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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 for treatment of trauma sustained in a fall. The client believes bugs are crawling on the bed. The client is anxious, agitated, diaphoretic and has a history of chronic drinking. The nurse can anticipate that the physician will order which medication?
benzodiazepine, such as diazepam or chlordiazepoxide
An intoxicated client was admitted for trauma treatment last night at 2:00 AM (0200). When should the nurse expect to be alert for withdrawal symptoms?
between 8:00 and 10:00 AM (0800 and 1000) today (6 to 8 hours after drinking stopped)
A client is being discharged from an alcoholism treatment center. Which of the following is a realistic client statement?
"I'm going to take it one day at a time."
A nurse shows an understanding of the use of nursing outcomes regarding triggers for a client diagnosed with chronic alcohol abuse when making which statement?
"I'm pleased you've identified three situations that trigger your abuse of alcohol."
Which of the following symptoms is consistent with alcohol withdrawal?
Coarse hand tremors
Which statements identify positive aspects of methadone as a substitute for heroin? Select all that apply.
It is a legal medication. It is controlled by a health care provider. It is available in tablet form.
Which characteristic of the 12-step program distinguishes it from other programs?
It is a self-help group that focuses on total abstinence.
Which of the following is used as a substitute for heroin in some maintenance programs?
Methadone
A client is admitted for a drug overdose with a barbiturate. Which is the priority nursing action when planning care for this client?
Monitor respiratory function.
A client is admitted for a drug overdose with a central nervous system (CNS) depressant. The priority nursing action when planning care for this client would be to ...
Monitor respiratory function.
The nurse is observing a coworker that is exhibiting some questionable behavior. Which are general warning signs of substance abuse that a nurse should be alert for in coworkers? Select all that apply.
Poor work performance Frequent absenteeism Unusual behavior Slurred speech Isolation from peers
As a component of the standard nursing admission assessment at the hospital, a nurse is using the CAGE tool. Which of the following questions will the nurse ask the client?
"Have you ever felt like you should cut down on your drinking?"
A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse?
"I can still hang out with my old friends. I am just not going to use."
The nurse is leading a family therapy group with a client addicted to alcohol. Which statement made by the spouse indicates the need for additional education regarding alcoholism as a family illness?
"I have to call in sick for the client when the client is too hung over to go to work."
A client asks the nurse, "What is Alcoholics Anonymous all about?" Which is the best response by the nurse?
"It is a self-help group for which the norm is sobriety."
A client calls the emergency department of the local hospital reporting that after 16 years of heavy drinking, the client is tired and wants to quit "cold turkey." What would be the best response by the nurse?
"It is not safe to stop drinking suddenly without medicine."
A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. Upon admission, he tells the nurse, "I am so ashamed." Which of the following would be the best response by the nurse?
"Tell me what has happened since your last admission."
The spouse of a client who is alcoholic asks the nurse how to respond to the client in a helpful way when the client is disruptive in family life. Which is the nurse's best response?
"Try to maintain a normal home environment for yourself and the children."
A client has entered treatment for alcohol dependency at the client's spouse's insistence. The client's spouse has threatened to leave the marriage unless the client seeks treatment. The client admits that the client drinks every day, but that the drinking is well in control. The nurse recognizes the client's comments as denial. What is the best response by the nurse?
"What negative consequences have resulted from your 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."
The body can metabolize how much beer per hour without intoxication?
12 oz
A client with alcohol abuse is to receive disulfiram. The client's last drink was at 4 PM. The client should receive the medication no earlier than at which time?
4 AM
A client who has been abusing opioids for about one year has run out of the drug. The last time he used the drug was at 12 noon. The client would most likely develop signs and symptoms of withdrawal by which time?
9 PM
A client has been admitted to the inpatient unit after using inhalants recently. Upon assessment, the nurse finds the client with slurred speech and nystagmus. Which is an antidote to treat inhalant toxicity?
There is no antidote
A client has been admitted to the inpatient unit after using inhalants recently. Which of the following is an antidote to treat inhalant toxicity?
