Public Health Nursing Ch 37

The nurse is educating a group of parents on biopsychosocial models of addiction. Which statement made by a parent indicates an understanding of the concept?

"Addiction runs in our family, which places our children at higher risk."

A patient arrives at the outpatient clinic stumbling and smelling of alcohol. The nurse detects a dysrhythmia and obtains a blood sample for a metabolic panel. Which is the priority action for the nurse to take next?

Obtain an electrocardiogram (ECG)

A patient presents to the county health department after sustaining an injury from a fall. The patient appears intoxicated and admits to having had several alcoholic drinks. Which question would most help the nurse determine the severity of the patient's drinking problem?

"Have you had any legal problems as a result of drinking?"

The nurse is caring for a patient who reports the spouse is abusive when drinking. Which statement indicates the patient is enabling the spouse to continue abusing alcohol?

"I have covered for him by telling his boss he is sick when he is hungover."

The nurse manager is leading a discussion about working with individuals who have drug and alcohol problems. Which statement made by a nurse indicates bias against people with substance use disorders?

"People with addictions will never change, and it's futile to waste expenses."

The nurse is educating a group of adults about the dangers of over-the- counter (OTC) and herbal medications. Which statement made by a participant indicates the need for further education?

"Taking more than one OTC medication for an extended period of time is safe."

The nurse is working with a patient who reports intravenous drug abuse several times per week. Based on this information, which will the nurse include in the patient's care?

Obtain blood work for hepatitis C.

Which statement made by a patient who tested positive for heroin indicates denial?

"There was something wrong with the drug test."

The nurse is educating a group of college students about the dangers of smoking and tobacco use. Which statement made by a student indicates the need for further education?

"Using electronic cigarettes is less dangerous than smoking cigars."

The nurse is reviewing the medical record of a patient who reports polysubstance abuse. Which question can the nurse ask during the assessment to address this issue?

"Which drugs do you use on a daily basis?"

The nurse is caring for a 160-pound male patient who reports drinking about 12 shots of alcohol over the past couple of hours. The patient is unable to walk in a straight line, is slurring his words, and cannot stay on task. The nurse obtains a blood alcohol concentration (BAC) level. Based on presentation and examination findings, which would the nurse anticipate the patient's BAC level to be?

.20

The nurse is evaluating variables that predispose a person to use drugs. Which represents the set within the patterns of drug use? Select all that apply. One, some, or all may be correct.

Person using the drug Desired effect of the drug

In reviewing historical perspectives on alcohol and drug problems in the United States, which event was related to the banning of alcoholic beverages?

Prohibition

The nurse is caring for a patient at the outpatient clinic who reports using heroin twice a day. The patient states he has been stealing to obtain money to buy the drug and is unable to stop using the drug. Which term will the nurse use to document in the medical record?

Addiction

The public health nurse is developing a substance abuse program based on the harm reduction model. Which factor is appropriate to include in the program? Select all that apply. One, some, or all may be correct.

Addiction is a health problem. All psychoactive drugs can be abused. People who abuse can be successfully treațed.

Which environmental factor influences the setting in which drug abuse occurs? Select all that apply. One, some, or all may be correct.

Advertising Competition Fast pace of life

Which substance most abused by adolescents would the nurse include when planning anti-drug educational activities for a neighborhood youth center?

Alcohol

After experiencing withdrawal from alcohol use and completing an inpatient treatment program, a patient expresses the desire to stay sober. Which resource will the nurse recommend for the patient?

Alcoholics Anonymous

Which psychoactive drug would be beneficial for a patient with attention-deficit/hyperactivity disorder (ADHD)?

Amphetamines

The nurse is developing a screening tool for determining whether a patient has an alcohol, tobacco, or other drug problem (ATOD). Which question would be included when using the five As? Select all that apply. One, some, or all may be correct.

Ask about use. Assess amount of use. Assist with finding resources.

The nurse is working with a patient who has just delivered a baby. The patient's laboratory results are positive for opioids. Which nursing action is the priority when caring for the infant?

Assess for irritability and seizures

The nurse is planning to use the Screening, Brief Intervention, and Referral to Treatment (SBIRT) tool to determine a plan of care for a patient suspected of using illicit drugs. Which is the priority action for the nurse to perform when using this tool?

Assess how often the patient uses drugs

The school nurse is planning an educational program for middle and high school students about the hazards of alcohol use. Which consequence is most important to address with this age group?

Binge drinking

Which clinical manifestation would the nurse record that indicates a person dropped off at a neighborhood clinic had consumed high doses of cocaine? Select all that apply. One, some, or all responses may be correct.

Body temperature 102°F Blood pressure 180/100 mm Hg Prolonged QRS and QT intervals

The nurse is caring for a patient who presents with an increased appetite and constricted pupils and appears very relaxed despite a heart rate of 114 beats per minute. Which psychoactive drug would the nurse suspect the patient has used?

Cannabis

Which problem can arise in a community where people are using illicit drugs? Select all that apply. One, some, or all may be correct.

Crime Prostitution Homelessness Communicable disease

Which action reflects the harm reduction approach to decreasing alcohol abuse in the community?

Decreasing advertising of alcohol products

A patient presents to the clinic feeling unwell. The patient reports chronic long-term alcohol abuse, but states they have not had a drink since midnight. Which will the nurse assess for when managing this patient's care?

Delirium tremens

The family of a patient tells the nurse that the patient drinks a fifth of vodka every day, is frequently intoxicated, and can be verbally abusive. The patient responds by stating that they have control over their drinking and does not get drunk. Based on this response, which behavior is the patient displaying?

