2. " When a person uses amphetamines, paranoid tendencies may continue for months." 3. " Sometimes, family dynamics and a high suspicion of continued drug use make a person paranoid." 4. " Amphetamine abusers may have severe anxiety and paranoid thinking."

2.

A nurse is caring for a client addicted to heroin who is experiencing withdrawal symptoms. The nurse is aware that the withdrawal symptoms may be affected by which factor? 1. Ego strength 2. Liver function 3. Seizure history 4. Kidney function

2.

A nurse is caring for a client recovering from cocaine abuse. The priority intervention for this client would be? 1. Skin care 2. Suicide precautions 3. Frequent orientation 4. Nutrition consultation

2.

An alcoholic client tells the nurse, "I feel so depressed about what I've done to my family that I feel like giving up." It is most important for the nurse to assess the client for which of the following? 1. Family support 2. A plan for self-harm 3. A sponsor for the client 4. Other ambivalent feelings

2.

The nurse anticipates that a client undergoing nicotine withdrawal may make which statement? 1. " I sometimes feel like I'm seeing things." 2. " I feel lousy, and I'm grumpy with everybody." 3. " I can't believe I feel fine after just having stopped smoking." 4. " I'm always yawning now." .

2.

The nurse is caring for a client struggling with alcohol dependence. It is most important for the nurse to do which of the following? 1. Speak briefly and directly. 2. Avoid blaming or preaching to the client. 3. Confront feelings and examples of perfectionism. 4. Determine if nonverbal communication will be more effective.

2.

The nurse is performing an assessment of a client with a history of polysubstance abuse. What is the most important information for the nurse to obtain? 1. Oral administration of any drug 2. Time of last use of each drug 3. How the drug was obtained 4. The place the drug was used

2.

What is the most important teaching information for the nurse to provide a client who abuses prescription drugs? 1. Herbal substitutes are safer to use. 2. Medication should be used only for the reason prescribed. 3. The client should consult a physician before using a drug. 4. Consider if family members influence the client to use drugs.

2.

A client asks the nurse, "Why does it matter if I talk to my peers in group therapy?" What is the most appropriate response by the nurse? 1. " Group therapy lets you see what you're doing wrong in your life." 2. " Group therapy acts as a defense against your disorganized behavior." 3. " Group therapy provides a way to ask for support as well as to support others." 4. " In group therapy, you can vent your frustrations and others will listen."

3.

A client recovering from alcohol abuse needs to develop effective coping skills to handle daily stressors. What is the most appropriate nursing intervention for this client? 1. Determine the client's level of verbal skills. 2. Help the client avoid areas that cause conflict. 3. Discuss examples of successful coping behavior. 4. Teach the client to accept uncomfortable situations.

3.

A client recovering from cocaine abuse is participating in group therapy. The nurse determines that the client has benefited from the therapy when the client makes which statement? 1. " I think the laws about drug possession are too strict in this country." 2. " I'll be more careful about talking about my drug use to my children." 3. " I finally realize the short high from cocaine isn't worth the depression." 4. " I can't understand how I could get all these problems that we talked about in group."

3.

A client who abuses alcohol is admitted to an outpatient drug and alcohol treatment facility. The nurse determines that which of the following is the most objective way to determine if the client is still using alcohol? 1. Having the client walk a straight line 2. Smelling the client's breath 3. Giving the client a breath alcohol test 4. Asking the client if he has been drinking

3.

A pregnant client is thinking about stopping cocaine use. The nurse determines that teaching about drug use and pregnancy has been effective when the client makes which statement? 1. " Right after birth, I'll give the baby up for adoption." 2. " I'll help the baby get through the withdrawal period." 3. " I don't want the baby to have withdrawal symptoms." 4. " It's scary to think the baby may have Down syndrome."

3.

The nurse has just completed an assessment of a client recovering from alcohol addiction who has limited coping skills. During the assessment, the nurse also identified that the client is experiencing relationship problems. This assessment is supported by which finding? 1. The client is prone to panic attacks. 2. The client doesn't pay attention to details. 3. The client has poor problem-solving skills. 4. The client ignores the need to relax and rest.

3.

The nurse is facilitating a family meeting for a client who abuses alcohol. During the meeting, the nurse observes the communication and determines an unhealthy pattern of: 1. use of descriptive jargon. 2. disapproval of behaviors. 3. avoidance of conflicting issues. 4. unlimited expression of nonverbal communication.

3.

The nurse is trying to determine if a client who abuses heroin has any drug-related problems. What is the most appropriate question for the nurse to ask? 1. " When did your spouse become aware of your use of heroin?" 2. " Do you have a probation officer that you report to periodically?" 3. " Have you experienced any legal violations while being intoxicated?" 4. " Do you have a history of frequent visits with the employee assistance program manager?"

3.

The nurse is caring for a client who uses cocaine and has been admitted to an intensive outpatient rehabilitation program. It is most important for the nurse to assess the client for which finding? 1. GI distress 2. Blurred vision 3. Perceptual distortions 4. Increased appetite .

4.

What is the most important assessment for a nurse to implement before starting a teaching session for a client who abuses alcohol? 1. Sleep patterns 2. Decision making 3. Note-taking skills 4. Readiness to learn

4.