Substance Abuse

A client is experiencing problems from the excessive use of caffeine. Prioritize these withdrawal symptoms from earliest to latest" 1. nausea and muscle pain 2. fatigue and drowsiness 3. headache 4. irritability and depression

3. headache 2. fatigue and drowsiness 4. irritability and depression 1. nausea and muscle pain

A client addicted to alcohol tells a nurse, "Making friends used to be hard for me." The nurse determines that client teaching about relationships has been successful when the client makes which statement? a. "I am trying to set boundaries with others." b. "I need to be judgmental of others." c. "I won't become intimately involved with others." d. "I can't bear to see myself hurt again in a relationship."

a. "I am trying to set boundaries with others."

A nurse is caring for a very pessimistic client undergoing tx for cocaine use. Which statement would the nurse anticipate from this client? a. "I'll never get better. This is useless." b. "I don't think I want to see my family anymore. They're not supportive." c. "I'm fatigued all the time. My energy is low." d. "I want to get better now. Can't we rush the treatment?"

a. "I'll never get better. This is useless." Clients withdrawing from cocaine frequently experience depression.

A client who has been drinking alcohol for 30 years, asks a nurse if permanent damage has occurred to his immune system. What is the nurse's best response? a. "There is often less resistance to infections." b. "Sometimes, the body's metabolism will increase." c. "Put your energies into maintaining sobriety for now." d. "Drinking puts you at high risk for disease later in life."

a. "There is often less resistance to infections." Chronic alcohol use depresses the immune system and causes increased susceptibility to infections. A nutritionally well-balanced diet, that includes foods high in protein and B vitamins, will have develop a strong immune system. Drinking may put the client at risk for immune system problems at any time in life.

A client who uses cocaine finally admits he also abused other drugs to equalize the effect of cocaine. The nurse is aware that the client's drug history may include which substance? a. Alcohol b. Amphetamines c. Caffeine d. Phencyclidine

a. Alcohol A cocaine addict will commonly use alcohol to decrease or equalize the stimulating effects of cocaine.

A client who smoked marijuana daily for 10 years tells a nurse, "I don't have any goals, and I just don't know what to do." What is the most appropriate nursing intervention for this client? a. Focus the interaction. b. Use nonverbal methods. c. Use reflection techniques. d. Ask open-ended questions.

a. Focus the interaction. A client with a-motivational syndrome from chronic use of marijuana tends to talk in tangents and needs the nurse to focus the conversation

A nurse has developed a therapeutic relationship with a client who has an addiction problem. The nurse determines that their interactions are in the working stage when the client: (select all) a. addresses how the addiction has contributed to family distress b. reluctantly shares the family history of addiction c. verbalizes difficulty identifying personal strengths d. discusses financial problems related to addiction e. expresses uncertainty about meeting with the nurse f. acknowledges the addiction's effects on the children

a. addresses how the addiction has contributed to family distress c. verbalizes difficulty identifying personal strengths f. acknowledges the addiction's effects on the children These statements are indicative of the nurse-client working phase, in which the client explores, evaluates, and determines solutions to identified problems. The remaining statements address the introductory phase

A client who uses alcohol tells a nurse, "Alcohol helps me sleep." What is the most appropriate response by the nurse? a. alcohol does not help promote sleep b. continued alcohol use causes insomnia c. one glass of alcohol at dinnertime can induce sleep d. sometimes, alcohol can make one drowsy enough to fall asleep

a. alcohol does not help promote sleep Alcohol use may initially induce sleep, but with continued use, it causes insomnia.

A nurse is caring for a client who is experiencing amphetamine withdrawal. The nurse should assess the client for: a. disturbed sleep b. increased yawning c. psychomotor agitation d. an inability to concentrate

a. disturbed sleep Common for a person withdrawing from amphetamines to experience disturbed sleep and unpleasant dreams. Psychomotor agitation is seen in cocaine withdrawal. Inability to concentrate is seen with caffeine withdrawal

During a family therapy session, a client who uses alcohol tells a family member, "You made it easy for me to use alcohol. You always made excuses for my behavior." What should the nurse encourage this family to do? a. give up enabling behaviors b. manage the client's self-care c. deal with negative behaviors d. evaluate the home environment

a. give up enabling behaviors Enabling behaviors from family members allow this client to continue his addiction by rationalizing, denying, or otherwise excusing the problem.

