Deck 23: Chemically Mediated Responses and Substance-Related Disorders

Question 1

When a recovering impaired colleague returns to work,nursing professionals can be most helpful by:

A) directly offering support.
B) double-checking all the nurse's activities.
C) assigning another nurse to watch the recovering nurse closely.
D) avoiding mention of the problem unless the recovering nurse mentions it.

Answer 1

directly offering support.

Question 2

An individual who is admitted to an alcohol detoxification unit has had no alcohol intake for 3 days.On admission the patient is noted to have tremors,anxiety,insomnia,and disorientation accompanied by tachycardia and diaphoresis.These signs and symptoms are characteristic of the syndrome known as:

A) alcoholic hallucinosis.
B) alcohol-induced psychosis.
C) alcoholic seizure disorder.
D) alcohol withdrawal delirium.

Answer 2

alcohol withdrawal delirium.

Question 3

A patient asks a nurse,"What is the primary aim of self-help groups for alcohol abusers?" The nurse should reply,"The goal is first to:

A) always be available to help others with an addiction."
B) commit to always strive for total abstinence."
C) find and rely on the help of the member's sponsor."
D) admit powerlessness over the addiction."

Answer 3

commit to always strive for total abstinence."

Question 4

An appropriate short-term goal related to abstinence for a drug abuser would be "The patient will:

A) verbalize details of the addiction to significant others."
B) declaratively state an intention to abstain from drug use of any sort."
C) be able to identify the underlying causes that resulted in an addiction to drugs."
D) contact a supportive person if experiencing an urge to use an addictive substance."

Question 5

In the emergency room a nurse learns that a patient has recently taken a large amount of the drug PCP.The nurse should be ready to provide interventions for:

A) acute psychosis, agitation, and violence.
B) hypotension, sedation, and respiratory depression.
C) heightened sensory perceptions, dizziness, and ataxia.
D) paranoid thinking, hyperthermia, hyperactivity, and arrhythmias.

Question 6

A nurse suspects that a patient being admitted for outpatient surgery may have a history of alcohol abuse.To further assess this issue,the nurse should consider:

A) using a screening tool, such as AUDIT-C to assess the extent of the abuse.
B) asking directly if the patient has ever had problems with abusing alcohol.
C) interviewing the family because the patient is likely to deny having a problem.
D) addressing the suspicion before discharge since it has no direct effect on the patient's surgery.

Question 7

The most positive initial action for a health care agency to take for an impaired nurse would be:

A) job dismissal.
B) eliciting a promise to abstain.
C) counseling by the nurse manager.
D) referral to the employee assistance program.

Question 8

A patient has been admitted in an acute psychotic state after ingesting PCP.The nurse has not been able to administer the prescribed dose of benzodiazepine because of the patient's aggressive behavior.The most appropriate intervention under these circumstances would be to:

A) provide an alternative activity to channel energy.
B) move the patient to a quiet room to minimize stimulation.
C) perform a lavage to prevent continuing absorption of drug.
D) assign a nurse to stay with the patient to reassure and calm the patient.

Question 9

A short-term goal for a patient in the early stage of therapy for addiction to sedatives and stimulants is,"The patient will:

A) verbalize dependence on drugs."
B) discuss his or her addictive behavior with others."
C) recognize the situations in which drugs are abused."
D) understand the reasons the dependency on drugs developed."

Question 10

A patient sustained a fractured femur while driving under the influence of drugs.Family members indicate that the patient has "dabbled in drugs" for years.When the patient obtains little relief from the prescribed dose of narcotic analgesic,the nurse suspects the ineffective pain relief is related to:

A) drug tolerance to the narcotic prescribed.
B) the predictable onset of withdrawal symptoms.
C) insufficient analgesic dosage to manage the pain.
D) the strong likelihood of a history of substance abuse.

Question 11

The nursing intervention of highest priority relative to alcohol withdrawal delirium is:

A) application of restraints.
B) reorientation of the patient to reality.
C) identification of existing social supports.
D) maintenance of fluid and electrolyte balance.

Question 12

In assessing risks and planning interventions,a nurse should recognize that the longer the half-life of a drug of abuse,the:

A) shorter the withdrawal.
B) less intense the withdrawal symptoms.
C) sooner the patient will begin to crave the drug.
D) shorter the withdrawal and the more intense the symptoms.

Question 13

A nurse should specifically assess a patient opiate withdrawal for:

A) lacrimation, rhinorrhea, dilated pupils, and muscle pain.
B) somnolence, constipation, normal pupils, and hypothermia.
C) tremors, hypertension, constricted pupils, and deep sleep.
D) visual and tactile hallucinations, agitation, and generalized seizures.

