Mental 19
31. Which are general warning signs of substance abuse that a nurse should be alert for in coworkers? Select all that apply. A) Poor work performance B) Frequent absenteeism C) Unusual behavior D) Slurred speech E) Isolation from peers F) Substance abuse is not a problem in health professionals
A, B, C, D, E
18. A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms? A) Alcohol withdrawal syndrome B) Continuing intoxication C) Delirium tremens D) WernickeñKorsakoff syndrome
A
23. The nurse is coleading a family therapy group with a client addicted to alcohol. Which statement made by the wife indicates the need for additional education regarding alcoholism as a family illness? A) ìI have to call in sick for my husband when he is too hung over to go to work.î B) ìLast time he got arrested, I just let him sit in jail.î C) ìWe have separated our finances so that I will not go broke.î D) ìI take my kids with me to Al-anon meetings every week.î
A
25. A client calls the emergency department of the local hospital reporting that after 16 years of heavy drinking, he is tired and wants to quit ìcold turkey.î What would be the best response by the nurse? A) ìIt is not safe to stop drinking suddenly without medicine.î B) ìYou sound really motivated. Come in and we will help you find a treatment center.î C) ìAfter a few days of rest, you should feel much better as long as you do not drink anything.î D) ìYou will likely feel anxious and get a severe headache. Treat these symptoms with acetaminophen and rest, and come in if they do not get better in 3 to 5 days.î
A
3. Which of the following groups could benefit most from prevention programs? A) Children, prior to first use B) Adults who have already engaged in substance abuse C) Older adults D) Infants
A
34. A client is readmitted to the detox unit for the fourth time in 3 years. The nurse states in the morning report, ìNot again! Why should we keep trying to help this guy? He obviously doesn't want it.î What does this statement reflect? A) The nurse lacks the self-awareness to work effectively with this addicted client. B) The nurse understands the cycle of remission and relapse characteristic of addiction. C) The nurse has repressed negative emotions from past experiences with addiction. D) The nurse is trying to conceal his or her own addictions.
A
5. The nurse is assessing a client's risk factors for developing a substance abuse disorder. Which family characteristics would the nurse identify as a significant risk factor? A) One parent who is an alcoholic B) Parents who practiced strict discipline C) Overprotective parents D) Being raised in an urban area
A
9. The nurse is discussing the principles of 12-step programs for recovery with a client. Which statement is consistent with the principles of 12-step programs? A) The client will need to abstain from all substances for successful recovery. B) Once sober, the person can safely return to life as it was before becoming addicted. C) The prognosis for recovery is enhanced with the aid of maintenance medications. D) Recovery requires adherence to a plan of achieving long-term goals.
A
2. Which statements are important reasons for why the problem of substance abuse must be addressed? Select all that apply. A)Increasing numbers of infants are suffering the physiologic and emotional consequences of prenatal exposure to alcohol or drugs. B)Chemical abuse results in increased violence. C)Drug abuse costs business and industry an estimated $102 billion annually. D) Alcohol abuse is a too frequent cause of or contributor to death. E) Substance abuse is decreasing
A, B, C, D
35. Which reasons make it necessary for the nurse to examine his or her beliefs and attitudes about substance abuse? Select all that apply. A) The nurse may be overly harsh and critical of the client. B) The nurse may unknowingly act out old family roles and engage in enabling behavior. C) The nurse or close friends and family of the nurse may abuse substances. D) The nurse may have different attitudes about various substances of abuse. E) The nurse is not likely to have had any experience with substance abuse.
A, B, C, D
27. The nurse is coleading a family therapy group for clients and families of drug-addicted individuals. The family of a cocaine addict is angry and cannot understand why the client cannot just stop using. The nurse guides the group to discuss their understanding of the nature of addiction. Which statements would the nurse identify as an accurate understanding of the nature of addiction? Select all that apply. A) It is a medical illness that is progressive. B) The client will eventually be cured. C) Relapses and remissions are part of the illness. D) Clients can learn to get control over the substance.
A, C
12. The nurse is assessing the drinking history of a client being admitted for alcohol abuse. Which statement would the nurse expect the client to make? A) ìI really need some help. My drinking is tearing my family apart.î B) ìI have tried so many times to stop drinking. It is so hard.î C) ìI don't really have a problem with alcohol. I've just been having a streak of bad luck lately.î D) ìI have no intention to stop drinking. I like the way it makes me feel.î
C
15. A client is being discharged on disulfiram (Antabuse). Which instruction for Antabuse should the client receive? A) Take disulfiram with food to avoid stomach upset. B) Skip the daily dose of disulfiram on days when consumption of alcoholic beverages is likely. C) Read products labels carefully to avoid all products containing alcohol. D) Disulfiram will prevent the desire to drink alcoholic beverages.
C
1. A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse to plan a program? A) Teenagers in a high school health class B) School-age children in an after-school program C) Parents attending a parentñteacher association meeting D) Elementary school teachers and counselors
B
10. Which characteristic of the 12-step program distinguishes it from other programs? A) The philosophy that it is possible to reduce the use of substances without abstaining. B) It is a self-help group that does not necessarily use health professionals as leaders. C) Persons who use this program are independent in their sobriety. D) Infrequent attendance is usually successful.
B
14. 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? A) ìI am going to take up a new hobby. It's time to start something new.î B) ìI can still hang out with my old friends. I am just not going to use.î C) ìI'm not very comfortable with being alone yet.î D) ìShooting baskets helps me not think about getting high.î
B
17. 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) Unlike heroin, methadone is nonaddicting. B) Methadone will meet the physical need for opiates without producing cravings for more. C) Methadone will produce a high similar to heroin. D) People taking methadone run the same risks associated with IV drug use as those taking heroin.
