Chapter 25 PrepU: Addiction & Substance-Related Disorders FIRST BACK FROM WILLY'S GAME <3 #88

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

During an assessment, a client states the inability to have long-term relationships and fears being abandoned. Which question would the nurse ask to help identify the reason for the client's feelings?

"Did your parents consume alcohol when you were growing up?"

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."

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 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 caring for a client who began drinking a six-pack of beer every day in freshman year of college. By sophomore year, the client was drinking two six-packs to get the same effect. After educating the client on the chronic use of alcohol, the nurse determines education has been effective when the client makes which statement describing this phenomena?

"I developed a tolerance to alcohol over this period of time."

A client with alcohol use disorder is admitted for treatment. Which statement indicates that the nurse has an issue with the client's condition?

"I have family members with the same problem."

The nurse is obtaining a history for a client and is attempting to identify if the client has developed tolerance to alcohol. Which statement made by the client is identified by the nurse as having developed alcohol tolerance?

"I started off drinking a few beers and now, it takes 12 cans to feel a buzz."

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."

The nurse is interviewing family members of a client being treated for substance use disorder. Which statement by a family member would alert the nurse to the possibility of codependency?

"My sibling would not drink as much if their spouse was more understanding."

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

The family of a client admitted for substance use disorder is being taught about enabling behaviors. Which statement(s) by the family demonstrates their understanding of the information provided by the nurse? Select all that apply. -"We will not participate in social events with them." -"We will be shamed when the church finds out." -"We are not responsible for their money failures." -"We will have to be more assertive and less passive." -"We can no longer make excuses or lie for them."

-"We are not responsible for their money failures." -"We will have to be more assertive and less passive." -"We can no longer make excuses or lie for them

A client is experiencing severe alcohol withdrawal. Which would the nurse identify during the assessment that correlates with the withdrawal symptoms? Select all that apply. -Auditory hallucinations -Heart rate around 72 beats/min -Increased appetite -Marked diaphoresis -Gross uncontrollable tremors

-Auditory hallucinations -Marked diaphoresis -Gross uncontrollable tremors

The nurse is talking with a client that grew up in a home where both parents were alcoholics. Which behavior(s) does the nurse identify when assessing this client that correlate with this home life? Select all that apply. -Divorced 3 times with tumultuous relationships with spouses -Several trusting relationships with friends -Drinks alcohol to excess 3 days a week -Went back to college to complete a degree in nursing -States that they hold on to bad relationships due to fear of being alone

-Divorced 3 times with tumultuous relationships with spouses -Drinks alcohol to excess 3 days a week -States that they hold on to bad relationships due to fear of being alone

Which statements identify positive aspects of methadone as a substitute for heroin? Select all that apply. -It is a legal medication -It is available in tablet form -It is controlled by a health care provider -It is available in IV form

-It is a legal medication -It is available in tablet form -It is controlled by a health care provider

A psychiatric-mental health nurse is teaching a client about the physiological effects of long-term alcohol use. Which effect(s) may occur in the client with long-term alcohol use? Select all that apply. -diabetes melitus -cirrhosis -pancreatitis -cardiac myopathy -Wernicke encephalopathy

-cirrhosis -pancreatitis -cardiac myopathy -Wernicke encephalopathy

The manager is observing the behavior of a staff nurse. Which observation(s) would suggest to the manager that the nurse is abusing substances? Select all that apply. -provides a doctor's excuse when absent from work -leaves the unit several times during a scheduled shift -offers to pick up narcotics from the pharmacy -counts narcotic incorrectly when working -arrives early for work daily for no apparent reason

-leaves the unit several times during a scheduled shift -offers to pick up narcotics from the pharmacy -counts narcotic incorrectly when working -arrives early for work daily for no apparent reason

The nurse is teaching a community awareness group about opioids. Which drugs should the nurse include in the discussion? Select all that apply. -morphine -codeine -amphetamines -hydrocodone -heroin

