CEN SUBSTANCE ABUSE Questions
Which of the following conditions is a complication of heroin use? A. Myocarditis B. Bacterial endocarditis C. Cardiomyopathy D. Acute coronary syndrome
A complication of heroin use is bacterial endocarditis. Intravenous use of heroin (or other intravenous drug use) increases the risk for human immunodeficiency virus (HIV), hepatitis, skin abscesses/soft tissue infections, phlebitis, and bacterial endocarditis. Myocarditis, cardiomyopathy and acute coronary syndrome are complications of cocaine use.
Which of the following conditions is a complication of heroin use? A. Myocarditis B. Bacterial endocarditis C. Cardiomyopathy D. Acute coronary syndrome
A complication of heroin use is bacterial endocarditis. Intravenous use of heroin (or other intravenous drug use) increases the risk for human immunodeficiency virus (HIV), hepatitis, skin abscesses/soft tissue infections, phlebitis, and bacterial endocarditis. Myocarditis, cardiomyopathy and acute coronary syndrome are complications of cocaine use.
Abuse of synthetic cathinone ("bath salts") can produce which set of symptoms? A. Constipation, confusion, and respiratory depression B. Depression, poor judgment, and life-threatening withdrawal C. Kidney failure, enlargement of the heart, and changes in blood cholesterol D. Dehydration, breakdown of skeletal muscle tissue, and kidney failure
Abuse of synthetic cathinones can produce a syndrome known as "excited delirium" that includes dehydration, breakdown of skeletal muscle tissue, and kidney failure. Abuse of opioids can produce constipation, confusion, and respiratory depression. Depression, poor judgment, and life-threatening withdrawal are associated with abuse of barbiturates. Abuse of anabolic steroids can result in kidney failure, enlargement of the heart, and changes in blood cholesterol.
Which of the following is the most commonly used and abused depressant in the United States? A. Heroin B. Inhalants C. Alcohol D. Cocaine
Alcohol is the most commonly used and abused depressant in the United States and a leading cause of morbidity and mortality.
Which of the following statements regarding alcoholism is accurate? A. Alcoholism can cause sexual dysfunction. B. Older adults have a decreased peak alcohol concentration. C. Medication absorption is increased in alcoholics. D. Alcohol is classified as a stimulant.
Alcoholism can cause sexual dysfunction. Alcoholism causes the following effects in males: erectile dysfunction, decreased sperm production, testicular atrophy; and in females: infertility, spontaneous abortion, amenorrhea. Older adults have an increased peak alcohol concentration with any given dose as a result of decreased lean body mass and renal clearance. Delayed gastric emptying as a result of alcoholism can affect absorption and drug clearance, resulting in adverse effects. Alcohol is classified as a depressant.
what is the most serious stage of withdrawal?
Delirium tremens is the most serious stage of withdrawal; fifteen percent of patient experiencing the disorientation, confusion, and profound autonomic hyperactivity that define this stage, die from cardiovascular or respiratory collapse. Seizures may occur in this stage but they do not define its onset.
Which of the following substances causes an increased respiratory rate? A. Hashish B. Ketamine C. Dexedrine D. Heroin
Dexedrine, an amphetamine, is a stimulant and causes rapid breathing. Ketamine, a dissociative anesthetic, can cause respiratory depression and arrest. Hashish, a cannabinoid, can cause respiratory infections but does not cause an increased respiratory rate. Heroin, an opiate, results in shallow breathing.
what type of disease is drug addiction considered
Drug addiction is considered a "brain disease" because the drugs physically change brain structure and function. Drug addiction is a biologically based disease characterized by compulsive drug seeking and use despite harmful consequences Substance abuse occurs among persons of all socioeconomic groups and ages, including health care providers.
Which of the following substances could cause a frostbite injury to the mouth, nose and lips? A. Methamphetamine B. Inhalants C. Crack D. Phencyclidine (PCP)
Frostbite injury to the mouth, nose and lips has been noted with use of some inhalant substances (e.g., Freon). Long term use of methamphetamine has been associated with decreased circulation to all body parts, causing the individual to be prone to infection, acne and sores on the skin as a result of excessive scratching due to the sensation of "bugs crawling under the skin." Crack, the smokable form of cocaine, is reportedly 10 times more powerful than the effects caused by snorting, and greater than that of other drugs of abuse. It would not cause a frostbite injury. Phencyclidine (PCP) can be snorted as well as injecting or smoking it. Repeated snorting of any substance can cause injuries to the nose and nosebleeds, but would not cause a frostbite injury.
