Substance-Related and Addictive disorders Practice Q's

A client with alcohol addiction says, "My spouse and children think that I am an alcoholic. I do not have a drinking problem. I can quit drinking any time." What is the first step in decreasing the use of denial in the client?

*Explaining the relationship between substance abuse and personal problems*

A pharmacy technician arrives on the nursing unit to deliver opioids and, following hospital protocol, asked the nurse to receive the medication's. The nurse is assisting a confused and unsteady client back to the clients room. How would the nurse respond to the technician?

I can't receive them right now. Please wait a few minutes or come back

For a client who has an addiction problem, which client communication shows progress in the working stage of the nurse client relationship?

Identifies personal strengths and weaknesses Acknowledges the effects of the addiction on the family Addresses how the addiction has contributed to family distress

Which physical findings on the skin indicates opioid abuse?

Needle marks

Which nursing action would be the primary consideration when caring for a client with a substance use disorder?

Setting firm, consistent limits and not varying from them

A client with a history of cocaine abuse has been admitted to a healthcare facility with a sinus disorder. Which action with the nurse take?

Assess the clients drug intake and ensure that the individual does not prematurely leave the healthcare facility

A 20 year old Carpenter with a history of substance abuse falls from a roof and sustains fractures of the right femur and left tibia. Which intervention is the most important?

Assessing for amount and time of last substance use

The nurse is educating about necessary precautions to a client on disulfiram therapy. Which statement of the client would most likely indicate effective learning?

*"I should avoid alcohol"*

A patient asks for information about Alcoholics Anonymous (AA). Which is the nurse's best response?

*"It is a self-help group with the goal of sobriety"*

Which statement most accurately describes substance addiction?

*A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance*

A client after the withdrawal from a hallucinogen says, "I feel I am still on the drug." What is the condition of the client?

*Flashback*

Which is an important intervention when giving care to a patient withdrawing from a central nervous system stimulant?

*Observe for depression and suicidal ideation*

Which is most likely to be used as a form of self-medication to alleviate depression?

*Amphetamine*

A patient with a history of daily alcohol abuse was hospitalized at 0200 today. When would the nurse expect withdrawal symptoms to peak?

*Between 0200 tomorrow and hospital day 2 (24-48 hrs after cessation)*

A client who is a chronic alcoholic says, "My fingers are aching. I can feel a burning and prickling sensation." Which disorder will the nurse suspect in the client?

*Peripheral neuropathy*

Which drug would the nurse expect to be used in substitution therapy for a client withdrawing from alcohol?

*Chlordiazepoxide*

Which drug does the nurse expect the PHCP will prescribe for a client with symptoms of cocaine withdrawal?

*Desipramine* -Treats depression and cravings during detox and withdrawal

While caring for a client with ineffective coping, the nurse maintains consistency in administering the consequences for a violation of limits. Which outcome does the nurse expect in the client after this intervention?

*The client will demonstrate no manipulative behaviors.*

In which time interval do the most serious life-threatening affects of alcohol withdrawal occur?

24 to 72 hours

The CAGE questionnaire is used to screen the clients use of which substance?

Alcohol

Which substance is considered addictive in the DSM-5?

Alcohol, caffeine, cannabis, gambling, hallucinogens, antianxiety medication

Which signs and symptoms will the nurse observe in a client experiencing alcohol withdrawal?

Anxiety Diaphoresis Psychomotor agitation

Which characteristics are observed in clients who have cocaine addiction?

Anxiety Palpations Weight loss

Which behavior indicates codependence for the wife of a husband who abuses multiple drugs?

Attempts to cover up the husbands drug abuse

As a client addicted to cocaine withdraws from the drug, which behavior with the nurse observe?

Depression

Which substance produces sneezing, yawning, and tearing of the eyes as withdrawal occurs?

Heroin

Which psychosocial clues would be explored to confirm substance abuse in an adolescent?

Increased school absenteeism Changes in interpersonal relationships

A staff nurse states, "why are we wasting time on this nurse who is returning to work after going through drug rehab? Addicts always abuse substances when the pressure increases." Which response would the nurse manager give?

Tell me about your feelings toward this nurse or others who had problems with drugs

Which physical assessment of the skin indicates that a client is addicted to phencycladine?

Red and dry skin

The registered nurse diagnosed with chemical impairment issues is transferred to work at a rehabilitation center as a part of the treatment. Which actions performed by the nurse manager at the new workplace result in effective outcome of treatment for chemical impairment?

Restricting the RN from access to controlled substances Restricting the RN from administering any controlled substances

A client with a known history of opioid addiction has a surgical repair of multiple stab wounds to the abdomen. After surgery, the client's pain is not relieved by the prescribed morphine injections. The nurse realizes that the failure to achieve pain relief indicates that the client is probably experiencing which phenomenon?

Tolerance

Which initial outcome criterian would be appropriate for a client who is a poly substance abuser and is mandated to seek drug and alcohol counseling?

Verbalizes that a substance abuse problem exists