Psychiatric - Chp 19 - 2

Which of the following terms describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking? a) Tolerance break b) Intoxication c) Tolerance d) Blackout

a) Tolerance break

A client can expect symptoms of alcohol withdrawal to begin how many hours after the last drink? a) 2 b) 8 c) 24 d) 16

b) 8

George is admitted to the detoxification unit on Sunday evening. His withdrawal symptoms from alcohol are most likely to begin, and he will likely need the most support, at what time? a) Friday evening b) Wednesday morning c) Tuesday evening d) Monday morning

c) Tuesday evening

A 51-year-old male has been admitted to the detoxification unit with acute symptoms of alcohol withdrawal. Nursing assessment is likely to reveal what? a) Anhidrosis, hypotonicity, and delusions b) Psychomotor hypoactivity, hypotension, and increased appetite c) Tremors, headache, flushed face, and hallucinations d) Hypomania, bradycardia, and generalized seizures

C

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 his history of alcohol abuse? a) Pancreatitis, esophagitis, gastritis, and elevated liver enzymes b) Pancreatitis and elevated liver enzymes c) All the conditions are attributable to the alcohol abuse d) Gastritis and elevated liver enzymes

C

Safe alcohol withdrawal usually is accomplished with the administration of which medication classification? a) Anticonvulsants b) Antidepressants c) Antipsychotics d) Benzodiazepines

D

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 ... a) suicide precautions because suicide attempts are frequent during withdrawal. b) seizure precautions and vital signs. c) vital signs; medications as prescribed. d) observation for symptoms; vital signs; seizure and fall precautions; medications as ordered.

D

Which of the following clients is exhibiting the effects of an alcohol use disorder? a) A 28-year-old woman who is experiencing the signs and symptoms of alcohol withdrawal b) A 22-year-old male student who now drinks nine or ten drinks in order to get the same effect that he used to get from drinking a six pack c) A 59-year-old woman whose recent CT scan reveals the presence of Wernicke's encephalopathy d) A 66-year-old man who has been admitted to the emergency department with apparent delirium tremens

b) A 22-year-old male student who now drinks nine or ten drinks in order to get the same effect that he used to get from drinking a six pack

Suspicion that a nursing professional is impaired by a substance abuse problem is most supported by ... a) Spending a considerable amount of shift time off the unit b) Frequently calling off work for undefined illnesses c) Asking to be scheduled for weekend shifts as much as possible d) Having several clients complain that their pain medication is not working

d) Having several clients complain that their pain medication is not working

"Substance abuse" is a term that is used when ... a) a person uses any form of drug or alcohol. b) a person is addicted to drugs or alcohol and cannot stop using them. c) a person uses alcohol or drugs repeatedly, but not compulsively or addictively; the person who is abusing substances will not experience withdrawal. d) a person uses drugs continuously despite negative consequences; the person does experience tolerance.

c) a person uses alcohol or drugs repeatedly, but not compulsively or addictively; the person who is abusing substances will not experience withdrawal.

The recommended first-line pharmacologic agents for managing severe alcohol withdrawal symptoms are a) serotonin reuptake inhibitors. b) major tranquilizers. c) benzodiazepines. d) atypical antipsychotics.

c) benzodiazepines.

A client can expect symptoms of alcohol withdrawal to begin how many hours after the last drink? a) 24 b) 2 c) 16 d) 8

d) 8

The mental health nurse recognizes that genetic intolerance of alcohol has been documented among ethnic a) Italians b) Africans c) Germans d) Asians

d) Asians

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) Limit alcohol consumption to a moderate level b) Have weekly blood alcohol levels drawn c) Do not drive heavy machinery d) Avoid all products containing alcohol

d) Avoid all products containing alcohol

Which of the following is the most common defense mechanism used by a client diagnosed with a substance use problem? a) Repression b) Regression c) Suppression d) Denial

d) Denial

Clonidine (Catapres) is most effective for which of the following symptoms of opioid withdrawal? a) Anxiety b) Muscles aches c) Restlessness d) Diarrhea

d) Diarrhea

"Substance abuse" is a term that is used when ... a) a person uses drugs continuously despite negative consequences; the person does experience tolerance. b) a person uses alcohol or drugs repeatedly, but not compulsively or addictively; the person who is abusing substances will not experience withdrawal. c) a person uses any form of drug or alcohol. d) a person is addicted to drugs or alcohol and cannot stop using them.