-morphine -codeine -hydrocodone -heroin

The nurse is caring for a client who has an acute intoxication of cocaine. Which assessment finding(s) will the nurse most likely find? Select all that apply. -oral temperature of 38C -heart rate 58 -moist skin -pinpoint pupils -2+ pitting edema

-oral temperature of 38C -moist skin

A client has been brought to the emergency room by the police after they were trying to walk down a six-lane interstate highway. Witnesses state the client was seen smoking marijuana a few hours earlier at a park nearby. Which element(s) will the nurse likely find during assessment? -reports of dry mouth -impaired long-term memory -increased heart rate -request for food -conjunctival redness

-reports of dry mouth -increased heart rate -request for food -conjunctival redness

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

The body can metabolize how much beer per hour without intoxication?

12 oz

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

The nurse is caring for a client with alcohol use disorder that is acutely intoxicated. Which action will the nurse perform to treat the Wernicke-Korsakoff syndrome the client is experiencing?

Administer Vitamin B1

The nurse is caring for a client experiencing alcohol withdrawal. Which intervention will the nurse perform to alleviate the physical effects associated with alcohol withdrawal?

Administer fixed-dose chlordiazepoxide as prescribed

The client is brought to the emergency room with opioid overdose. After the initial assessment for central nervous system (CNS) function, what will be the nurse's priority action?

Administer naloxone

Which of the following substances is abused most often in the United States?

Alcohol

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

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

A nurse reports for work looking unkempt and disheveled. Her movements are uncoordinated and her breath smells like mouthwash. Another nurse suspects this nurse is intoxicated. What should the nurse do first?

Confront the nurse about her behavior and relieve her of her responsibilities

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

The charge nurse observes another nurse reporting for work looking unkempt and disheveled with uncoordinated movements and breath smelling of alcohol. Which is the priority action by the charge nurse?

Immediately call the supervisor to report the nurses' behavior

A client has a blood alcohol level of 0.05%. The nurse would expect which behavior to occur?

Impaired judgment

The nurse is caring for a client with opioid addiction who is on a methadone treatment plan. Which statement about methadone does the nurse understand is the reason it is used for opioid detoxification?

It has a long half-life

Which characteristic of the 12-step program distinguishes it from other programs?

It is a self-help group that focuses on total abstinence

A client is being treated for alcoholism. Which of the following medications is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

Which medication is used to prevent alcohol withdrawal symptoms?

Lorazepam (Ativan)

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 client with a history of alcohol use disorder has presented to the emergency department with hallucinations and relays being followed by the police. Which action will the nurse take given this information?

Monitor for Korsakoff syndrome from long-term effects of alcohol use.

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 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

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 of symptoms, vital signs, seizure and fall precautions, medications as ordered

The nurse is visiting the home of a client with a substance use disorder. Which observation indicates to the nurse that the client's behavior is being enabled?

Parent tells the client that attending an Alcoholics Anonymous meeting is not necessary

A client is brought for emergency care for symptoms that developed after ingesting mescaline, a hallucinogen. Which action will the nurse make a priority when caring for the client?

Reduce environmental stimuli

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

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

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

The nurse is working with a client with alcohol use disorder that has difficult behaviors to manage. Which action by the nurse is a priority to effectively care for this client?

The nurse must recognize their own beliefs, backgrounds, and attitudes related to substance use disorder

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?

Users of marijuana always experience relaxation and euphoria

The nurse is working with a group of health care professionals on a program to address the use of substances in the community. Which information would the nurse emphasize to include in the program?

actions to prevent relapse

The nurse is caring for a client with delirium tremens (DTs). Which development constitutes a medical emergency?

development of seizure activity

The nurse is caring for an adult client that has been admitted to the detoxification unit. Due to acute withdrawal, what cues will the nurse likely assess?

flushed face, headache, and tremors

An adolescent client is brought for emergency care after being found stuporous from sniffing glue. Which treatment will the nurse anticipate for the client?

oxygen therapy