MH Module 8- Substance Related and Addictive Disorders

Which interventions are most appropriate for caring for a client in alcohol withdrawal? Select all that apply. A. Monitor vital signs B. Provide a safe environment C. Address hallucinations therapeutically D. Provide stimulation in environment E. Provide reality orientation as appropriate F. Maintain NPO status

A. Monitor vital signs B. Provide a safe environment C. Address hallucinations therapeutically E. Provide stimulation in environment

A patient being treated for alcoholic cirrhosis of the liver tells a nurse that his friends are against him because they warn that his continued drinking could be fatal. Which is the best response by the nurse? "Your friends may have problems with their own drinking." "It's unfortunate that your friends are being judgmental about your drinking." I'm sorry to hear that your friends are not more supportive during your treatment." "Your friends are concerned that your drinking has consequences."

"Your friends are concerned that your drinking has consequences."

Dan begins attendance at AA meetings. Which of the statements by Dan reflects the purpose of this organization: A. "The program's support will help me stay sober if I work the program." B. "I'll dry out in AA, then I can have a social drink now and then. C. "AA is for people who have reached the bottom." D. "If I lose my job AA will help me find another."

A. "The program's support will help me stay sober if I work the program."

Mr. White is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports he has been a heavy drinker for a number of years. Lab report reveals BAL of 250 mg/dl (.25 g/dl) He is placed on chemical addiction unit for detox. When would the first signs of alcohol withdrawal symptoms be expected to occur? A. Several hours after the last drink B. 2-3 days after the last drink C. 4-5 days after the last drink D. 6-7 days after the last drink

A. Several hours after the last drink

A client is in the rehabilitative stage of treatment for substance use disorder. When teaching relapse prevention skills, what should the nurse emphasize: (Select all that apply - hint 3 correct) A. preventing fatigue B. maintaining physical health c. suppressing thoughts of returning to substance use D. reducing amount of solitary unstructured time E. reconnecting with the old social network

A. preventing fatigue B. maintaining physical health D. reducing amount of solitary unstructured time

A patient has been prescribed Xanax (alprazolam) for anxiety. The nurse should explain to the person that this medication: Is non-addictive Increases the duration of REM sleep May decrease total sleep hours Can cause potentially dangerous withdrawal symptoms

Can cause potentially dangerous withdrawal symptoms

When administered for a heroin overdose, the planned effect of Narcan (naloxone hydrochloride) is to: Decrease analgesia and the comatose state induced by heroin Compete with heroin for receptors controlling respiration Accelerate the metabolism of heroin and stimulate respiratory centers Stimulate cortical sites controlling consciousness and cardiovascular function

Compete with heroin for receptors controlling respiration

The nurse is monitoring a hospitalized client who abuses alcohol. Which findings should alert the nurse to the potential for alcohol withdrawal delirium. A. Hypotension, ataxia, hunger B. Stupor, lethargy, muscular rigidity C. Hypotension, coarse hand tremors, lethargy D. Hypertension, changes in level of consciousness, hallucinations

D. Hypertension, changes in level of consciousness, hallucinations

A patient is in the detoxification unit for abuse of heroin. The nurse should explain to the person that opiate addiction is frequently treated with which medication? Buspar (buspirone) Dolophine (methadone) Halcion (triazolam) Thorazine (chlorpromazine)

Dolophine (methadone)

A patient has been referred to Alcoholics Anonymous (AA). The nurse should explain to the person that one of the therapeutic elements of AA is: Providing one-on-one cognitive therapy Focusing on abstinence and one's loss of control about drinking Providing psychoeducation about the treatment therapies Allowing clients to be codependent for as long as necessary

Focusing on abstinence and one's loss of control about drinking

Most studies conclude that the etiology of alcoholism is: Poor parenting practices Antisocial personality disorders Obsessive-compulsive disorders Genetics and environmental factors

Genetics and environmental factors

A patient in a detoxification unit for substance abuse is being referred to support group. After explaining the advantages, the nurse determines that the instructions have been understood when the person states that support groups: Reduce the sense of isolation Focus on immediate issues Overcome negative self-thoughts Focus on spiritual power to help a patient