The nurse is caring for a client who is experiencing alcohol withdrawal. The nurse would be most concerned if the client exhibited: a. hallucinations b. nervousness c. diaphoresis d. nausea

a. hallucinations Hallucinations are a sign of late alcohol withdrawal. The nurse should stay with the client, have someone notify the HCP, and institute seizure precautions. Nervousness, diaphoresis, and nausea are early signs of withdrawal.

What is the priority nursing intervention for a client recovering from cocaine addiction? a. help the client find ways to be happy and competent b. foster the creative use of self in community activities c. teach the client to handle stresses in the work setting d. help the client acknowledge the current level of dependency

a. help the client find ways to be happy and competent Major component of a treatment program for a client with cocaine addiction is to have the client feel happy and competent. Cocaine addiction is difficult to tx because the drug's action reinforce its use. Clients often credit the drug with giving them creative energy instead of looking within themselves. Fostering the creative use of self may inadvertently reinforce the client's drug use.

A client addicted to alcohol is scheduled to begin individual therapy with the nurse. What is the most appropriate nursing intervention for the client? a. help the client learn to express feelings b. have the client establish new roles in the family c. encourage the client to determine strategies for socializing d. have the client decrease preoccupation with physical health

a. help the client learn to express feelings The client must address issues, learn way to cope effectively with life stressors, and express his needs appropriately. After the client establishes sobriety, the possibility of taking on new roles can become a reality. Usually these clients need to change former socializing habits.

A nurse is performing a physical assessment on a client who uses heroin. It is most important for the nurse to assess the client for: a. hepatitis b. peptic ulcers c. hypertension d. chronic pharyngitis

a. hepatitis Hepatitis = most common medical complication of heroin use

The nurse is working with a client diagnosed with heroin overdose. What are the most important symptoms to monitor after establishing and maintaining a stable airway? a. hypertension and seizures b. incoordination and slurred speech c. nausea and vomiting d. psychosis and hyper-vigilance

a. hypertension and seizures

A nurse suggests to a client, struggling with alcohol addiction, that keeping a journal may be helpful. What is the goal for this intervention? a. identify stressors and the client's response to them b. understand the diagnosis c. help other by reading the journal to them d. develop an emergency plan for use in a crisis

a. identify stressors and the client's response to them Keeping a journal enables the client to identify problems and patterns of coping. From this information, the difficulties the client faces can be addressed. Journals help the client understand himself better

A client is receiving Chlordiazepoxide as needed for signs and symptoms of alcohol withdrawal. The nurse assesses the client and determines the need for medication when the client displays: a. mild tremors, hypertension, tachycardia b. bradycardia, hyperthermia, sedation c. hypotension, decreased reflexes, drowsiness d. hypothermia, mild tremors, slurred speech

a. mild tremors, hypertension, tachycardia Chlordiazepoxide is given during alcohol withdrawal. Symptoms that indicate a need for this drug include tremors, hypertension, tachycardia, and elevated body temperature.

A nurse is assessing a client with a history of substance use. The client has pinpoint pupils, a heart rate of 56 bpm, a respiratory rate of 6 breaths/min, and temperature of 96.4 F (35.8 C). What is the most likely cause of the client's symptoms? a. opioids b. amphetamines c. cannabis d. alcohol

a. opioids Opioids, such as morphine and heroin, can cause pinpoint pupils and a reduced HR, RR, and body temp with intoxication. Amphetamine intoxication can lead to tachycardia, euphoria, and irritability Cannabis intoxication can cause slowed reflexes, lethargy, and tachycardia Alcohol intoxication leads to slurred speech, unsteady gait, and incoordination

A client with ploy-substance use is hospitalized for withdrawal complications. What is the most important goal for this client? a. remain safe during the detoxification period b. develop an accurate perception of his drug problem c. abstain from mood-altering drugs d. learn coping strategies to help decrease reliance on drugs

a. remain safe during the detoxification period

A client tells the nurse that he uses amphetamines to be productive at work. The nurse is aware that abrupt discontinuation of the drug will produce: a. severe anxiety b. increased yawning c. altered perceptions d. a-motivational syndrome

a. severe anxiety When amphetamines are abruptly d/c, the client may experience severe anxiety or agitation. Increased yawning is a symptoms of opioid withdrawal. Altered perceptions occur when a client is withdrawing from hallucinogens. A-motivational syndrome is seen with clients using marijuana

A nurse is working with the parents of an adolescent who uses inhalants. What is the most important info for the nurse to provide? a. specific consequences must be enforceable b. everything can become a consequence c. when setting consequences, be verbally forceful d. consequences are seldom needed with adolescents

a. specific consequences must be enforceable Consequences should be specific and enforceable. Can be used with every person regardless of their developmental stage.

