Question 1

Which client statement demonstrates positive progress toward recovery from a substance use disorder?

Accepted Answer

Rationale: A client who takes responsibility for the consequences of substance use disorder or substance addiction is making positive progress toward recovery.This would indicate completion of the first step of a 12-step program.

Question 2

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium?

Accepted Answer

Rationale: The nurse should anticipate that a physician would order chlordiazepoxide and phenytoin for a client who has a history of benzodiazepine withdrawal delirium.It is common for long-lasting benzodiazepines to be prescribed for substitution therapy.Phenytoin is an anticonvulsant used to prevent seizures.

Question 3

A nurse evaluates a client's patient-controlled analgesia (PCA)pump and notices 100 attempts within a 30-minute period.Which is the best rationale for assessing this client for substance addiction?

Accepted Answer

The nurse should assess the client for substance addiction,because clients who are addicted to alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control.Cross-tolerance is exhibited when one drug results in a lessened response to another drug.

Question 4

A nurse is assessing a pathological gambler.What would differentiate this client's behaviors from the behaviors of a non-pathological gambler?

Accepted Answer

Rationale: There is a correlation between pathological gambling and abnormalities in the serotonergic,noradrenergic,and dopaminergic neurotransmitter systems.This is not the case with non-pathological gambling.For a pathological gambler,the preoccupation with and impulse to gamble intensifies when the individual is under stress.This is not the case with non-pathological gambling.Pathological gambling occurs more commonly among men not women and generally runs a chronic not acute course.

Question 5

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification.Which client outcome,related to AA,would be most appropriate for a nurse to discuss with the client during discharge teaching?

Accepted Answer

Rationale: The most appropriate client outcome for the nurse to discuss during discharge teaching is attending 90 AA meetings in 90 days after discharge.AA is a major self-help organization for the treatment of alcohol addiction.It accepts alcohol addiction as an illness and promotes total abstinence as the only cure.

Question 6

A client with a history of heavy alcohol use is brought to an emergency department (ED)by family members who state that the client has had nothing to drink in the last 48 hours.When the nurse reports to the ED physician,which client symptom should be the nurse's first priority?

Accepted Answer

Rationale: The nurse should recognize that high blood pressure is a symptom of alcohol withdrawal syndrome and should promptly report this finding to the physician.Complications associated with alcohol withdrawal syndrome may progress to alcohol withdrawal delirium in about the second or third day following cessation of prolonged alcohol use.

Question 7

A lonely,depressed divorcée has been self-medicating with small amounts of cocaine for the past year.Which term should a nurse use to best describe this individual's situation?

Accepted Answer

Rationale: The nurse should use the term psychological addiction to best describe the client's situation.A client is considered to be psychologically addicted to a substance when there is an overwhelming desire to use a drug in order to produce pleasure or avoid discomfort.

Question 8

A client's wife has been making excuses for her alcoholic husband's work absences.In family therapy,she states,"His problems at work are my fault." Which is the appropriate nursing response?

Accepted Answer

Rationale: The appropriate nursing response is to use confrontation with caring.The nurse should understand that the client's wife may be in denial and enabling the husband's behavior.Codependency is a typical behavior of spouses of alcoholics.Partners of clients with substance addiction must come to realize that the only behavior they can control is their own.

Question 9

Which client statement indicates a knowledge deficit related to a substance use disorder?

Accepted Answer

Rationale: The nurse should determine that the client has a knowledge deficit related to substance use disorders when the client compares marijuana to smoking cigarettes and claims it to be harmless.Cannabis is the second most widely abused drug in the United States.

Question 10

A nurse is reviewing the stat laboratory data of a client in the emergency department.At what minimum blood alcohol level should a nurse expect intoxication to occur?

Accepted Answer

Rationale: The nurse should expect that 100 mg/dL is the minimum blood alcohol level at which intoxication occurs.Intoxication usually occurs between 100 and 200 mg/dL.Death has been reported at levels ranging from 400 to 700 mg/dL.

