Deck 9: Drugs of Abuse

Question 1

A client with a history of long-term alcohol abuse is diagnosed with Wernicke's encephalopathy. The nurse would plan the client's care with the knowledge that which treatment will be needed first?

A) Large volumes of intravenous fluids to rehydrate
B) Bolus of high-concentration glucose solution to treat hypoglycemia
C) Intravenous thiamine to address nutritional deficiency
D) Administration of stimulants to counteract depression

Answer 1

Intravenous thiamine to address nutritional deficiency

Question 2

A client enters the emergency department complaining of acute lower right quadrant abdominal pain. It is determined that the client has appendicitis and is scheduled to go to the operating room immediately. The nurse notes on the database that the client generally drinks 10 to 12 beers a day, although he did not drink in the past 4 days because of the pain. The nurse would expect that the:

A) client's surgery would be canceled because of the threat of a withdrawal reaction.
B) client's surgery would proceed with no change in the plan of care.
C) client would require a greater level of anesthesia as a result of cross-tolerance.
D) client would need less anesthesia because of the circulating blood alcohol.

Answer 2

client would require a greater level of anesthesia as a result of cross-tolerance.

Question 3

A client is admitted to a nursing unit in acute alcoholic withdrawal. Which nursing diagnosis is the highest priority early in this admission?

A) Risk for injury related to disorientation and seizure activity
B) Disturbed thought processes due to symptoms of withdrawal
C) Imbalanced nutrition: less than body requirements due to poor intake
D) Acute constipation related to effects of poor nutrition and decreased activity

Answer 3

Risk for injury related to disorientation and seizure activity

Question 4

The spouse of a client asks why her husband seems to drink more when he is depressed. What should the nurse say in response?

A) "The body craves alcohol more when someone is sad."
B) "A person's mood does not have any impact on his or her drinking."
C) "Depression is an excuse to drink."
D) "Research indicates that alcohol elevates a person's mood."

Question 5

A client with congestive heart failure receives digoxin (Lanoxin) to slow and strengthen ventricular contraction. He tells a nurse during his health history that he frequently uses amphetamines to "deal with all the stress." Which assessments and diagnostics would be a priority for this client?

A) Urinalysis and creatinine clearance
B) Digoxin levels and palpation for edema
C) Blood pressure and BUN
D) Auscultation of heart rhythm and an ECG

Question 6

The nurse is caring for a client with opioid addiction. The client requires the reversal of respiratory depression and coma. The nurse anticipates that she will be treated with which medication?

A) Methadone (Dolophine)
B) Buprenorphine (Subutex)
C) Naltrexone (ReVia, Depade)
D) Naloxone (Narcan)

Question 7

The nurse is caring for a client who is detoxifying after an opioid overdose. The nurse anticipates that which drug will be given to substitute for the opioid?

A) Nalmefene (Revex)
B) Naltrexone (ReVia, Depade)
C) Phenytoin (Dilantin)
D) Buprenorphine (Subutex)

Question 8

The nurse instructs a client prescribed alprazolam (Xanax) for treatment of short-term anxiety to avoid which herbal preparation?

A) Chamomile
B) Ginger
C) Saw palmetto
D) Valerian

Question 9

A client has terminal cancer. She is taking large doses of opiates to control pain. The nurse should:

A) inform the client to decrease drug dose to avoid drug addiction.
B) instruct the client to increase drug dose.
C) discontinue the client's opiates to avoid drug addiction.
D) allow the prescribed opiate dose unless drug toxicity occurs.

Question 10

Which client statement demonstrates the greatest readiness for smoking or alcohol cessation?

A) "I will cut down my smoking and drinking, but I won't stop completely."
B) "I don't know why everyone thinks my smoking and drinking are a problem."
C) "I need help in dealing with my addiction to smoking and drinking."
D) "I will quit when my smoking and drinking really affect my life."

Question 11

A client expresses the desire to quit smoking. She elects to use Nicorette gum replacement therapy. Which statement by the nurse is true regarding this smoking cessation technique?

A) "You should not eat or drink for 15 minutes before or after chewing the gum."
B) "You may experience a skin rash as a result of this treatment."
C) "Using a nicotine replacement system will decrease the risk of cancer."
D) "The gum will take away the craving to smoke."

Question 12

A nurse in the emergency department receives a call that a client is being transported to the hospital by paramedics. The client is a known heroin addict and is showing signs of potential overdose. The nurse would expect which symptoms?

A) Anxiety, blurred vision, agitation
B) Clammy skin, constricted pupils, decreased level of consciousness
C) Fatigue, paranoia, hallucinations
D) Panic behaviors, tachycardia, hypertension

Question 13

A postoperative client received morphine in the recovery room. On assessment, the nurse notes that the client's respiratory rate is 6 breaths per minute and that the client has a decreased level of consciousness. The anesthesiologist orders naloxone (Narcan). The nurse administers this medication with the knowledge that this drug is a(n):

A) respiratory stimulant.
B) opioid antagonist.
C) bronchodilator.
D) anticonvulsant.

Question 14

A client is admitted to the emergency room after overdosing on a benzodiazepine. The nurse anticipates that the healthcare provider will order which antidote?

A) Caffeine
B) Epinephrine (Adrenalin)
C) Flumazenil (Romazicon)
D) Phentolamine (Regitine)

Question 15

The client is receiving nicotine replacement therapy in the form of the Commit lozenge. The client tells the nurse that she has been experiencing extreme nausea and indigestion. The nurse recognizes that the client is probably making which mistake?

A) Taking too many of the lozenges per day
B) Letting the lozenge dissolve over a long time period
C) Chewing and swallowing the lozenge
D) Taking too few of the lozenges per day