There is no antidote
Which of the following is the most abused substance 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
A nurse suspects that a client is experiencing alcohol withdrawal based on assessment of which of the following?
Elevated temperature
Which statements are important reasons for why the problem of substance abuse must be addressed? Select all that apply.
Increasing numbers of infants are suffering the physiologic and emotional consequences of prenatal exposure to alcohol or drugs. Chemical abuse results in increased violence. 130 deaths occur daily in the United States from opioid overdose. Alcohol abuse is a too frequent cause of or contributor to death.
Which of the following is the best description of the term substance use disorders, according to the American Psychiatric Association?
Is an umbrella term for substance abuse and substance dependence
An older adult client with liver disease is experiencing alcohol withdrawal. Based on the nurse's understanding of drug therapy, which of the following would the nurse expect to be prescribed?
Lorazepam
Which medication is used to prevent alcohol withdrawal symptoms?
Lorazepam (Ativan)
A client is being discharged on disulfiram. Which instruction for disulfiram should the client receive?
Read product labels carefully to avoid all products containing alcohol.
A nurse who started recovering from alcohol abuse 3 months earlier is ready to return to work. When speaking with the therapist, the nurse states the nurse is nervous about how coworkers will respond to the nurse now that "they all know I'm a drunk." Which diagnosis best targets the problem implicit in the nurse's remarks?
Situational low self-esteem related to medical condition
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 discussing the principles of 12-step programs for recovery with a client. Which information would the nurse most likely incorporate into the discusssion about this type of program?
The client will need to abstain from all substances for successful recovery.
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 nurse is working with a couple seeking counseling for marital discord. The history indicates one of the clients was treated for substance abuse 4 years ago and attends Alcoholics Anonymous (AA) meetings occasionally. Which statement made by the recovering client should alert the nurse for the need for further education?
"My spouse gets upset when I hang out with my old buddies on the weekends."
A client is prescribed naltrexone as part of the treatment plan for alcohol and opioid abuse. When developing an education plan about this drug for the client, which of the following would the nurse need to keep in mind?
The individual should be free of opioids for at least 1 week.
The nurse is dealing with a difficult client. Which reasons make it necessary for the nurse to examine his or her beliefs and attitudes about substance abuse? Select all that apply.
The nurse may be overly harsh and critical of the client. The nurse may unknowingly act out old family roles and engage in enabling behavior. The nurse or close friends and family of the nurse may abuse substances. The nurse may have different attitudes about various substances of abuse.
Disulfiram should not be administered until a client has abstained from alcohol for at least how long?
12 hours
A client's history reveals that he continues to use cocaine despite the negative consequences. The nurse identifies this as which of the following?
Addiction
A nurse is assessing a client with substance abuse for evidence of possible long-term complications. Which finding would alert the nurse to the development of a complication affecting the hematologic system? Select all that apply.
Anemia Leukemia Hematomas
A client is being treated on the inpatient unit for alcoholism. Disulfiram (Antabuse) has been prescribed for a client receiving treatment for alcoholism. Which of the following should be included in the client's plan of care?
Avoid all products containing alcohol
Disulfiram has been prescribed for a client receiving treatment for alcoholism. Which should be included in the client's plan of care?
Avoid all products containing alcohol
Children of those who abuse substances are at high risk for both substance abuse and which of the following?
Behavior disorders
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
Which group could benefit most from prevention programs?
Children, prior to first use
A client is diagnosed with Korsakoff amnesic syndrome. Which of the following would the nurse most likely assess? Select all that apply.
Confabulation Attention deficit Vision impairment
A client who has used IV heroin every day for the past 10 years says, "I don't have a drug problem. I can quit whenever I want." Which defense mechanism is being used by the client?
Denial
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 client who comes to the emergency department has a blood alcohol level of 0.05. Which finding would the nurse expect to assess?
Giddiness
A client is admitted to the emergency department after using MDMA (Ecstasy). The nurse identifies this drug as which of the following?