Question 11

Which of the following nursing statements exemplify the cognitive process that must be completed by a nurse prior to caring for clients diagnosed with a substance-related disorder? (Select all that apply.)

Accepted Answer

Rationale: The nurse should complete a cognitive process prior to caring for clients diagnosed with substance-abuse disorders.It is important for nurses to identify potential areas of need within their own cognitions that may affect their relationships with clients diagnosed with this problem.

Question 12

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97$\degree$F (36$\degree$C)with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?

Accepted Answer

Rationale: The nurse should assess that the priority nursing diagnosis is imbalanced nutrition: less than body requirements.The client is exhibiting signs and symptoms of malnutrition as well as alcohol withdrawal.The nurse should consult a dietitian,restrict sodium intake to minimize fluid retention,and provide small,frequent feedings of nonirritating foods.

Question 13

A nurse is interviewing a client in an outpatient addiction clinic.To promote success in the recovery process,which outcome should the nurse expect the client to initially accomplish?

Accepted Answer

Rationale: The nurse should expect that the client would initially correlate life problems with alcohol addiction.Acceptance of the problem is the first part of the recovery process.

Question 14

Which term should a nurse use to describe the administration of a central nervous system (CNS)depressant during the substance induced disorder of alcohol withdrawal?

Accepted Answer

Rationale: Various medications have been used to decrease the intensity of symptoms in an individual who is withdrawing from,or who is experiencing the effects of excessive use of,alcohol and other drugs.This is called substitution therapy and may be required to reduce the life-threatening effects of alcohol withdrawal.

Question 15

A nursing instructor is teaching about the impaired nurse and the consequences of this impairment.Which statement by a student indicates that further instruction is needed?

Accepted Answer

Rationale: Several state boards of nursing have passed diversionary laws that allow impaired nurses to avoid disciplinary action by agreeing to seek treatment.This may require successful completion of inpatient,outpatient,group,or individual counseling treatment program(s); evidence of regular attendance at nurse support groups or 12-step program; random negative drug screens; and employment or volunteer activities during the suspension period.When a nurse is deemed safe to return to practice,he or she may be closely monitored for several years and required to undergo random drug screenings.

Question 16

On the first day of a client's alcohol detoxification,which nursing intervention should take priority?

Accepted Answer

Rationale: The priority nursing intervention for this client should be to administer ordered chlordiazepoxide in a dosage according to protocol.Chlordiazepoxide is a benzodiazepine and is often used for substitution therapy in alcohol withdrawal to reduce life-threatening complications.

Question 17

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the client's physician to treat this disorder.The nurse would give the client information on which medications?

Accepted Answer

Rationale: The SSRIs and clomipramine have been used successfully in the treatment of pathological gambling as a form of obsessive-compulsive disorder.Lithium,carbamazepine,and naltrexone have also been shown to be effective.The antipsychotic medications clozapine,olanzapine,and ziprasidone are not treatments of choice for this disorder.

Question 18

What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?

Accepted Answer

Rationale: The priority nursing diagnosis for a client experiencing alcohol withdrawal should be risk for injury R/T central nervous system stimulation.Alcohol withdrawal may include the following symptoms: course tremors of hands,tongue,or eyelids; nausea or vomiting; malaise or weakness; tachycardia; sweating; elevated blood pressure; anxiety; depressed mood; hallucinations; headache; and insomnia.

Question 19

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?

Accepted Answer

The nurse should recommend nonpharmacological interventions to this client because sedative-hypnotics are potentially addictive,and their effectiveness will be compromised owing to tolerance.The effects of central nervous system depressants are additive with one another,capable of producing physiological and psychological addiction.

Question 20

A nurse holds the hand of a client who is withdrawing from alcohol.What is the nurse's rationale for this intervention?

Accepted Answer

The nurse is most likely assessing the client for fine tremors secondary to alcohol withdrawal.Withdrawal from alcohol can also cause headache,insomnia,transient hallucinations,depression,irritability,anxiety,elevated blood pressure,sweating,tachycardia,malaise,and coarse tremors.

