Deck 11: Substance Use

Question 1

During which stage of alcohol withdrawal would the nurse expect to see a patient experience delirium tremens?

A) Early
B) Minor
C) Intermediate
D) Major

Answer 1

Major

Question 2

A patient has a history of drug abuse and is hospitalized following a fall down a flight of stairs.After a visit by a friend,the nurse finds the patient unresponsive,with pinpoint pupils.What drug should the nurse anticipate will be used to treat this patient?

A) Caffeine
B) Methadone
C) Naloxone (Narcan)
D) Diazepam (Valium)

Answer 2

Naloxone (Narcan)

Question 3

When working with individuals with any substance dependency,during cessation and recovery,why does the nurse advise them to avoid activities and places associated with the substance use?

A) To decrease cue-induced craving
B) To increase their motivation to continue abstinence
C) To prevent substance-abusing friends from influencing their behaviour
D) To avoid reminders of the negative behaviours they previously demonstrated

Answer 3

To decrease cue-induced craving

Question 4

A patient with alcohol dependence is admitted to the hospital following an episode of hematemesis.Twenty-four hours after admission,the patient becomes very tremulous and anxious.What is an appropriate nursing intervention?

A) Promoting oral intake to 3000 mL/day
B) Administering narcotics to provide sedation
C) Providing a calm,quiet,well-lit environment
D) Restraining the patient with vest and arm restraints

Question 5

A 36-year-old man is admitted to the hospital for treatment of large abscesses of both anterior thighs.He has multiple needle puncture sites on both arms and is drowsy during the nursing assessment.After 12 hours,which of the following signs would lead the nurse to suspect opioid abuse by the patient?

A) Tachycardia,convulsions,and delirium
B) Diaphoresis,restlessness,and lacrimation
C) Depression,irritability,and disorientation
D) Gross tremor,hallucinations,and seizures

Question 6

A patient who is alcohol intoxicated must undergo emergency surgery for a ruptured spleen.What does the nurse recognize about the postoperative period for this patient?

A) The patient will require lower than normal doses of analgesics.
B) The patient is likely to develop withdrawal symptoms within 24 hours.
C) The patient is at increased risk for bleeding and respiratory complications.
D) The patient should be stimulated every hour to prevent the prolonged effects of the anaesthesia.

Question 7

While the night nurse is giving a morning report on a patient who has been admitted with an opiate overdose,one nurse says,"I don't know why we should waste our efforts on her.This is her third admission,and she'll be back on the needle as soon as we save her life." What is the most appropriate response by the night nurse to this remark?

A) "That's a totally unprofessional attitude,and you should be ashamed of yourself."
B) "You know the patient always comes first,even though we feel that way about her."
C) "You probably shouldn't care for this patient since you have such negative feelings about her."
D) "It is important for us to recognize and deal with the feelings we have about caring for difficult patients like this woman."

Question 8

Which of the following is an objective measure that would indicate alcohol dependence?

A) The person drinks fewer than four drinks every day.
B) The person is usually considered socially stable.
C) The person has a mild tolerance to alcohol.
D) The person drinks more than 40 drinks in a week.

Question 9

During physical assessment of a patient with chronic alcohol abuse,what does the nurse identify as a pathophysiological change related to alcohol?

A) Hypotension
B) Hyperthermia
C) Hepatomegaly
D) Dependent edema

Question 10

A 60-year-old man has been a heavy drinker for 30 years,drinking daily with his business associates.When he is seen at the clinic for acute gastritis,which of the following responses by the patient will help the nurse determine that the patient is in the contemplation stage of change?

A) "Alcohol has never bothered my stomach.I may just have the flu."
B) "I know that I have to stop drinking,but it is the only way I can relax."
C) "I think my drinking is affecting my stomach,but maybe some drugs will help calm it down."
D) "My wife keeps telling me that I am killing myself with alcohol,but I really feel pretty good,except for my stomach."

Question 11

A patient comes to the health clinic because of a chronic respiratory infection and sinus headache.During physical assessment of the patient,the nurse finds nasal sores and necrosis of the nasal septum.What drug use should the nurse ask the patient specifically about?

A) Heroin
B) Cocaine
C) Tobacco
D) Marijuana

Question 12

A patient hospitalized for a stab wound is found to be addicted to opioids.Which of the following statements by the patient leads the nurse to believe that the patient is in the contemplation stage of change?

A) "I need to reform my friends."
B) "What kind of help is there for me?"
C) "I promise I will never use drugs again."
D) "Would sniffing drugs be better for me than shooting up?"

Question 13

For which reason does the nurse administer thiamine and multivitamins to a patient in alcohol withdrawal?

A) To prevent development of encephalopathy
B) To offset vitamin deficiencies caused by excessive drinking
C) To begin to reverse the symptoms of malnutrition
D) To aid in flushing the liver of alcohol-related metabolites

Question 14

A young woman was brought to the hospital by friends when she developed visual and auditory hallucinations and extreme agitation after she smoked a large dose of "speed" (amphetamines).Her vital signs are blood pressure 162/98 mm Hg,heart rate is 142 beats per minute and irregular,and respiration is 32 breaths per minute.What is the most important nursing intervention at this time?

A) Monitor the patient's electrocardiogram and vital signs.
B) Orient the patient with consistent verbal contact.
C) Obtain a health history that includes prior drug use.
D) Promote continuous ambulation and physical activity.

Question 15

Which statement is true in relation to Canada's low-risk drinking guidelines?

A) Drink no more than 15 drinks per week if you are a female.
B) Have no more than six drinks on any one occasion if you are a male.
C) Limit alcohol intake to two drinks in any three-hour period,regardless of gender.
D) Eat before but not while drinking alcohol.

Question 16

When explaining the effects of abused substances to a group of young adults,what should the nurse tell them about changes in the brain that are caused by prolonged use of these substances?

A) Causes increased sensitivity to environmental stimuli
B) Requires the continual use of the substances to feel normal
C) Promotes the hyperrelease and activity of neurotransmitters
D) Leads to destruction of brain cells in the cerebral cortex

Question 17

A patient at the clinic tells the nurse that she is worried about her 17-year-old son,who has been socializing with some teenagers she thinks are using drugs.What is the best motivational response to address the patient's concern?

A) "Most young people experiment with drugs,but very few really become addicted to illegal substances."
B) "You must stop his association with these friends to prevent him from being exposed to drug use."
C) "You should learn about the early signs and symptoms of drug abuse and share your concerns with your son."
D) "You need to make an appointment for your son with a drug counsellor so that he can be taught about the harmful effects of drugs."

Question 18

A young man is brought to the emergency department by the police,who found him running through traffic and yelling that he could fly over the cars.He is very agitated and restless.On questioning,he admits to the nurse that he took some drugs at a party a few hours before.What is an appropriate nursing diagnosis for the nurse to document for this patient?

A) Anxiety related to effects of drugs
B) Risk for injury related to altered perception
C) Risk for violence: self-directed related to guilt
D) Powerlessness related to loss of control of behaviour

Question 19

A patient hospitalized for elective surgery stopped smoking two days before admission as advised by the nurse.When caring for the patient postoperatively,what does the nurse recognize that nicotine withdrawal may cause?

A) Insomnia,craving,and hyperirritability
B) Headache,nervousness,and depression
C) Fatigue,somnolence,and shortness of breath
D) Loss of appetite,increased heart rate,and increased blood pressure