Question 1

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

Accepted Answer

Nonpharmacological interventions, such as cognitive-behavioral therapy for insomnia and sleep hygiene education, should be the first line of treatment for sleep disturbances associated with major depressive disorder and substance use disorder. Sedative-hypnotics are potentially addictive, and their effectiveness will be compromised owing to tolerance. Additionally, sedative-hypnotics may worsen depression and are not recommended for use in individuals with substance use disorders.

Question 2

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

Attending 90 AA meetings in 90 days is a common and important goal for clients with alcohol addiction who are beginning their recovery. This helps clients establish a routine and builds a strong support system of peers who are also in recovery. While having a sponsor and involving family are also important aspects of AA, attending meetings regularly is the priority for the immediate post-discharge period. Seeking deterrent medications through AA may be appropriate for some clients, but it is not a universal outcome to discuss during discharge teaching.

Question 3

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

Accepted Answer

Administering ordered chlordiazepoxide is the priority intervention on the first day of alcohol detoxification. This medication is used to prevent seizures and manage symptoms of alcohol withdrawal, which can potentially be life-threatening. It is important to follow the dosage protocol to ensure the client's safety. While education, encouragement to attend AA meetings, and vitamin supplementation are important aspects of care for clients undergoing alcohol detoxification, they are not the priority on the first day.

Question 4

A nursing instructor is teaching nursing students about cirrhosis of the liver. Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed?

Accepted Answer

A diet rich in protein is actually contraindicated in hepatic encephalopathy as it can lead to increased serum ammonia levels and worsen the condition. Therefore, the statement indicates further teaching is needed.

Question 5

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

With a history of heavy alcohol use and potential withdrawal, a blood pressure of 180/100 mm Hg is a red flag for potential severe withdrawal symptoms, including seizures and delirium tremens. This requires immediate intervention and assessment by the ED physician. Other symptoms should also be addressed, but the priority is to prevent more serious complications.

Question 6

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 high number of attempts within a short time period suggests that the client may have developed a tolerance to the medication, which can be caused by substance addiction. This may require increased doses of medication to achieve pain control. Therefore, the nurse should assess the client for substance addiction. Option A is a generalization and may not be true for all clients with substance use disorders. Option C is incorrect because PCA malfunction does not necessarily imply higher pain tolerance, and option D is not relevant to the situation described in the question.

Question 7

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

Intoxication can occur at blood alcohol levels of 100 mg/dL or higher. Option A (50 mg/dL) is too low, option C (250 mg/dL) and D (300 mg/dL) are much higher and can indicate severe intoxication, which may lead to respiratory depression, coma, and even death.

Question 8

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

Accepted Answer

Risk for injury is the priority nursing diagnosis for a client experiencing alcohol withdrawal because they are at risk for seizures, tremors, delirium tremens, and other complications that can lead to injury or death.

Question 9

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

The priority nursing diagnosis should be Imbalanced nutrition: less than body requirements as the client has not eaten in three days and is experiencing symptoms of alcohol withdrawal, indicating a lack of adequate nutrition. The client's vital signs also show signs of dehydration, with dry mucous membranes and poor skin turgor. Addressing the client's nutrition and hydration status is crucial in managing alcohol withdrawal and preventing potential complications. The other options may be appropriate diagnoses, but they are not the priority in this situation.

Question 10

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

Accepted Answer

Chlordiazepoxide (Librium) is a benzodiazepine used to treat withdrawal symptoms, including delirium. Phenytoin (Dilantin) may be added to control seizures that may occur during withdrawal. Haloperidol (Haldol) and fluoxetine (Prozac) are not commonly used for benzodiazepine withdrawal. Carbamazepine (Tegretol) and donepezil (Aricept) may be used to treat related conditions, but are not specifically indicated for benzodiazepine withdrawal. Disulfiram (Antabuse) is used to treat alcohol dependency, but has no role in benzodiazepine withdrawal. Lorazepam (Ativan) is another benzodiazepine that could be used for withdrawal, but is not the best choice given the patient's history of withdrawal delirium.

Question 11

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

Accepted Answer

This statement demonstrates acknowledgement of the negative consequences of substance use and the impact it has had on the client's life. It suggests the client is aware of the need for change and may be motivated to make progress toward recovery. Choices A, B, and C may indicate some progress, but they also suggest the client may not fully understand the nature of addiction or the challenges of sustained recovery.

Question 12

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

The nurse should support the client's understanding that her husband needs to take responsibility for his own actions.

Question 13

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

Psychological addiction refers to the emotional or mental attachment to a substance, where the individual feels a compulsion to use it for emotional relief, as seen in this scenario with the divorcée using cocaine to self-medicate for depression.

Question 14

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

Accepted Answer

Holding the client's hand allows the nurse to feel for fine tremors, which are a common symptom of alcohol withdrawal.

Question 15

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

Accepted Answer

Pathological gambling has been linked to abnormalities in neurotransmitter systems, particularly dopamine. Non-pathological gambling behaviors do not have this association.

Question 16

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

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Question 17

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

Accepted Answer

The statement that "marijuana is essentially harmless" indicates a knowledge deficit related to substance use disorder as it downplays the risks and negative consequences associated with marijuana use.

Question 18

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

Lithium carbonate and sertraline have been studied for their potential benefits in treating gambling disorder, as they can help manage mood and impulse control.

Question 19

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

Substitution therapy involves administering a safer medication that has similar effects to the drug of abuse. In this case, a CNS depressant may be administered to manage the symptoms of alcohol withdrawal. Antagonist therapy involves administering a medication that blocks the effects of the drug of abuse, deterrent therapy involves using medications to create unpleasant physical effects when the substance is consumed, and codependency therapy involves counseling for individuals who have a close relationship with the person with the substance use disorder. None of these terms accurately describe the administration of a CNS depressant during alcohol withdrawal.

Question 20

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?

Accepted Answer

The answer of Which of the following nursing statements exemplify...

Quiz 14: Substance Use and Addictive Disorders

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

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?

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

A nursing instructor is teaching nursing students about cirrhosis of the liver. Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed?

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 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 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?

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

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?

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

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

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?

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

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

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?

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

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?

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?

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?

Quiz 14: Substance Use and Addictive Disorders

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

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?

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

A nursing instructor is teaching nursing students about cirrhosis of the liver. Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed?

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 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 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?

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

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?

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

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

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?

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

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

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?

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

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?

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?

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?

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?