ch 19 mental health stuff

Which statements identify positive aspects of methadone as a substitute for heroin? Select all that apply.

It is a legal medication. It is controlled by a health care provider. It is available in tablet form.

When interviewing the family members of a client being treated for substance abuse problems, which of the following behaviors by the members would alert the nurse to the possibility of codependency?

Making excuses for the client's substance problem

A client is admitted to the detoxification unit on Sunday evening. The client discloses that the client's last alcoholic drink was just before the client was admitted to the unit. When can the nurse expect that the client's alcohol withdrawal symptoms will begin?

Monday morning

An appropriate goal for a client newly admitted to the unit for alcohol withdrawal is what?

Verbalize feeling safe and comfortable.

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

The psychiatric nurse managing the care of a client experiencing alcohol withdrawal instructs unit staff to anticipate that the client may experience which neurological response?

tactile hallucinations

High doses of alcohol produce which effect?

vomiting

A client with a history of alcohol abuse is participating in a 12-step Alcoholics Anonymous (AA) program. The nurse determines that the client is at step 2 when stating what?

"I realize that there is a higher power that can help me."

A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the education was successful when the client states what?

"I should eat small frequent meals if I get nauseated."

A client is prescribed disulfiram as part of the alcohol treatment program to prevent relapse. The client asks the nurse, "How will this drug help me?" Which response by a nurse would be most appropriate?

"It can help to prevent you from drinking."

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?

"What negative consequences have resulted from your drinking?"

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?

"Your parent's alcohol use problem is a chronic disease but can be treated."

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?

12 hours

A client with a long history of alcohol abuse is hospitalized. The client's last drink was 12 noon. The nurse would anticipate symptoms of withdrawal occurring no later than what time?

12 midnight

Approximately what percentage of U.S. adults have substance use disorders?

22%

A client can expect symptoms of alcohol withdrawal to begin how many hours after the last drink?

8

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?

Adolescents

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?

All the conditions are attributable to the alcohol abuse

The mental health nurse recognizes that genetic intolerance of alcohol has been documented among which ethnic group?

Asians

According to the psychodynamic theory regarding addiction, it is most important that the nurse assesses the client with an alcohol use disorder by considering what?

Asking the client to describe the client's childhood relationship with the client's parents

The mental health nurse should focus on preventative efforts including educational interventions related to the abuse of prescription drugs on which client group?

Both genders between the age of 12 and 17

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

While conducting an admission interview with a client, the nurse suspects the client may be in alcohol withdrawal. Which screening tool can help the nurse identify the severity of withdrawal symptoms?

CIWA-Ar

A client admitted for acute alcohol intoxication begins to experience mild sweating, tachycardia, fever, and nausea and vomiting. Of the following, the drug treatment of choice would be what?

Chlordiazepoxide

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?

Delirium tremens

The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?

Dopamine

A client has a history of consuming alcohol almost daily while pregnant. Her newborn baby has growth deficiency and facial malformations. What is the name for the pattern of birth defects that can occur due to exposure to alcohol?

Fetal alcohol syndrome

A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as which of the following?

Hallucinogen

Ecstasy is an example of which type of substance?

Hallucinogen

Suspicion that a nursing professional is impaired by a substance abuse problem is most supported by which situation?

Having several clients complain that their pain medication is not working

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?

Help them to identify appropriate diversional activities.

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is acting in a therapeutic role when doing what?

Helping the client identify positive coping mechanisms

An older adult client with liver disease is experiencing alcohol withdrawal. Based on the nurse's understanding of drug therapy, which of the following would the nurse expect to be prescribed?

Lorazepam

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

A client is experiencing severe alcohol withdrawal. Which would the nurse most likely assess? Select all that apply.

Marked diaphoresis Auditory hallucinations Gross uncontrollable tremors

A 20-year-old client arrives at the emergency department by ambulance. The client is unconscious, with slow respirations and pinpoint pupils. There are "tracks" visible on the client's arms. The friend who came with the client reports that the client had just "shot up" heroin when the client became unconscious. Which medication would the nurse most likely expect to administer?

Naloxone

A group of nursing students is reviewing information about nutritional supplementation used during alcohol detoxification. The students demonstrate the need for additional review when they identify which of the following as being used?

Naloxone

A 30-year-old client has been brought to the emergency department by emergency medical services with an apparent heroin overdose. In the immediate care of this client, what assessments should the nurse prioritize?

Neurological and respiratory assessments

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?

Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered

A client has been prescribed naltrexone for treatment of alcohol dependence. The nurse has explained the drug's purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which about the drug?

Reduces the Appeal of Alcohol

A 52-year-old client has a history of alcohol dependence and is admitted to a detoxification unit. The client has tremors, is anxious, has a pulse that has risen from 98 to 110 beats/min, has blood pressure that has risen from 140/88 to 152/100 mm Hg, and has a temperature 0.6º above normal. The client is slightly diaphoretic. Which nursing diagnosis would be the priority?

Risk for injury

A nursing student is aware that which accounts for more deaths, illnesses, and disabilities across the life span than any other preventable condition?

Substance abuse disorders

Which factor would contraindicate the use of disulfiram in the treatment of a client who has an alcohol use disorder?

The client had six drinks a few hours ago.

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?

The client most likely has a dual diagnosis since she has both a substance dependence and depression.

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?

The drug helps to satisfy the craving for the opioid.

Which term describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking?

Tolerance break

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?

Use of marijuana does not lead to addiction.

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?

Wernicke-Korsakoff syndrome