Question 14

A nurse has concerns about erratic behavior and slurred speech of another member of the nursing staff.The most appropriate action for the concerned nurse to take is to:

A) immediately confront the impaired nurse with the observation.
B) ask other nurses if they have observed anything unusual regarding the nurse in question.
C) personally supervise the team member whenever the care involves the preparation of pain medication.
D) notify the nursing supervisor to assess the team member's condition and performance.

Question 15

The spouse of a patient with alcoholism asks,"How do I respond in a helpful way even though this abuse is so harmful to my family?" The nurse's best response would be:

A) "Search the house regularly for hidden alcohol."
B) "Include your spouse in family activities whether or not drinking has occurred."
C) "Make your spouse responsible for the consequences of the disruptive behavior."
D) "Refuse to be supportive when your spouse is under the influence of alcohol."

Question 16

An unconscious patient is brought to the emergency department.It is suspected the patient overdosed on heroin.What drug can the nurse anticipate will be administered?

A) Disulfiram (Antabuse)
B) Naltrexone (Revia)
C) Methadone (Methadose)
D) Acamprosate (Campral)

Question 17

A novice nurse on the chemical dependence unit mentions,"The drugs of abuse all seem to cause patients to become violent." The best reply would be:

A) "Violence is usually associated with abuse rather than with drug withdrawal."
B) "There are abused drugs, such as heroin, that rarely produce violent behavior."
C) "The observation is generally true since most abusers have observable antisocial tendencies."
D) "Ineffective nursing actions toward patients are more responsible for violence than drugs are."

Question 18

Whenever possible,physical exercise and meditation should be a daily component of the ongoing program of treatment for a person with an addiction.The basis for these aspects of treatment is to make use of the body's natural:

A) endocrines.
B) endorphins.
C) enkephalins.
D) epinephrine.

Question 19

When designing a teaching plan for a patient taking disulfiram (Antabuse),a nurse should include an explanation on the importance of avoiding certain over-the-counter substances.With the appropriate instruction,which substance could the patient identify as being safe to use?

A) Antacids
B) Mouthwash
C) Cough syrups
D) Cold medications

Question 20

A patient addicted to both alcohol and benzodiazepines tells a nurse,"I can control my drug use anytime I want to." This statement is an example of the patient's use of:

A) denial.
B) repression.
C) compensation.
D) reaction formation.

Question 21

A patient is brought to the emergency department to be assessed after an auto accident.The patient has slurred speech and ataxia and reacts aggressively when examined.The patient's blood alcohol level (BAL) is 0.4 g/dl.From the relationship between the behavior and the BAL,the nurse can make the assessment that the patient:

A) takes disulfiram (Antabuse).
B) is experiencing alcohol poisoning.
C) has ingested acamprosate (Campral).
D) has a significantly high tolerance to alcohol.

Question 22

Short-term goals related to substance abstinence include which of the following? (Select all that apply.)

A) "The patient will make a daily commitment to abstain."
B) "The patient will attend at least two support group meetings weekly."
C) "The patient will focus on improving the quality of the relationship with a significant other."
D) "The patient will call a supportive person when experiencing an urge to use an addictive substance."
E) "The patient will commit to provide support to others expressing an interest and need to abstain from addictive substances."

Question 23

A nursing diagnosis universally appropriate for patients who abuse mood-altering drugs would be:

A) confusion.
B) ineffective coping.
C) imbalanced nutrition.
D) impaired environmental interpretation syndrome.

Question 24

The following are goals for a patient being treated for alcoholism.Select the order in which these goals should be approached.
A.Developing alternative coping skills
B.Attaining physiological stabilization
C.Learning about dependence and recovery
D.Abstinence and development of a support system

A) A,B,C,D
B) B,D,C,A
C) C,D,B,A
D) D,C,B,A

Question 25

A nurse using cognitive behavioral therapy to treat a patient with substance abuse problems will:

A) help the patient to develop self-control and social skills.
B) support the use of emotion-focused coping mechanisms.
C) focus on addiction as a disease requiring confrontational tactics.
D) help the patient see that society shares responsibility for the problem.

Question 26

Care planning for a patient undergoing detoxification for both alcohol and sedative-hypnotics is based on the treatment principle that states that:

A) medications are used to treat symptoms as they appear.
B) a cross-tolerant drug is used to gradually wean the patient.
C) liver function is preserved best by avoiding detoxification drugs.
D) forcing fluids is therapeutic since detoxification mainly occurs in the kidneys.

Question 27

It will be most helpful for a nurse to describe a relapse to a recovering substance abuser as a(n):

A) error from which to learn.
B) indicator of treatment failure.
C) event with a physiological cause.
D) need for additional environmental support.