Chapter 58 PrepU

Which neurotransmitter is most likely responsible for the rewarding and reinforcing effect of cocaine? Serotonin Epinephrine Dopamine Acetylcholine

Dopamine

There are several reasons why drug therapy is of limited use in treating substance dependence. Which of the following statements accurately describes a potentially serious risk of such therapy? The patient may not want to undergo drug therapy. The therapy is usually ineffective. The wide range of antidotes makes selection of the appropriate treatment drug difficult. Drug therapy could substitute one abused drug for another.

Drug therapy could substitute one abused drug for another.

Health care professionals are considered to be at high risk for development of substance abuse disorders, at least partly because of what factor? Easy access Low cost Lax regulations related to use Knowledge of the risks involved

Easy access

The emergency room nurse is admitting a client brought in after exhibiting threatening and unpredictable behavior, suspected to be the result of a recent binge of methamphetamine use. In addition to ensuring the client's immediate safety and that of others, what is the nurse's priority action? facilitating detoxification initiating a program aimed at long-term abstinence screening the client for addiction mobilizing the client's support system

facilitating detoxification

A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for: increased appetite. hypertension. bradycardia. stupor.

hypertension

A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of methamphetamine. cocaine. marijuana. nicotine.

marijuana.

When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for? insomnia sedation increased thirst anxiety

sedation

While the school nurse is providing health education to a group of children on the dangers of illicit drug use, a child asks the nurse what sniffing gasoline or glue does to the body. What response is most effective in addressing this question? "Doing that damages the brain and other body organs." "It depends on what a person sniffs and how often they do it." "The most serious effects are the damage to the nostrils and sinuses." "Let's talk about why you would want to sniff these substances."

"Doing that damages the brain and other body organs."

The high school nurse is explaining the dangers of substance abuse to the incoming freshman class. How would the nurse explain psychological dependence to the students? "It involves the unpleasant symptoms that result when you stop taking the drug." "It is the physiologic adaptation to chronic use of a drug." "It involves feelings of satisfaction and pleasure from taking the drug." "It is the decreased effect of the drug that occurs with extended use."

"It involves the unpleasant symptoms that result when you stop taking the drug."

A school nurse has been teaching high school students about the risks associated with marijuana use. However, the nurse has been met with considerable skepticism on the part of students, most of whom believe that marijuana is a benign drug. Which of the following teaching points should the nurse provide? "Most people don't know that marijuana can be just as addictive as heroin or cocaine over time." "Marijuana can easily interact with other drugs and cause potentially fatal reactions." "Every year, thousands of Americans end up in emergency departments with marijuana overdoses." "Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes."

"Smoking marijuana is just as bad, or worse, for your lungs as smoking cigarettes."

As a school nurse, you are preparing to do a presentation on cannabis and the long-term sequelae of its heavy use. To what body system or function do you understand cannabis use can cause the most damage? Blood pressure Cardiovascular Brain Liver

Brain

A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order? chlordiazepoxide varenicline bupropion cannabis

chlordiazepoxide

An client admitted to your emergency department (ED) is experiencing hallucinations. The friend who brought him to the ED indicates that the client has used recreational drugs in the past but has not done so for many weeks. Which of the following drugs can trigger recurrent hallucinations? Cocaine Marijuana Heroin Lysergic acid diethylamide (LSD)

Lysergic acid diethylamide (LSD)

Which drug would be classified as a hallucinogen? amyl nitrate heroin rohypnol PCP

PCP

A client has alcohol use disorder and has just been prescribed disulfiram 500 mg subcutaneous daily. Which of the nurse's actions is most appropriate? Administer the medication as ordered and monitor the effects. Question the health care provider regarding the dose. Question the health care provider regarding the frequency. Question the health care provider regarding the route.

Question the health care provider regarding the route.

During his assessment, Drew reveals that he is a frequent user of crack and has been on a binge for several days. The nurse realizes that he requires frequent cardiac assessments. The reason for this increased assessment of the cardiac system is because of the major risk for what condition as a result of crack cocaine use? Nasal mucosal atrophy Hepatotoxicity Rupture of the aorta Renal ischemia

Rupture of the aorta

Which of the following symptoms may be present during severe alcohol withdrawal? Bradycardia Hypothermia Seizures Hyperventilation

Seizures

A client was prescribed oral hydromorphone two weeks ago for the treatment of cancer pain. The client was able to achieve pain relief with 2 mg doses for the first 10 days, but has recently needed 3-4 mg to achieve the same effect. The client has expressed concern to the nurse that he is becoming addicted to hydromorphone. What should the nurse teach the client? The client is developing a tolerance, which is not the same as addiction. The client is likely developing a psychological dependence on morphine. There are interventions available to treat early addiction. The client will not become addicted because the medication has a legitimate use.

The client is developing a tolerance, which is not the same as addiction.

A family expresses concern when a family member withdrawing from alcohol is given lorazepam (Ativan). What information should be given to the family about the medication? The medication promotes a sense of wellbeing during the client's difficult withdrawal period The medication is given for a short time to help the client complete the withdrawal process The medication will help the client forget about the physical sensations that accompany alcohol withdrawal The medication helps in the treatment of coexisting diseases, such as cardiac problems and hypertension

The medication is given for a short time to help the client complete the withdrawal process

The nurse is taking a history from a patient who states that she smokes marijuana daily. The patient says, "It mellows me out and helps me to cope with the stresses of life. I go sometimes without it and it doesn't bother me." What does the nurse determine is this patient's issue with the substance? The patient has developed a physical dependence on marijuana. The patient will soon develop physical dependence on other substances in this class of drug. The patient has developed a psychological dependence for marijuana. The patient is tolerant to the effects of the marijuana.

The patient has developed a psychological dependence for marijuana.

What happens when clients return to opiate abuse while taking naltrexone? They have an increased potential for overdosage and death They do not experience the previous level of opiate effects They experience physiologic consequences of withdrawal They experience depression and are prone to commit suicide

They have an increased potential for overdosage and death

Which of the following refers to the reduction in a drug's effect that follows persistent use? Addiction Tolerance Withdrawal Dependence

Tolerance

Charlie, a homeless heroin addict, has been admitted into care and needs immediate intervention. A visiting health care provider has begun Charlie on methadone maintenance. What fact should the nurse consider during this client's treatment for substance use? Methadone is an ineffective drug. Using methadone maintenance may lead to a dependence on methadone. Methadone has a short duration of action. Methadone is expected to be soon banned in the United States.

Using methadone maintenance may lead to a dependence on methadone.

A client admits to smoking marijuana several times a day but denies being dependent on the drug. The nurse should base the discussion with the client on what characteristic of psychological dependence? Using the drug creates the feeling of satisfaction and pleasure. Stopping the drug results in unpleasant symptoms. Laboratory findings are congruent with frequent intoxication. There is a need to increase frequency of medication usage to achieve desired effects.

Using the drug creates the feeling of satisfaction and pleasure.

The nurse is caring for clients diagnosed with substance use disorder. Which client is most likely to benefit from treatment with chlordiazepoxide? the client experiencing acute alcohol withdrawal the client who has repeatedly failed at attempts at smoking cessation a client detoxifying from chronic fentanyl use a client having a "bad trip" from hallucinogenic mushrooms

the client experiencing acute alcohol withdrawal