Quiz 14 Substance Abuse

Which statement most accurately describes drug use among adolescents?

Adolescents tend to deny any possible negative outcome of drug use .

A patient is thin, tense, jittery, and has dilated pupils. The patient says, My heart is pounding in my chest. I need help. The patient allows vital signs to be taken but then becomes suspicious and says, You could be trying to kill me. The patient refuses further examination. Abuse of which substance is most likely?

Amphetamines

A nurse is caring for a client who is experiencing alcohol withdraw. Which of the following findings should the nurse expect?

Anxiety and diaphoresis

A nurser in a community clinic is collecting data front client who is withdrawing form heavy cocaine use. When collecting data from the client which of the following manifestations should the nurse expect to observe?

Apathy

A nurse explains that according to the intrapersonal theory addiction is caused by early childhood rejection, these substance abusers are thought to have common characteristics. What do these characteristics include?

Attention seeking, need for control, and self-centeredness

A pt who has alcoholism with a history of heavy drinking is brought in to the in patient psychiatric unit saying that he does not know where he is or what day it is. what should the nurse suspect he is exhibiting?

Blackout

Those who enable are considered codependent, in that their behavior is highly structured around managing and adapting to the alcoholic's dysfunctional behavior.

Codependent definition

A nurse documents signs of Wernicke encephalopathy in a patient with long-term alcoholism. What do these signs include? (Select all that apply.)

Confabulation. Ataxia. Delirium. Decreasing level of consciousness.

A nurse is discharging a patient with a pulmonary disorder to return home with her family. She has had a difficult time while in the hospital and has experienced withdrawal from tobacco. When the nurse tells her that community resources are available to help her to stop smoking, she says, Thats OK. I can stop whenever I want to. What does this exemplify?

Denial

Mr. White was arrested for public intoxication and was advised by his attorney to enroll in an alcohol treatment program. A nurse interviews him when he comes to a mental health center. He tells the nurse that he really does not have a problem with alcohol and that he just had a few too many drinks while celebrating with a friend. This is an example of which defense mechanism?

Denial

A nurse is assisting in the development of a community education course about the physical complications related to substance abuse disorder. Which of the following physical complications should the nurse include about the use of heroin?

Dental caries

A nurse is caring for a client who has depressive disorder, is in alcohol withdraw and reports a recent job loss. Which of the following should be the priority nursing intervention?

Determine the presence and degree of suicidal risk. **The nurse initially should establish the presence of suicide ideation when caring for a client who has a history of a depressive disorder, alcohol withdrawal, and recent job loss. Risk of suicide is increased in clients who have a history of depression and substance use. This is a safety issue and must be addressed immediately.

A nurses collecting data from a client who is experiencing alcohol withdraw, which of the following is an expected finding?

Diaphoresis The nurse should expect a client who is experiencing alcohol withdrawal to experience diaphoresis, or increased sweating.

The nurse is caring for a client who has a history of opioid abuse, and is monitoring the client for signs of withdrawal. Which manifestations are specifically associated with withdraw from opioids?

Fever yawning irritability diaphoresis diarrhea

A nurse explains that because the drug disulfiram (Antabuse) is deemed inappropriate, the patient has been put on the most reliable substitute, _____, which causes similar but less severe side effects in the people with alcoholism who continue to drink.

Flagyl.

Which supplements may be given to individuals with chronic alcoholism?

Folate and Vitamin B₆.

What is the chief advantage of using hair analysis to detect drug use?

Hair samples will reveal drug use as long as 1 year later .

A nurse is caring for a client who has a 10 year history of alcohol use disorder and is experiencing acute alcohol withdrawal. The nurse should notify which of the interventions as the priority?

Implement seizure precautions.

Nursing interventions for a pt on seizure precautions.

Intravenous magnesium sulfate may be used to prevent seizures in rare cases. Scheduled anticonvulsant agents are prescribed if seizures occur; the two most common anxiolytic benzodiazepines used to treat alcohol withdrawal are lorazepam (Ativan) and diazepam (Valium).

Thiamin (B1) and Niacin deficiency

Korsakoff psychosis

which are appropriate interventions for caring for the client in alcohol withdrawal? (SATA)

Monitor vital signs. Provide a safe environment. Address hallucinations therapeutically. Provide reality orientation as appropriate

A hospitalized client with a history of alcohol abuse tells the nurse, " I'm leaving now, I have to go I don't want anymore treatment, I have things I have to do right away" the client has not been discharged. In fact the client is to be scheduled for an important diagnostic test in one hour. After the nurse discusses the clients concerns with the client, the client dresses and begins to walk out of the hospital room, the appropriate nursing action is what?

Notify the RN

Young people should be warned that inhalants can cause which of the following

Progressive brain damage.

A nurse is assisting with a court ordered admission of a client to a substance abuse program, the client states " you are all angry with me and wish you could go out and have a drink" the clients response is an example of which of the following defense mechanisms?

Projection.

A patient with an alcohol addiction says, My drinking is all my wifes fault. She makes me so crazy I just have to have a drink. What does this exemplify?