Denial

In addition to drug treatment programs, which provider referral would the nurse recommend for a patient who reports frequent methamphetamine abuse?

Dentist

The public health nurse is developing strategies to decrease substance abuse. Which action reflects a primary prevention strategy?

Developing after school activities for kids to help keep them off the streets

The school nurse is educating a group of students on the dangers of abusing prescription medications. Which drug will the nurse include in the discussion? Select all that apply. One, some, or all may be correct.

Diazepam Охусodone Methylphenidate

The nurse is working with a family in which the husband abuses illicit drugs. The nurse suspects the spouse is codependent. Which characteristic does the nurse expect to notice when interacting with the spouse? Select all that apply. One, some, or all may be correct.

Does not talk about the addiction Does not trust others outside the family Does not show feelings about the addiction

The school nurse wants to work with local law enforcement officers to provide information on drug use dangers to students. Which program would help the nurse reach this goal?

Drug Abuse Resistance Education (DARE)

The nurse is initiating primary prevention strategies against drug abuse in schools. Which program would be appropriate to meet the needs of adolescents in this setting?

Drug-free events on weekends

The nurse has been under the influence of nonprescribed opioids in the past and is currently on probation. When the nurse reports to work groggy and incoherent, which action will the nursing supervisor take first?

Obtain a urine sample to test for substances

Which intervention would the nurse include when planning primary prevention activities to decrease substance abuse in the community? Select all that apply. One, some, or all may be correct.

Encouraging healthy lifestyles Educating about the dangers of drugs

The nurse is developing substance abuse programs for individuals in the community. Which action reflects a tertiary prevention strategy?

Free clean needle exchange programs

Which finding would lead the nurse to suspect a person is inhaling chemicals? Select all that apply. One, some, or all responses may be correct.

Frequent nose blowing Paint stains on the shirt Sores around the mouth

The nurse is assessing patients taking opioid painkillers to determine their risk of developing a substance use problem. Which patient has the lowest risk of abusing opioids?

Has terminal cancer

The nurse is educating a group of employees about health promotion and smoking cessation. Which option for smoking cessation will the nurse include? Select all that apply. One, some, or all may be correct.

Hypnosis Acupuncture Nicotine replacement

The nurse is planning an educational seminar for older adults at a senior citizen center about the hazards of alcohol and illicit substance misuse. Which factor increases the risk of substance abuse in this age group? Select all that apply. One, some, or all may be correct.

Loneliness Death of friends Loss of independence

The nurse is discussing the financial impact of alcohol abuse in the United States with community leaders. Which outcome would affect the community? Select all that apply. One, some, or all may be correct.

Lost wages Medical expenses Vehicular accidents

A patient is discussing opioid addiction with the nurse and expresses a desire to quit abusing drugs. The nurse notes the patient has had several failed attempts at rehabilitation. Which treatment plan would be most beneficial for this patient?

Methadone-assisted program

The nurse is screening pre-adolescents at a middle school for substance abuse disorders and notices a student with irritability and a chemical odor to the breath. Which will the nurse include in a focused assessment of the child? Select all that apply. One, some, or all responses may be correct.

Nutrition Lung sounds Pupil reaction Level of orientation

The community health nurse is providing information on polypharmacy to groups at a local health fair. Which age group would benefit most from this information?

Older adults

Which drug does the nurse recognize as contributing to the majority of drug-related deaths in the United States?

Opioids

Which is most negatively affected by federal government funding of drug control?

People requiring inpatient substance abuse treatment

Which action by the health care provider (HCP) aligns with the Centers for Disease Control and Prevention (CDC) guidelines for prescribing opioids?

Prescribing one week of opioids at a time

The nurse is working with a patient receiving treatment for a substance abuse disorder. Which action made by the patient indicates successful treatment?

Quits working in a bar and returns to college

The public health nurse is working with community leaders to decrease vaping in adolescents. Which action would be most effective?

Raise the age to purchase vaping,supplies to 21 years old

The nurse is working with a group of middle school children in the community to increase resiliency and deter drug abuse. Which action made by the nurse is an example of primary prevention?

Recognize a child's strengths.

When discussing the use of cannabidiol (CBD) in the treatment of certain health conditions, which medical condition would the nurse include that may benefit from treatment with CBD?

Rheumatoid arthritis (RA)

A patient presents to the clinic with multiple health problems. The nurse suspects the patient injects intravenous drugs. Which tool would be most appropriate for identifying the patient's health risk behaviors?

Screening, Brief Intervention, and Referral to Treatment (SBIRT)

The public health nurse is providing education about substance abuse to clinics in the area. Which information will be included regarding drug dependence?

Stopping the drug abruptly causes withdrawal symptoms.

The nurse is discussing ways to decrease caffeine consumption with adult patients who have heart disease. Which action made by a participant would be most harmful?

Taking Vivarin twice a day

A patient reports consuming six cans of beer per night every night of the week, but claims to be able to perform activities of daily living without impairment. Which phenomenon will the nurse document in the medical record?

Tolerance

Which action made by a parent reflects the "Just Say No" primary prevention strategy?

Uses ice and heat to treat back pain

An older patient expresses concern about the number of prescription medications their primary health care provider has prescribed for them. Which information will the nurse obtain to determine the patient's safety? Select all that apply. One, some, or all may be correct.

Which drugs are prescribed Pharmacokinetics of the drug Dosage and route of administration