Addiction Class NCLEX Questions 10/10

A client would be considered to have tested positive for risk of alcohol abuse using the CAGE screening questionnaire if they answered yes to which questions? (SATA) A. "Have you ever felt guilty about your drinking?" B. "Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?" C. "Have you ever felt you ought to cut down on your drinking?" D. "Have people annoyed you by criticizing your drinking?" E. "Do you use alcohol and other illicit substances concurrently?"

A. "Have you ever felt guilty about your drinking?" B. "Have you ever had a drink first thing in the morning to steady your nerves or get rid of a hangover?" C. "Have you ever felt you ought to cut down on your drinking?" D. "Have people annoyed you by criticizing your drinking?"

A patient arrived at the ED at 1500. A nurse knows to expect to see the first signs of withdrawal around what time? A. 2100 B. 0700 tomorrow morning C. 1700 D. 1500 the following day

A. 2100 4-12 hours is when the initial withdrawal symptoms could begin.

The nurse is educating a class of nursing students about delirium tremens, which statement indicates that the teaching was successful? A. A patient with delirium tremens will display profound disorientation. B. A patient with delirium tremens shows mild anxiety and agitation. C. A patient with delirium tremens will have complaints of insomnia. D. A patient with delirium tremens has fine hand tremors.

A. A patient with delirium tremens will display profound disorientation.

A patient is recently diagnosed with Wernicke-Syndrome, what is the most appropriate nursing action to treat the symptoms? A. Administer thiamine B. Initiate seizure precautions C. Encourage hydration D. Administer lorazepam

A. Administer thiamine

What adverse effects does disulfiram have on a patient using alcohol? (SATA) A. Dizziness B. Hypertension C. Nausea D. Palpitations E. Flushing

A. Dizziness C. Nausea D. Palpitations E. Flushing

Serotonin syndrome, which can be caused by SSRI overdose, can have symptoms that are very similar to: A. ETOH withdrawal B. Diet pill withdrawal C. Cannabis OD D. Benzodiazepine withdrawal

A. ETOH withdrawal Rationale: Serotonin syndrome has symptoms of seizures, HTN, agitation, elevated temp, and diaphoresis.

The nurse on the med surg unit has just been assigned a new client who came to the ED for alcohol withdrawal. The nurse is performing a physical assessment and knows to look for which of the following clinical manifestations of alcohol abuse? SATA A. Hypertension B. Hypothermia C. Enlarged Liver D. Ascites E. Acne rosacea

A. Hypertension C. Enlarged Liver D. Ascites E. Acne rosacea

When educating a patient and their family about substance abuse, the nurse recognizes the need for further teaching when the family member states: (SATA) A. I will call in sick for my husband when he feels shaky in the morning. B. I should not bring any alcohol to the household. C. It is okay if my dad has a beer as long as I am with him. D. I will report relapse when my sister becomes more isolated and skips work. E. If only my dad had the willpower to abstain from drinking when he gets home from work.

A. I will call in sick for my husband when he feels shaky in the morning. C. It is okay if my dad has a beer as long as I am with him. E. If only my dad had the willpower to abstain from drinking when he gets home from work. Rationale: A is correct because this is enabling the husband's behavior. C is correct because a person should never have alcohol in any circumstance if trying to be sober. E is correct because substance abuse is a disease/illness, not an issue of willpower and motivation.

When speaking with a client about taking Disulfiram, what comment by the patient indicates the need for further teaching? A. It's important to keep up my morning routine including using mouthwash after oral care. C. Consuming alcohol will make me feel ill C. I should not take this if i am diabetic. D. This medication will be a deterrent to consuming alcohol. E. Medication may cause skin flushing.

A. It's important to keep up my morning routine including using mouthwash after oral care.

A client was admitted to the BHU after a binge drinking episode this evening. When would withdrawal symptoms be expected to occur if his last drink was 3 hours ago? A. Later tonight/early morning B. Tomorrow morning C. 48-72 hours later D. Tomorrow evening

A. Later tonight/early morning

What would the nurse expect to observe in a client with Wernicke-Encephalopathy? (SATA) A. Nystagmus B. Ataxia C. Diplopia D. Stupor E. Confabulation

A. Nystagmus B. Ataxia C. Diplopia D. Stupor

The client who recently finished his detox from alcohol and is preparing for discharge states that he is interested in utilizing Alcoholic Anonymous to assist him with his goal of sobriety. The nurse should include which statements in teaching the client about how to have success with Al-Anon? (SATA) A. The client is solely responsible for maintaining their sobriety. B. Regular attendance is necessary. C. Alcoholic Anonymous is effective for all members. D. Anybody can attend these meetings, whether or not they have a substance abuse disorder. E. Complete abstinence is required for the group to be successful.