Which of the following substances causes somnolence? A. Ecstasy B. Lysergic acid diethylamide (LSD) C. Gamma hydroxybutyrate (GHB) D. Cocaine
GHB is a depressant and causes drowsiness, an agent associated with date facilitated rape due to its somnolence properties. All other substances cause insomnia.
Which of the following substances causes a decreased heart rate? A. Cocaine B. Nicotine C. Gamma hydroxybutyrate (GHB) D. Lysergic acid diethylamide (LSD)
Gamma hydroxybutyrate (GHB) can cause bradycardia. Atropine may be required for persistent bradycardia caused by this agent. All other substances mentioned cause an increased heart rate.
Which of the following agents increases the blood pressure? A. Flunitrazepam B. Gamma hydroxybutyrate (GHB) C. Lysergic acid diethylamide (LSD) D. Methaqualone
LSD is a hallucinogen, causing an increased blood pressure. All other substances are depressants and cause a decreased blood pressure.
Which of the following substances produces the sensation of "bugs crawling under the skin"? A. Marijuana B. Methamphetamine C. Ativan D. Heroin
Long term use of methamphetamine has been associated with decreased circulation to all body parts, causing the individual to be prone to infection, acne and sores on the skin as a result of excessive scratching due to the sensation of "bugs crawling under the skin." All of the other substances do not cause this to occur.
A patient presents with palpitations. On obtaining his oral temperature you note that his teeth are badly decayed and he is constantly grinding his teeth? Which of the following substances of abuse is this patient most likely to be using? A. Heroin B. Marijuana C. Ketamine D. Methamphetamine
Long term use of methamphetamine has been associated with findings of dental caries, teeth being worn down due to bruxism (grinding), dry mouth, poor nutrition and hygiene, causing a syndrome referred to as "meth mouth." Stimulants increase heart rate and may cause tachydysrhythmias.
Long-term tobacco abuse is linked to which health problems? A. Bronchitis and chronic obstructive pulmonary disease B. Colon cancer and hypertension C. Pulmonary fibrosis and lung cancer D. Stroke and gastrointestinal bleeding
Long-term tobacco abuse is linked to many health problems, including cardiovascular disease (i.e. stroke and hypertension), lung cancer, chronic obstructive pulmonary disease, and bronchitis. Smoking has not been linked to colon cancer or gastrointestinal bleeding.
Which of the following medications is most commonly used to decrease autonomic hyperactivity in the patient presenting with alcohol withdrawal? A. Thiamine B. Magnesium sulfate. C. Lorazepam (Ativan) D. Haloperidol (Haldol)
Lorazepam is used to control autonomic hyperactivity and manage seizures. Magnesium and thiamine may be administered to correct electrolyte and nutritional deficiencies. Haloperidol is an antipsychotic agent that may control behavior but it does not decrease autonomic hyperactivity and should be used with caution in patients with withdrawal symptoms because it lowers the seizure threshold.
Which of the following substances causes flashbacks? A. Mescaline B. Ketamine C. Heroin D. Cocaine
Mescaline is a hallucinogen and causes flashbacks. Ketamine, a dissociative anesthetic, has the effect of causing a sense of detachment from one's self and the environment and can cause delirium and depression. Heroin is classified as an opioid and morphine derivative and can cause euphoria, confusion and drowsiness. Cocaine is classified as a stimulant and can cause feelings of exhilaration, energy, and increased mental alertness.
Which of the following substances causes vasoconstriction? A. Alcohol B. Nicotine C. Halcion D. Dextromethorphan
Nicotine causes a short-term increase in blood pressure, heart rate, and the flow of blood from the heart. It also causes the arteries to narrow causing vasoconstriction. Alcohol causes vasodilation. Halcion, a depressant, and dextromethorphan, a dissociative anesthetic, do not cause vasoconstriction.
Which of the following substances can only be taken orally? A. Flunitrazepam B. Benzodiazepines C. Methaqualone D. Gamma-hydroxybutyrate (GHB)
Only gamma-hydroxybutyrate (GHB) is administered solely by ingestion. All of the other substances can be administered either by injection or taken orally.
Which of the following drug categories has a side effect of constipation? A. Dissociative anesthetics B. Hallucinogens C. Opioids and morphine derivatives D. Depressants
Opioids and morphine derivatives can cause constipation. Hallucinogens can cause nausea. Dissociative anesthetics and gamma hydroxybutyrate (GHB), a depressant, can cause nausea and vomiting.
