SUD

A client is asking the nurse about a newly prescribed medication, acamprosate calcium (Campral). Which is the nurse's best reply? A. "Acamprosate will help you maintain your abstinence." B. "Acamprosate will cause uncomfortable symptoms if you combine it with alcohol." C. "Acamprosate will decrease the effect alcohol has on your body." D. "Acamprosate will lower your risk of experiencing a complicated withdrawal."

A. "Acamprosate will help you maintain your abstinence."

Which nursing statements exemplify important insights to promote effective intervention with clients diagnosed with SUDs? Select all that apply. A. "I am easily manipulated and need to work on this prior to caring for these clients." B. "Because of my father's alcoholism, I need to examine my attitude toward these clients." C. "Drinking is legal, so the diagnosis of SUD is an infringement on client rights." D. "Opiate addicts are typically uneducated, unrefined individuals who will need a lot of education and social skills training." E. "I can fix clients with SUDs as long as I truly care about them."

A. "I am easily manipulated and need to work on this prior to caring for these clients." B. "Because of my father's alcoholism, I need to examine my attitude toward these clients."

Which meds promote long-term abstinence form alcohol? Select all that apply. A. Acamprosate B. Diazepam C. Disulfiram D. Lorazepam E. Naltrexone

A. Acamprosate C. Disulfiram E. Naltrexone

Which meds are appropriate for alcohol detoxification? Select all that apply. A. Acamprosate (Campral) B. Diazepam (Valium) C. Disulfiram (Antabuse) D. Lorazepam (Ativan) E. Naltrexone (Vivitrol)

A. Acamprosate (Campral) D. Lorazepam (Ativan)

A client diagnosed with Chronic Alcohol Use Disorder is being discharged from an inpatient treatment facility after detoxification. Which client outcome related to Alcoholics Anonymous (AA) is most appropriate for the nurse to discuss with the client during discharge teaching? A. After discharge, client will immediately attend 90 AA meetings in 90 days. B. After discharge, client will rely on an AA sponsor to help control alcohol cravings. C. After discharge, client will incorporate family in AA attendance. D. After discharge, client will seek appropriate deterrent medications through AA.

A. After discharge, client will immediately attend 90 AA meetings in 90 days.

What contributes to dementia? A. Alcohol use disorder B. Dehydration C. Hypotension D. Change in environment

A. Alcohol use disorder

Which drug can relieve intense craving for cocaine, agitation, depression, poor appetite? A. Amantadine B. Buprenorphine C. Wellbutrin D. Phenobarbital

A. Amantadine

A client has a history of daily bourbon drinking for the past 6 months. He is brought to an ED by family, who report that his last drink was 1 hour ago. It is now 12 midnight. When will the nurse expect this client to exhibit withdrawal symptoms? A. Between 3 a.m. and 11 a.m. B. Shortly after a 24-hour period C. At the beginning of the third day D. Withdrawal is individualized and cannot be predicted

A. Between 3 a.m. and 11 a.m.

Which assessment is made before giving clonidine for opioid withdrawal? A. Blood pressure B. Complete physical assessment C. Last time patient used an opiate D. Tremors

A. Blood pressure

Which are symptoms of an amphetamine overdose? Select all that apply A. Coma B. Convulsions C. Bradycardia D. Hypotension E. Cardiac arrhythmia

A. Coma B. Convulsions E. Cardiac arrhythmia

What is a need for immediate intervention in delirium? A. Command hallucinations B. Impaired memory C. Rapid mood swings D. Inappropriate speech patterns

A. Command hallucinations

Which symptom is associated with cocaine withdrawal? A. Fatigue B. Tremors C. Rapid speech D. Seizures

A. Fatigue

What is true about self help groups like AA? A. Members themselves run the group with leadership usually rotating among members. B. Self help groups used to be the treatment of choice, but their popularity is waning. C. There is little research to support AA's effectiveness. D. These groups have no external regulation, so patients need to be cautious.

