Addiction and Substance-Related Disorders
The nurse is providing support to a client's child regarding the parent's alcohol use disorder. When integrating the disease concept treatment approach about this type of disorder, which statement by the nurse would be most effective? "A brief intervention for alcohol use problems is very effective." "Your parent's alcohol use problem is a chronic disease but can be treated." "With your parent's cooperation, your parent can go through the detoxification process." "Your parent wants to stop drinking but the parent is addicted to the alcohol."
"Your parent's alcohol use problem is a chronic disease but can be treated."
A client will be taking disulfiram after discharge from an alcohol treatment program. Which statement would indicate that teaching has been effective? "Disulfiram is safe to take with any over-the-counter cold medication." "If I drink while taking disulfiram, it will make me vomit before the alcohol affects me." "Drinking alcohol while taking disulfiram can cause dangerous symptoms." "Disulfiram will block my cravings for alcohol, so I'll have less desire to drink."
"Drinking alcohol while taking disulfiram can cause dangerous symptoms."
As a component of the standard nursing admission assessment at the hospital, a nurse is using the CAGE tool. Which of the following questions will the nurse ask the client? "Have you ever felt like you should cut down on your drinking?" "Do you consider yourself to be an alcoholic?" "Have you ever required medical treatment for an illness related to alcohol use?" "How many drinks do you have in a typical week?"
"Have you ever felt like you should cut down on your drinking?"
A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse? "I can still hang out with my old friends. I am just not going to use." "I'm not very comfortable with being alone yet." "Shooting baskets helps me not think about getting high." "I am going to take up a new hobby. It's time to start something new."
"I can still hang out with my old friends. I am just not going to use."
A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, the client tells the nurse, "I am so ashamed." What should the nurse reply? "I really thought you would make it." "Why did you start drinking again?" "You have nothing to be ashamed of." "Tell me what has happened since your last admission."
"Tell me what has happened since your last admission."
An unconscious client is admitted to the emergency department after a motor vehicle accident. The client's blood alcohol level upon admission was .17. The client's family soon arrives, reporting that the client is an extended family member who is visiting from out of town. They cannot give much more history other than that the client is a "social drinker." After being transported to the unit, the client starts sweating and has elevated vital signs. What information should the nurse request of the family? Does the client have a history of any sort of anxiety disorder? For what occasion is the client visiting from out of town? Who is the next of kin? Are there other indications that the client may be a heavy drinker?
Are there other indications that the client may be a heavy drinker?
Disulfiram has been prescribed for a client receiving treatment for alcoholism. Which should be included in the client's plan of care? Have weekly blood alcohol levels drawn Avoid all products containing alcohol Do not drive heavy machinery Limit alcohol consumption to a moderate level
Avoid all products containing alcohol
The nurse is assessing a client admitted for drug and alcohol abuse. Which data from the assessment will increase the nurse's suspicion that the client may experience withdrawal symptoms? Elevated liver enzymes and low blood pressure Psychomotor agitation and flight of ideas Flat affect and labile mood Elevated vital signs and nervousness
Elevated vital signs and nervousness
Disulfiram has which of the following effects on prothrombin time? Decrease Increase Remains within normal limits No effect
Increase
The client began drinking a six-pack of beer every day in the client's freshman year of college. By sophomore year, the client is drinking two six-packs to get the same effect. This is best described as which phenomena?
Intoxication Tolerance Dependence Alcohol abuse Tolerance
Which characteristic of the 12-step program distinguishes it from other programs? It is a self-help group that does not necessarily use health professionals as leaders. Infrequent attendance is usually successful. Persons who use this program are independent in their sobriety. The philosophy that it is possible to reduce the use of substances without abstaining.
It is a self-help group that does not necessarily use health professionals as leaders.
Which statement incorrectly identifies positive aspects regarding methadone for heroin addiction? It is controlled by a physician. It is available in tablet form. It is a legal medication. It is available in IV form.
It is available in IV form.
