Question 1

A community health nurse is planning a substance abuse prevention program. Which group would be the best target audience for the nurse to plan a program?

Accepted Answer

Forty-three percent of all Americans have been exposed to alcoholism in their families. Children of alcoholics are four times more likely than the general population to develop problems with alcohol. Many adult people in treatment programs as adults report having had their first drink of alcohol as a young child, when they were younger than age 10.
With the increasing rates of use being reported among young people today, this problem could spiral out of control unless great strides can be made through programs for prevention, early detection, and effective treatment.

Question 2

Which statements are important reasons for why the problem of substance abuse must be addressed? Select all that apply.

Accepted Answer

Increasing numbers of infants are suffering the physiologic and emotional consequences of prenatal exposure to alcohol or drugs. Chemical abuse results in increased violence. Drug abuse costs business and industry an estimated $102 billion annually. Alcohol abuse is a too frequent cause of or contributor to death. Substance use/abuse and related disorders are a national health problem.

Question 3

Which of the following groups could benefit most from prevention programs?

Accepted Answer

Poor outcomes have been associated with an earlier age at onset and longer periods of substance use. Children who have not yet used substances may be easily influenced because of their age and the fact that they have not already become addicted. Adults who have already engaged in substance abuse will not benefit as greatly from prevention programs as will children. Older adults will not benefit as greatly from prevention programs as will children. Infants will not benefit from prevention programs as they do not have self-efficacy.

Question 4

Which of the following neurochemical influences is a probable cause of substance abuse?

Accepted Answer

Neurochemical influences on substance use patterns have been studied primarily in animal research (Jaffe & Anthony, 2005). The ingestion of mood-altering substances stimulates dopamine pathways in the limbic system, which produces pleasant feelings or a high that is a reinforcing, or positive, experience.

Question 5

The nurse is assessing a client's risk factors for developing a substance abuse disorder. Which family characteristics would the nurse identify as a significant risk factor?

Accepted Answer

The strongest indication of risk factors comes from studies that indicate children of alcoholic parents are four times as likely to develop alcoholism that of nonalcoholic parents. Some theorists also believe that inconsistency in the parent's behavior, poor role modeling, and lack of nurturing pave the way for the child to adopt a similar style of maladaptive coping, stormy relationships, and substance abuse. Others hypothesize that even children who abhorred their family lives are likely to abuse substances as adults because they lack adaptive coping skills and cannot form successful relationships.
Urban areas where drugs and alcohol are readily available also have high crime rates, high unemployment, and substandard school systems that contribute to high rates of cocaine and opioid use and low rates of recovery.

Question 6

A client reports drinking one to two drinks when drinking behavior first began. Now the client reports drinking at least six drinks with every episode in order to have a good time. Which term would best describe this phenomenon?

Accepted Answer

As the person continues to drink, he or she often develops a tolerance for alcohol; that is, he or she needs more alcohol to produce the same effect. Intoxication is use of a substance that results in maladaptive behavior. Withdrawal syndrome refers to the negative psychological and physical reactions that occur when use of a substance ceases or dramatically decreases. Substance dependence also includes problems associated with addiction such as tolerance, withdrawal, and unsuccessful attempts to stop using the substance.

Question 7

The nurse is talking with the friend of a client with alcoholism. The friend tells the nurse that his relationship with the client was codependent and enabling. Which is an example of codependent behavior?

Accepted Answer

Codependent behavior appears helpful on the surface but actually prolongs the drinking behavior. The other choices are not examples of codependent behavior.

Question 8

When interviewing the family members of a client being treated for substance abuse problems, which behavior would alert the nurse to the possibility of codependency?

Accepted Answer

Self-blame is an example of maladaptive coping or codependent behavior. The other choices do not correlate with codependency behaviors.

Question 9

The nurse is discussing the principles of 12-step programs for recovery with a client. Which statement is consistent with the principles of 12-step programs?

Accepted Answer

Alcoholics Anonymous (AA) developed the 12-step program model for recovery, which is based on the philosophy that total abstinence is essential and that alcoholics need the help and support of others to maintain sobriety. Key slogans reflect the ideas in the 12 steps, such as one day at a time (approach sobriety one day at a time), easy does it (don't get frenzied about daily life and problems), and let go and let God (turn your life over to a higher power).

Question 10

Which characteristic of the 12-step program distinguishes it from other programs?

Accepted Answer

Alcoholics Anonymous (AA) was founded in the 1930s by alcoholics. This self-help group developed the 12-step program model for recovery, which is based on the philosophy that total abstinence is essential and that alcoholics need the help and support of others to maintain sobriety. Regular attendance at meetings is emphasized.

Question 11

Which slogans would be used in a 12-step program? Select all that apply.