Which substance may cause violent behavior? A. Marijuana B. Methaqualone C. Fentanyl D. Inhalants
Prolonged use of inhalants, such as paint thinner, can lead to irreversible brain damage, muscle weakness, nosebleeds, sensory disturbances, arrhythmias, kidney and liver damage, cognitive problems, and violent behavior. Lorazepam, an anxiolytic medication; fentanyl, an opioid; and marijuana are not associated with violent behavior.
Which of the following substances can cause feelings of paranoia? A. Psilocybin B. Hashish C. Xanax D. Cocaine
Psilocybin also known as magic mushroom can cause symptoms of nervousness and paranoia. Amphetamine use is another cause of paranoia. Hashish, a cannabinoid, can cause symptoms of euphoria, slowed thinking and reaction time, confusion, anxiety and/or panic attacks. Xanax, a benzodiazepine (depressant), causes a feeling of well-being, lowered inhibitions, sedation, drowsiness and/or dizziness. Cocaine is classified as a stimulant and can cause feelings of exhilaration, energy, and increased mental alertness.
Which of the following statements regarding alcohol withdrawal is true? A. Signs of alcohol withdrawal can occur in the patient who has a positive blood alcohol level. B. In the Clinical Institute Withdrawal Assessment Alcohol scale (CIWR - Ar), the lower the score, the more severe the withdrawal. C. Hallucinations occur in the majority of patients experiencing alcohol withdrawal. D. Delirium tremens is defined by the onset of seizures.
Signs of alcohol withdrawal can occur in the patient who has a positive blood alcohol level. Symptoms result when the patient's alcohol level falls below his/her baseline level, not necessarily when there is no alcohol in the patient's system. Hallucinations occur in approximately 25% of patients experiencing alcohol withdrawal. Seizures are a sign of neuronal excitation, a separate stage of withdrawal than delirium tremens.
Which cocaine delivery route produces the quickest strongest high? A. Huffing B. Snorting C. Smoking D. Swallowing
Smoking produces the quickest strongest high. Crack, the smokable form of cocaine, is reportedly 10 times more powerful than the effects obtained by snorting, and greater than that of other drugs of abuse. Cocaine is a strong stimulant that can be snorted, smoked, or injected.
Which of the following statements regarding substance abuse is correct? A. It predominately affects those who are poor. B. It is a significant problem among older adults. C. Substance abusers only use illicit drugs. D. Over-exposure to serotonin causes brain alterations.
Substance abuse is a significant problem among older adults. Prescription drug abuse is two or three times higher than in the general population and alcohol abuse is prevalent in 10-15% of older adults. Substance abuse contributes to injuries (falls) and cognitive and memory deficits. Substance abuse affects all socioeconomic groups. Prescriptive and over the counter drugs can also be abused. The pleasure center in the brain is significantly impacted by repeated overproduction of the neurotransmitter dopamine, not serotonin.
Which of the following is characteristic of substance dependence? A. Withdrawal symptoms when the substance is stopped. B. Failure to fulfill major role obligations. C. Continued use despite adverse social or personal effects. D. Use of a substance when it is physically hazardous.
Substance dependence is characterized by the occurrence of withdrawal symptoms when the substance is stopped.
An adolescent is found unresponsive, apneic, and pulseless. A rag soaked in an unknown chemical was found lying next to the patient's head. Which of the following intoxicants is the most likely cause of this patient's presentation? A. Alcohol B. An inhalant C. Dextromethorphan D. Ecstasy
The chemical-soaked rag suggests that the patient had been huffing an inhalant. Use of inhalants, products frequently found in the home, is more likely to occur in younger adolescents. Deaths from inhalants may result from aspiration, asphyxiation, and accidental trauma; fifty percent of deaths are attributed to sudden sniffing death syndrome. Although an overdose of alcohol (a depressant), dextromethorphan (a hallucinogen) and ecstasy (a stimulant) may be a consideration, the presence of materials associated with inhalant use suggests an inhalant as the most likely cause.
Which of the following substances is amenable to reversal with an antidote? A. Ecstasy B. Gamma hydroxybutyrate (GHB) C. Cannabis D. Heroin
The effects of Heroin can be reversed with naloxone (Narcan). The other substances do not have an antidote and are treated supportively.
