Question 1

The nurse is teaching a patient who will be discharged home with naltrexone (ReVia) after treatment for opioid addiction. What information will the nurse include in the teaching for this patient?

Accepted Answer

Naltrexone (ReVia) works by blocking the effects of opioids, including the pleasurable sensations, which helps prevent relapse in individuals recovering from opioid addiction.

Question 2

A patient with a long history of alcohol abuse is admitted to the hospital for detoxification. In addition to medications needed to treat withdrawal symptoms, the nurse will anticipate giving which of the following intramuscularly?

Accepted Answer

Thiamine (vitamin B1) is often deficient in individuals with long-term alcohol abuse and is necessary for the metabolism of glucose. Giving thiamine can help prevent severe complications such as Wernicke-Korsakoff syndrome, which can lead to permanent brain damage. While dopamine, fluid boluses, and glucose may be necessary in certain situations, they are not typically given intramuscularly during alcohol detoxification.

Question 3

The nurse is caring for a patient who is being treated for alcohol intoxication. The nurse notes that the patient's serum alcohol level is 400 mg/dL. The patient is awake and talkative even though this is a potentially lethal dose. The nurse recognizes this as alcohol:

Accepted Answer

The patient's ability to be awake and talkative despite a potentially lethal dose of alcohol indicates tolerance, which is the body's adaptation to prolonged exposure to alcohol that results in the need for higher doses to achieve the desired effect. Substance use disorder or dependence may also be present, but tolerance is the most appropriate choice based on the given information. Misuse refers to using a substance in a way that is not intended or recommended.

Question 4

Cough and cold products are also used for substance abuse. Which of the following contains the two most commonly misused cough and cold products?

Accepted Answer

Dextromethorphan and promethazine-codeine are the two most commonly misused cough and cold products. Dextromethorphan is a cough suppressant and can produce hallucinations and dissociative effects in high doses. Promethazine-codeine is a combination medication that contains an opioid (codeine) and an antihistamine (promethazine). The codeine can produce a sense of euphoria and relaxation when abused, while the promethazine can potentiate the effects of the codeine.

Question 5

The nurse is teaching a group in the community about drug abuse. Which statement by the nurse is correct?

Accepted Answer

The correct statement is "Substance use disorder occurs when recurrent use causes clinically and functionally significant impairment." This is the definition of substance use disorder according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Cravings may not disappear after long periods of abstinence (option A), substance abuse and addiction are not synonymous terms (option B), and physical dependence is not the sole criteria for diagnosing substance use disorder (option D).

Question 6

The nurse is counseling a patient who wants to stop smoking. Which statement by the nurse is correct?

Accepted Answer

Nicotine withdrawal symptoms, including headaches, irritability, and increased appetite, can persist for several months after quitting smoking. This is a common and expected part of the cessation process. Options A, B, and C contain inaccuracies regarding the safety, necessity of behavioral therapy, and duration of use for smoking cessation aids.

Question 7

A patient who is unconscious arrives in the emergency department with clammy skin and constricted pupils. The nurse assesses a respiratory rate of 8 to 10 breaths per minute. The paramedics report obvious signs of drug abuse in the patient's home. The nurse suspects that this patient is likely experiencing an overdose of which substance?

Accepted Answer

The patient's clinical presentation suggests an opioid overdose, which can cause respiratory depression (low respiratory rate) and constricted pupils. Clammy skin is also a possible sign of opioid overdose. The reported history of drug abuse further supports this suspicion. Alcohol and LSD do not typically produce these symptoms, and while methamphetamine can cause CNS depression, it more commonly produces agitation and other signs of sympathetic nervous system stimulation.

Question 8

What does the nurse understand must occur in order to produce withdrawal syndrome?

Accepted Answer

Withdrawal syndrome occurs due to physical dependence, which is a state in which the body has adapted to the presence of a drug and requires continued exposure to it to function normally. If the drug is abruptly discontinued or the dose is decreased, withdrawal symptoms can occur. Intoxication, craving, and drug tolerance are not necessary factors for producing withdrawal syndrome.

Question 9

The nurse is discussing smoking cessation with a nurse colleague who smokes. Which statement indicates a readiness to quit smoking?

Accepted Answer

This statement shows a willingness to quit smoking and a recognition that help will be needed in order to do so. The other statements do not necessarily indicate readiness to quit or a commitment to making a change.

Question 10

A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of "several six packs" of beer every day for the past year. The nurse anticipates administering which medication or treatment?

Accepted Answer

Chlordiazepoxide (Librium) is a benzodiazepine that can be used to manage acute alcohol withdrawal symptoms such as agitation, tremors, and seizures. It is often used as a first-line treatment in the emergency department for alcohol intoxication. Disulfiram (Antabuse) is a medication used for alcohol addiction treatment, but it is not indicated in the acute management of alcohol intoxication. Gastric lavage and vasoconstrictors are not typically used in the management of alcohol intoxication.

Question 11

The nurse is teaching a patient who has completed detoxification for alcohol abuse who will be discharged home with a prescription for disulfiram (Antabuse). Which statement by the patient indicates understanding of the teaching?

Accepted Answer

The statement "Even use of mouthwash can cause serious adverse effects while I am taking this drug" indicates that the patient understands the potential for disulfiram to cause a severe reaction if even small amounts of alcohol are consumed. This is an important aspect of patient education when prescribing disulfiram for alcohol dependency. The other answer choices are not accurate or complete statements regarding the use of disulfiram.

Question 12

A patient is brought to the emergency department after ingesting an overdose of an opioid several hours prior. The patient has a respiratory rate of 6 to 10 breaths per minute and is unconscious. The nurse will prepare to perform which action?

Accepted Answer

The patient is showing signs of opioid overdose, which includes respiratory depression and unconsciousness. Naloxone (Narcan) is the antidote for opioid overdose and should be administered to reverse the effects of the opioid. Administering activated charcoal or performing gastric lavage would be ineffective at this point since several hours have passed since the ingestion of the opioid. Flumazenil (Romazicon) is the antidote for benzodiazepine overdose, not opioid overdose.

Question 13

The nurse is caring for a patient who is chronically irritable and anxious and prone to violent behaviors. The patient has several teeth missing and has dental caries in the remaining teeth. The nurse suspects previous chronic use of which drug?

Accepted Answer

Methamphetamine use is associated with chronic irritability, anxiety, and violent behaviors. The drug also causes dental problems such as missing teeth and dental caries. Alcohol use can also lead to dental problems, but it is not typically associated with violent behaviors. Cocaine and LSD do not typically cause dental problems, although they may contribute to psychiatric symptoms.

Question 14

Which of the following is NOT generally considered a side effect of nicotine replacement?

Accepted Answer

Somnolence, or drowsiness, is not typically considered a side effect of nicotine replacement therapies. Tachycardia (rapid heart rate), dizziness, and dyspepsia (indigestion) are all potential side effects of nicotine replacement products.

Question 15

A patient is brought to the emergency department by a family member. The patient reports symptoms of paranoia and believes they are being followed. The patient presents with an elevated body temperature, elevated pulse, and high blood pressure. The nurse suspects that this patient is abusing which of the following drugs?

Accepted Answer

Elevated body temperature, elevated pulse, and high blood pressure are all common physical symptoms of cocaine abuse. Additionally, paranoia and the belief of being followed can be indicative of cocaine-induced paranoia. The other options are not typically associated with these symptoms.

Quiz 8: Drugs of Abuse