Safety is the nursing priority for a client who is at risk for alcohol withdrawal. A care plan for the client who is in withdrawal must include which nursing interventions? -Suicide precautions because suicide attempts are frequent during withdrawal -Vital signs and medications as prescribed -Seizure precautions and vital signs -Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered
Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered
A client who is abusing substances is to undergo brief intervention. The nurse understands that this technique is most effective for a client who exhibits which symptoms? Short history of drug use High levels of dependence Multiple problems involving drug use Unstable backgrounds
Short history of drug use
Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder? The client engages in binge drinking a few times a week rather than drinking consistently each day. The client uses marijuana in addition to alcohol. The client had six drinks a few hours ago. The client has a demonstrated family history of alcoholism.
The client had six drinks a few hours ago.
A client reports drinking one to two drinks when drinking behavior first began. Now the client reports drinking at least six drinks with every episode in order to "have a good time." Which term would best describe this phenomenon? Tolerance Dependence Intoxication Withdrawal
Tolerance
A client's history reveals that he continues to use cocaine despite the negative consequences. The nurse identifies this as which of the following? A. Use B. Addiction C. Withdrawal D. Abuse
B. Addiction
A client has a blood alcohol level of 0.05%. The nurse would expect which behavior to occur? A. Difficulty driving B. Coma C. Stupor D. Impaired judgment
D. Impaired judgment
A nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance? Opioid Inhalant Cannabis Hallucinogen
Hallucinogen
The nurse is assessing the drinking history of a client with a history of alcohol abuse. The client is being admitted after being found unresponsive in a public place. Which statement would indicate the use of defense mechanisms? -"I have tried so many times to stop drinking. It is so hard." -"I don't really have a problem with alcohol. I've just been having a streak of bad luck lately." -"I really need some help. My drinking is tearing my family apart." -"I have no intention to stop drinking. I like the way it makes me feel."
"I don't really have a problem with alcohol. I've just been having a streak of bad luck lately."
The nurse is leading a family therapy group with a client addicted to alcohol. Which statement made by the spouse indicates the need for additional education regarding alcoholism as a family illness? "Last time the client got arrested, I just let the client sit in jail." "We have separated our finances so that I will not go broke." "I have to call in sick for the client when the client is too hung over to go to work." "I take my kids with me to Al-anon meetings every week."
"I have to call in sick for the client when the client is too hung over to go to work."
The nurse is conducting a health promotion class on drug awareness with a group of junior high school students. Which of the following teaching points should the nurse include in this session? "Heavy marijuana use has resulted in severe withdrawal symptoms in some people once they decide to quit." "Marijuana and heroin actually have a very similar potential for addiction." "Most people are unaware of the fact that marijuana is actually a very addictive drug." "Marijuana use can result in psychological dependence, which can have a very negative effect on your life."
"Marijuana use can result in psychological dependence, which can have a very negative effect on your life."
Which of the following is the best description of the term substance use disorders, according to the American Psychiatric Association? -Indicates that the client does not experience tolerance and withdrawal symptoms -Is an umbrella term for substance abuse and substance dependence -Indicates that the client experiences tolerance and withdrawal symptoms -Indicates that the client has a medical reason for taking the substance
-Is an umbrella term for substance abuse and substance dependence
A client with chronic alcoholism has been found to have Korsakoff's psychosis. This irreversible complication is characterized by what? -Thiamine, or vitamin B1, deficiency -Hypothalamic and mammillary body lesions -Double vision and rapid eye movement -Inability to learn new skills and short-term memory loss
-Thiamine, or vitamin B1, deficiency
A client has entered treatment for alcohol dependency at the client's spouse's insistence. The client's spouse has threatened to leave the marriage unless the client seeks treatment. The client admits that the client drinks every day, but that the drinking is well in control. The nurse recognizes the client's comments as denial. What is the best response by the nurse? "How much do you drink per day as compared to your friends?" "What negative consequences have resulted from your drinking?" "Your spouse doesn't seem to think your drinking is in control. Do you know why?" "You're in denial, which is common in the early stages of recovery."
"What negative consequences have resulted from your drinking?"