A client has been admitted to the ER and states that he just used cocaine. The nurse should monitor this client for" a. tachycardia b. hypothermia c. hypotension d. bradypnea

a. tachycardia Tachycardia is common because cocaine increases the heart's demand for oxygen. Cocaine causes hyperthermia.

A client has received an ordered dose of Chlordiazepoxide to control the sx of alcohol withdrawal. Which sx would indicate that this client should receive an additional dose of the prescribed medication? (select all) a. tachycardia b. mood swings c. elevated BP and temp d. piloerection e. tremors f. increasing anxiety

a. tachycardia c. elevated BP and temp e. tremors f. increasing anxiety Benzos are usually administered based on elevations in HR, BP, and temp as well as on the presence of tremors and increasing anxiety Mood swings are expected in withdrawal and do not need further medication

A client tells the nurse, "I have been drinking ever since they told me I had learning disabilities." How does the nurse interpret this response? a. the client is self-medicating b. the client has an excuse to drink c. the client isn't a productive person d. the client will be unable to stop drinking

a. the client is self-medicating

The family of a client in rehab following heroin withdrawal asks a nurse why the client is receiving Naltrexone. What is the nurse's best response? a. to help reverse withdrawal symptoms b. to keep the client sedated during withdrawal c. to take the place of detoxification with Methadone d. to decrease the client's memory of the withdrawal experience

a. to help reverse withdrawal symptoms Naltrexone is an opioid antagonist and helps the client stay drug free

The nurse anticipates that a client undergoing nicotine withdrawal may state: a. "I sometimes feel like I'm seeing things" b. "I feel lousy, and I'm grumpy with everybody" c. "I can't believe I feel fine after just having stopped smoking." d. "I'm always yawning now"

b. "I feel lousy, and I'm grumpy with everybody" During nicotine withdrawal, the client is typically irritable and nervous Yawning is associated with withdrawal from opioids

The nurse determines that teaching about cocaine has been effective when the client states: a. "I wasn't using cocaine to feel better about myself" b. "I started using cocaine more and more until I couldn't stop" c. "I'm not addicted to cocaine because I don't use it every day" d. "I only use it on holidays, and am not a chronic user"

b. "I started using cocaine more and more until I couldn't stop" People gravitate to the drug and continue its use because it gives them a sense of well-being, competency, and power. Cocaine users tend to be binge users and can be drug free for days or weeks between uses, but they still have a drug problem.

A client who is in recovery from years of alcohol use, is trying to decrease his excessive use of caffeine. The nurse educated the client on his caffeine consumption. Which response, by the client, indicated the nurse's teaching was effective? a. "Caffeine must be the cause of my awful dreams and disrupted sleep" b. "Now I know why I sometimes have tremors and feel nervous" c. "I'm glad to hear that I won't have any problems when I stop drinking coffee" d. "Having nasal drainage occur when I stop drinking caffeine may not be worth it."

b. "Now I know why I sometimes have tremors and feel nervous" Common withdrawal sx of caffeine are tremors, irritability, and nervousness Amphetamines withdrawal sx --> unpleasant dreams and disturbed sleep Opioid withdrawal sx --> rhinorrhea, lacrimation, and yawning

A client recovering from alcohol tells the nurse, "I get nothing out of AA meetings." What is the nurse's best response? a. "What were you told about going to AA meetings?" b. "What do you want to get out of AA meetings?" c. "When do you think you will stop going to the meetings?" d. "Do you think you can control what happens in a meeting?"

b. "What do you want to get out of AA meetings?" This response puts some of the responsibility for staying sober on the client, and encourages the client to take a more active role.

