MS2 Q14 Substance Abuse

Blackout

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

Projection

A pt with alcohol addiction says, "My drinking is all my wife's fault. She makes me so crazy I just have to drink." What does this exemplify?

Depression

An LPN is assisting w the development of a nursing care plan for a patient who has been using cocaine for 5 years. What should the nurse consider will most commonly need to be dealt w in this patient?

"Rate your weekly usage on a scale of 1-15"

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 nurse's best response when trying to disclose more precise info?

An accidental OD by mixing alc w/ anxiolytic, anti-psychotic/depressant meds

In some cases, patients will use drugs or alc to treat the disturbing symptoms of psychiatric disease. What can occur in this scenario?

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

The nurse determined that the wife of an alcoholic client is benefiting from attending an Al-Anon group when the nurse hears the wife say which?

"I should expect fine hand tremors to start less than 24 hours after I stop drinking"

A nurse is reinforcing teaching about alcohol withdrawal with a client who has a history of alc use disorder. Which of the following client statements indicates an understanding of the teaching?

" I am powerless over my addiction to alcohol"

A nurse is reinforcing teaching w/ a client about AA. Which of the following statements by the client indicates an understanding of the program's basic concepts?

Based on a 12-step approach with a strong religious base

A nurse recommends to an alcoholic that he join AA. What is true about this organization?

Biologic

A pt diagnosed with alcoholism. A nurse tells him that he has a physical illness with a genetic predisposition to alcoholism and the only effective treatment is abstinence from alc. This type of approach characterizes which theory?

"How much do you use and what effects does it have on you?"

The nurse is caring for a client who is suspected for being dependent on drugs on drugs. Which question should be appropriate for the nurse to ask when collecting data from the client regarding drug abuse?

Hypertension, disorientation, hallucinations

The nurse is monitoring a client who abuses alc for signs of alc withdrawal delirium. The nurse should monitor for which?

Call the nursing supervisor

A hospitalized client with a history of alcohol abuse tells the nurse, "I am leaving now. I have to go. I don't wany any more treatment. I have things that I have to do right away" The client has not been d/c. In fact, the client is scheduled for an important diagnostic test to be performed in 1 hr. After the nurse discusses the client's concerns with the client, the client dresses and begins to walk out of the hospital room. The appropriate nurse action is which?

Attention-seeking, need for control and self-centeredness

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?

Apathy

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

"Let's talk about what is causing you to feel guilty"

A nurse is assisting in the care of an adolescent client who has a new diagnosis of schizo. The client's parents are tearful and express feelings of guilt. Which of the following responses should the nurse make?

Dental carries

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

Projection

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

Determine the presence and degree of risk of suicidality

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

Anxiety and diaphoresis

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

"What have you done in the past to cope with this issue?"

A nurse is caring for a client whose partner asks to speak with the nurse. The client's partner relates that she is concerned because her partner abuses alc and has difficulty maintaining employment. Which of the following responses should the nurse make?

1. visual hallucinations 2. paranoid delusions 3. tremors

A nurse is collecting data from a client who is experiencing alc withdrawal delirium. Which of the following findings should the nurse expect? (SATA-3)

Seizure activity

A nurse is collecting data from a client who is experiencing alcohol withdrawal. Which of the following is an expected finding?

Denial

A nurse is discharging a pt 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, "That's OK. I can stop whenever I want to." What does this exemplify?

Acute withdrawal symptoms

Narcan has been given to a person with respiratory depression who is addicted to heroin. What should the nurse be alert for indications of?

Within 6-12 hours

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

Yawning, irritability, diaphoresis, cramps and diarrhea

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 withdrawal from opioids?

1. falls 2. malnutrition 3. bone demineralization 4. cirrhosis

What does alc abuse in the older adult place him/her at risk for? (SATA-4)

1. egocentricity 2. poor impulse control 3. desire of peer identification

What factors make the adolescent extremely vulnerable to substance abuse? (SATA-3)

Does not give the "rush" that a person addicted to heroin is looking for

What is the rational for using methadone in the treatment of heroin abuse?

Mouthwash

What should be avoided to prevent the accidental activation of Antabuse (Disulfram)?

1. monitor vitals 2. provide a safe environment 3. address hallucinations therapeutically 4. provide a reality orientation as appropriate

Which are appropriate interventions for caring for the client in alc withdrawal? (SATA-4)

Stress management

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

Wernicke's Encephalopathy

Which syndrome of alcoholism is related to thiamine deficiency?