Deck 62: Substance Abuse

Question 1

An alcoholic is brought into the emergency department in an intoxicated state at 2000.The day shift nurse assesses the patient to exhibit tremors, have increased blood pressure, and agitation at 0800 rounds.What do these signs and symptoms indicate?

A) Major withdrawal
B) Early withdrawal
C) Delirium tremens
D) Minor withdrawal

Answer 1

Early withdrawal

Question 2

What might the positive effects of marijuana be used to treat?

A) Diet control in morbidly obese patients
B) Chemotherapy-induced nausea and vomiting
C) Air hunger in patients with end-stage emphysema
D) Early diabetic-induced cataracts

Answer 2

Chemotherapy-induced nausea and vomiting

Question 3

Which information about a patient should lead a nurse to suspect substance abuse?

A) Abnormal liver function test result and a gastrointestinal (GI)bleed
B) Positive syphilis screening result and varicose veins
C) Fungal infection and a potassium level of 4.2.mEq/L
D) Decreased albumin level and creatinine level of 1.2 mg/dL

Answer 3

Abnormal liver function test result and a gastrointestinal (GI)bleed

Question 4

Two treatment plans for abusers of alcohol and drugs are similar-90 meetings in 90 days and 12-step programs.What is the major difference in the success of the two types of programs?

A) One program uses a 12-step approach, and the other program has a religious base.
B) Heroin addicts have a higher success rate.
C) Alcohol abusers have an easier time staying with the program.
D) Relapse rates for patients using drugs other than alcohol alone are much higher.

Question 5

A patient has been diagnosed with alcoholism.A nurse tells him that he has a physical illness with a genetic predisposition to alcoholism, and the only effective treatment is total abstinence from alcohol.This type of approach characterizes which theory?

A) Biologic
B) Behavioral
C) Sociocultural
D) Intrapersonal

Question 6

A patient who has alcoholism with a history of heavy drinking is brought to the inpatient psychiatric unit saying that he does not know where he is or what day it is.What should the nurse suspect he is exhibiting?

A) Delirium
B) Alcoholic dementia
C) Blackout
D) Amnesia

Question 7

What should be avoided to prevent the accidental activation of Antabuse?

A) Aged cheese
B) Pickled foods
C) Mouthwash
D) Chocolate candy

Question 8

A nurse in the admissions unit is informed that a patient is being brought in who has been using "ice." What should the nurse assess?

A) Extreme dehydration
B) Coma
C) Dangerous hypertension
D) Violent behavior

Question 9

Which implementation can be used to help prevent relapse in a patient who has a substance abuse problem?

A) Self-hypnosis
B) Imagery
C) Stress management
D) Blocking

Question 10

What is the rationale for using methadone in the treatment of heroin abuse?

A) Substitutes one opioid for another.
B) Is less constipating than heroin.
C) Does not give the "rush" that a person addicted to heroin is looking for.
D) Is a synthetic opioid, which makes it less addicting.

Question 11

A urine drug screen is ordered for a patient suspected of a driving while intoxicated (DWI).What drugs are included in this screening?

A) Lysergic acid diethylamide (LSD), Valium, and Percocet
B) Crack, heroin, and nonsteroidal anti-inflammatory drugs (NSAIDs)
C) Marijuana, amphetamines, and Elavil
D) Librium, cocaine, and Zoloft

Question 12

An LPN is assisting with the development of a nursing care plan for a patient who has been using cocaine for 5 years.What should the nurse consider will most commonly need to be dealt with in this patient?

A) Depression
B) Violent behavior
C) Nasal erosion
D) Suicide attempts

Question 13

During the taking of a medical history, a patient who is addicted to heroin reports he only uses the drug a few times a week.What is the nurse's best response when trying to disclose more precise information?

A) "OK.You only use heroin two times a week?"
B) "What do you mean when you say 'a few?'"
C) "Are you saying that in a week's time would you use heroin only two times?"
D) "Rate your weekly usage on a scale of 1 to 15."