Quiz 14: Substance Use and Addictive Disorders

Which client statement demonstrates positive progress toward recovery from a substance use disorder?

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium?

A nurse evaluates a client's patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period.Which is the best rationale for assessing this client for substance addiction?

A nurse is assessing a pathological gambler.What would differentiate this client's behaviors from the behaviors of a non-pathological gambler?

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification.Which client outcome,related to AA,would be most appropriate for a nurse to discuss with the client during discharge teaching?

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 48 hours.When the nurse reports to the ED physician,which client symptom should be the nurse's first priority?

A lonely,depressed divorcée has been self-medicating with small amounts of cocaine for the past year.Which term should a nurse use to best describe this individual's situation?

A client's wife has been making excuses for her alcoholic husband's work absences.In family therapy,she states,"His problems at work are my fault." Which is the appropriate nursing response?

Which client statement indicates a knowledge deficit related to a substance use disorder?

A nurse is reviewing the stat laboratory data of a client in the emergency department.At what minimum blood alcohol level should a nurse expect intoxication to occur?

Which of the following nursing statements exemplify the cognitive process that must be completed by a nurse prior to caring for clients diagnosed with a substance-related disorder? (Select all that apply.)

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97 $\degree$ F (36 $\degree$ C) with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?

A nurse is interviewing a client in an outpatient addiction clinic.To promote success in the recovery process,which outcome should the nurse expect the client to initially accomplish?

Which term should a nurse use to describe the administration of a central nervous system (CNS) depressant during the substance induced disorder of alcohol withdrawal?

A nursing instructor is teaching about the impaired nurse and the consequences of this impairment.Which statement by a student indicates that further instruction is needed?

On the first day of a client's alcohol detoxification,which nursing intervention should take priority?

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the client's physician to treat this disorder.The nurse would give the client information on which medications?

What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?

A nurse holds the hand of a client who is withdrawing from alcohol.What is the nurse's rationale for this intervention?

Quiz 14: Substance Use and Addictive Disorders

Which client statement demonstrates positive progress toward recovery from a substance use disorder?

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium?

A nurse evaluates a client's patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period.Which is the best rationale for assessing this client for substance addiction?

A nurse is assessing a pathological gambler.What would differentiate this client's behaviors from the behaviors of a non-pathological gambler?

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification.Which client outcome,related to AA,would be most appropriate for a nurse to discuss with the client during discharge teaching?

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 48 hours.When the nurse reports to the ED physician,which client symptom should be the nurse's first priority?

A lonely,depressed divorcée has been self-medicating with small amounts of cocaine for the past year.Which term should a nurse use to best describe this individual's situation?

A client's wife has been making excuses for her alcoholic husband's work absences.In family therapy,she states,"His problems at work are my fault." Which is the appropriate nursing response?

Which client statement indicates a knowledge deficit related to a substance use disorder?

A nurse is reviewing the stat laboratory data of a client in the emergency department.At what minimum blood alcohol level should a nurse expect intoxication to occur?

Which of the following nursing statements exemplify the cognitive process that must be completed by a nurse prior to caring for clients diagnosed with a substance-related disorder? (Select all that apply.)

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97 °\degree° F (36 °\degree° C) with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?

A nurse is interviewing a client in an outpatient addiction clinic.To promote success in the recovery process,which outcome should the nurse expect the client to initially accomplish?

Which term should a nurse use to describe the administration of a central nervous system (CNS) depressant during the substance induced disorder of alcohol withdrawal?

A nursing instructor is teaching about the impaired nurse and the consequences of this impairment.Which statement by a student indicates that further instruction is needed?

On the first day of a client's alcohol detoxification,which nursing intervention should take priority?

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the client's physician to treat this disorder.The nurse would give the client information on which medications?

What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?

A nurse holds the hand of a client who is withdrawing from alcohol.What is the nurse's rationale for this intervention?

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97 $\degree$ F (36 $\degree$ C) with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?