Family members if an alcoholic client ask the nurse to help them intervene. Which action is essential for a successful intervention? a. All family members must tell the client they are powerless b. All family members must describe how the addiction affects them c. All family members must come up with their share of financial support d. All family members must become caregivers during detoxification

b. All family members must describe how the addiction affects them After the family is taught about addiction, they must write down examples of how the addiction has affected each of them.

A client withdrawing from alcohol tells the nurse that he is worried about periodic hallucinations. What is the most appropriate intervention by the nurse? a. Point out that the sensation doesn't exist. b. Allow the client to talk about the experience. c. Encourage the client to wash the body areas well. d. Determine if the client has a cognitive impairment.

b. Allow the client to talk about the experience. The client needs to talk about the periodic hallucinations to prevent them from becoming triggers to acting out behaviors and possible self-injury. The client's experience of sensory-perceptual alterations must be acknowledged

A client with a history of alcohol use has been diagnosed with nutritional deficits. What is the nurse's best interventions? a. Encourage the client to eat a diet high in calories b. Help the client recognize and follow a balanced diet c. Have the client drink liquid protein supplements daily d. Have the client monitor the calories consumed each day

b. Help the client recognize and follow a balanced diet Clients who use alcohol are usually malnourished.

The nurse determines further teaching about nutrition is necessary when a client who uses alcohol states: a. I should avoid foods high in fat b. I should only eat one balanced meal per day c. I should take vitamin and mineral supplements d. I should eat large portions of food containing fiber

b. I should only eat one balanced meal per day

The nurse is reviewing the diagnostic studies for a client who used an excessive amount of steroids. What lab would be abnormal? a. Decreased low-density lipoprotein (LDL) b. Increased blood urea nitrogen (BUN) c. Increase high density lipoprotein (HDL) d. Decreased prothrombin time/international normalized ratio (INR)

b. Increased blood urea nitrogen (BUN) Steroids increase BUN, LDL, and decrease HDL Steroids also increase clotting time- increasing risk of blood clots

A client who formerly used lysergic acid diethylamide (LSD) is seeking counseling. The nurse anticipates that the assessment of the client will include: a. Lack of trust b. Panic attacks c. Recurrent depression d. Loss of ego boundaries

b. Panic attacks Clients who use LSD typically have a history of panic attacks or psychotic behavior. This is often referred to as a "bad trip"

A client with a history of alcohol use tells the nurse that he refuses to take his thiamine vitamin. The client won't share the reason for refusing the medication. What is the most appropriate response by the nurse? a. It is important to take vitamins to stop your craving b. Prolonged use of alcohol can cause vitamin depletion c. For every vitamin you take, you will help your liver heal d. By taking vitamins, you don't need to worry about your diet

b. Prolonged use of alcohol can cause vitamin depletion Chronic alcoholism interferes with the metabolism of many vitamins. Vitamin supplements can help prevent deficiencies. Taking vitamins does not stop cravings or heal a damaged liver. A balanced diet is essential in addition to taking multivitamins

A client, who is withdrawing from alcohol, is being given lorazepam. The client's family asks the nurse about the medication. What is the nurse's best response? a. Short-term use of lorazepam can lead to dependence b. The lorazepam will reduce the symptoms of withdrawal c. The lorazepam will make the client forget about symptoms of withdrawal d. The lorazepam will also help heart disease

b. The lorazepam will reduce the symptoms of withdrawal Lorazepam is a short-acting benzo usually given for one week to ease the effects of alcohol withdrawal. Long-term use can lead to dependence.

A client who uses alcohol tells the nurse, "I feel so depressed about what I've done to my family that I feel like giving up." It is most important for the nurse to assess the client for: a. family support b. a plan for self-harm c. a sponsor for the client d. other ambivalent feelings

b. a plan for self-harm When the client talks about giving up, the nurse must explore the potential for suicidal behavior.

The nurse is caring for a client struggling with alcohol dependence. It is most important for the nurse to: a. speak briefly and directly b. avoid blaming or preaching to the client c. confront feelings and examples of perfectionism d. determine if nonverbal communication will be more effective

b. avoid blaming or preaching to the client Blaming or preaching to the client causes negativity and prevents the client from hearing what the nurse has to say. Speaking briefly may not allow time for adequate communication.

