PNU 128 Videbeck PrepU Chapter 19:Addiction

A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as belonging to what class?

Hallucinogen

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.

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

When discussing methadone treatment with a client, the nurse should include what?

It decreases the severity of heroin withdrawal symptoms.

A client is experiencing severe alcohol withdrawal. Which would the nurse most likely assess? Select all that apply.

Marked diaphoresis Auditory hallucinations Gross uncontrollable tremors

A nurse observes a colleague who has unsteady gait and slurred speech. The nurse suspects that the colleague, a nurse, is impaired. Which would be the appropriate action to take?

Report the colleague's behavior to the supervisor.

A client has been using paint thinner and glue to receive a "high." The nurse knows that these are what type of substances?

inhalants.

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."

The nurse is providing support to a client's child regarding the parent's alcohol use disorder. When integrating the disease concept treatment approach about this type of disorder, which statement by the nurse would be most effective?

"Your parent's alcohol use problem is a chronic disease but can be treated."

Which medication is used to prevent Wernicke-Korsakoff syndrome?

Thiamine (vitamin B1)

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

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

According to the psychodynamic theory regarding addiction, it is most important that the nurse assesses the client with an alcohol use disorder by considering what?

Asking the client to describe the client's childhood relationship with the client's parents

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 is experiencing alcohol withdrawal symptoms. Which of the following would the nurse expect to be prescribed to assist with the withdrawal symptoms, acting as a substitute for the alcohol?

Benzodiazepines

Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?

Benzodiazepines

Which is used as a first-line treatment for alcohol withdrawal?

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

Which is the most common defense mechanism used by a client diagnosed with a substance use problem?

Denial

Which is an example of a benzodiazepine?

Diazepam

The ingestion of mood-altering substances stimulates which neurotransmitter pathway in the limbic system to produce a "high" that is a pleasant experience?

Dopamine

A client has a history of consuming alcohol almost daily while pregnant. Her newborn baby has growth deficiency and facial malformations. What is the name for the pattern of birth defects that can occur due to exposure to alcohol?

Fetal alcohol syndrome

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

A client with a long history of alcohol abuse has presented to the emergency department with hallucinations and an incoherent story about being followed by the police. The client is likely experiencing which physiologic effect of alcohol use?

Korsakoff's psychosis

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

A 20-year-old client arrives at the emergency department by ambulance. The client is unconscious, with slow respirations and pinpoint pupils. There are "tracks" visible on the client's arms. The friend who came with the client reports that the client had just "shot up" heroin when the client became unconscious. Which medication would the nurse most likely expect to administer?

Naloxone

Which drug reverses opioid toxicity?

Naloxone

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

A client has been prescribed naltrexone for treatment of alcohol dependence. The nurse has explained the drug's purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which about the drug?

Reduces the appeal of alcohol

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

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

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

Which statement most accurately describes the etiology of substance-related disorders?

Substance-related disorders result from the interplay of biologic, genetic, and psychosocial factors.

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 nurse is assessing a client the nurse suspects may have a drinking problem. The nurse asks the client how much alcohol the client drinks per day. The client replies, "The important point is that even if I have 10 drinks, I don't get drunk. I can hold my liquor." The client's reply suggests what?

The client has developed tolerance.

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.

When a person can ingest an increasing amount of alcohol before he or she experiences a "high" and begins to show effects on cognitive and motor skills, it is termed which of the following?

Tolerance

Which term describes a situation that occurs when very small amounts of alcohol intoxicates the person after continued heavy drinking?

Tolerance break

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.

An appropriate goal for a client newly admitted to the unit for alcohol withdrawal is what?

Verbalize feeling safe and comfortable.

High doses of alcohol produce which effect?

Vomiting

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