An intoxicated client was admitted for trauma treatment last night at 2:00 AM (0200). When should the nurse expect to be alert for withdrawal symptoms? -about 2:00 AM (0200) tomorrow (24 hours after drinking stopped) -about 2:00 AM (0200) of hospital day 3 (72 hours after drinking stopped) -between 8:00 and 10:00 AM (0800 and 1000) today (6 to 8 hours after drinking stopped) -about 2:00 AM (0200) of hospital day 2 (48 hours after drinking stopped)
-between 8:00 and 10:00 AM (0800 and 1000) today (6 to 8 hours after drinking stopped)
In a person who abuses alcohol or is a chronic drinker, alcohol withdrawal syndrome usually begins within which time frame from abrupt discontinuation or an attempt to decrease consumption? 48 hours 12 hours 18 hours 24 hours
12 hours
The nurse in an outpatient rehabilitation program is speaking with a group of clients who have recently recovered from alcohol abuse. Which issue should the nurse raise before the clients leave for the day? A. Help them to identify appropriate diversional activities. B. Remind them that substance dependency is a disease, not a mental disorder. C. Ask them to make a list of all the people they harmed during their addictions. D. Suggest that they try to confront other issues in their lives, such as estranged relationships or financial issues.
A. Help them to identify appropriate diversional activities.
A client with alcohol abuse is to receive disulfiram. The client's last drink was at 4 PM. The client should receive the medication no earlier than at which time? 12 midnight 4 AM 8 PM 8 AM
4 AM
A client is being treated for alcoholism. Which of the following medications is used to prevent alcohol withdrawal symptoms? A. Lorazepam (Ativan) B. Folic acid (Folate) C. Naltrexone (ReVia) D. Clonidine (Catapres)
A. Lorazepam (Ativan)
Which of the following is used as a substitute for heroin in some maintenance programs? A. Methadone B. Benzodiazepines C. Amphetamines D. Barbiturates
A. Methadone
A nurse is exploring treatment options with a client addicted to heroin. Which information regarding the use of methadone is important for the nurse to include? A. Methadone will meet the physical need for opiates without producing cravings for more. B. Methadone will produce a high similar to heroin. C. Unlike heroin, methadone is nonaddicting. D. People taking methadone run the same risks associated with intravenous drug use as those taking heroin.
A. Methadone will meet the physical need for opiates without producing cravings for more.
A client who has been abusing opioids for about one year has run out of the drug. The last time he used the drug was at 12 noon. The client would most likely develop signs and symptoms of withdrawal by which time? 2 AM 6 PM 9 PM 2 PM
9 PM
A client is admitted for a drug overdose with a barbiturate. Which is the priority nursing action when planning care for this client? A. Monitor respiratory function. B. Check the client's belongings for additional drugs. C. Prepare a dose of ipecac, an emetic. D. Pad the side rails of the bed because seizures are likely.
A. Monitor respiratory function.
Which are effects of alcohol withdrawal syndrome? Select all that apply. A. Seizures B. Decreased blood pressure C. Hand tremors D. Delirium tremens E. Increased pulse
A. Seizures C. Hand tremors E. Increased pulse D. Delirium tremens
A nurse is teaching a female client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements indicates understanding of the teaching? a. "I should avoid eating right before I chew a piece of nicotine gum." b. "I will need to stop using the nicotine gum after 1 year." c. "I know that nicotine gum is a safe alternative to smoking if I become pregnant." d. "I must chew the nicotine gum quickly for about 15 min."
A. "I should avoid eating right before I chew a piece of nicotine gum."
A nurse is discussing the use of methadone with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? SELECT ALL THAT APPLY a. "methadone is a replacement for physical dependence to opioids." 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 risk for acetaldehyde syndrome." e. "methadone must be prescribed and dispensed by an approved treatment center."
A. "methadone is a replacement for physical dependence to opioids." B. "methadone reduces the unpleasant effects associated with abstinence syndrome." C. "methadone can be used during opioid withdrawal and to maintain abstinence." E. "methadone must be prescribed and dispensed by an approved treatment center."
A nurse is providing teaching to a client who has alcohol use disorder and a new prescription for carbamazepine. Which of the following information should the nurse include in the teaching? a. "this medication will help prevent seizures during alcohol withdrawal." b. "taking this medication will decrease your cravings for alcohol." c. "this medication maintains your blood pressure at a normal level during alcohol withdrawal." d. "taking this medication will improve your ability to maintain abstinence from alcohol."
