Chapter 58 Substance Abuse Prep U

Which of the following medications are used as an alcohol deterrent?

Disulfiram (Antabuse)

Which neurotransmitter is most likely responsible for the rewarding and reinforcing effect of cocaine?

Dopamine

There are several reasons why drug therapy is of limited use in treating substance dependence. Which of the following statements accurately describes a potentially serious risk of such therapy?

Drug therapy could substitute one abused drug for another.

Health care professionals are considered to be at high risk for development of substance abuse disorders, at least partly because of what factor?

Easy access

A nurse has admitted a client diagnosed with substance abuse intoxication to the unit. The nursing assessment will first be directed toward data regarding:

drug use.

The emergency room nurse is admitting a client brought in after exhibiting threatening and unpredictable behavior, suspected to be the result of a recent binge of methamphetamine use. In addition to ensuring the client's immediate safety and that of others, what is the nurse's priorityaction?

facilitating detoxification

A nurse is working in the emergency department and is assigned to a client brought in by family members. The family thinks that the client is on methamphetamine. The nurse should assess for:

hypertension.

A nurse is a member of the emergency response team responding to a client's overdose of lorazepam. The client has just been administered a dose of flumazenil 0.2 mg IV with no apparent therapeutic effect. The nurse should prepare for what action?

immediate administration of another dose of flumazenil

A nurse is giving an educational presentation on recreational drugs to a parents' group at the local middle school. What would the nurse indicate is a potential consequence of cocaine use?

life-threatening cardiac arrhythmias

A nurse is caring for a patient with cancer who has been prescribed dronabinol (Marinol) to help reduce nausea and vomiting from chemotherapy. The nurse will inform the patient that he or she is taking an oral form of

marijuana.

The nurse is providing care for a client physically dependent on an opioid. How is physical dependence best characterized?

physiologic adaptation that results in unpleasant symptoms when the drug is stopped

When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for?

sedation

While the school nurse is providing health education to a group of children on the dangers of illicit drug use, a child asks the nurse what sniffing gasoline or glue does to the body. What response is most effective in addressing this question?

"Doing that damages the brain and other body organs."

The nurse is talking with a patient who is in the hospital from complications related to alcoholism. The patient states, "My father and grandfather were alcoholics. Do you think this is why I am?" What is the best response by the nurse?

"Many studies say that certain genes can cause alcoholism."

The nurse is caring for a client who had abdominal surgery 1 day ago. The client is reluctant to get up and ambulate because of the pain. The nurse encourages the client to take the prescribed medication (morphine sulfate) and then ambulate with assistance. The client refuses because of fear of becoming addicted to the medication. What is the nurse's best response to this client?

"Most people who receive pain medications because of a medical reason don't become addicted to the medication."

A client with a substance use disorder has been prescribed haloperidol 3.5 mg IM. The nurse obtains a vial of haloperidol 5 mg/mL. The nurse should draw up what quantity of the medication?

0.7

The nurse at a community clinic administers methadone to clients in recovery from opioid addictions. A client is prescribed methadone 40 mg PO daily and the medication is available in an oral solution at 10 mg/5 mL. What quantity of methadone should the nurse administer?

20

As a school nurse, you are preparing to do a presentation on cannabis and the long-term sequelae of its heavy use. To what body system or function do you understand cannabis use can cause the most damage?

Brain

Nurses can help prevent drug abuse by all of the following EXCEPT:

Demanding drug testing for all clients.

A client admitted to your emergency department (ED) is experiencing hallucinations. The friend who brought him to the ED indicates that the client has used recreational drugs in the past but has not done so for many weeks. Which of the following drugs can trigger recurrent hallucinations?

Lysergic acid diethylamide (LSD)

Which of the following medication is a narcotic antagonist?

Naloxone (Narcan)

A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?

Nausea

Which drug would be classified as a hallucinogen?

PCP

A client diagnosed with a substance use disorder asks the nurse why it is necessary to attend counseling in addition to taking the prescribed medication. What statement should inform the nurse's response?

Plans that combine methods of therapy are typically more successful.

A 17-year-old male is brought to the emergency department after taking diazepam with alcohol. The ED nurse knows to monitor the patient for which of the following adverse reactions?

Respiratory depression

During his assessment, Drew reveals that he is a frequent user of crack and has been on a binge for several days. The nurse realizes that he requires frequent cardiac assessments. The reason for this increased assessment of the cardiac system is because of the major risk for what condition as a result of crack cocaine use?

Rupture of the aorta

Which of the following is a clinical manifestation of alcohol withdrawal?

Seizures

A client with chronic pain has trialed several different pain-control regimens, the most recent of which was oral oxycodone 10 days ago; the client has described adequate pain relief from the oxycodone. When performing a follow-up assessment, what finding most warrants the nurse's follow-up?

The client admits to enjoying the euphoria that follows a scheduled dose.

A client was prescribed oral hydromorphone two weeks ago for the treatment of cancer pain. The client was able to achieve pain relief with 2 mg doses for the first 10 days, but has recently needed 3-4 mg to achieve the same effect. The client has expressed concern to the nurse that he is becoming addicted to hydromorphone. What should the nurse teach the client?

The client is developing a tolerance, which is not the same as addiction.

Substances containing gasoline, benzene, or carbon tetrachloride are especially likely to cause serious damage to which organs?

The liver, kidneys, and bone marrow.

A family expresses concern when a family member withdrawing from alcohol is given lorazepam (Ativan). What information should be given to the family about the medication?

The medication is given for a short time to help the client complete the withdrawal process

A 28-year-old patient comes into the emergency department with chest pain. The client's blood pressure is 170/108, heart rate 116, and respiratory rate 32. The client states having "used drugs." The nurse would question the client about the use of:

cocaine.

The nurse is taking a history from a patient who states that she smokes marijuana daily. The patient says, "It mellows me out and helps me to cope with the stresses of life. I go sometimes without it and it doesn't bother me." What does the nurse determine is this patient's issue with the substance?

The patient has developed a psychological dependence for marijuana.

A client with chronic pain was prescribed oxycodone several months ago and has developed a tolerance, requiring gradual increases in dose. As well, the client admits to experiencing psychological dependence and is showing signs and symptoms of physical dependence. The nurse should advocate for what approach?

close monitoring and gradual tapering down of the dose

The nurse is caring for a client for whom a psychological therapy has been ordered to assist with recovery from an addictive disorder. The nurse understands that what statement is true about psychological rehabilitation efforts?

They should be part of any treatment program for a drug-dependent person.

The nurse is taking a health history from a patient in the clinic and asks about the use of alcohol. The patient states that he drinks approximately a case of beer on some weekends. What does the nurse understand about this type of substance use?

This patient abuses alcohol on weekends; this is considered substance abuse.

Charlie, a homeless heroin addict, has been admitted into care and needs immediate intervention. A visiting health care provider has begun Charlie on methadone maintenance. What fact should the nurse consider during this client's treatment for substance use?

Using methadone maintenance may lead to a dependence on methadone.

A client admits to smoking marijuana several times a day but denies being dependent on the drug. The nurse should base the discussion with the client on what characteristic of psychological dependence?

Using the drug creates the feeling of satisfaction and pleasure.

A client is experiencing acute alcohol withdrawal. What medication does the nurse anticipate the prescriber to order?

chlordiazepoxide