Deck 31: Substance Abuse Disorders

Question 1

The nurse assesses a patient who abuses large quantities of amphetamines. Assessment findings are likely to be similar to which psychiatric disorder?

A) Wernicke-Korsakoff syndrome
B) Bipolar disorder, manic phase
C) Generalized anxiety disorder
D) Paranoid schizophrenia

Answer 1

Paranoid schizophrenia

Question 2

A cocaine abuser complains, "There are bugs crawling under my skin." Which term should the nurse use to document this finding?

A) Confabulation
B) Formication
C) Synesthesia
D) Euphoria

Answer 2

Formication

Question 3

A patient has a history of alcohol abuse. The prescription drug that would cause the nurse to be most concerned about cross-dependence is:

A) hydrochlorothiazide ( Diuril ).
B) benztropine ( Cogentin ).
C) clonazepam ( Klonopin ).
D) olanzapine ( Zyprexa ).

Answer 3

clonazepam ( Klonopin ).

Question 4

During the rehabilitation phase of alcoholism treatment, the medication is prescribed to reduce the pleasurable effects of drinking alcohol. The nurse can expect to teach the patient about:

A) chlordiazepoxide ( Librium ).
B) disulfiram ( Antabuse ).
C) lorazepam ( Ativan ).
D) naltrexone ( Revia ).

Question 5

The most serious assessment findings associated with barbiturate withdrawal are:

A) delirium and seizures.
B) muscle twitching and anxiety.
C) nausea, vomiting, and tremors.
D) orthostatic hypotension and weakness.

Question 6

Which assessment findings would prompt the nurse to suspect a disulfiram (Antabuse) reaction?

A) Skin rash, itching, and urticaria
B) Pallor, hypotension, and muscle cramping
C) Dry skin, bradycardia, fatigue, and headache
D) Headache, dyspnea, nausea, vomiting, and flushing

Question 7

An individual experiencing a heroin overdose has been given one dose of naloxone (Narcan) intravenously. The priority nursing intervention is:

A) close observation to determine the need for an additional dose of naloxone.
B) seizure precautions for 2 hours immediately after administration of naloxone.
C) acidification of urine by encouraging the patient to drink cranberry juice.
D) a nonstimulating environment and administration of oral fluids.

Question 8

A patient asks, "How does Alcoholics Anonymous ( AA ) work?" Select the nurse's best response.

A) "The goal of AA is for members to learn controlled drinking with the support of a higher power."
B) "An individual is supported by peers while striving for abstinence one day at a time."
C) "You must make a commitment to permanently abstain from alcohol and other drugs."
D) "You will be given a sponsor who will plan your treatment program."

Question 9

A patient in the emergency department says, "I took a drug that makes me feel like I'm outside my body looking at the world. Colors move like music." The nurse should assess that the patient:

A) probably has schizophreniform disorder.
B) has probably ingested a hallucinogen.
C) is experiencing formication.
D) is using confabulation.

Question 10

A patient says, "I felt good from drinking a six-pack a few months ago. Now I need a few extra cans to get the same high." The nurse assesses this phenomenon as related to:

A) tolerance.
B) withdrawal.
C) co-dependency.
D) abstinence syndrome.

Question 11

A blackout is described as:

A) a comatose period related to alcohol withdrawal.
B) a comatose episode associated with alcohol intoxication and poisoning.
C) a time period in which a person who has used alcohol is unresponsive to the environment.
D) an episode in which a person under the influence of alcohol functions normally but later is unable to remember.

Question 12

A patient with Wernicke-Korsakoff syndrome has the nursing diagnosis impaired memory, related to neurotoxicity of alcohol. Which defining characteristic applies to this diagnosis?

A) Confabulation
B) Hallucinosis
C) Flashbacks
D) Blackouts

Question 13

A patient with insomnia reports taking diazepam (Valium) and wine in increasing amounts to be able to sleep. The nurse should teach the patient about:

A) dangers of central nervous system (CNS) depression.
B) risks of acetaldehyde toxicity.
C) risks of fetal alcohol syndrome.
D) diazepam and dietary precautions.