The nurse is assessing a client who repeatedly uses cocaine. It is important for the nurse to observe the client for: a. panic attacks b. bipolar cycling c. attention deficits d. expressive aphasia

b. bipolar cycling Clients who frequently use cocaine will experience the rapid cycling effect of excitement and then severe depression.

A nurse is caring for a client undergoing treatment for acute alcohol dependence. The client tells the nurse, "I don't have a problem. My wide made me come here." Which defense mechanism does this client's statement represent? a. projection and suppression b. denial and rationalization c. rationalization and repression d. suppression and denial

b. denial and rationalization Denial is the unconscious disclaimer of unacceptable thoughts, feelings, needs, or certain external factors. Rationalization is the unconscious effort to justify intolerable feelings, behaviors, and motives

The nurse is caring for a client with a history of chronic alcoholism and is aware that the client may be predisposed to: a. arteriosclerosis b. heart failure c. heart valve damage d. pericarditis

b. heart failure Heart failure is a severe cardiac consequence associated with long-term alcohol use.

A nurse is caring for a heroine-addicted client who is experiencing withdrawal symptoms. The nurse is aware that the withdrawal symptoms may be affected by: a. ego strength b. liver function c. seizure history d. kidney function

b. liver function Liver function status is an important variable that can indicate the severity of a client's drug withdrawal

A client tells a nurse, "I'm not going to incur problems from smoking marijuana." What is the nurse's most appropriate response? a. evidence shows it can cause major health problems b. marijuana produces physical and psychological dependence c. smoking marijuana isn't as dangerous as smoking cigarettes d. some people have minor or no reactions to smoking marijuana

b. marijuana produces physical and psychological dependence Marijuana causes cardiac, respiratory, immune, and reproductive health problems. All people who smoke marijuana have symptoms of intoxication. The residue from marijuana is more toxic than those from cigarettes.

What is the most important teaching information for the nurse to provide a client who uses prescription drugs without a prescription? a. herbal substitutes are safer b. medication should be used only for the reason prescribed c. the client should consult a provider before using a drug d. consider if family members influence the clients drug use

b. medication should be used only for the reason prescribed People often misuse drugs to self-medicate or experience a sense of euphoria

A nurse is caring for a client recovering from cocaine use. Which is the priority intervention for this client? a. skin care b. suicide precautions c. frequent orientation d. nutrition consultation

b. suicide precautions Clients recovering from cocaine use are prone to post-coke depression, and have a likelihood of becoming suicidal if they can't take the drug

The nurse is performing an assessment of a client with a history of poly-substance use. What is the most important information for the nurse to obtain? a. oral admin of any drug b. time of last use of each drug c. how the drug was obtained d. the place the drug was used

b. time of last use of each drug Time of last use gives info about expected withdrawal symptoms of the drugs and what immediate treatment is necessary.

What is the most important short-term goal for a client who is curious about the effects of alcohol on her body? a. have blood chemistries tested daily b. verbalize the results of substance use c. meet with a pharmacist to discuss alcohol ingestion d. attend a weekly aerobic exercise program

b. verbalize the results of substance use

A family tells the nurse that they are concerned about a sister who stopped using amphetamines three months ago and is now acting paranoid. What is the nurse's best response? a. a person gets symptoms of paranoia with poly-substance use b. when a person uses amphetamines, paranoid tendencies may continue for months c. sometimes, family dynamics and a high suspicion of continued drug use make a person paranoid d. amphetamine users may have severe depression and paranoid thinking

b. when a person uses amphetamines, paranoid tendencies may continue for month After amphetamine use, there may be long-term effects that exist for months after use. Two common effects are paranoia and ideas of reference. Even with polysubstance use, the paranoia comes from the chronic use of amphetamines.

A client experiencing alcohol withdrawal tells the nurse that she is upset about going through detoxification. Which goal is the priority for this client? a. committing to a drug-free lifestyle b. working with the nurse to remain safe c. drinking plenty of fluids on a daily basis d. making a personal inventory of strengths

b. working with the nurse to remain safe Priority goal = safety.