b) a person uses alcohol or drugs repeatedly, but not compulsively or addictively; the person who is abusing substances will not experience withdrawal.

When discussing methadone treatment with a client, the nurse teaches what? a) It decreases the severity of heroin withdrawal symptoms. b) The cure rate is extremely high. c) It is a nonaddictive treatment. d) It takes 1 to 2 years to cure an opiate addict.

a) It decreases the severity of heroin withdrawal symptoms.

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) Methadone b) Gabapentin (Neurontin) c) Ondansetron (Zofran) d) Amphetamines

a) Methadone

When educating the public concerning marijuana use, the nurse stresses that heavy, regular use is likely to result in a) Psychological dependence with an increased risk for self-harm b) Accidental drug poisoning and tachycardia c) Both physiological and psychological dependence and an increased risk for respiratory problems d) Extraordinary pain tolerance and extreme hypertension

a) Psychological dependence with an increased risk for self-harm

People addicted to alcohol and drugs have a rate of suicide that is what percentage higher than that of the general population? a) 20 b) 30 c) 40 d) 10

a) 20

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 of the following as the substance most abused in the United States? a) Alcohol b) Heroin c) Marijuana d) Cocaine

a) Alcohol

A client who has used IV heroin every day for the past 10 years says, "I don't have a drug problem. I can quit whenever I want." Which of the following defense mechanisms is being used by the client? a) Denial b) Compensation c) Repression d) Rationalization

a) Denial

Tracy consumed alcohol almost daily while she was 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? a) Fetal alcohol syndrome b) Natal alcohol syndrome c) Fatal alcohol syndrome d) Prenatal alcohol syndrome

a) Fetal alcohol syndrome

The nurse is assessing a client she suspects may have a drinking problem. She asks the client how much alcohol he 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 which of the following? a) He has become tolerant to alcohol. b) He is minimizing his intake. c) He has blackouts. d) He may drink frequently or a lot, but he doesn't have a problem.

a) He has become tolerant to alcohol.

After educating a group of students about caffeine, the instructor determines that the education was successful when the group identifies which of the following as indicating intoxication? Select all that apply. a) Insomnia b) Pale face c) Nervousness d) Urinary retention e) Restlessness f) Excitement

a) Insomnia c) Nervousness d) Urinary retention e) Restlessness f) Excitement

When educating the public regarding substance-related disorders, the mental health nurse explains that the condition of drug dependence is a state defined as ... a) Physical effects resulting from the multiple episodes of substance use b) Chronic or recurrent drug intoxication, characterized by psychological and physical dependence c) Emotional dependence on a drug or a desire or compulsion to continue taking a drug d) Substance-seeking activities and pathological use patterns of the person using substances

b) Chronic or recurrent drug intoxication, characterized by psychological and physical dependence

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

When a client is working toward the prevention of an alcohol abuse relapse, the nurse is most therapeutic when a) Discussing the pros and the cons of alcohol abuse b) Helping the client identify positive coping mechanisms c) Planning strategies to prevent further relapses d) Monitoring the effects of treatment

b) Helping the client identify positive coping mechanisms

When conducting an adolescent drug awareness program, the nurse describes which of the following drugs as having the highest addiction potential? a) Marijuana and nicotine b) Heroin and morphine c) Cocaine and codeine d) Amphetamines and barbiturates

b) Heroin and morphine

All of the following are positive aspects regarding methadone for heroin addiction except ... a) It is controlled be a physician. b) It is available in IV form. c) It is available in tablet form. d) It is a legal medication.

b) It is available in IV form.