B
19. A client with alcohol dependence is admitted to the hospital with pancreatitis. Which intervention should be included in the client's plan of care? A) Fluid restriction of 1000 mL per 24 hours B) Glucometer checks b.i.d. C) High-protein diet D) Protective isolation precautions
B
21. A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, he tells the nurse, ìI am so ashamed.î What should the nurse reply? A) ìI really thought you would make it.î B) ìTell me what has happened since your last admission.î C) ìYou have nothing to be ashamed of.î D) ìWhy did you start drinking again?î
B
30. A nurse suspects a coworker is signing out narcotics for clients and is using them herself. Which action should be taken by the nurse who has these suspicions? A) Ignore suspicions and leave it to the supervisor to intervene. B) Report the observations to the supervisor. C) Follow behind the coworker to ensure client comfort and safety. D) Confront the coworker about suspicions.
B
32. The 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 a particular nurse. This nurse returns from lunch exhibiting slurred speech and euphoria. Which is the best action for the nurse to take? A) Ask other nurses if they have noticed anything unusual. B) Call the manager and report the observations. C) Observe the nurse as injections are prepared and administered. D) Tell the nurse, ìI know you've been stealing Valium.î
B
33. A peer reports for work looking unkempt and disheveled. Her movements are uncoordinated, and her breath smells like mouthwash. Another nurse suspects this peer is intoxicated. What should be the action of the nurse who suspects that a peer is intoxicated? A) Immediately call the supervisor to report the peer's behavior. B) Ask the peer if she feels alright and express concern. C) Give the peer some information about the hospital's employee assistance program. D) Ignore the situation until someone else validates the observations.
B
7. 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 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
8. 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) Being flexible but angry B) Blaming themselves for the family's problems C) Expressing thoughts and feelings openly D) Taking pleasure in self-accomplishments
B
24. A nurse is working with a couple seeking counseling for marital discord. The history indicates the husband was treated for substance abuse 4 years ago and attends AA meetings occasionally. Which statement made by the recovering husband should alert the nurse for the need for further education? A) ìI still need to go to AA meetings even though I have been sober for years.î B) ìAfter all these years, I just don't have the will power to stop if I started using again.î C) ìShe gets upset when I hang out with my old buddies on the weekends.î D) ìI wish I could be able to handle just one beer with dinner.î
C
29. A client will be taking disulfiram (Antabuse) after discharge from an alcohol treatment program. Which statement would indicate that teaching has been effective? A) ìAntabuse is safe to take with any over-the-counter cold medication.î B) ìAntabuse will block my cravings for alcohol, so I'll have less desire to drink.î C) ìDrinking alcohol while taking Antabuse can cause dangerous symptoms.î D) ìIf I drink while taking Antabuse, it will make me vomit before the alcohol affects me
C
6. 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 ìhave a good time.î Which term would best describe this phenomenon? A) Dependence B) Intoxication C) Tolerance D) Withdrawal
C
11. Which slogans would be used in a 12-step program? Select all that apply. A) ìPull yourself together.î B) ìGet control of your problem.î C) ìOne day at a time.î D) ìEasy does it.î E) ìLet go and let God.î
C, D, E
13. A client in treatment for drug abuse makes the statement, ìI am a winner. You all are the losers because you can't beat this on your own.î What common characteristic of persons addicted to drugs is revealed in this statement? A) Realistic understanding of successful recovery of drug addiction B) Indication of an underlying personality disorder C) Brain damages resulting from chronic drug use D) Defending against a negative self-concept
D
16. The client asks the nurse, ìWhat will happen if I drink while taking Antabuse?î What should be the nurse's reply? A) ìYou will not want to drink while taking Antabuse. It reduces the cravings.î B) ìYou will not get any effect from the alcohol you drink.î C) ìAntabuse will reverse the effects of alcohol.î D) ìYou will experience a severe reaction, including a throbbing headache and vomiting.î
D
20. A client is admitted for a drug overdose with a Barbiturate? Which is the priority nursing action when planning care for this client? A) Check the client's belongings for additional drugs. B) Pad the side rails of the bed because seizures are likely. C) Prepare a dose of ipecac, an emetic. D) Monitor respiratory function.
D
22. A client has been admitted to the inpatient unit after using inhalants recently. Which is an antidote to treat inhalant toxicity? A) Ativan B) Narcan C) Antabuse D) There is no antidote
D
26. An unconscious client is admitted to the emergency department after a motor vehicle accident. The client's blood alcohol level upon admission was 1.7. The client's family soon arrives, reporting that the client is an uncle who is visiting from out of town. They cannot give much more history other than that he is a ìsocial drinker.î After being transported to the unit, the client starts sweating and has elevated vital signs. What information should the nurse request of the family? A) Who is the next of kin? B) For what occasion is the uncle visiting from out of town? C) Does the uncle have a history of any sort of anxiety disorder? D) Are there other indications that the client may be a heavy drinker?
D
28. The wife of a client who is alcoholic asks the nurse how to respond to him in a helpful way when he is disruptive in family life. Which is the nurse's best response? A) ìHelp him avoid embarrassment by supporting him when he makes excuses for failing to meet obligations.î B) ìInclude him in family outings even when he is drinking.î C) ìSearch the house regularly for alcohol.î D) ìTry to maintain a normal home environment for yourself and the children.î
D
4. Which of the following neurochemical influences is a probable cause of substance abuse? A) Imbalances of serotonin and norepinephrine in the brain B) Inhibition of GABA in the brain C) Excessive serotonin activity in the CNS D) Stimulation of dopamine pathways in the brain
D
