Question 1

The patient with a history of alcohol abuse is being discharged to a treatment facility.Which prescription does the nurse anticipate for this patient?

Accepted Answer

Disulfiram is a medication used to support the treatment of alcoholism and works by causing unpleasant symptoms such as nausea, flushing, and headaches if the patient consumes alcohol. Therefore, it is the best choice for a patient with a history of alcohol abuse being discharged to a treatment facility. Naloxone is used to treat opioid overdose, bupropion hydrochloride is used for smoking cessation or treating depression, and varenicline is also used for smoking cessation. These medications would not be the best choice for a patient with a history of alcohol abuse.

Question 2

The employee health nurse is providing care to an employee who was injured on the job.The patient has a history of drug addiction and is currently enrolled in a 12-step recovery program.In order to determine whether the employee was impaired at the time of the accident,which diagnostic tool will the nurse use?

Accepted Answer

Urine toxicology testing is the most appropriate diagnostic tool to determine whether the employee was impaired at the time of the accident. This test can detect the presence of drugs or alcohol in the body and can inform the nurse's treatment plan for the patient. Liver enzymes, stool guaiac, and hair testing are not relevant to assessing current drug use or impairment.

Question 3

The nurse assesses a patient with a history of alcoholism who is hospitalized with anorexia,dysphagia,odynophagia,and chest pressure after eating.Which nursing diagnosis is a priority for this patient?

Accepted Answer

The patient's symptoms suggest a possible esophageal disorder, which can lead to malnutrition and weight loss. Anorexia and dysphagia can cause the patient to eat less, leading to an imbalanced nutrition status. Therefore, addressing the patient's nutritional status should be a priority.

Question 4

The nurse is caring for a patient who is an intravenous drug user.The nurse anticipates the need for assessment for which complication?

Accepted Answer

Intravenous drug use increases the risk of infective endocarditis, an infection in the endocardium, which is the inner lining of the heart. Therefore, the nurse should assess for signs and symptoms of infective endocarditis in this patient. Cardiac tamponade, myocardial infarction, and congestive heart failure are not commonly associated with intravenous drug use.

Question 5

The nurse is completing a health history and determines the patient would benefit from teaching about substance abuse.Which patient statement does not support the need for this teaching?

Accepted Answer

The statement "I get good grades in school" does not indicate a need for teaching about substance abuse. The other statements suggest that the patient may be engaging in risky behaviors related to substance use.

Question 6

A patient is admitted to the emergency department with signs of drug use.The patient reports having ingested Percocet and is experiencing respiratory depression.Based on this data,which prescription does the nurse anticipate for this patient?

Accepted Answer

Naloxone is used to reverse respiratory depression caused by opioids and it would be the appropriate prescription in this situation. Diazepam and Haldol are not indicated for opioid overdose management. Vitamin B₁₂ is not a medication and is not relevant to this scenario.

Question 7

The nurse is caring for a patient who requires an opiate medication for chronic pain associated with a previous injury.The patient tells the nurse,"Even though I don't feel like I'm addicted to the medication,I get tremors in my hands if I miss a dose." What is the nurse's best response?

Accepted Answer

The patient describes physical dependence, which is a normal physiological response to chronic opiate therapy. Addiction, on the other hand, involves psychological dependence, compulsive use, and negative consequences. The nurse's response should acknowledge the distinction between physical dependence and addiction and reassure the patient that physical dependence does not necessarily mean addiction.

Question 8

A patient who is attending a Narcotics Anonymous (NA)program asks the nurse what the most important initial goal of attending the meetings is.When responding to the patient,which indication will the nurse take into account?

Accepted Answer

Admitting to having a problem is the first step in the twelve-step program of NA. This is important to recognize and acknowledge in order to begin the process of recovery. While learning problem-solving skills, taking a moral inventory of self, and making amends to people they have hurt are important aspects of the program, admitting to having a problem is the very first priority.

Question 9

The nurse is providing care to a patient with alcohol and opioid dependency.A family member states,"I don't understand why Naltrexone treatment is prescribed because it causes a high too,right?" Which response by the nurse is appropriate?

Accepted Answer

Naltrexone is an opioid antagonist that works by blocking the effects of opioids in the brain. It does not cause a high or euphoria. Naltrexone helps reduce cravings for alcohol and opioids, which can aid in the treatment of addiction.

Question 10

The nurse is planning to implement addiction treatment groups at the inner city clinic.Which knowledge regarding addictions and its related therapies will facilitate implementation of the groups?