A. Members themselves run the group with leadership usually rotating among members.

A patient states, "I cope with his job by drinking." What defense mechanism is being used? A. Rationalization B. Repression C. Intellectualization D. Introjection

A. Rationalization

Which is the priority nursing diagnosis for a client experiencing alcohol withdrawal? A. Risk for injury R/T central nervous system stimulation B. Disturbed thought processes R/T tactile hallucinations C. Ineffective coping R/T powerlessness over alcohol use D. Ineffective denial R/T continued alcohol use despite negative consequences

A. Risk for injury R/T central nervous system stimulation

A client diagnosed with depression and SUD has an altered sleep pattern and demands that a psychiatrist prescribe a sedative. Which rationale explains why the nurse should encourage the client to try nonpharmacological interventions first? A. Sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance. B. Sedative-hypnotics are expensive and have numerous side effects. C. Sedative-hypnotics interfere with necessary rapid eye movement (REM) sleep. D. Sedative-hypnotics are not as effective to promote sleep as are antidepressant medications.

A. Sedative-hypnotics are potentially addictive and will lose their effectiveness due to tolerance.

What are the symptoms of Wernicke's encephalopathy? Select all that apply. A. Stupor B. Jaundice C. Diplopia D. Somnolence E. Confabulation

A. Stupor C. Diplopia (double vision) D. Somnolence (sleepiness or drowsiness)

A lonely, depressed divorcée has been self-medicating with cocaine for the past year. Which term does the nurse identify that best describes the client's situation? A. The client is experiencing psychological addiction. B. The client is experiencing physical addiction. C. The client is experiencing substance addiction. D. The client is experiencing social addiction.

A. The client is experiencing psychological addiction.

What is an appropriate discharge outcome after detoxification for chronic alcohol use? A. Will immediately attend 90 AA meetings in 90 days. B. Will rely on AA sponsor to help control alcohol cravings. C. Will incorporate family in AA attendance. D. Will seek appropriate deterrent medications through AA.

A. Will immediately attend 90 AA meetings in 90 days.

A mother with a history of chronic heroin use lost custody of her children due to abuse and neglect. She has been admitted to an inpatient drug rehabilitation program. Which statement indicates to the nurse that the client has a positive prognosis? A. "I won't use heroin ever again. I know I've got the willpower to do it this time." B. "I cannot control my use of heroin. It's stronger than I am." C. "I'm going to get all my children back. They need their mother." D. "Once I deal with my childhood physical abuse, recovery should be easy."

B. "I cannot control my use of heroin. It's stronger than I am."

The nurse in the ED is reviewing STAT laboratory data. What is the minimum blood alcohol level at which the nurse expects intoxication to occur? A. 50 mg/dL B. 100 mg/dL C. 250 mg/dL D. 300 mg/dL

B. 100 mg/dL

Which is the priority nursing intervention for a client admitted for acute alcohol intoxication? A. Darken the room to reduce stimuli to prevent seizures. B. Assess aggressive behaviors to prevent injury to self or others. C. Administer lorazepam (Ativan) to reduce the rebound effects on the CNS. D. Teach the negative effects of alcohol on the body.

B. Assess aggressive behaviors to prevent injury to self or others.

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 24 hours. Which client symptom should the nurse immediately report to the ED physician? A. Antecubital bruising B. Blood pressure of 180/100 mm Hg C. Mood rating of 2/10 on numeric scale D. Dehydration

B. Blood pressure of 180/100 mm Hg

What might the patient experience if clonidine is used to help patient abstain from opioids? A. Diarrhea B. Dry mouth C. Insomnia D. Peripheral edema

B. Dry mouth

Which are symptoms of inhalant intoxication? Select all that apply. A. Bradycardia B. Euphoria C. Hyperactive reflexes D. Ataxia E. Nystagmus

B. Euphoria D. Ataxia E. Nystagmus

What are expected findings in AWS? Select all that apply. A. Bradycardia B. Fine tremors of both hands C. Hypotension D. Restlessness E. Vomiting

B. Fine tremors of both hands D. Restlessness E. Vomiting

Which behavior indicates stimulant intoxication? A. Depersonalization, dilated pupils, visual hallucinations B. Hyperactivity, talkativeness, euphoria C. Relaxed inhibitions, increased appetite, distorted perceptions D. Slurred speech, unsteady gait, impaired concentration

B. Hyperactivity, talkativeness, euphoria

A client with an opium use disorder tells the nurse, "I don't have any problems because of using opium." The nurse responds, "It's your behavior rather you personally that is unacceptable." What outcome will the nurse expect from this intervention? A. Maintains a therapeutic relationship with the nurse. B. Verbalizes feelings of dignity and self-worth. C. Focuses on his or her behavior as an illness that requires help. D. Is able to demonstrate the relationship between substance use and personal problems.