Reduce the sense of isolation

A patient has been prescribed ReVia (naltrexone) for treatment of alcohol dependency. After explaining the purpose of the drug, the nurse determines that the instructions have been understood when the person states that ReVia: Is a deterrent to impulsively drink alcohol Causes severe reactions when alcohol is consumed Reduces the cravings for alcohol Will improve appetite and nutritional status

Reduces the cravings for alcohol

A patient admitted to the detoxification unit following alcohol abuse is diagnosed with delirium tremens. The nurse anticipates that the person will exhibit: Tachycardia Bradycardia Hypotension Chills

Tachycardia

A homeless adult male with no family passed out on the street and was brought to the hospital by emergency medical responders. He expresses a wish to die. A physician, recognizing evidence of substance abuse and mental health issues, recommends the man be admitted for inpatient treatment. What rationale(s) is/are there for choosing this treatment option? Select all that apply: Intermittent supervision is available in an inpatient setting. This person requires stabilization of his multiple symptoms. He has nutritional and self-care needs. Medication adherence will be mandated. The man is in imminent danger of harming himself.

The man is in imminent danger of harming himself.

A patient with Wernicke's syndrome has been admitted. The nurse should explain to the person that treatment for this condition is the administration of: Thiamine Vitamin C Riboflavin Vitamin K

Thiamine

A patient has been prescribed the medication Antabuse (disulfiram). The nurse should caution the person that ingesting any alcohol will cause severe: Hypertension Nausea Diarrhea Constipation

Nausea

A patient in the emergency room is experiencing heroin withdrawal. The nurse should assess the person for: Abdominal cramps Tachycardia Constricted pupils Tremors

Abdominal cramps

A patient has been admitted with acute alcohol withdrawal. The nurse should explain to the person that the antianxiety medication often prescribed is: Prozac (fluoxetine) Thorazine (chlorpromazine) Ativan (lorazepam) Haldol (haloperidol)

Ativan (lorazepam)

A mother brings daughter to the ED. Daughter was at dance party for last many hours, is sweating and does not look well. Temp is now 103F, teeth grinding and weight loss. What should be the nurse's greatest concern? A. poor nutrition - possible eating disorder b. dehydration and electrolyte imbalance C. influenza with accompanying high fever D. dental problems due to teeth grinding

b. dehydration and electrolyte imbalance

A patient tells a nurse that she has quit drinking coffee because caffeine was making her nervous. The nurse should explain to the person that a common withdrawal symptom is: Tremors Headaches Tachycardia Nystagmus

Headaches

A patient who has overdosed on heroin has been admitted. The nurse should plan to administer which medication? Normeperidine Catapres (clonidine) Narcan (naloxone) ReVia (naltrexone)

Narcan (naloxone)

A nurse advising a colleague about the Texas Peer Assistance Program for Nurses (TPAPN) should explain that: Participation in the program is voluntary. Enrollment in TPAPN guarantees a nurse can return to practice. TPAPN is designed exclusively for persons with substance abuse problems. No one but a TPAPN counselor will know the colleague is in the program.

Participation in the program is voluntary.

To assist chemically dependent nurses by securing evaluation, treatment, monitoring, and ongoing support, several state nursing associations have established treatment programs that are termed: Chemical dependency programs Peer assistance programs Nursing substance abuse programs Non-punitive support programs

Peer assistance programs

When a patient requires larger doses of a given medication to maintain its therapeutic effect, the nurse determines that the person has developed: Sensitivity Tolerance Functionality Allergies

Tolerance

A patient is in a detoxification unit due to alcohol abuse and is suffering from withdrawal symptoms. The nurse should explain to the person that one of the withdrawal symptoms is: Severe dysphoria Agitation Vivid dreams Tremors

Tremors

True or False The effects of CNS depressants are additive with one another. CNS depressants are not capable of producing physiological addiction. In substance use disorders, peer feedback is often more accepted than feedback from authority figures. A step in decreasing denial is for the client to see the relationship between substance use and personal problems. ReVia (naltrexone) is used for the treatment of alcohol and opioid addiction.

True False True True True