A. The client is solely responsible for maintaining their sobriety. B. Regular attendance is necessary. E. Complete abstinence is required for the group to be successful.

The patient in the ED is currently experiencing hallucinations and hand tremors. It was noted in hand-off report that the patient last had an ETOH drink 8 hours ago. What medications would you anticipate seeing on the MAR? (SATA) A. Thiamine, folic acid, B12 B. Lorazepam C. Naloxone D. Propanol E. Carbamazepine

A. Thiamine, folic acid, B12 B. Lorazepam D. Propanol E. Carbamazepine Rationale: vitamins are for malabsorption of GI, Lorazepam for seizure precautions with GABA inhibition, Propanol decreases in autonomic response, Carbamazepine decreases seizure activity

A patient is being discharged from the BHU on Naltrexone. Which statements indicates a correct understanding about the medication. (Select all that apply) A. This will reduce my cravings for alcohol. B. This medication will make me sick if I drink alcohol. C. I should take this medication with food. D. This will prevent me from having tremors. E. This could cause me to go through withdrawal from my prescription opiate medications.

A. This will reduce my cravings for alcohol. C. I should take this medication with food. E. This could cause me to go through withdrawal from my prescription opiate medications. Videbeck, page 366 (Table 19-1)

A nurse knows they are required to report a colleague for suspicion of substance abuse due to which of the following behaviors? SATA A. Unexplained absences B. Visualized wasting of a medication C. Multiple trips to the bathroom D. Consistent offers to obtain medications from the Pyxis E. Patient reports that their pain has been well managed

A. Unexplained absences C. Multiple trips to the bathroom D. Consistent offers to obtain medications from the Pyxis B - visualized wasting is not a correct answer. That is the proper way to waste medication. E - patient reports that their pain is well managed. That would indicate that the nurse is administering medication that is prescribed to the patient.

The client has been prescribed disulfiram (Antebuse) for alcohol abstinence maintenance. Which of the following will the nurse advise the client to avoid? SATA A. cough medicines B. vinegar C. aftershave D. mouthwash E. rubbing alcohol F. vanilla extract G. hand-sanitizer

ALL ANSWERS

What of the following are symptoms of alcohol abuse? Select all that apply A. Insomnia B. Anxiety C. Tremors D. Vomiting

ALL ANSWERS A. Insomnia B. Anxiety C. Tremors D. Vomiting

Your patient suffers from chronic pain and states upon assessment that their pain medication does not seem to work like it used to. The nurse understands that this is an example of what? A) Physical dependence B) Tolerance C) Withdrawal D) Drug seeking

B) Tolerance Tolerance is defined by the need for increased medication/dosage to maintain the same effect.

Which patient is GGT the least reliable lab for indication of alcohol usage? A. 60 year old male who reports 14+ drink a week B. 25 year old college student who reports social drinking C. 40 year old stay at home mom who has an occasional glass of wine D. 16 year old who reports no alcohol use

B. 25 year old college student who reports social drinking

Which of the following patients would be a candidate for disulfiram? SATA. A. A patient with a history of diabetes mellitus. B. A patient who has a strong support system and plan of action who is serious about gaining sobriety. C. A patient who has a history of atherosclerosis and MI w/ stents. D. A patient who's GFR is <30mL/min E. A patient who has been hospitalized previously for schizophrenic psychosis.