B. Verbalizes feelings of dignity and self-worth.

What is a correct statement about nicotine replacement therapy? A. "I know that nicotine gum is a safe alternative to smoking if I become pregnant." B. "I must chew the nicotine gum quickly for about 15 minutes." C. "I should avoid eating right before I chew a piece of nicotine gum." D. "I will need to stop using the nicotine gum after 1 year."

C. "I should avoid eating right before I chew a piece of nicotine gum."

Which statement by the son of a woman with SUD indicates a need for further teaching? A. "Eliminating any codependent behavior will promote her recovery." B. "She needs to discuss her feelings about substance use to help her recover." C. "She should participate in Al-Anon groups to help her recover." D. The primary goal of treatment is abstinence from substance use."

C. "She should participate in Al-Anon groups to help her recover."

What is a statement of effective teaching on naltrexone (ReVia)? A. "If I use opioids while taking naltrexone, I'll become extremely ill." B. "I'll get sick if I use heroin while taking this medication." C. "This medication will block the effects of any opioid substance I take." D. "Using naltrexone may make me dizzy."

C. "This medication will block the effects of any opioid substance I take."

A client's wife has been making excuses for her alcoholic husband's work absences. In family therapy, she states, "I just need to work harder to get him there on time." Which is the appropriate nursing response? A. "Why do you assume responsibility for his behaviors?" B. "Codependency is a typical behavior of spouses of alcoholics." C. "Your husband needs to deal with the consequences of his drinking." D. "Do you understand what the term enabler means?"

C. "Your husband needs to deal with the consequences of his drinking."

A relapse occurs in a client recovering from SUD when he drinks a glass of wine. The client presents in the ED experiencing severe throbbing headache, tachycardia, flushed face, dyspnea, and continuous vomiting. What do the symptoms indicate? A. Alcohol poisoning B. Cardiovascular accident (CVA) C. A reaction to disulfiram (Antabuse) D. A reaction to tannins in the red wine

C. A reaction to disulfiram (Antabuse)

On the first day of a client's alcohol detoxification, which nursing intervention is the priority? A. Encourage the client to attend 90 Alcoholics Anonymous meetings in 90 days. B. Educate the client about the biopsychosocial consequences of alcohol abuse. C. Administer ordered chlordiazepoxide (Librium) in a dosage per protocol. D. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.

C. Administer ordered chlordiazepoxide (Librium) in a dosage per protocol.

The nurse believes that a client being admitted for a surgical procedure may have a drinking problem. How should the nurse further evaluate this possibility? A. By asking directly if the client has ever had a problem with alcohol B. By holistically assessing the client, using the Clinical Institute Withdrawal Assessment scale C. By using a screening tool such as the CAGE questionnaire D. By referring the client for physician evaluation

C. By using a screening tool such as the CAGE questionnaire

Which therapeutic communication technique is being used in this nurse-client interaction? Client: "When I am anxious, the only thing that calms me down is alcohol." Nurse: "Other than drinking, what alternatives have you explored to decrease anxiety?" A. Reflecting B. Making observations C. Formulating a plan of action D. Giving recognition

C. Formulating a plan of action

Upon admission for symptoms of alcohol withdrawal, a client states, "I haven't eaten in 3 days." Assessment reveals BP 170/100 mm Hg, P 110, R 28, and T 97°F (36°C) with dry skin, dry mucous membranes, and poor skin turgor. What is the priority nursing diagnosis? A. Knowledge deficit B. Fluid volume excess C. Imbalanced nutrition: less than body requirements D. Ineffective individual coping

C. Imbalanced nutrition: less than body requirements

What is the priority nursing action for clonidine used in opioid withdrawal? A. Administer the clonidine as prescribed on the schedule. B. Educate the patient on effects of clonidine. C. Obtain the patient's baseline vital signs. D. Provide ice chips at the patient's bedside.