A. "this medication will help prevent seizures during alcohol withdrawal."
When interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency? A. Blaming themselves for the client's problems B. Being flexible but angry C. Taking pleasure in self-accomplishments D. Expressing thoughts and feelings openly
A. Blaming themselves for the client's problems Rationale: Self-blame is an example of maladaptive coping or codependent behavior. Anger can be a reasonable and appropriate response to a difficult situation; it is not considered pathologic and can lead to positive change. Open expression of ideas and recognition of accomplishments are positive coping strategies in a stressful situation, not indications of codependency.
Which group could benefit most from prevention programs? A. Infants B. Older adults C. Adults who have already engaged in substance abuse D. Children, prior to first use
A. Children, prior to first use
A client in treatment for drug abuse makes the statement to some of the other clients, "I am a winner. You all are the losers because you can't beat this on your own." What common characteristic of persons addicted to drugs is revealed in this statement? A. Defending against a negative self-concept B. Indication of an underlying personality disorder C. Realistic understanding of successful recovery of drug addiction D. Brain damages resulting from chronic drug use
A. Defending against a negative self-concept
A client is to receive cognitive behavioral therapy as part of the treatment for a substance abuse problem. Which of the following would the nurse need to integrate into the discussion when describing this treatment? Select all that apply. A. The client will need to analyze his distorted thinking. B. It is a treatment that is considered long-term therapy. C. It will decrease physiological cravings D. It focuses on the immediate problem. E. It requires the client to examine his thinking process related to the problem.
A. The client will need to analyze his distorted thinking. D. It focuses on the immediate problem. E. It requires the client to examine his thinking process related to the problem.
A client with opioid addiction is prescribed methadone maintenance therapy. When explaining this treatment to the client, which of the following would the nurse need to keep in mind? A. The drug helps to satisfy the craving for the opioid. B. Methadone simulates the high of heroin. C. Methadone is a not physiologically addictive. D. Methadone is a non-opioid drug.
A. The drug helps to satisfy the craving for the opioid.
Wernick-Korsakoff syndrome is a neurologic condition that can result from heavy drinking. Which of the following medications is used to prevent Wernicke-Korsakoff syndrome? A. Thiamine (vitamin B1) B. Folic acid (Folate) C. Lorazepam (Ativan) D. Cyanocabalamin (vitamin B12)
A. Thiamine (vitamin B1)
A nurse is teaching a school-age child and his parents about a new prescription for lisdexamfetamine. Which of the following information should the nurse include in the teaching? SELECT ALL THAT APPLY a. an adverse effect of this medication is CNS stimulation b. administer the medication before bedtime c. monitor blood pressure while taking this medication d. therapeutic effects of this medication will take 1 to 3 weeks to fully develop e. this medication raises the levels of dopamine in the brain
A. an adverse effect of this medication is CNS stimulation C. monitor blood pressure while taking this medication E. this medication raises the levels of dopamine in the brain
A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? SELECT ALL THAT APPLY a. lorazepam b. diazepam c. disulfiram d. naltrexone e. acamprosate
A. lorazepam B. diazepam Rationale: benzodiazepines used during alcohol withdrawal to decrease anxiety and reduce risk for seizures (LAM + PAM)
A nurse is teaching an adolescent client who has a new prescription for clomipramine for OCD. Which of the following instructions should the nurse include to minimize an adverse effect of his medication? a. wear sunglasses when outdoors b. check you temperature daily c. take this medication in the morning d. add extra calories to your diet
A. wear sunglasses when outdoors
A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicate an understanding of the teaching? SELECT ALL THAT APPLY a. "we need to understand that she is responsible for her disorder." b. "eliminating any codependent behavior will promote her recovery." c. "she should participate in an Al-Anon group to help her recover." d. "the primary goal of her treatment is abstinence from substance use." e. "she needs to discuss her feelings about substance use to help her recover."
