Deck 22: Addiction

Question 1

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

A) "Are you a heavy drinker?"
B) "How many alcoholic beverages do you drink each day?"
C) "Is alcohol use a concern for you?"
D) "Drinking doesn't cause any problems for you, does it?"

Answer 1

"How many alcoholic beverages do you drink each day?"

Question 2

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?

A) Initiate a community assessment of the campus.
B) Contact the campus nurse and refer the student.
C) Notify campus security to watch for driving under the influence.
D) Complete a crisis assessment.

Answer 2

Complete a crisis assessment.

Question 3

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

A) Disulfiram
B) Naloxone
C) Bupropion hydrochloride
D) Varenicline

Answer 3

Disulfiram

Question 4

A client with alcoholism is receiving court-ordered care in a residential treatment facility.After alcohol is discovered in the client's room,the client states,"It is not mine." Which responses by the nurse are appropriate in this situation? Select all that apply.

A) "You will lose your day pass privileges for this Sunday."
B) "We have a video of you accepting the alcohol from your brother."
C) "What do you think about sharing this at AA tonight?"
D) "You won't be allowed to go to dinner tonight."
E) "You have violated our behavior contract."

Question 5

The employee health nurse is providing care to an employee who was injured on the job.The client 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?

A) Liver enzymes
B) Stool guaiac
C) Urine toxicology testing
D) Hair testing

Question 6

A nurse educator is a teaching a group of students about the comprehensive theory of addiction by George Engel.Which statements indicate that the students understand the theory? Select all that apply.

A) "Addiction occurs due to a lack of emotional attachment."
B) "There is a biological factor involved in the development of addiction."
C) "There are social factors that contribute to the development of addiction."
D) "There is a moral factor involved in the development of addiction."
E) "There is a psychological factor involved in the development of addiction."

Question 7

A college student attends a seminar on alcohol abuse.Which statement would alert the nurse that the student needs more education?

A) "The children of alcoholics are less likely to become alcoholics."
B) "Native Americans are more likely to become alcoholics."
C) "Married college graduates are less likely to become alcoholics."
D) "Childless people are more likely to become alcoholics than parents."

Question 8

The nurse is conducting a crisis assessment for a client who admits to cocaine use.Which questions are appropriate for the nurse to ask the client during this process? Select all that apply.

A) "Are recreational centers available?"
B) "What is the most significant stress/problem occurring in your life right now?"
C) "How long has this been a problem?"
D) "What are the living conditions of the neighborhood?"
E) "What other stresses do you have in your life?"

Question 9

The nurse is evaluating outcome goals written by a student for a client diagnosed with alcoholism who is being discharged from a detoxification program.Which outcomes are appropriate for this client? Select all that apply.

A) Follow a 2000-calorie high-carbohydrate diet.
B) Sponsor a participant in Alcoholics Anonymous (AA) meetings.
C) Obtain at least 6-8 hours of sleep per night.
D) Acknowledge the blame that family members must take for codependent behavior.
E) Enroll in the Employee Assistance Program (EAP) through his employer.

Question 10

The nurse is conducting a health promotion class to adolescents regarding smoking.Which point is most important to convey to this audience?

A) Teens are not strongly influenced by tobacco advertising.
B) Smoking causes lung cancer.
C) Cost is no deterrent to smoking.
D) Alcohol use is strongly associated with smoking.

Question 11

The nurse assesses a client 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 client?

A) Ineffective Coping
B) Imbalanced Nutrition: Less Than Body Requirements
C) Disturbed Sensory Perception
D) Disturbed Thought Processes

Question 12

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

A) Diazepam
B) Haldol
C) Vitamin B₁₂
D) Naloxone

Question 13

A client is admitted for the fourth time in 4 years for alcohol detoxification.When planning care for this client,the nurse will include which pathophysiology aspect of alcoholism due to its impact on client care?

A) Aging can impact the ability of the body to handle detoxification from alcohol and drugs.
B) The withdrawal may be greater this time.
C) The dependency might have been greater this time.
D) Increased difficulty with alcohol detoxification is likely the result of an addiction to another substance at the same time.

Question 14

The nurse is providing care to a client who admits to smoking 2 packs of per day for 34 years.The client also has a history of intermittent claudication,chronic bronchitis,and emphysema.After 6 weeks of smoking cessation the client reports,"yelling at my spouse" and "flying off the handle." Which effects of cigarette smoking are associated with the data collected from the client? Select all that apply.