C. Obtain the patient's baseline vital signs.

Which one of the following best describes this patient's current concern? A. Chronic idiopathic constipation B. Functional GI motility disorder C. Opioid exacerbated chronic constipation D. Irritable bowel syndrome with constipation

C. Opioid exacerbated chronic constipation

What is the interpretation of the patient with AUD stating, "My life is unmanageable"?. A. Patient is using minimization as an ego defense. B. Patient is ready to sign an AA contract for sobriety. C. Patient has accomplished the first of 12 steps advocated by AA. D. Patient has met the requirements to be designated as an AA sponsor.

C. Patient has accomplished the first of 12 steps advocated by AA.

What is the rationale for assessing SUD if a patient on a PCA pump makes 100 attempts in 30 minutes? A. Narcotic pain medication is contraindicated for all clients with active substance use problems. B. Patient is experiencing symptoms of withdrawal and needs to be accurately assessed for lorazepam dosage. C. Patients who are regularly using alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control. D. There is no need to assess the client for SUD. There is obvious PCA malfunction.

C. Patients who are regularly using alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control.

What is appropriate teaching on propranolol? A. Propranolol increases the risk for seizure activity. B. Propranolol provides a form of aversion therapy. C. Propranolol decreases cravings. D. Propranolol results in mild hypertension.

C. Propranolol decreases cravings.

The nurse is assessing a client 8 hours after the client stopped taking Demerol and Oxycontin. Which symptoms will the nurse observe in the client? A. Bone pain B. Insomnia C. Runny nose D. Goose bumps

C. Runny nose

A client diagnosed with Alcohol Use Disorder joins a community 12-step program and states, "My life is unmanageable." Which of the following indicates the nurse's interpretation of the client's statement? A. The client is using minimization as an ego defense. B. The client is ready to sign an AA contract for sobriety. C. The client has accomplished the first of 12 steps advocated by AA. D. The client has met the requirements to be designated as an AA sponsor.

C. The client has accomplished the first of 12 steps advocated by AA.

During group therapy, a client diagnosed with Alcohol Use Disorder states, "I would not have boozed it up if my wife hadn't been nagging me all the time to get a job. She never did think that I was good enough for her." How should the nurse interpret this statement? A. The client is using denial by avoiding responsibility. B. The client is using displacement by blaming his wife. C. The client is using rationalization to excuse his alcohol dependence. D. The client is using reaction formation by appealing to the group for sympathy.

C. The client is using rationalization to excuse his alcohol dependence.

Why is subcutaneous methylnaltrexone given to patients on large doses of morphine? A. To increase respirations B. To prevent dependence on the morphine C. To relieve opioid-induced constipation D. To increase pain relief

C. To relieve opioid-induced constipation

Which client statement indicates a knowledge deficit related to substance use? A. "Although it's legal, alcohol is one of the most widely abused drugs in the U.S.A." B. "Tolerance to heroin develops quickly." C. "Flashbacks LSD use may reoccur spontaneously." D. "Everyone smokes marijuana. It's like smoking cigarettes. It's harmless."

D. "Everyone smokes marijuana. It's like smoking cigarettes. It's harmless."

Which statement about dolophine shows a need for further teaching? A. "Methadone is a replacement for the patient's opioid addiction." B. "Methadone reduces the unpleasant effects associated with abstinence syndrome." C. "Methadone can be used during opioid withdrawal and to maintain abstinence." D. "Methadone increases the patient's risk for acetaldehyde syndrome."

D. "Methadone increases the patient's risk for acetaldehyde syndrome."

Which information should the nurse include when teaching a client about disulfiram used as a deterrent to alcohol relapse? A. "Only oral ingestion of alcohol will cause a reaction when taking this drug." B. "It is safe to drink beverages that have only 12 percent alcohol content." C. "This medication will decrease your cravings for alcohol." D. "Reactions to combining Antabuse with alcohol can occur for as long as 2 weeks after stopping the drug."