A client who uses alcohol tells a nurse, "I'm sure I can become a social drinker." What is the most appropriate response by the nurse? a. "When do you think you can become a social drinker?" b. "What makes you think you'll learn to drink normally?" c. "Can you tell me how the use of alcohol affects your life?" d. "How many alcohol drinks can a social drinker consume?"

c. "Can you tell me how the use of alcohol affects your life?" This question may help the client recall the problematic results of using alcohol, and the reasons the client began treatment. Asking when he can become a social drinker will only encourage the person to deny the problem and develop an unrealistic, self-deflating goal. Asking how many beverages can her consume and why he thinks he can drink normally will encourage him to defend and deny the problem.

A client asks the nurse, "Why does it matter if I talk to my peers in group therapy?" What is the nurse's most appropriate response? a. "Group therapy lets you see what you're doing wrong in your life." b. "Group therapy acts as defense against your disorganized behavior." c. "Group therapy provides a way to ask for support as well as to support others." d. "In group therapy, you can vent your frustrations and others will listen."

c. "Group therapy provides a way to ask for support as well as to support others."

A pregnant client is thinking about stopping cocaine use. The nurse determines that teaching about drug use and pregnancy has been effective when the client states: a. "Right after birth, I'll give my baby up for adoption" b. "I'll help the baby get through the withdrawal period." c. "I don't want the baby to have withdrawal symptoms" d. "It's scary to think the baby may have Down syndrome"

c. "I don't want the baby to have withdrawal symptoms" Neonates born to mothers addicted to cocaine have withdrawal symptoms. Use of cocaine during pregnancy does not contribute to Down syndrome

A client recovering from cocaine use is participating in group therapy. The nurse determines that the client has benefited from the therapy when the client states: a. "I think the laws about drug possession are too strict in this country" b. "I'll be more careful about talking about my drug use to my children" c. "I finally realize the short high from cocaine isn't worth the depression" d. "I can't understand how I could have all the problems we talked about in group"

c. "I finally realize the short high from cocaine isn't worth the depression"

A group of teenagers tell the school nurse they used cocaine because they were bored. What is the most important goal for the nurse? a. Prepare a drug lecture. b. Restrict school privileges. c. Establish an activity schedule. d. Report the incident to their parents.

c. Establish an activity schedule. Activity scheduling enables the adolescents to develop coping skills to make better choices about what to do with their free time. Drug lectures and restricting privileges will not be useful and may contribute to their inappropriate behavior. The children should tell their parents about their drug use.

A nurse is trying to determine if a client, who uses heroin, has any drug-related problems. What is the most appropriate question for the nurse to ask? a. When did your spouse become aware of your use of heroin? b. Do you have a probation officer that you report to periodically? c. Have you experienced any legal violations while being intoxicated? d. Do you have a history of frequent visits with the employee assistance program manager?

c. Have you experienced any legal violations while being intoxicated?

The nurse is facilitating a family meeting for a client who abuses alcohol. During the meeting, the nurse observes the communication and determines an unhealthy pattern of: a. use of descriptive jargon. b. disapproval of other's behaviors. c. avoidance of conflicting issues. d. unlimited expression of nonverbal communication.

c. avoidance of conflicting issues. The interaction pattern of a family with a member who uses alcohol often revolves around denying the problem, avoiding conflict, or rationalizing the addiction. The family might have a problem setting limits and expressing disapproval of the client's behavior

A client has stopped using phencyclidine (PCP). It is most important for the nurse to monitor the client's behavior for: a. fatigue and feelings of being overwhelmed b. agitation and mood swings c. bizarre behavior leading to psychotic episode d. memory loss and forgetfulness

c. bizarre behavior leading to psychotic episode Can indicate psychosis

A client recovering from alcohol use needs to develop effective coping skills to handle daily stressors. What is the most appropriate nursing intervention for this client? a. determine the client's level of verbal skills b. help the client avoid areas that cause conflict c. discuss examples of successful coping behavior d. teach the client to accept uncomfortable situations

c. discuss examples of successful coping behavior identify successful coping behavior and developing ways to incorporate that behavior into daily functioning.

A nurse is working with a client on recognizing the relationship between alcohol use and interpersonal problems. What is the nurse's priority intervention for this client? a. help the client recognize personal strengths b. have the client identify compulsive behaviors c. encourage the client's use of defense mechanisms d. have the client work with peers who can serve as role models

c. encourage the client's use of defense mechanisms Defense mechanisms can impede the development of healthy relationships and cause the client pain. After identifying barriers to relationship problems, it would be appropriate to identify or clarify personal strengths.