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.
Disulfiram has which of the following effects on prothrombin time?
Increase
A client has been using paint thinner and glue to receive a "high." The nurse knows that these substances are
Inhalants
The most significant risk factors for alcoholism include all of the following except ...
Low socioeconomic status
While at a nightclub, an adolescent male consumed a pill handed to him by a friend. His friends brought him to the emergency room after he collapsed at the club. When the nurse takes his temperature, a reading of 105°F is obtained. The pill was most likely which of the following?
MDMA (ecstasy)
A nurse is exploring treatment options with a client addicted to heroin. Which information regarding the use of methadone is important for the nurse to include?
Methadone will meet the physical need for opiates without producing cravings for more.
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
A group of nursing students is reviewing information about nutritional supplementation used during alcohol detoxification. The students demonstrate the need for additional review when they identify which of the following as being used?
Naloxone
A client is receiving treatment for opioid toxicity. Which drug reverses opioid toxicity?
Naloxone (Narcan)
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
Which neurochemical influences is a probable cause of substance abuse?
Stimulation of dopamine pathways in the brain
A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse?
Teenagers in a high school health class
A client reports drinking one to two drinks when drinking behavior first began. Now the client reports drinking at least six drinks with every episode in order to "have a good time." Which term would best describe this phenomenon?
Tolerance
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
"Substance abuse" is a term that is used when ...
a person uses alcohol or drugs repeatedly, but not compulsively or addictively; the person who is abusing substances will not experience withdrawal.
A nurse is speaking to a group of expectant mothers. One person asks, "what can expectant mothers do that would prevent most of the cases of intellectual disability in newborns?" Which is the best response from the nurse?
abstain from alcohol
Which disorder across the lifespan accounts for more deaths than any other preventable health condition?
Substance abuse disorders
A nurse suspects that a client brought to the emergency department may have used ketamine. Which assessment findings would support this suspicion? Select all that apply.
Tachycardia Memory loss Numbness Vomiting
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.
The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that the friend's relationship with the client was codependent and enabling. Which is an example of codependent behavior?
The friend called the client every night to make sure the client got home safely and went looking for the client if not at home.
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
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
Safe alcohol withdrawal usually is accomplished with the administration of which medication classification?
Benzodiazepines
A client will be taking disulfiram (Antabuse) after discharge from an alcohol treatment program. Which of the following statements would indicate that teaching has been effective?
"Drinking alcohol while taking Antabuse can cause dangerous symptoms."
A client will be taking disulfiram after discharge from an alcohol treatment program. Which statement would indicate that teaching has been effective?
"Drinking alcohol while taking disulfiram can cause dangerous symptoms."
The nurse is conducting a health promotion class on drug awareness with a group of junior high school students. Which of the following teaching points should the nurse include in this session?
"Marijuana use can result in psychological dependence, which can have a very negative effect on your life."
A client is readmitted to the substance abuse program for the second time in 6 months for alcohol abuse. On admission, the client tells the nurse, "I am so ashamed." What should the nurse reply?
"Tell me what has happened since your last admission."
The client asks the nurse, "What will happen if I drink while taking disulfiram?" What should be the nurse's reply?
"You will experience a severe reaction, including a throbbing headache and vomiting."
The nurse is providing care to a client who has abused alcohol for several years and is monitoring the client for signs of alcohol withdrawal, anticipating that they would begin within how many hours after the client has the last drink?
12
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 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
Which of the following substances is abused most often in the United States?
Alcohol
A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. The nurse recognizes these symptoms as typical of which of the following?
Alcohol withdrawal syndrome
A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The nurse assesses the client and finds the client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which is typical of these symptoms?
Alcohol withdrawal syndrome
Supported by research results, the mental health nurse includes alcohol-related problem assessment questions when interviewing which of the following client groups?
All clients regardless of age and gender
An unconscious client is admitted to the emergency department after a motor vehicle accident. The client's blood alcohol level upon admission was .17. The client's family soon arrives, reporting that the client is an extended family member who is visiting from out of town. They cannot give much more history other than that the client is a "social drinker." After being transported to the unit, the client starts sweating and has elevated vital signs. What information should the nurse request of the family?