D. "Reactions to combining Antabuse with alcohol can occur for as long as 2 weeks after stopping the drug."

Which client statement demonstrates positive progress toward recovery from SUD? A. "I have completed detox and therefore am in control of my drug use." B. "I'll faithfully attend Narcotics Anonymous (NA) when I can't control cravings." C. "As a church deacon, my focus will now be on spiritual renewal." D. "Taking those pills got out of control and cost me my job, marriage, and kids."

D. "Taking those pills got out of control and cost me my job, marriage, and kids."

What is the best initial preventive regimen for this patient? A. Bulking agent B. Diet high in soluble fiber C. Increased oral fluid intake D. Adding a stimulant laxative

D. Adding a stimulant laxative

The nurse in the ED assesses a 17-year-old client exhibiting symptoms of opiate intoxication. Which should be the nurse's first action? A. Contact the parents. B. Administer oxygen. C. Open the crash cart. D. Administer naloxone (Narcan).

D. Administer naloxone (Narcan).

Which medication will the nurse expect to be prescribed clients mildly addicted to opiates? A. Clonidine B. Methadone C. Desipramine D. Buprenorphine

D. Buprenorphine

Which drug would the nurse expect to be used in substitution therapy for a client withdrawing from alcohol? A. Clonidine B. Phenobarbital C. Carbamazepine D. Chlordiazepoxide

D. Chlordiazepoxide

Which drugs produce anterograde amnesia and sedative intoxication? Select all that apply. A. Diazepam (Valium) B. Oxazepam (Serax) C. Lorazepam (Ativan) D. Flunitrazepam (Rohypnol) E. Gamma hydroxybutyric acid (GHB)

D. Flunitrazepam (Rohypnol) E. Gamma hydroxybutyric acid (GHB)

Which term should the nurse use to describe the administration of a CNS depressant during alcohol withdrawal? A. Antagonist therapy B. Deterrent therapy C. Codependency therapy D. Substitution therapy

D. Substitution therapy

A client with SUD and mental illness is scheduled for cognitive therapy. Which client outcome would indicate effective therapy? A. The client can achieve and maintain sobriety. B. The client learns more adaptive ways of coping. C. The client knows how psychiatric disorders and substance abuse reinforce each other. D. The client learns to monitor moods and thought processes that lead to substance abuse.

D. The client learns to monitor moods and thought processes that lead to substance abuse.

The nurse is interviewing a client in an outpatient drug treatment clinic. To promote success in the recovery process, which initial outcome should the nurse expect the client to accomplish? A. The client will identify one person to turn to for support. B. The client will give up all old drinking buddies. C. The client will be able to verbalize the effects of alcohol on the body. D. The client will correlate life problems with alcohol use.

D. The client will correlate life problems with alcohol use.

The nurse holds the hand of a client who is withdrawing from alcohol. What is the nurse's rationale for this intervention? A. To assess for emotional strength B. To assess for Wernicke-Korsakoff syndrome C. To assess for tachycardia D. To assess for fine tremors

D. To assess for fine tremors

A patient with AUD tells the nurse, "No matter how much I drink, I can drive just fine." In a caring tone, the nurse responds, "The lab report shows that you were under the influence of alcohol when you had the accident." What is the rationale for this nursing intervention? A. To make client understand the relationship between substance abuse and personal problems B. To develop a trusting relationship with the client C. To make the client verbalize feelings related to dignity and self-worth D. To interfere with the client's ability to deny and to prevent him or her from becoming defensive without affecting his or her self-esteem.

D. To interfere with the client's ability to deny and to prevent him or her from becoming defensive without affecting his or her self-esteem.

An older adult recovering from hip surgery is ordered oxycodone as needed for pain. What is the priority nursing assessment? A. Blood glucose elevation B. Loss of appetite C. Respiratory alkalosis D. Urinary retention

D. Urinary retention