What is the most objective way for the nurse to determine if the client is still using alcohol? a. having the client walk a straight line b. smelling the client's breath c. giving the client a breath alcohol test d. asking the client if he has been drinking

c. giving the client a breath alcohol test

A client discusses with the nurse how drug addiction has made life unmanageable. The nurse determines that coping methods for this client should include: a. how peers have committed to sobriety b. how to accomplish family of origin work c. how to understand the addiction process d. how environmental stimuli can serve as a drug trigger

c. how to understand the addiction process The best strategy is to teach the client about the addiction, how to obtain support, and how to develop new coping skills.

A 20-year-old client is admitted with bone marrow depression. He tells the nurse he's been using drugs since age 13. Which drug should the nurse anticipate finding in the client's history? a. amphetamines b. cocaine c. inhalants d. marijuana

c. inhalants

A nurse is working with a client, addicted to cocaine, who is in denial. What is the most appropriate intervention for the nurse to implement? a. ask if the client sees the drug use as a problem b. focus on the pain the client is having during withdrawal c. reinforce the connection between drug use and harmful results d. help the client recognize reality by pointing out withdrawal symptoms

c. reinforce the connection between drug use and harmful results To deal with denial, the nurse must confront the drug use and point out the results of the behavior.

The nurse has just completed the assessment of client, recovering from alcohol addiction, who has limited coping skills. During the assessment, the nurse also identified that the client is experiencing relationship problems. Which assessment finding would indicate relationship difficulties? a. the client is prone to panic attacks b. the client doesn't pay attention to details c. the client has poor communication skills d. the client ignores the need to relax and rest

c. the client has poor communication skills To have satisfying relationships, a person must be able to communicate and problem solve.

A client who uses alcohol tells the nurse that everyone in his family has an alcohol problem and nothing can be done about it. What is the nurse's most appropriate response? a. "You're right it is much harder to recover from alcoholism" b. "This is just an excuse so you don't have to work on your sobriety." c. "Sometimes nothing can be done, but you may be an exception in your family." d. "Alcohol problems can occur in families, but sobriety is your choice."

d. "Alcohol problems can occur in families, but sobriety is your choice."

A client recovering from alcohol addiction asks the nurse how to talk to his children about how his addiction has impacted them. What is the nurse's best response? a. "Try to limit references to the addiction and focus on the present." b. "Talk about all the hardships you've had in working to remain sober." c. "Tell them you're sorry and emphasize that you're doing so much better now." d. "Talk to them by acknowledging the difficulties and pain your drinking caused."

d. "Talk to them by acknowledging the difficulties and pain your drinking caused." Part of the healing process for the family is to acknowledge the pain, embarrassment, and overall difficulties the client's drinking has caused the family. The addiction must be addressed and the children's pain addressed.

An adult client asks the nurse not to tell his parents about his alcohol problem. Wha tis the most appropriate response by the nurse? a. "It would be dishonest not to tell them" b. "Don't you think you'll need to tell them someday?" c. "Does alcoholism run in either side of your family?" d. "What do you think will happen if you tell your parents?"

d. "What do you think will happen if you tell your parents?" Clients who struggle with addiction often believe others will be judgmental, rejecting, and uncaring if their history of alcohol use is revealed.

A client who uses cocaine denies that drug use is a problem. What is the best intervention by the nurse? a. State ways to cope with stress. b. Repeat the drug facts as needed. c. Identify the client's ambivalence. d. Use open-ended, factual questions.

d. Use open-ended, factual questions. Helps the client acknowledge that a drug problem is present

A nurse is assessing a client with a history of cocaine use. The nurse is aware that the assessment may include: a. glossitis b. pharyngitis c. bilateral ear infections d. a perforated nasal septum

d. a perforated nasal septum

The nurse is developing interventions to prevent a client, who used alcohol, from relapsing. What is the most important intervention for this client? a. avoid taking OTC medications b. limit monthly contact with the family of origin c. refrain from becoming involved in group activities d. avoid people, places, and activities from the former lifestyle

d. avoid people, places, and activities from the former lifestyle Changing the client's old habits is essential for sustaining a sober lifestyle . Certain OTC medications that don't contain alcohol will probably need to be used by the client at certain times. Going to AA and other support groups will help prevent relapse

The nurse is preparing a teaching plan for a client who used alcohol. What is the most important information for the nurse to include? a. personal needs b. illness exacerbation c. cognitive distortions d. communication skills

d. communication skills Addicted clients typically have difficulty communicating their needs in an appropriate way. Learning appropriate communication skills is a major goal of treatment. Behavior that focuses on self and meeting personal needs will be addressed next.