A) Nicotine causes destruction of the alveoli.
B) The release of epinephrine causes vasoconstriction.
C) Dopaminergic processes are implicated in withdrawal symptoms.
D) Tar causes the mucus production seen in chronic bronchitis.
E) Tobacco use causes atherosclerosis.

Question 15

The nurse is providing care for a client of Asian descent who admits to an alcohol addiction.The client admits to being able to hide the addiction from family and friends.Based on this data,which independent nursing intervention is appropriate for this client?

A) Assertiveness training
B) Milieu therapy
C) Family therapy
D) Communication training

Question 16

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?

A) Relapse is a common feature of substance abuse.
B) Hereditary, as well as complex environmental influences, predisposes one to substance dependence.
C) Clients with a substance dependence cannot be held accountable for their actions.
D) Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are accepted treatment approaches.

Question 17

During visitation on the unit,the nurse is observing the family dynamics of an adolescent client who has an addiction problem and recognizes that the family is experiencing behaviors consistent with codependence.Based on this data,which manifestation does the nurse anticipate from the client's family?

A) Frustration intolerance
B) Enabling
C) Argumentative behaviors
D) Impatience

Question 18

An older adult client with heart disease tells the nurse,"I am sick because I sinned by smoking cigarettes." Which response by the nurse is appropriate?

A) "Smoking cigarettes isn't a sin. There are many worse habits you could have."
B) "Cigarette smoking was desirable when you began smoking. We didn't know about the problems it could cause."
C) "Why don't we call the hospital chaplain and you can pray about your sins?"
D) "You are correct, but it is too late to do anything about it now."

Question 19

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

A) Sertraline
B) Methadone
C) Naloxone
D) Multivitamin with folic acid

Question 20

While practicing at an outpatient addiction clinic,the nurse is summarizing a diagram in the orientation handbook for a new nurse who requires orientation.Which statement made by the new nurse most closely aligns with the meaning of this diagram?

A) "Addiction involves an alteration in the amount of available neurotransmitters."
B) "Actions at the neurotransmitter level affecting addiction are not genetic."
C) "High self-esteem as a basis for pleasure seeking lowers neurotransmitter levels."
D) "An addictive personality is identified by differences in the processing of neurotransmitters."

Question 21

The nurse is providing education to a client who wants to quit smoking.Which statements are appropriate for the nurse to include in the teaching session with this client? Select all that apply.

A) "There is no adverse risk if the client chooses to smoke while wearing a nicotine patch."
B) "Bupropion (Zyban) is used to suppress the craving for tobacco."
C) "A piece of nicotine gum should be chewed for 5 minutes of every waking hour then held in the cheek."
D) "Most persons quit smoking several times before they are successful."
E) "Alternative therapies should be considered to help reduce the stress that accompanies smoking cessation."

Question 22

A nurse is caring for a client who smokes cigarettes and asks the nurse about nicotine replacement therapy (NRT).Which statement regarding this product is appropriate for the nurse to include in the teaching session?

A) "Over-the-counter (OTC) NRTs include transdermal patches, gums, nicotine inhalers, and nasal sprays."
B) "NRT helps to relieve the psychological and physiological effects of nicotine withdrawal."
C) "NRT does not address addictive behavior."
D) "Combining the use of NRT and a smoking cessation program is no more effective than NRT use alone."

Question 23

The nurse provides a wellness program to a group of pregnant adolescents at risk for substance abuse.Which participant statement indicates that teaching has been effective?

A) "Drinking alcohol and smoking marijuana can harm my baby."
B) "I need to take good care of myself by participating in vigorous exercise."
C) "My anemia and eating mostly fast food are not important."
D) "I should seek prenatal care at some point in the pregnancy."

Question 24

A pregnant client experiences abruptio placentae.The father of the baby asks the nurse why this has happened to them.Which risk factor in the client's history is the likely cause for this condition?

A) Maternal smoking
B) Genetic history
C) Maternal cocaine use
D) The mother having low levels of folic acid

Question 25

The nurse is providing care to a client who has a history of chronic obstructive pulmonary disease (COPD)who wants help and information regarding nicotine addiction and ways to quit smoking.After providing education to this client regarding smoking cessation,which statement indicates appropriate understanding of the information presented?

A) "I will keep a pack of cigarettes in my closet in case I need it."
B) "I will taper off smoking gradually."
C) "I will chew sugar-free gum when I want a cigarette."
D) "I will eat a snack when I am feeling nervous."

Question 26

A nurse is caring for a newborn who is being treated in the newborn intensive care unit (NICU)due to complications from exposure to illicit drugs in utero.The newborn has microcephaly,multiple cerebral infarcts and is inconsolable with a high-pitched cry.Which illicit drug is likely to blame for the newborn's symptoms?