B. A patient who has a strong support system and plan of action who is serious about gaining sobriety.

Which classification of medication is given to a patient experiencing ETOH withdrawal to help prevent seizures and help with anxiety? A. Beta blockers B. Benzodiazepines C. SSRIs D. Anticonvulsants

B. Benzodiazepines

During the shift change report, the off going nurse tells you that you've been assigned to care for a patient who has just arrived in the ED. Your colleague states that this patient reports heavy alcohol consumption and that their last drink was 9 hours ago. Based on this information, you expect your patient to potentially be exhibiting which of the following signs and symptoms? (SATA) A. Decreased DTRs B. Elevated temperature C. Hand tremors D. Hypersomnia E. Seizures

B. Elevated temperature C. Hand tremors E. Seizures

Which lab test is the best/most reliable indicator of chronic alcohol use across the ages? A. GGT B. INR C. PT D. ALT

B. INR

When educating a group of nursing students about supplemental needs for a patient going through alcohol withdrawal, which of the following supplements selected by the students would indicate a need for further teaching? A. Thiamine B. Iron C. Folic acid D. Vitamin B12

B. Iron Videbeck, page 366 (Table 19-1)

A patient scores a 12 on a CIWA screening. Which symptoms would the nurse be expected to observe? SATA A. The patient is calm and resting well. B. The patient is experiencing hand tremors. C. The patient is experiencing seizure activity. D. The patient shows signs of auditory or visual hallucinations. E. The patient has an elevated BP, HR and Temp.

B. The patient is experiencing hand tremors. D. The patient shows signs of auditory or visual hallucinations. E. The patient has an elevated BP, HR and Temp.

A patient is admitted on the behavior health unit with the diagnosis of alcoholism. At the beginning of the shift, the nurse assesses the patient using the CIWA-R scale. At what CIWA score range would the nurse consider the signs and symptoms of the patient to be MODERATE, therefore, requiring further intervention? A. >3 B. >5 C. >10 D. >15

C. >10 Rationale: According the CIWA protocol, if the patient's score is above 10 it means moderate s/s of alcohol withdraw which would require increased monitoring and possible pharmacological interventions.

A confused patient was brought to the ER by police with a BP of 152/104 mmHg, hand tremors, diaphoresis, and has emesis-stained clothing. The ER nurse is aware that the patient may be experiencing withdrawal from what? (SATA) A. Cannabis B. Steroids C. Barbiturates D. MDMA E. ETOH

C. Barbiturates E. ETOH Rationale: Barbiturate withdrawal mimics alcohol withdrawal. Signs and symptoms of alcohol and barbiturate withdrawal include HTN, diaphoresis, tremors, confusion, anxiety, and seizures.

The nurse expects the physician to prescribe which medication that acts on the same receptor site as alcohol and can be thought of as the "solid form of a drink" to prevent the incidence of seizures for a client experiencing alcohol withdrawal? A. Propranolol B. Acetaminophen C. Lorazepam D. Disulfiram

C. Lorazepam

The patient was admitted to the behavioral health unit with a diagnosis of alcohol abuse. The patient has been previously admitted to the behavioral health a month ago as well. This patient fell and hit their head on the bar twelve hours ago. Upon assessment, they are exhibiting jaundice, a blood pressure of 94/50, hallucinations of insects on the walls, agitation, and expressing that they want to leave the unit. They are in seizure precautions. What medication would the nurse prioritize to give to the patient? A. Lorazepam B. Carbamazepine C. Disulfiram D. Chlordiazepoxide

D. Chlordiazepoxide Rationale: The patient is beginning to experience severe withdrawal. Jaundice and hypotension are late signs of alcohol abuse and withdrawal. Lorazepam is a short-acting medication that is used in moderate alcohol withdrawal. Disulfiram would not be appropriate at this time because this medication is for patients who have already gone through withdrawal. Carbamazepine is for patients who are already experiencing seizures.

The clinical instructor is providing education regarding use of the Clinical Instrument for Withdrawal from Alcohol-Revised (CIWA-R) to assess patients. Which remark by the students would indicate a need for further education? A. Severe withdrawal is seen when a patient scores above 15. B. A patient that scores less than 8 indicates absent or mild withdrawal. C. A score of 13 would mean a patient is experiencing moderate withdrawal. D. Symptoms of withdrawal progress in a predictable manner.

D. Symptoms of withdrawal progress in a predictable manner.

T/F: It is okay for a person struggling with sobriety from vodka to wean their addiction using beer instead because it has a lower ABV %.

FALSE; patients seeking sobriety must sustain from drinking alcohol entirely.