Deck 27: Pharmacology of Substance Abuse

Question 1

The client is admitted to the inpatient substance abuse unit.She tells the nurse she has been buying "yellow jackets" (pentobarbital,or Nembutal)on the street,but has not had any for a few days.Which plan,by the nurse,is the most appropriate at this time?

A)Prepare to do frequent room searches,as the client's friends will most likely bring drugs in for her.
B)Prepare to manage the depression and suicidal thoughts the client will have.
C)Prepare to manage a withdrawal that will likely be minimal.
D)Prepare to manage a withdrawal that could be life threatening.

Answer 1

Prepare to manage a withdrawal that could be life threatening.

Question 2

The nurse is managing care for a group of substance abusers.The clients have completed group education about the disease of addiction.The nurse determines that learning has occurred when the clients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"A heroin addict can die from heroin withdrawal."
B)"Addiction includes a compulsion to use a mood-altering substance."
C)"Most addicts became addicted from pain medication in a hospital."
D)"Substance abuse depends on complex variables."
E)"There is most likely a genetic component to addiction."

Answer 2

"Addiction includes a compulsion to use a mood-altering substance."
"Substance abuse depends on complex variables."
"There is most likely a genetic component to addiction."

Question 3

The nurse is reinforcing factors that contribute to addiction to a group of clients recovering from addiction and their family members.Which statement made by a client or family member would indicate the need for additional teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"I'm not likely to have any more problems with addiction since neither of my parents had a problem with addiction."
B)"I can still see my friends as long as I stay away from alcohol."
C)"I don't want to become addicted like my husband did.I'm never going to take any kind of drug unless I absolutely have to."
D)"I realize now that I was just looking for ways to help me feel good about myself."
E)"After a while,it just seemed even though I was not in pain,I would still want to take the pain pills."

Answer 3

"I'm not likely to have any more problems with addiction since neither of my parents had a problem with addiction."
"I can still see my friends as long as I stay away from alcohol."
"I don't want to become addicted like my husband did.I'm never going to take any kind of drug unless I absolutely have to."

Question 4

The client had been abusing cocaine for several years.Recently,the client snorted cocaine that was much purer than was thought,resulting in an overdose.The client died in the emergency department.What does the nurse recognize as the most likely cause of death?

A)Impurities in the cocaine
B)Bowel ischemia
C)Rhabdomyolysis
D)Respiratory arrest

Question 5

A nurse preparing a teaching plan for a group of high school athletes on anabolic steroid use and abuse would include which key points in the presentation? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)While anabolic steroids do enhance performance,their use can also produce serious side effects such as liver disease and stroke.
B)Anabolic steroids can cause infertility,impotence,and breast enlargement in men.
C)Anabolic steroids can cause women to develop masculine traits such as increased body hair,deepening voice,and shrinking breasts.
D)Anabolic steroids can cause personality changes such as aggression,violent behavior,depression,and insomnia.
E)Anabolic steroids can be taken safely if the "pyramiding" method is used.

Question 6

A client with an extensive history of alcoholism is having coronary bypass surgery.While administering anesthesia,the certified nurse anesthetist notes that the client requires greater than usual amounts of the drug.The nurse correctly evaluates this response as which phenomenon?

A)The client has developed a resistance to the anesthesia,so it will not work very well.
B)The client has developed a paradoxical reaction to the anesthesia and will require a different drug.
C)The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this client.
D)The client had developed cross-tolerance to the anesthesia and will require greater amounts.

Question 7

A nurse is preparing to admit a client suspected of overdose.Which drugs will the nurse monitor for because of their high potential for abuse? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Oxycodone (OxyContin)
B)Nicotine
C)Marijuana
D)Amobarbital (Amytal)
E)Secobarbital (Seconal)

Question 8

Which is a priority outcome for the client who is diagnosed with chronic alcoholism and liver damage?

A)The client will switch to a safer drug,such as a benzodiazepine.
B)The client will become involved in Alcoholics Anonymous (AA).
C)The client will learn to drink more responsibly.
D)The client will keep all appointments with the doctor that is treating the liver damage.

Question 9

The client comes to the emergency department and tells the nurse,"I have been off my drugs for three days." The nurse assesses the client for withdrawal symptoms associated with the category of drug used.Withdrawal from which drug,if taken by the client,should cause the nurse the most concern?

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

Question 10

The nurse is caring for a client who is one day post surgery for an abdominal hysterectomy.The client is requesting morphine sulfate intravenous (IV),which is prescribed.The client rates her pain as 8 out of 10,with 10 being the most intense.The nurse says to another nurse on the unit,"She really doesn't look like she is in pain.Maybe she is an addict." Which is the best response by the other nurse?

A)"Maybe you could tell her to do some distraction techniques first."
B)"You could call the doctor and get an order for an oral medication."
C)"I would give the morphine; pain is subjective,and we don't know her history."
D)"I would hold the medication until she looks like she is in pain."