While working as a nurse in a hospital, you notice that a co-worker has unsteady gait and slurred speech. You suspect that your co-worker may be an impaired nurse. Which of the following would be the appropriate action to take? a) Ignore your co-worker's behavior until others notice the problem. b) Report your co-worker's behavior to your supervisor. c) Confront the co-worker with your suspicions. d) Ask your co-worker to perform a sobriety test.

b) Report your co-worker's behavior to your supervisor.

The nurse is counseling a group of clients recovering from substance abuse about the nature of denial. Which of the following interventions should the nurse teach the clients to use to help them gain insight into their denial? a) Teach them to have realistic expectations about themselves. b) Teach them to question why they feel threatened. c) Teach them meditation techniques. d) Teach them alternative coping strategies.

b) Teach them to question why they feel threatened.

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 of the following terms should the nurse use to describe this drinking behavior? a) Intoxication b) Tolerance c) Withdrawal d) Abuse

b) Tolerance

Shaundra was admitted to the emergency department for intoxication with alcohol. She has an unsteady gait, myopathy, and neuropathy, and cannot remember past or recent events. When treated with thiamine, her symptoms greatly improve. Shaundra is most likely suffering from ... a) alcoholic dementia. b) Wernicke-Korsakoff syndrome. c) alcohol dependence with memory impairment. d) scurvy.

b) Wernicke-Korsakoff syndrome.

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? a) "Heavy marijuana use has resulted in severe withdrawal symptoms in some people once they decide to quit." b) "Marijuana and heroin actually have a very similar potential for addiction." c) "Marijuana use can result in psychological dependence, which can have a very negative effect on your life." d) "Most people are unaware of the fact that marijuana is actually a very addictive drug."

c) "Marijuana use can result in psychological dependence, which can have a very negative effect on your life."

Supported by research results, the mental health nurse includes alcohol-related problem assessment questions when interviewing ... a) All adult females b) All males between the ages of 18 and 45 years of age c) All clients regardless of age and gender d) White males 45 to 65 years of age

c) All clients regardless of age and gender

A client has been using paint thinner and glue to receive a "high." The nurse knows that these substances are ... a) Hypnotics b) Hallucinogens c) Inhalants d) Sedatives

c) Inhalants

When preparing to monitor a client scheduled for drug-managed substance detoxification, the nurse prepares the client for diagnostic testing to determine the functioning status primarily of the client's a) Lungs b) Stomach c) Liver d) Kidneys

c) Liver

A male in his 30s 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? a) Monitoring of fluid and electrolyte levels b) Musculoskeletal and integumentary assessments c) Neurological and respiratory assessments d) Psychosocial assessment and identification of support systems

c) Neurological and respiratory assessments

Which technique is a type of cognitive behavioral therapy? a) Music therapy b) Guided imagery c) Self-monitoring d) Distraction

c) Self-monitoring

Which of the following statements 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 young man has been brought to the emergency department (ED) by police after exhibiting bizarre and violent behavior on the patio outside a restaurant. Upon questioning, the man's girlfriend admits that he had been smoking PCP with his friend. While in the ED, the man 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 patient? a) The client will demonstrate appropriate social skills. b) The client will verbalize acceptance of responsibility for his behavior. c) The client will be physically safe and without injury. d) The client will establish a balance of rest, sleep, and activity.

c) The client will be physically safe and without injury.