B. "eliminating any codependent behavior will promote her recovery." - families should be aware of codependent behaviors, such as enabling, that can promote substance use rather than recovery D. "the primary goal of her treatment is abstinence from substance use." -abstinence is the primary treatment goal E. "she needs to discuss her feelings about substance use to help her recover." -clients must acknowledge their feelings about substance use as part of a substance use recovery program
A nurse is evaluating a client's understanding of a new prescription for clonidine for the treatment of opioid use disorder. Which of the followings statements by the client indicates an understanding of the teaching? a. "taking this medication will help reduce my craving for heroin." b. "while taking this medication I should keep a pack of sugarless gum." c. I can expect some diarrhea from taking this medicine." d. "each dose of this medication should be placed under my tongue to dissolve."
B. "while taking this medication I should keep a pack of sugarless gum" Rationale: clonidine commonly causes clients to experience dry mouth. chewing sugarless gum is an effective method to address this adverse effect
The mental health nurse is preparing a presentation about prescription drug abuse to a local community group. When describing the incidence, which age group would the nurse identify as experiencing an increase? A. Middle-age males B. Adolescents C. Chronically ill females D. Cognitively impaired older adults
B. Adolescents
A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The nurse assesses the client and finds the client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which is typical of these symptoms? A. Delirium tremens B. Alcohol withdrawal syndrome C. Wernicke-Korsakoff syndrome D. Continuing intoxication
B. Alcohol withdrawal syndrome
Children of those who abuse substances are at high risk for both substance abuse and which of the following? A. Eating disorders B. Behavior disorders C. Autism D. Schizophrenia
B. Behavior disorders
The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience? A. Norepinephrine B. Dopamine C.Serotonin D. Acetylcholine
B. Dopamine
A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as which of the following? A. Stimulant B. Hallucinogen C. Sedative D. Opioid
B. Hallucinogen
A client is brought to the emergency department following a car accident. The client's blood alcohol level (BAL) is 0.10%. Which of the following would the client likely exhibit? A. Ataxia B. Impaired coordination C. Giddiness D. Emotional lability
B. Impaired coordination
When discussing methadone treatment with a client, the nurse should include what? A. It takes 1 to 2 years to cure an opiate addict. B. It decreases the severity of heroin withdrawal symptoms. C. The cure rate is extremely high. D. It is a nonaddictive treatment.
B. It decreases the severity of heroin withdrawal symptoms.
While at a nightclub, an adolescent male consumed a pill handed to him by a friend. His friends brought him to the emergency room after he collapsed at the club. When the nurse takes his temperature, a reading of 105°F is obtained. The pill was most likely which of the following? A. Methamphetamine B. MDMA (ecstasy) C. Cocaine D. Cannabis
B. MDMA (ecstasy)
The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that his relationship with the client was codependent and enabling. Which of the following is an example of codependent behavior? A. The friend called Alcoholics Anonymous when the client expressed a need to stop drinking. B. The friend called the client every night to make sure he got home safely, and went looking for him if he was not at home. C. The friend confronted the client on the effect of his drinking on their relationship. D. The friend refused to go out drinking with the client to celebrate the client's birthday.
B. The friend called the client every night to make sure he got home safely, and went looking for him if he was not at home.
A nurse is providing teaching to a client who has a new prescription for clonidine to assist with maintenance of abstinence from opioids. The nurse should instruct the client to monitor for which of the following adverse effects? a. diarrhea b. dry mouth c. insomnia d. hypertension
B. dry mouth
A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? SELECT ALL THAT APPLY a. bradycardia b. fine tremors of both hands c. hypotension d. vomiting e. restlessness
B. fine tremors of both hands D. vomiting E. restlessness
A nurse is teaching the parents of a school-age child about transdermal methylphenidate. Which of the following instructions should the nurse include? a. apply one patch twice per day b. leave the patch on for 9 hr. c. apply the patch to the child's waist d. use opened tray within 6 months
B. leave the patch on for 9 hr
A nurse is caring for a school-age child who has a new prescription for atomoxetine. The nurse should monitor the client for which of the following adverse effects of this medication? a. kidney toxicity b. liver damage c. seizure activity d. adrenal insufficiency
B. liver damage Rationale: monitor for manifestations such as jaundice, upper abdominal tenderness, darkening of urine, and elevated liver enzymes
A nurse is teaching the parents of a child who has a new prescription for desipramine. The nurse should instruct the parents that which of the following adverse effects is the priority to report to the provider? a. constipation b. suicidal thoughts c. photophobia d. dry mouth
B. suicidal thoughts Rationale: greatest risk to the client is injury from suicide attempt. Desipramine can cause suicidal thoughts and behaviors.
