Prep U for Videbeck's Psychiatric-Mental Health Nursing, 7 Edition: Chapter 19-Addiction

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."

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."

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

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?

Benzodiazepines

Which of the following agents would be helpful in alleviating the physical complications associated with alcohol withdrawal?

Benzodiazepines

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 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 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 vital signs and nervousness

A nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance?

Hallucinogen

Ecstasy is an example of which type of substance?

Hallucinogen

Which are effects of alcohol withdrawal syndrome? Select all that apply.

Hand tremors, Seizures, Increased Pulse & Delirium tremens

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.

A client has been using paint thinner and glue to receive a "high." The nurse knows that these substances are ...

Inhalants

Which statement incorrectly identifies positive aspects regarding methadone for heroin addiction?

Its available in IV form.

A client with a long history of alcohol abuse has presented to the emergency department with hallucinations and an incoherent story about being followed by the police. The client is likely experiencing which physiologic effect of alcohol use?

Korsakoff's psychosis

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

A nurse is implementing a brief intervention with a client who is abusing alcohol. The nurse most likely would be involved with which action?

Negotiating a conversation with the client about the need to change

How are psychosocial and environmental factors implicated in the development of substance abuse disorders?

Psychosocial and environmental factors increase the client's vulnerability to drug or alcohol

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 nurse observes a colleague who has unsteady gait and slurred speech. The nurse suspects that the colleague, a nurse, is impaired. Which would be the appropriate action to take?

Report the colleague's behavior to the supervisor.

A client is brought to the emergency department with a suspected heroin overdose. Which of the following would support this suspicion?

Respiratory depression

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 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

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

A nurse is preparing an educational session for family members affected by substance abuse. Which point should the nurse include in the session? Select all that apply.

Substance abuse is an illness like any other and An individual with substance abuse issues typically cannot use drugs socially.

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.

A nurse is assessing a client with bizzare and aggressive behavior in the emergency department. Upon questioning, the client's partner discloses that the client had been smoking PCP. While in the emergency department, the client continues to exhibit signs of PCP-induced psychosis and has required physical restraints. What nursing outcome should the nurse prioritize in the care of this client?

The client will be physically safe and without injury

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.

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

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?

Tolerance

When a person can ingest an increasing amount of alcohol before he or she experiences a "high" and begins to show effects on cognitive and motor skills, it is termed which of the following?

Tolerance

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

Tolerance break

A 51-year-old client has been admitted to the detoxification unit with acute symptoms of alcohol withdrawal. Nursing assessment is likely to reveal what?

Tremors, headache, flushed face, and hallucinations

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.

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

Verbalize feeling safe and comfortable.

High doses of alcohol produce which effect?

Vomiting

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

Which drug reverses opioid toxicity?

Naloxone

Which statement most accurately describes the etiology of substance-related disorders?

Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors.

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 about which time?

12 midnight

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

8

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

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

Dopamine

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

A 47-year-old client has been admitted to the hospital after being found unconscious in a park. Upon regaining consciousness, the client admits to heavy alcohol use over many years. Assessment reveals a low body mass index, low electrolyte levels, and impaired skin integrity. Vital signs are within normal ranges. What nursing diagnosis should be prioritized in the care of this client?

Imbalanced nutrition: less than body requirements related to chronic alcohol intake

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

The nurse is counseling a group of clients recovering from substance abuse about the nature of denial. Which intervention should the nurse teach the clients to use to help them gain insight into their denial?

Teach them to question why they feel threatened

The nurse is assessing a client the nurse suspects may have a drinking problem. The nurse asks the client how much alcohol the client drinks per day. The client replies, "The important point is that even if I have 10 drinks, I don't get drunk. I can hold my liquor." The client's reply suggests what?

The client has developed tolerance.

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 ~a thiamine deficiency (Vit. B1)

Which client is exhibiting the effects of alcohol tolerance?

a 22 y/o male student who now drinks nine or ten drinks to get the same effect that he used to get from drinking a 6 pack