Projection.

The nurse is assigned to care for a client at risk for alcohol withdraw, the nurse monitors the client knowing that the early signs of withdraw will usually develop within which time after cessation or reduction of alcohol intake?

The signs of early withdrawal from alcohol are agitation and elevated vital signs. These warning signs usually occur 6 to 12 hours after the last drink.

Which syndrome of alcoholism is related to thiamine (B1) deficiency?

Warnikee-korsikoff Wernicke encephalopathy and Korsakoff psychosis

Thiamin (B1) deficiency with delirium that could lead to a coma

Wernicke encephalopathy

Which implementation can be used to help prevent relapse in a patient who has had substance abuse problems?

assisting patients to identify triggers to their substance use

A patient is given anxiolytic medications for a mental disorder. What type of approach is this considered? a. Analytical b. Interpersonal c. Biologic d. Psychoanalytic

c. Biologic The biologic approach attempts to manage the physiologic effects of mental illness using medications.

A patient states that he feels angry at work for no reason and often yells at his coworkers. The therapist asks the patient to describe events and then tells the patient to try different strategies to cope with these angry outbursts. What type of approach is this considered? a. Biologic b. Analytical c. Cognitive or behavioral d. Interpersonal

d. Interpersonal The interpersonal approach helps the patient develop new coping skills.

LPN is assisting with the development of a nursing care plan for a client who has been using cocaine for 5 years, what should the nurse consider would most commonly need to be dealt with in this patient?

depression?

Disulfiram-Alcohol Reaction.

flushing. headache. nausea. vomiting. dizziness. rapid heart rate. difficulty breathing. sweating. confusion. hypotension. that may lead to coma, convulsions, and death.

What might the positive effects of marijuana be used to treat?

glaucoma, asthma, nausea and vomiting as a result of chemotherapy, and as an appetite stimulant.

A patient admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The patient is now shaky, irritable, anxious, diaphoretic, and reports nightmares. The pulse rate is 130 beats/min. The patient shouts, Bugs are crawling on my bed. I've got to get out of here. Select the most accurate assessment of this situation. The patient:

has symptoms of alcohol-withdrawal delirium.

Naloxone hydrochloride

opioid antagonist

Program developed for health professionals addicted to a substance to prevent having their licenses revoked are called.

peer assistance program

A nurse is collecting data from a client who is experiencing alcohol withdraw delirium, which if the following findings should the nurse expect? SATA

seizures hallucinations tremens

The nurse is monitoring a client who abuses alcohol for sign of alcohol withdraw delirium. The nurse should monitor for which?

seizures or hallucinations or tremens

The nurse is monitoring a client who abuses alcohol for sign of alcohol withdraw delirium. The nurse should monitor for which?

seizures or hallucinations or tremens.

patient has smoked two packs of cigarettes daily for many years. When the patient tries to reduce smoking, anxiety, craving, poor concentration, and headache occur. This scenario describes:

substance addiction.

Methadone

synthetic opioid that is less euphorigenic than heroin and similar drugs used to manage withdrawal symptoms in opiate users

The nurses caring for a client whose suspected of being dependent on drugs, which question should be appropriate for the nurse to ask when collecting data form the client regarding drug abuse?

"How much do you use & what effect does it have on you?"

A nurses reinforcing teaching with a client about AA, which of the following statements by the client, indicates an understanding of the programs basic concepts?

"I am powerless against my addiction to alcohol."

The nurse determines that the wife of an alcoholic client is benefiting from attending an alanon group when the nurse hears the wife say which statement?

"I no longer feel that I deserve the beatings my husband inflicts on me."

A nurse is reinforcing teaching about alcohol withdraw with a client who has a history of alcohol use disorder, which of the following client statements indicates an understanding?

"I should expect tremors to start less than 24 hours after I stop drinking."**Signs of withdrawal might develop within a few hours of the client's last drink of alcohol.

During the taking of a medical history, a pt who is addicted to heroin reports he only uses the drug a few times a week. What is the nurses best response when trying to disclose more precise information?

"Rate your weekly usage on a scale of 1 to 15."

A nurses caring for a client whose partner asks to speak with the nurse. The clients partner relates that she is concerned bc her partner abuse alcohol and has difficulty maintaining employment, which of the following response should the nurse make?

"What have you done in the past to cope with this issue?" **This asks a relevant question and is therapeutic; it moves the discussion from a general direction to a specific focus on the partner's concerns and is open-ended.

A nurses assisting in the care of an adolescent client who has been diagnosed with schizophrenia, the clients parents are tearful and express feelings of guilt. Which of the following responses should the nurse make?

"you said that you feel guilty about your daughter's diagnosis. let's talk about what is causing you to feel this way"

Which are goals of an intervention for an impaired nurse? (SATA)

1. Assist the nurse whose practice is impaired to receive treatment. 2. Protect the public from an untreated nurse. 3. Help the recovering nurse to re enter nursing in a systemic, planned, and safe way. 4. Assist in monitoring the continued recovery of the nurse for a period of time.