Disulfiram should not be administered until a client has abstained from alcohol for at least how long? A. 8 hours B. 16 hours C. 12 hours D. 4 hours
C. 12 hours
Which of the following agents would be helpful in alleviating the physical complications associated with alcohol withdrawal? A. Tricyclic antidepressants B. MAOIs C. Benzodiazepines D. SSRIs
C. Benzodiazepines
Which is the most common defense mechanism used by a client diagnosed with a substance use problem? A. Suppression B. Repression C. Denial D. Regression
C. Denial
After a long history of intravenous heroin use, a client has expressed willingness to stop using heroin. The nurse would expect the client to receive which medication to decrease the severity of withdrawal? A. Amphetamines B. Ondansetron C. Methadone D. Gabapentin
C. Methadone
Which statement most accurately describes the etiology of substance-related disorders? A. The primary predictors of substance-related disorders are childhood trauma and parental abuse or neglect. B. Substance abuse is a learned behavior. C. Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors. D. Substance-related disorders are primarily a result of the presence of an individual's inherently addictive personality.
C. Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors.
A client is admitted to the emergency department for intoxication with alcohol. The client has an unsteady gait, myopathy, and neuropathy and cannot remember past or recent events. When treated with thiamine, the client's symptoms greatly improve. Which condition was the client likely experiencing? A. Alcoholic dementia B. Alcohol dependence with memory impairment C. Wernicke-Korsakoff syndrome D. Scurvy
C. Wernicke-Korsakoff syndrome
A nurse is teaching a client who has tobacco use disorder about the use of nicotine gum. Which of the following information should the nurse include in the teaching? a. chew the gum for no more than 10 min. b. rinse out the mouth immediately before chewing the gum c. avoid eating 15 minutes prior to chewing the gum d. use of the gum is limited to 90 days
C. avoid eating 15 minutes prior to chewing gum
A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse include in the teaching? a. increases the risk for seizure activity b. provides a form of aversion therapy c. decreases cravings d. results in mild hypertension
C. decreases cravings
A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? a. chlordiazepoxide b. bupropion c. disulfiram d. carbamazepine
C. disulfiram Rationale: the nurse should expect to administer disulfiram to help the client maintain abstinence from alcohol
A nurse is assisting in the discharge planning for a client following alcohol detoxification. The nurse should anticipate prescriptions for which of the following medications to promote long-term abstinence from alcohol? SELECT ALL THAT APPLY a. lorazepam b. diazepam c. disulfiram d. naltrexone e. acamprosate
C. disulfiram -promotes abstinence through aversion therapy D. naltrexone -promotes abstinence by suppressing the craving and pleasurable effects of alcohol E. acamprosate -decreases the unpleasant effects resulting from abstinence
A nurse is planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following interventions should the nurse identify as the priority? a. orient the client frequently to time, place, and person b. offer fluids and nourishing diet as tolerated c. implement seizure precautions d. encourage participation in group therapy sessions
C. implement seizure precautions
A nurse is planning a staff education program on substance use in older adults. Which of the following is appropriate for the nurse to include in the presentation? a. older adults require higher doses of a substance to achieve a desired effect. b. older adults commonly use rationalization to cope with a substance use disorder c. older adults are at an increased risk for substance use following retirement d. older adults develop substance use to mask manifestations of dementia
C. older adults are at an increased risk for substance use following retirement Rationale: Retirement and other life change stressors increase the risk for substance use in older adults, especially if there is a prior history of substance use
When educating the public regarding substance-related disorders, the mental health nurse explains that the condition of drug dependence is a state defined as ... Chronic or recurrent drug intoxication, characterized by psychological and physical dependence Physical effects resulting from the multiple episodes of substance use Emotional dependence on a drug or a desire or compulsion to continue taking a drug Substance-seeking activities and pathological use patterns of the person using substances