Are there other indications that the client may be a heavy drinker?
Which of the following agents would be helpful in alleviating the physical complications associated with alcohol withdrawal?
Benzodiazepines
When interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency?
Blaming themselves for the client's problems
A nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam (Valium) when the injections are given by another nurse. That nurse returns from lunch exhibiting slurred speech and euphoria. Which of the following is the best action for the ICU nurse to take?
Call the manager and report the observations.
The nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam when the injections are given by a particular nurse. This nurse returns from lunch exhibiting slurred speech and euphoria. Which is the best action for the nurse to take?
Call the manager and report the observations.
When educating the public regarding substance-related disorders, the mental health nurse explains that the condition of drug dependence is a state defined as ...
Chronic or recurrent drug intoxication, characterized by psychological and physical dependence
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 in treatment for drug abuse makes the statement to some of the other clients, "I am a winner. You all are the losers because you can't beat this on your own." What common characteristic of persons addicted to drugs is revealed in this statement?
Defending against a negative self-concept
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
A client is brought to the emergency department by law enforcement after suspicion of driving under the influence. A blood alcohol level is drawn and is found to be 0.10 mg%. Which of the following would the nurse expect to assess?
Difficulty coordinating movements
A nurse is caring for a client who uses phencyclidine (PCP). PCP is classified as which type of substance?
Hallucinogen
Which are effects of alcohol withdrawal syndrome? Select all that apply.
Hand tremors Seizures Increased pulse Delirium tremens
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
When conducting an adolescent drug awareness program, the nurse describes which of the following drugs as having the highest addiction potential?
Heroin and morphine
A peer reports for work looking unkempt and disheveled. The peer's movements are uncoordinated, and the peer's breath smells of alcohol. Another nurse suspects this peer is intoxicated. Which action by the nurse who suspects that a peer is intoxicated would be most appropriate?
Immediately call the supervisor to report the peer's behavior.
A client has a blood alcohol level of 0.05%. The nurse would expect which behavior to occur?
Impaired judgment
When discussing methadone treatment with a client, the nurse should include what?
It decreases the severity of heroin withdrawal symptoms.
A client is being treated for alcoholism. Which of the following medications is used to prevent alcohol withdrawal symptoms?
Lorazepam (Ativan)
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
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 nurse suspects a coworker is signing out narcotics for clients and is using them personally. Which action should be taken by the nurse who has these suspicions?
Report the observations to the supervisor.
A nurse has a reasonable suspicion that another member of the nursing staff suffers from substance use disorder that is resulting in impaired care practices. What action should the nurse take to protect both the clients and staff member?
Report the suspicion as required by the state's nurse practice act
A client is brought to the emergency department with a suspected heroin overdose. Which of the following would support this suspicion?
Respiratory depression
After educating a group of nurses about caffeine, the group leader determines that the education was successful when the group identifies which finding as indicating intoxication? Select all that apply.
Restlessness Nervousness Excitement Insomnia Urinary retention
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
An adult male is admitted to the inpatient detoxification unit for acute alcohol withdrawal and is experiencing diaphoresis, tachycardia, and illusions. An appropriate nursing diagnosis for the client at this time is what?
Sensory perceptual alterations related to alcohol withdrawal
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 client is readmitted to the detox unit for the fourth time in 3 years. The nurse states in the morning report, "Not again! Why should we keep trying to help this guy? He obviously doesn't want it." Which statement is reflective of the nurse?
The nurse lacks the self-awareness to work effectively with this addicted client.
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.
Wernick-Korsakoff syndrome is a neurologic condition that can result from heavy drinking. Which of the following medications is used to prevent Wernicke-Korsakoff syndrome?
Thiamine (vitamin B1)
Which medication is used to prevent Wernicke-Korsakoff syndrome?
Thiamine (vitamin B1)
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