A) Marijuana
B) PCP
C) Cocaine
D) LSD

Question 27

A nurse is caring for a client with congestive heart failure (CHF)who currently smokes cigarettes and has a 50 pack-year smoking history.When providing smoking cessation education to the client,which statements regarding the pathophysiology of nicotine use are appropriate? Select all that apply.

A) "In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine."
B) "In high doses, nicotine stimulates the parasympathetic system to release epinephrine, causing vasoconstriction."
C) "Initially, nicotine increases mental alertness and cognitive ability."
D) "Nicotine is a nonpsychoactive substance found in tobacco."
E) "Gradual reduction of nicotine appears to be the best method of cessation."

Question 28

A pregnant woman,who admits to intravenous drug use,had a negative human immunodeficiency virus (HIV)screening test just after missing her first menstrual period.Which assessment data would indicate the client needs to be retested for HIV?

A) Hemoglobin of 11 g/dL and a rapid weight gain
B) Elevated blood pressure and ankle edema
C) Unusual fatigue and oral thrush
D) Shortness of breath and frequent urination

Question 29

The nurse is doing preconception counseling with an adult client with no prior pregnancies.Which client statement indicates that teaching has been effective?

A) "I can continue to drink alcohol throughout my pregnancy."
B) "A beer once a week will not damage the fetus."
C) "I don't need to stop drinking alcohol until my pregnancy is confirmed."
D) "I can't drink alcohol while breastfeeding, because it will pass into the breast milk."

Question 30

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

A) Anxiety
B) Diabetes
C) Weight gain
D) Kidney stones

Question 31

The nurse is caring for a pregnant woman who admits to using Ecstasy on a regular basis.The client states,"Everybody knows that alcohol is bad during pregnancy,but what's the big deal about Ecstasy?" Which response by the nurse is appropriate?

A) "Ecstasy use leads to deficiencies of thiamine and folic acid, which help the baby develop."
B) "Ecstasy use produces babies with small heads, short bodies, and brain function alterations."
C) "Ecstasy use results in intrauterine growth restriction and meconium aspiration."
D) "Ecstasy use has been associated with long-term impaired memory and learning in the child."

Question 32

A young adult client is at 28 weeks' gestation.The prenatal history reveals past drug abuse,and urine screening indicates that she has recently used heroin.Which potential fetal health problem should the nurse use to select a nursing diagnosis to guide care?

A) Congenital anomalies
B) Abruptio placentae
C) Diabetes mellitus
D) Intrauterine growth restriction (IUGR)

Question 33

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

A) "The dopamine D(1) and dopamine D(2) receptors are responsible for co-occurring disorders."
B) "Dopamine increases opioid transmission, and this reinforces the cycle of substance abuse."
C) "Dopamine causes changes in brain neurotransmission that enhance the cycle of substance abuse."
D) "The dopamine D(3) receptor is involved in drug-seeking behaviors."

Question 34

A nurse working in an outpatient primary care clinic is caring for a client with asthma who has an 80 pack-year smoking history.When assessing the client's current use of nicotine,which question is most appropriate?

A) "Have you tried a nicotine patch for quitting smoking?"
B) "Do you smoke cigarettes with filters or without?"
C) "Do you smoke upon waking?"
D) "Tell me about any attempts you've made to quit using nicotine."

Question 35

A nurse works at a clinic which provides care to a community which has a high population of smokers.The nurse is planning an educational session on "Tips to Quit." Which action by the nurse is appropriate?

A) Telling this group that smoking is unacceptable.
B) Making sure the group is aware of the increased risk of liver disease and cancer of the esophagus.
C) Reviewing the available pharmacologic adjuncts to cessation.
D) Recommending hypnosis at a local dinner theater.

Question 36

The nurse is collecting data on prenatal clients at a clinic on a Native American reservation in Arizona.One client has risk factors for substance abuse.What physical sign or signs did the nurse assess that suggest substance abuse in this client? Select all that apply.

A) Dilated pupils
B) Odor of alcohol on the breath
C) Frequent accidents or falls
D) Underweight
E) Dressed in jeans and a t-shirt

Question 37

The nurse is providing care to a pregnant client during a prenatal visit.The nurse suspects that the client has used cocaine.Which clinical manifestations support the nurse's suspicion? Select all that apply.