Which of the following statements is accurate? A. Inhaled drugs take time to get into the circulation. B. Morphine has less effect on respiratory depression than codeine. C. The potential for violence increases in individuals under the influence of drugs. D. Suspicion of drug abuse should be reported to the police.
The potential for violence increases in individuals under the influence of drugs. Patients often present for treatment of injuries associated with high-risk behavior such as assault, penetrating or blunt trauma, motor vehicle crashes, or falls rather than the substance abuse. Codeine causes less analgesia, sedation, and respiratory depression than morphine. Drugs inhaled or used intravenously are more readily absorbed. An individual using these routes may repeat their use in order to achieve the "high". Suspicion of drug abuse should be reported to the physician. Once the patient is medically cleared, consultation should be made with a psychiatric nurse, social worker, or drug treatment center.
disulfiram (Antabuse)
The priority for the patient taking disulfiram (Antabuse) is to remain abstinent. Antabuse reacts with alcohol to cause adverse effects, which is why it is given to alcoholics
WhIch of the following substances is referred to as a "gateway drug"? A. Cocaine B. Marijuana C. Inhalants D. Alcohol
The use of inhalant substances which can be legally obtained are often the first intoxicants used, setting the stage for potential escalation to the abuse of illegal substances. Inhalants for this reason may be referred to as "gateway drugs." Use of inhalants is more likely to occur in younger adolescents, or sometimes children as young as fifth graders, with boys and girls at equal risk for use.
Which of the following statements is accurate? A. Drug addiction is a psychologically based disease. B. There is no genetic predisposition to substance abuse. C. Substance abuse predominately affects those who are unemployed. D. Use of tobacco products is considered substance abuse.
The use of tobacco products is considered substance abuse.
Which of the following statements is accurate? A. Drug addiction is a psychologically based disease. B. There is no genetic predisposition to substance abuse. C. Substance abuse predominately affects those who are unemployed. D. Use of tobacco products is considered substance abuse.
The use of tobacco products is considered substance abuse. Substance abuse is defined as the use of illicit substances, alcohol, tobacco, and the inappropriate use of prescription and over the counter drugs. Researchers have discovered that some alcoholics are genetically predisposed to alcoholism; however, they have not been able to determine if abusers of other substances have a similar genetic predisposition. Substance abuse occurs among persons of all socioeconomic groups and ages, including health care providers. Drug addiction is a biologically based disease characterized by compulsive drug seeking and use despite harmful consequences. Drug addiction is considered a "brain disease" because the drugs physically change brain structure and function.
Which substance of abuse has an increased risk of respiratory depression when combined with alcohol? A. Lysergic acid diethylamide (LSD) B. Phencyclidine (PCP) C. Zolpidem (Ambien) D. Amphetamine (Dexedrine)
When zolpidem is combined with alcohol, there is increased risk of respiratory distress and death. The other drugs listed are not associated with respiratory distress.
Which substance of abuse has an increased risk of respiratory depression when combined with alcohol? A. Lysergic acid diethylamide (LSD) B. Phencyclidine (PCP) C. Zolpidem (Ambien) D. Amphetamine (Dexedrine)
When zolpidem is combined with alcohol, there is increased risk of respiratory distress and death. The other drugs listed are not associated with respiratory distress.
Substance abuse is defined
as the use of illicit substances, alcohol, tobacco, and the inappropriate use of prescription and over the counter drugs.
WHAT IS The purpose of an escharotomy?
is to relieve compartment syndrome and facilitate the return of distal pulses. Bleeding is considered to be a complication, not a therapeutic technique. Direct pressure to the site will help to decreasing bleeding.
Researchers have discovered that genetic predisposition effects abusers of substances how
some alcoholics are genetically predisposed to alcoholism; however, they have not been able to determine if abusers of other substances have a similar genetic predisposition.
In the Clinical Institute Withdrawal Assessment Alcohol scale (CIWR-Ar), what scores coincides with mild or severe withdrawal
the milder the withdrawal; scores greater than 20 reflect severe withdrawal.
According to the American Psychiatric Association, substance dependence is the maladaptive use of a substance that leads to impairment and/or distress as manifested by any three of the following, occurring in a single year:
•Tolerance to the effect of a substance •Increasing quantity or use over a longer period than intended •Unsuccessful efforts to cut down or quit use •Increased time devoted to getting or using the substance or recover from its effects •Ordinary activities curtailed in favor of use of the substance •Continued substance use despite knowledge of its adverse effects