Question 11

A 10-year-old child is admitted to the emergency department after "huffing" gasoline.The health care provider suspects mild brain damage.Which clinical manifestations will the nurse teach the parents to observe for after they take the child home?

A)Irregular pulse,fainting,and anger
B)Slurred speech,memory loss,and personality changes
C)Nausea,vomiting,and dizziness
D)Depression,cold extremities,and dyspnea

Question 12

The nurse is preparing care for a client diagnosed with substance abuse of a schedule I drug.Which drugs are schedule I drugs? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Heroin
B)Marijuana
C)LSD
D)Cocaine
E)Diazepam (Valium)

Question 13

The client is withdrawing from opioids.Which symptoms best describe the results of the nurse's assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)Abdominal cramping and pain
B)Dilated pupils
C)Pinpoint pupils
D)Diaphoresis
E)Hypotension

Question 14

The nurse is preparing discharge instructions for a client admitted for drug overdose of an illegal substance.The client asks the nurse why some drugs are illegal,while others are not.Which response by the nurse is the most appropriate? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)"Some drugs are restricted or regulated because they have the potential for abuse."
B)"The government is committed to making sure drug dealers do not have the means to acquire drugs to sell to the public."
C)"Some drugs are restricted because they can cause significant harm to the user and the public."
D)"There are five schedules of drugs the government considers dangerous.Schedule V drugs have the highest potential for abuse,while some schedule I drugs do not need a prescription."
E)"Some drugs have a strong potential for abuse but also have therapeutic value.These drugs will be restricted to medical necessity."

Question 15

The client has been abusing alcohol for several years and tells the nurse,"I used to drink a pint of whiskey every day.Now I get sick and pass out after just two drinks." What does the nurse correctly recognize about this client?

A)The client has brain damage from the alcohol and cannot remember how much he consumes.
B)The client is in denial and most likely is misrepresenting the amount of alcohol he consumes.
C)The client could have liver damage,resulting in an inability to metabolize large amounts of alcohol.
D)The client's symptoms are related to hyperglycemia; he might have pancreatic damage.

Question 16

The client has smoked a pack of cigarettes per day for 20 years.The client also takes oral contraceptives.In implementing a teaching plan,what is the most important information for the nurse to include?

A)"You are at a greater risk for emphysema than are nonsmokers."
B)"You are at a greater risk for developing diabetes than are smokers who do not use birth control pills."
C)"You are at a greater risk for a heart attack than are nonsmokers."
D)"The nicotine will decrease the effectiveness of your birth control pills."

Question 17

A client is assessing a group of clients for the complications of long-term abuse of anabolic steroids.Which clients would the nurse focus the assessment on due to their history? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)A 23-year-old personal trainer
B)A 17-year-old senior high school baseball player
C)A 35-year-old weightlifter
D)A 32-year-old professional football player
E)A 21-year-old downhill skier preparing for the Olympics

Question 18

The client tells the nurse that her 12-year-old child asks to use her nail polish remover several times a day.When her friends come to visit,this seems to occur more frequently.Which response by the nurse is the most appropriate?

A)"Your daughter might be 'huffing'; that is really scary."
B)"Your daughter might be 'huffing,' or inhaling the remover."
C)"Your daughter might be 'huffing,' or drinking small amounts of the remover."
D)"Your daughter might be 'huffing,' or rubbing the remover on her skin."

Question 19

The mother of an adolescent client says to the nurse,"I think my son is staying up too late studying,and I see him using Visine eye drops all the time for his red eyes.Should I have his vision checked?" Which response by the nurse is the most appropriate?

A)"It sounds like he could be smoking marijuana,and I would talk to him."
B)"Yes,that is a great idea,he might need some glasses."
C)"Sounds like he is using cocaine; I have seen this before."
D)"He might be depressed; insomnia is common with depression."

Question 20

The adolescent client is in a drug rehabilitation program.The mother of this client says to the nurse,"The health care provider said my son has a physical addiction to alcohol.What does this mean?" Which response by the nurse is the most appropriate?

A)"He will have feelings of depression when stopping alcohol; we need to monitor him for suicide."
B)"His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped."
C)"His brain remembers the euphoria he had with alcohol,and he has a craving to return to it."
D)"He will have an intense craving for alcohol; this is best managed in group therapy."

Question 21

A client is abusing an antianxiety medication.Which assessment by the nurse would confirm a psychological dependence instead of physical dependence? Note: Credit will be given only if all correct choices and no incorrect choices are selected.Standard Text: Select all that apply.

A)The client's history reveals the long-term use of high doses of an antianxiety medication.
B)The client describes the "need" to use the antianxiety medication despite not feeling anxious.
C)The client describes feeling nauseous with abdominal cramping.
D)The client tells you her family has "disowned" her because of her need for the antianxiety medication.
E)The client complains she has not slept in days,feels anxious,and tired.