A) Increased appetite
B) Pinpoint pupils
C) Muscle jerks
D) Hypertension
E) Bradycardia

Question 38

A young adult pregnant client tells the nurse that she and her husband are going to a 50th wedding anniversary party for her grandparents this weekend.The client asks the nurse if it will be okay to have a few glasses of wine at the party.Which response by the nurse is appropriate?

A) "Drinking a few glasses of wine will not be a problem."
B) "Alcohol during pregnancy can cause the baby to be born without limbs."
C) "Drinking any alcoholic beverages during pregnancy puts your baby at risk for injury."
D) "Wine is acceptable but not hard liquor."

Question 39

The nurse is planning care for a client with esophageal cancer due to years of nicotine abuse.Which is the priority nursing diagnosis for this client?

A) Decisional Conflict
B) Situational Social Isolation
C) Disturbed Body Image
D) Ineffective Airway Clearance

Question 40

A nurse is caring for a client who is pregnant and requires IV antibiotic therapy for treatment of pyelonephritis.Prior to administering the medication,the nurse discovers the medication is Category B for pregnancy.When planning care for this client,which will the nurse take into consideration regarding this medication?

A) Controlled studies in women have demonstrated no associated fetal risk.
B) There have been no controlled studies in women in particular, but controlled human studies have failed to demonstrate a risk.
C) Animal studies show teratogenic effects, but no controlled studies in women are available.
D) Evidence of human fetal risk exists, but the benefits of the drug in certain situations are thought to outweigh the risks.

Question 41

A nurse is caring for a client who displays addiction behavior toward the use of alcohol.The client states to the nurse,"I have been in jail twice for driving under the influence." When planning care for this client,which behavioral therapy is most appropriate?

A) Positive reinforcement
B) Negative reinforcement
C) Positive punishment
D) Negative punishment

Question 42

A nurse working in the emergency department is caring for a client who has overdosed on cocaine.The nurse receives a prescription to administer an antipsychotic medication from the healthcare provider.Which symptom would this medication help to manage? Select all that apply.

A) Alkaline urine
B) Decreased deep tendon reflexes
C) Hyperpyrexia
D) Respiratory distress
E) CNS depression

Question 43

A nurse manager in the intensive care unit (ICU)notes a pattern for a staff nurse who excessively "wastes" narcotics,and the manager suspects the staff nurse may be impaired.Which clinical situation may have contributed to the staff nurse's problem?

A) Caring for clients who require IV medications
B) Easy access to prescription drugs
C) Easy access to client care areas
D) Caring for clients who require numerous oral medications

Question 44

The nurse is providing care to a client 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?

A) "Naltrexone will cause your daughter to become violently ill if she drinks alcohol or abuses drugs."
B) "Naltrexone is less potent than the street drugs your daughter is currently taking and therefore safer."
C) "Naltrexone diminishes the cravings your daughter will feel for alcohol and opioids."
D) "Naltrexone will prevent your daughter from getting drunk when she drinks."

Question 45

A client 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 client,which will the nurse take into account?

A) To admit to having a problem
B) To learn problem-solving skills
C) To take a moral inventory of self
D) To make amends to people they have hurt

Question 46

A client is admitted to the emergency department after overdosing on phencyclidine piperidine (PCP).Based on this actions,which actions are appropriate by the nurse? Select all that apply.

A) Obtain materials to assist with lavage.
B) Initiate an IV.
C) Initiate seizure precautions.
D) Induce vomiting.
E) Administer ammonium chloride.

Question 47

The nurse is completing a health history with an adolescent client and determines the client would benefit from teaching about substance abuse.Which client statements caused the nurse to come to this conclusion? Select all that apply.

A) "I drink alcohol with my friends on the weekends."
B) "I smoke cigarettes on a daily basis."
C) "I use my seat belt every time I ride in a car."
D) "I became sexually active at the age of 13."
E) "I get all A's and B's in school."

Question 48

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

A) "Sometimes a client doesn't show much effort."
B) "We are legally obligated to provide care."
C) "It is important to remain nonjudgmental when caring for any client, even a drug addict."
D) "You are right. I don't know why we bother."

Question 49

A nurse is concerned about potential substance abuse by a coworker.Which of the coworker's behaviors would place the clients on the unit at risk for injury?

A) The nurse in question frequently volunteers to give medications to clients.
B) The nurse in question prefers not to be the "medication nurse" on the shift.
C) The nurse in question declines to take scheduled breaks.
D) The nurse in question frequently requests the largest client care assignment for the shift.

Question 50

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

A) Hallucinations
B) Respiratory depression
C) Seizure activity
D) Signs of withdrawal