Chronic or recurrent drug intoxication, characterized by psychological and physical dependence
The body can metabolize how much beer per hour without intoxication? A. 16 oz B. 28 oz C. 14 oz D. 12 oz
D. 12 oz
A nurse is conducting a seminar with a local parent group about substance use and abuse. The nurse determines that the seminar was successful when the group identifies which substance as the most abused in the United States? A. Heroin B. Marijuana C. Cocaine D. Alcohol
D. Alcohol
The nurse is performing a history and physical examination on a client with chronic alcoholism. The client has a history of gastritis, esophagitis, elevated liver enzymes, cardiomyopathy, and pancreatitis. Which of these conditions are attributable to the client's history of alcohol abuse? A. Pancreatitis and elevated liver enzymes B. Pancreatitis, esophagitis, gastritis, and elevated liver enzymes C. Gastritis and elevated liver enzymes D. All the conditions are attributable to the alcohol abuse
D. All the conditions are attributable to the alcohol abuse
A client is being treated on the inpatient unit for alcoholism. Disulfiram (Antabuse) has been prescribed for a client receiving treatment for alcoholism. Which of the following should be included in the client's plan of care? A. Have weekly blood alcohol levels drawn B. Do not drive heavy machinery C. Limit alcohol consumption to a moderate level D. Avoid all products containing alcohol
D. Avoid all products containing alcohol
A client is experiencing alcohol withdrawal symptoms. Which of the following would the nurse expect to be prescribed to assist with the withdrawal symptoms, acting as a substitute for the alcohol? A. Phenothiazines B.Beta-blockers C. Anti-seizure agents D. Benzodiazepines
D. Benzodiazepines
A nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam (Valium) when the injections are given by another nurse. That nurse returns from lunch exhibiting slurred speech and euphoria. Which of the following is the best action for the ICU nurse to take? A. Observe the nurse as injections are prepared and administered. B. Tell the nurse, "I know you've been stealing Valium." C. Ask other nurses if they have noticed anything unusual. D. Call the manager and report the observations.
D. Call the manager and report the observations.
Which drug reverses opioid toxicity? A. Clonidine B. Methadone C. Disulfiram D. Naloxone
D. Naloxone
A client is brought to the emergency department with a suspected heroin overdose. Which of the following would support this suspicion? A. Euphoria B. Reduced libido C. Impaired memory D. Respiratory depression
D. Respiratory depression
Which disorder across the lifespan accounts for more deaths than any other preventable health condition? A. Eating disorders B. Personality disorders C. Schizophrenia D. Substance abuse disorders
D. Substance abuse disorders
A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse? A. Elementary school teachers and counselors B. Parents attending a parent-teacher association meeting C. School-age children in an after-school program D. Teenagers in a high school health class
D. Teenagers in a high school health class
The client was diagnosed with cocaine abuse at age 30. When the client was 23, the client was diagnosed with major depressive episode, and has continued to have depression off and on since then. Which statement would reflect this situation? A. The client's prognosis is very poor because discontinuing the cocaine use will exacerbate depressive symptoms. B. The client is probably using cocaine in combination with her antidepressants to enhance the effects of the cocaine. C. The client needs to address the cocaine abuse first before addressing her episodes of depression. D. The client most likely has a dual diagnosis since she has both a substance dependence and depression.
D. The client most likely has a dual diagnosis since she has both a substance dependence and depression.
A client has been admitted to the inpatient unit after using inhalants recently. Which of the following is an antidote to treat inhalant toxicity? A. Disulfiram B. Naloxone C. Lorezpam D. There is no antidote
D. There is no antidote
A nurse is conducting a class for a group of high school students about marijuana use and abuse. The nurse determines that the class needs further discussion when they state which of the following? A. It is not known if marijuana smoke contributes to the risk of lung cancer. B. Marijuana can produce the same respiratory problems as tobacco. C. It interferes with coordination and balance. D. Use of marijuana does not lead to addiction.