Which of the following medications is used to prevent Wernicke-Korsakoff syndrome? a) Folic acid (Folate) b) Cyanocabalamin c) Thiamine (vitamin B1) d) Lorazepam (Ativan)

c) Thiamine (vitamin B1)

A client with chronic alcoholism has been found to have Korsakoff's psychosis. This irreversible complication is characterized by what? a) Inability to learn new skills and short-term memory loss b) Double vision and rapid eye movement c) Thiamine, or vitamin B1, deficiency d) Hypothalamic and mammillary body lesions

c) Thiamine, or vitamin B1, deficiency

Which of the following is the best description of the term substance use disorders, according to the American Psychiatric Association? a) Indicates that the client does not experience tolerance and withdrawal symptoms b) Indicates that the client experiences tolerance and withdrawal symptoms c) Indicates that the client has a medical reason for taking the substance d) Is an umbrella term for substance abuse and substance dependence

d) Is an umbrella term for substance abuse and substance dependence

All of the following are positive aspects regarding methadone for heroin addiction except ... a) It is available in tablet form. b) It is a legal medication. c) It is controlled be a physician. d) It is available in IV form.

d) It is available in IV form.

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? a) Paxil b) Haldol c) Tegretol d) Librium

d) Librium

Which of the following medications is used to prevent alcohol withdrawal symptoms? a) Folic acid (Folate) b) Clonidine (Catapres) c) Naltrexone (ReVia) d) Lorazepam (Ativan)

d) Lorazepam (Ativan)

Which drug reverses opioid toxicity? a) Disulfiram (Antabuse) b) Methadone c) Clonidine (Catapres) d) Naloxone (Narcan)

d) Naloxone (Narcan)

Sandra was diagnosed with cocaine abuse at age 30. When she was 23, Sandra was diagnosed with major depressive episode, and she has continued to have depression off and on since then. Which of the following is the most correct statement? a) Sandra is probably using cocaine in combination with her antidepressants to try to get higher. b) Sandra will have a very poor prognosis for recovery if she discontinues cocaine because it will enhance her depressive symptoms. c) Sandra will need to have the cocaine abuse treated before anything can be done about her depression. d) Sandra is probably using cocaine to cope with her depressive symptoms, and she would be considered to have a dual diagnosis.

d) Sandra is probably using cocaine to cope with her depressive symptoms, and she would be considered to have a dual diagnosis.

A nurse who started recovering from alcohol abuse 3 months earlier is ready to return to work. When speaking with her therapist, she states she is nervous about how her co-workers will respond to her now that "they all know I'm a drunk." Which of the following diagnoses best targets the problem implicit in the nurse's remarks? a) Powerlessness related to perceived inability to change the opinions of others b) Ineffective coping related to long history of alcohol use c) Anxiety related to situational crisis d) Situational low self-esteem related to medical condition

d) Situational low self-esteem related to medical condition

A client tells the nurse that she went to a party and had several drinks. When she woke up the next morning, she could not remember driving home. What does the nurse suspect? a) The client was using other drugs in addition to the alcohol. b) The client has alcoholic amnestic disorder. c) The client has an underlying neurologic problem. d) The client had a blackout.

d) The client had a blackout.

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) Methadone is a not physiologically addictive. b) Methadone simulates the high of heroin. c) Methadone is a non-opioid drug. d) The drug helps to satisfy the craving for the opioid.

d) The drug helps to satisfy the craving for the opioid.

When assessing a client diagnosed with chronic alcoholism, the nurse addresses potential memory dysfunction by reviewing the client's serum level of ... a) Iron b) Vitamin E c) Vitamin C d) Thiamine

d) Thiamine

The major difference between substance abuse and substance dependency is that a) people who abuse substances are often seen by their peers as "alcoholic." b) in substance dependence, the individual has shared with his or her significant others that there is definitely a problem. c) people who are dependent often lose their jobs or drop out of school. d) a person who is abusing does not have withdrawal symptoms, whereas the dependent person uses the substance despite significant functional difficulties and will have withdrawal.

d) a person who is abusing does not have withdrawal symptoms, whereas the dependent person uses the substance despite significant functional difficulties and will have withdrawal.

John began drinking a six-pack of beer every day in his freshman year of college. By his sophomore year, he is drinking two six-packs to get the same effect. This phenomenon is best described as ... a) alcohol abuse b) dependence c) intoxication d) tolerance

d) tolerance