Accepted Answer

The answer of The nurse is planning to implement addiction...

Question 11

A college student is incoherent after taking "downers with beer." For which health problem should the nurse also observe for in this patient?

Accepted Answer

Taking downers (depressants) with beer can lead to respiratory depression, which is a potentially life-threatening condition where breathing becomes slow and shallow or stops completely. It is important for the nurse to closely monitor the patient's respiratory rate and depth to prevent complications. Hallucinations, seizure activity, and signs of withdrawal may also be possible, but respiratory depression is the most immediate concern in this scenario.

Question 12

The nurse is providing care to a patient diagnosed with alcoholism.The patient's physical examination reveals a BMI of 18.Which prescription does the nurse anticipate to manage the patient's nutritional status?

Accepted Answer

A BMI of 18 indicates that this patient is underweight and likely malnourished. Providing a multivitamin with folic acid can help address any nutritional deficiencies and support overall health. Sertraline and methadone are medications used to treat mental health and addiction issues, respectively, but are not directly related to managing nutritional status. Naloxone is used to reverse opioid overdose and is not relevant to this patient's care.

Question 13

The nurse is caring for a patient who is diagnosed with cocaine addiction.For which additional disorder should the nurse assess this patient?

Accepted Answer

Cocaine addiction is often associated with anxiety, and the nurse should assess the patient for this comorbid disorder. Diabetes, weight gain, and kidney stones may not necessarily be related to cocaine addiction, although they could still be present in the patient.

Question 14

The nurse is conducting a class in the community regarding alcohol use to a group of college seniors.During the class a participant admits to frequently using alcohol.Which is the priority action of the nurse?

Accepted Answer

The priority action is to complete a crisis assessment to determine the immediate risk and needs of the participant who admits to frequently using alcohol.

Question 15

A patient being treated for an alcohol use disorder asks the nurse,"Can my children inherit this?" Which response by the nurse is most appropriate?

Accepted Answer

While studies have suggested a genetic component to substance use disorders, the exact role of genetics has not been determined. It is important to educate the patient that while there may be some genetic predisposition, environmental factors also play a significant role in the development of alcohol use disorders.

Question 16

The nurse is evaluating outcome goals written by a student for a patient diagnosed with alcoholism who is being discharged from a detoxification program.Which outcome is appropriate for this patient?

Accepted Answer

Obtaining adequate sleep is a realistic and appropriate outcome goal for a patient recovering from alcoholism, as it supports overall health and recovery.

Question 17

A patient is brought to the emergency department by a parent.The nursing assessment reveals that the patient has been acting strangely for the past three hours and is hypervigilant,grandiose,and irritable.Vital signs reveal hypertension,tachycardia,and some arrhythmias.Which substance does the nurse suspect that the patient has been using?

Accepted Answer

The symptoms of hypervigilance, grandiosity, irritability, hypertension, tachycardia, and arrhythmias are all consistent with the use of amphetamines. Alcohol may cause some of these symptoms but not all of them, and the onset of symptoms would likely be delayed if the patient had been using marijuana or heroin.

Question 18

A nursing instructor is teaching a class about the role of dopamine in substance abuse.Which student statement indicates appropriate understanding?

Accepted Answer

The answer of A nursing instructor is teaching a class...

Question 19

The nurse is conducting a health history for a patient and wants to determine the patient's alcohol use.What question from the nurse will provide the greatest amount of information?

Accepted Answer

Asking "How many alcoholic beverages do you drink each day?" provides a specific and quantifiable response that will give the nurse a better understanding of the patient's level of alcohol use. The question is also open-ended enough to allow the patient to provide additional information. The other options either use language that could be interpreted subjectively ("heavy drinker" and "concern for you") or suggest a socially desirable response ("no problems").

Question 20

After an assessment of a patient,a nursing student expresses a belief that drug addiction is not a real illness,as these patients "did it to themselves." Which response by the staff nurse is appropriate?

Accepted Answer

The appropriate response is C because it stresses the importance of remaining non-judgmental when caring for any patient, regardless of their condition or behavior. It is important to provide care and support to patients with drug addiction, just like any other illness. Stigmatizing or blaming the patient is not productive and can harm the therapeutic relationship, making it more difficult for the patient to recover. The other options are inappropriate as they do not address the student's negative attitude towards the patient and their condition.

Quiz 69: Substance Use Disorders in the Adult Population