Chapter 19 PrepU NRS330

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

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 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."

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

8

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

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 substance as the most abused in the United States?

Alcohol

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

The recommended first-line pharmacologic agents for managing severe alcohol withdrawal symptoms are in which class of medications?

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 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?

Chlordiazepoxide

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 client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as which of the following?

Hallucinogen

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

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

It is available in IV form.

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

A client is admitted to the detoxification unit on Sunday evening. The client discloses that the client's last alcoholic drink was just before the client was admitted to the unit. When can the nurse expect that the client's alcohol withdrawal symptoms will begin?

Monday morning

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 which nursing interventions?

Observation for symptoms, vital signs, seizure and fall precautions, medications as ordered

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 abuse.

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

The nurse is interviewing a client with alcoholism. Which of the following would alert the nurse to the fact that the client is in denial?

Says that he can control and enjoy drinking

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

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.

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.

The client was diagnosed with cocaine abuse at age 30. When the client was 23, the client was diagnosed with major depressive episode, and has continued to have depression off and on since then. Which statement would reflect this situation?

The client most likely has a dual diagnosis since she has both a substance dependence and depression.

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 is in treatment for depression and alcohol abuse. The client is unwilling to confront substance abuse issues, stating the client uses alcohol to ease feelings of depression. The client's spouse reports that the spouse often has to care for the client when the client is hung over, calling in sick for the client and doing what the spouse can to help the client catch up with household or job responsibilities. The nurse diagnoses the client's family with dysfunctional family processes. The nurse and clients develop a plan of care. Which goal indicates an understanding of the family situation and the linkages between the diagnosis and the outcomes?

The spouse will refrain from the enabling the client's drinking behaviors.

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

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.

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 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