Question 14

When caring for patients withdrawing from cocaine and amphetamines, the nurse should plan measures recognizing that:

A) physical withdrawal is severe and often fatal.
B) psychologic withdrawal is more severe than physical.
C) physical and psychologic withdrawal are equally severe.
D) physical withdrawal is a problem only if the individual used injection.

Question 15

An unconscious patient is brought to the emergency department with a suspected heroin overdose. Which vital signs support the suspected diagnosis?

A) Blood pressure (BP) 200/100 mm Hg; pulse (P) 92 beats/min; respirations (R) 22 breaths/min
B) BP 150/85 mm Hg; P 76 beats/min; R 28 breaths/min
C) BP 110/70 mm Hg; P 84 beats/min; R 20 breaths/min
D) BP 70/40 mm Hg; P 100 beats/min; R 10 breaths/min

Question 16

Family members of an individual undergoing a 30-day alcohol rehabilitation program ask, "How can we help?" Select the nurse's best response.

A) "Alcoholism is a lifelong disease. Relapses are expected."
B) "Use search-and-destroy tactics to keep the home alcohol free."
C) "Prevent embarrassment by covering for your loved one's lapses."
D) "Make your loved one responsible for the consequences of his or her behavior."

Question 17

The milieu for a patient with a hallucinogen overdose should have which features?

A) Simple and safe
B) Active and bright
C) Stimulating and colorful
D) Confrontational and challenging

Question 18

Which assessment findings support a nurse's suspicion that a patient has been using inhalants?

A) Perforated nasal septum and hypertension
B) Drowsiness, euphoria, and constipation
C) Pinpoint pupils and respiratory rate 12 breaths/min
D) Confusion, mouth ulcers, and ataxia

Question 19

A patient who has ingested LSD describes experiencing chimes as the color blue and seeing the blare of a horn. This occurrence can be assessed as:

A) confabulation.
B) synesthesia.
C) formication.
D) piloerection.

Question 20

A nurse cares for a patient who experienced an opioid overdose. Which focused assessment has the highest priority?

A) Cardiovascular
B) Respiratory
C) Neurologic
D) Hepatic

Question 21

Substance dependence is defined by (select all that apply):

A) a compulsion to use a substance.
B) loss of control over use of a substance.
C) a physiologic need to use a substance.
D) continued use of a substance despite adverse consequences.
E) a substance-specific syndrome due to recent ingestion of a substance.

Question 22

Loneliness, related to unacceptable interpersonal behaviors is the nursing diagnosis for a patient in an alcohol rehabilitation program. Which AA step is most directly related to this problem?

A) Admitted powerlessness over alcohol
B) Turned our lives over to a higher power
C) Made amends to persons we had harmed
D) Tried to carry the AA principles to alcoholics

Question 23

Which statements accurately portray differences in the effects of alcohol between men and women? Select all that apply.

A) Women's gastrointestinal systems have less alcohol dehydrogenase, so less ethanol is oxidized on first pass before it enters the bloodstream.
B) Hot coffee increases the metabolic rate and speeds oxidation of ethanol more in men than in women.
C) Women have higher proportions of body fat, which absorbs alcohol and releases it slowly.
D) The microsomal ethanol-oxidizing system in women is less efficient than in men.
E) Women become intoxicated more easily than men.

Question 24

Naltrexone ( ReVia ) is prescribed for a patient with alcohol dependency. What information should the nurse provide to the patient? Select all that apply.

A) "This medication is part of a total program to help you remain abstinent from alcohol."
B) "Do not use alcohol-containing products, such as aftershave lotion and mouthwash."
C) "Avoid foods that contain tyramine, such as aged cheeses and meats."
D) "This medication will help reduce the likelihood of a relapse."
E) "This medication will eliminate your desire for alcohol."