Question 14

A nurse is discharging a patient with a pulmonary disorder to return home with her family.She has had a difficult time while in the hospital and has experienced withdrawal from tobacco.When the nurse tells her that community resources are available to help her to stop smoking, she says, "That's OK.I can stop whenever I want to." What does this exemplify?

A) Rationalization
B) Denial
C) Intellectualization
D) Projection

Question 15

A patient with an alcohol addiction says, "My drinking is all my wife's fault.She makes me so crazy I just have to have a drink." What does this exemplify?

A) Rationalization
B) Denial
C) Intellectualization
D) Projection

Question 16

Narcan has been given to a person with respiratory depression who is addicted to heroin.What should the nurse be alert for indications of?

A) Acute withdrawal symptoms
B) Respiratory arrest
C) Hypotensive crisis
D) Cardiac arrest

Question 17

A nurse recommends to an alcoholic that he join Alcoholics Anonymous.What is true about this organization?

A) Based on a 12-step approach with a strong religious base
B) A social group of ex-drinkers who befriend one another in the process of maintaining sobriety
C) A religious support group that assists alcoholics during rehabilitation
D) An anonymous group of sponsors who offer help to alcoholics

Question 18

Which syndrome of alcoholism is related to thiamine deficiency?

A) Fetal alcohol syndrome
B) Wernicke encephalopathy
C) Korsakoff psychosis
D) Alcoholic dementia

Question 19

A wife of a man with long-term alcoholism wants to help her husband quit drinking.The nurse tells her that an initial approach might be for a group of friends and family to confront the patient with his alcoholism.What should this group be prepared to indicate during this confrontation?

A) He needs help; his drinking is out of hand.
B) They are fed up with him and will no longer be his friend.
C) They reject his drinking but think he is a valuable person.
D) He is still their friend even if he does not stop drinking.

Question 20

A nurse is counseling a pregnant cocaine abuser.What should the nurse inform this patient that she is placing her baby at significant risk for?

A) Severe allergies
B) Neurologic impairments
C) Hearing impairment
D) Higher birth weights

Question 21

In some cases, patients will use drugs or alcohol to treat the disturbing symptoms of a psychiatric disease.What can occur in this scenario?

A) A mixed-drug reaction, which may heighten the effects of both drugs
B) Decreased psychiatric symptoms, which makes the psychiatric condition harder to treat
C) An accidental overdose by mixing alcohol with anxiolytic medications, antipsychotic medications, or antidepressants
D) An increase in psychiatric symptoms because the psychiatric drugs become less effective in the presence of alcohol

Question 22

What factors make the adolescent extremely vulnerable to substance abuse (Select all that apply.)

A) Egocentricity
B) Ability to use good judgment
C) Poor impulse control
D) Awareness of possible consequences
E) Desire for peer identification

Question 23

What is true regarding hair analysis done on an alcoholic? (Select all that apply.)

A) Requires sensitive technology
B) Is not reliable on treated or dyed hair
C) Can determine addiction
D) Can be informative in the treatment of a short-term abuser
E) Can assess relapse

Question 24

A nurse explains that a test that can detect substance abuse for up to 1 year after only 2 or 3 days of use is performed on ______.

Question 25

A nurse indicates that a urine sample is needed for screening in a case of DWI.What actions should be implemented? (Select all that apply.)

A) Collection and witnessing by a staff member of the same gender
B) Documented with a chain-of-custody form signed by all who handle the specimen
C) Keep specimen under secure conditions if temporary storage is necessary
D) Never be out of sight until someone from law enforcement takes it
E) Place in a specially marked container

Question 26

What does alcohol abuse in the older adult place him or her at risk for? (Select all that apply.)

A) Falls
B) Malnutrition
C) Respiratory infections
D) Bone demineralization
E) Cirrhosis

Question 27

A nurse documents signs of Wernicke encephalopathy in a patient with long-term alcoholism.What do these signs include? (Select all that apply.)

A) Confabulation
B) Ataxia
C) Delirium
D) Decreasing level of consciousness
E) Projectile vomiting