A client says, "I started using cocaine as a recreational drug on weekends, and now I can't seem to get through a weekend without it." The nurse interprets the client's statement as most consistent with: a. toxic dose b. dual diagnosis c. cross-tolerance d. compulsive use

d. compulsive use Compulsive drug use involves taking a substance for a period of time significantly longer than intended. A toxic dose is the amount of a drug with poisonous effect. Dual diagnosis is the coexistence of a drug problem and a mental health problem. Cross-tolerance occurs when the effects of a drug are decreased and the client takes larger amounts to achieve the desired drug effect

The nurse is preparing a client with the diagnosis of alcohol dependency for discharge from the hospital. What is the most important goal for the client? a. find a way to drink socially b. allow self to grieve recent losses c. work to bring others into treatment d. develop relapse-prevention strategies

d. develop relapse-prevention strategies Primary goal for a client in outpatient treatment is to focus on strategies to prevent relapse.

The nurse is caring for a client who uses cocaine and has been admitted to an intensive outpatient rehab program. For which is it most important for the nurse to assess the client? a. GI distress b. blurred vision c. perceptual distortions d. increased appetite

d. increased appetite Increases appetite is typical during cocaine or nicotine withdrawal GI distress occurs during alcohol or opioid withdrawal Perceptual distortions are common during withdrawal from phencyclidine, amphetamines, and hallucinogens

A client tells a nurse, "I've been clean from drugs for the past five years, but my life really hasn't changed." The nurse determines that further discussion should include: a. further education b. conflict resolution c. career development d. personal development

d. personal development True recovery involves changing the client's distorted thinking and working on personal and emotional development. Before the client pursues further education, career development, or conflict resolution skills, it is imperative that the client devote energy to emotional and personal development

What is the most important assessment for a nurse to implement before starting a teaching session for a client who uses alcohol? a. sleep patterns b. decision making c. note-taking skill d. readiness to learn

d. readiness to learn It is important to know if the client's current situation helps or hinders the potential to learn

The nurse is caring for a client who was admitted to the hospital unit after experiencing an overdose of cocaine. What is the most important symptom to monitor after this client is admitted? a. hypertension b. hypothermia c. hyperglycemia d. seizures

d. seizures Seizures are a major sign of cocaine OD as they can cause extreme physiologic instability Hypertension and increased body temp are normal SE of cocaine use Clients with cocaine OD may present with hypoglycemia

A client, newly admitted to the inpatient unit, has incurred physical health problems due to the long-term use of cannabis. What should the nurse expect to assess? a. brain and liver changes b. euphoria followed by depression c. slurred speech and diplopia d. tachycardia and orthostatic hypotension

d. tachycardia and orthostatic hypotension With a decrease in BP, oxygen supply to myocardial tissue is decreased, and tachycardia then increases the oxygen demand Alcohol = brain and liver damage Cocaine = euphoria followed by depression and letdown Inhalants = slurred speech and diplopia

A client with an alcohol addiction requests a prescription for Disulfiram. To determine the client's ability to take the drug appropriately, the nurse should assess whether: a. the client is capable of maintaining a medication regimen b. the client's family accepts the use of this treatment strategy c. the client is willing to follow the necessary dietary restrictions d. the client is motivated to maintain sobriety

d. the client is motivated to maintain sobriety A client with a strong craving for alcohol, and a lack of impulse control is not a good candidate for Disulfiram therapy. Alcohol must not be consumed, but specific dietary restrictions are not necessary during Disulfiram therapy

A client with a history of cocaine use exhibits behavior changes following return from a weekend pass to visit his family. Which diagnostic screening should the nurse anticipate the health care provider will order? a. antibody b. glucose c. hepatic d. urine

d. urine A urine toxicology screen would show the presence of cocaine in the body