D. Use of marijuana does not lead to addiction.
A client is admitted for treatment of trauma sustained in a fall. The client believes bugs are crawling on the bed. The client is anxious, agitated, diaphoretic and has a history of chronic drinking. The nurse can anticipate that the physician will order which medication? A. monoamine oxidase inhibitor, such as phenelzine B. narcotic, such as codeine C. phenothiazine, such as chlorpromazine or thioridazine D. benzodiazepine, such as diazepam or chlordiazepoxide
D. benzodiazepine, such as diazepam or chlordiazepoxide
A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the priority? a. administer the clonidine on the prescribed schedule b. provide ice chips at the client's bedside c. educate the client on the effects of clonidine d. obtain baseline vital signs
D. obtain baseline vital signs Rationale: assessment is the initial step of the nursing process. obtaining client's baseline vital signs is the priority
A client enters the emergency room exhibiting tremors, agitation, and restlessness. Upon assessment, the client's blood pressure is 160/90, pulse is 110, and respirations are 22. It has been 36 hours since the client's last drink of alcohol. The nurse would suspect which conditions to be occurring? Korsakoff's psychosis Alcohol tolerance Delirium tremens Wernicke's encephalopathy
Delirium tremens
Suspicion that a nursing professional is impaired by a substance abuse problem is most supported by which situation? Asking to be scheduled for weekend shifts as much as possible Frequently calling off work for undefined illnesses Spending a considerable amount of shift time off the unit Having several clients complain that their pain medication is not working
Having several clients complain that their pain medication is not working
When conducting an adolescent drug awareness program, the nurse describes which of the following drugs as having the highest addiction potential? Marijuana and nicotine Cocaine and codeine Amphetamines and barbiturates Heroin and morphine
Heroin and morphine
A peer reports for work looking unkempt and disheveled. The peer's movements are uncoordinated, and the peer's breath smells of alcohol. Another nurse suspects this peer is intoxicated. Which action by the nurse who suspects that a peer is intoxicated would be most appropriate? Immediately call the supervisor to report the peer's behavior. Give the peer some information about the hospital's employee assistance program. Tell the peer that the peer should go home. Ignore the situation until someone else validates the observations.
Immediately call the supervisor to report the peer's behavior.
A nurse who started recovering from alcohol abuse 3 months earlier is ready to return to work. When speaking with the therapist, the nurse states the nurse is nervous about how coworkers will respond to the nurse now that "they all know I'm a drunk." Which diagnosis best targets the problem implicit in the nurse's remarks? Anxiety related to situational crisis Powerlessness related to perceived inability to change the opinions of others Ineffective coping related to long history of alcohol use Situational low self-esteem related to medical condition
Situational low self-esteem related to medical condition
Which neurochemical influences is a probable cause of substance abuse? Inhibition of gamma-Aminobutyric acid (GABA) in the brain Stimulation of dopamine pathways in the brain Imbalances of serotonin and norepinephrine in the brain Excessive serotonin activity in the central nervous system
Stimulation of dopamine pathways in the brain
A client is in treatment for depression and alcohol abuse. The client is unwilling to confront substance abuse issues, stating the client uses alcohol to ease feelings of depression. The client's spouse reports that the spouse often has to care for the client when the client is hung over, calling in sick for the client and doing what the spouse can to help the client catch up with household or job responsibilities. The nurse diagnoses the client's family with dysfunctional family processes. The nurse and clients develop a plan of care. Which goal indicates an understanding of the family situation and the linkages between the diagnosis and the outcomes? The client and spouse will develop better problem-solving techniques. The spouse will refrain from the enabling the client's drinking behaviors. The client will admit that the client is an alcoholic. The spouse will work through anger at the client.
The spouse will refrain from the enabling the client's drinking behaviors.
A client is admitted to the emergency department for intoxication with alcohol. The client has an unsteady gait, myopathy, and neuropathy and cannot remember past or recent events. When treated with thiamine, the client's symptoms greatly improve. Which condition was the client likely experiencing? Alcoholic dementia Alcohol dependence with memory impairment Scurvy Wernicke-Korsakoff syndrome
Wernicke-Korsakoff syndrome
A client drinks 24 oz. of vodka every day, having gradually increased to this level over the past 2 to 3 years. The client continues to maintain a job and functions well in activities of daily living, relationships, and other aspects of social life. Which term should the nurse use to describe this drinking behavior?
Withdrawal Tolerance Abuse Intoxication Tolerance