Accepted Answer

Before the illness of addiction was fully understood, most of the society and even the medical community viewed chemical dependency as a personal problem; the user was advised to pull yourself together and get control of your problem. Key slogans in AA reflect the ideas in the 12 steps, such as One day at a time (approach sobriety one day at a time), easy does it (don't get frenzied about daily life and problems, and let go and let God (turn your life over to a higher power).

Question 12

The nurse is assessing the drinking history of a client being admitted for alcohol abuse. Which statement would the nurse expect the client to make?

Accepted Answer

Substance use typically includes the use of defense mechanisms, especially denial. Clients may deny directly having any problems or may minimize the extent of problems or actual substance use. During assessment of thought process and content, clients are likely to minimize their substance use, blame others for their problems, and rationalize their behavior. They may believe that they could quit on their own if they wanted to, and they continue to deny or minimize the extent of the problem. Upon admission, the nurse would not expect the client have the insight to know how badly help is needed, or to express powerlessness over alcohol. The client would have some motivation for treatment if admission was underway. Often the motivation is external, such as pressure from family or employers.

Question 13

Which reasons make it necessary for the nurse to examine his or her beliefs and attitudes about substance abuse? Select all that apply.

Accepted Answer

The nurse must examine his or her beliefs and attitudes about substance abuse. A history of substance abuse in the nurse's family can strongly influence his or her interaction with clients. The nurse may be overly harsh and critical. Conversely, the nurse may unknowingly act out old family roles and engage in enabling behavior. Examining one's own substance use or use by close friends and family may be difficult and unpleasant but is necessary if the nurse is to have therapeutic relationships with clients. The nurse also might have different attitudes about various substances of abuse. Health-care professionals also have higher rates of alcoholism than the general population. With the pervasive nature of substance abuse nationally, odds are great that nurses and other health professionals have been affected by substance abuse in their lives.

Question 14

A client is being discharged from treatment for addiction to cocaine. Which statement made by the client would cause the most concern for the nurse?

Accepted Answer

Clients are likely to have exercised poor judgment. They may still believe they can control the substance use. The nurse can help clients to find ways to relieve stress or anxiety that do not involve substance use. Relaxing, exercising, listening to music, or engaging in activities may be effective. Clients also may need to develop new social activities or leisure pursuits if most of their friends or habits of socializing involved the use of substances. Acknowledging difficulties shows insight into the changes needed for recovery. Assuming that old friends will not be a relapse trigger shows a lack of understanding of the relapse dynamics associated with former leisure activities.

Question 15

A client is being discharged on disulfiram (Antabuse). Which instruction for Antabuse should the client receive?

Accepted Answer

The client must avoid a wide variety of products that contain alcohol such as cough syrup, lotions, mouthwash, perfume, aftershave, vinegar, and vanilla and other extracts. The client must read product labels carefully, because any product containing alcohol can produce symptoms. Ingestion of alcohol may cause unpleasant symptoms for 1 to 2 weeks after the last dose of disulfiram.

Question 16

The client asks the nurse, What will happen if I drink while taking Antabuse? What should be the nurse's reply?

Accepted Answer

Disulfiram (Antabuse) may be prescribed to help deter clients from drinking. If a client taking disulfiram drinks alcohol, a severe adverse reaction occurs with flushing, a throbbing headache, sweating, nausea, and vomiting. In severe cases, severe hypotension, confusion, coma, and even death may result.

Question 17

A nurse is exploring treatment options with a client addicted to heroin. Which information regarding the use of methadone is important for the nurse to include?

Accepted Answer

Methadone, a potent synthetic opiate, is used as a substitute for heroin in some maintenance programs. The client takes one daily dose of methadone, which meets the physical need for opiates but does not produce cravings for more. Methadone does not produce the high associated with heroin. The client has essentially substituted his or her addiction to heroin for an addiction to methadone; however, methadone is safer because it is legal, controlled by a physician, and available in tablet form. The client avoids the risks of intravenous drug use, the high cost of heroin (which often leads to criminal acts), and the questionable content of street drugs.

Question 18

A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms?

Accepted Answer

Withdrawal from alcohol produces shakiness, weakness, diaphoresis, and GI symptoms. These are not symptoms of continuing intoxication. Delirium tremens produce hypertension, delusions, hallucinations, and agitated behavior. Wernicke-Korsakoff syndrome is a type of dementia caused by long-term, excessive alcohol intake that results in a chronic thiamine or vitamin B₆ deficiency.

Question 19

A client with alcohol dependence is admitted to the hospital with pancreatitis. Which intervention should be included in the client's plan of care?

Accepted Answer

Pancreatitis can cause elevated serum glucose levels. The other choices are not necessarily appropriate.

Question 20

A client is admitted for a drug overdose with a Barbiturate? Which is the priority nursing action when planning care for this client?

Accepted Answer

CNS depressants depress respiratory functioning. Answer choices A, B, and C would not be priority nursing actions in this situation.

Quiz 19: Addiction