Deck 50: Substance Abuse

Question 1

A mother brings her a college-age son to the primary care NP and asks the NP to talk to him about alcohol use.He reports binge drinking on occasion and drinking only beer on weekends.The NP notes diaphoresis,tachycardia,and an easy startle reflex.The NP should:

A) admit him to the hospital for detoxification.
B) ask him how much he had to drink last night.
C) prescribe lorazepam (Ativan) to help with symptoms.
D) suggest that he talk to a counselor about alcohol abuse.

Answer 1

admit him to the hospital for detoxification.

Question 2

The primary care NP is preparing to prescribe acamprosate for a patient who is an alcoholic.Before initiating treatment with this medication,the NP should:

A) assess renal function.
B) obtain liver function tests.
C) teach the patient never to take the drug with alcohol.
D) tell the patient that this medication is used to treat withdrawal symptoms.

Answer 2

assess renal function.

Question 3

A patient is brought to the clinic by a spouse because of increased somnolence and disorientation.The spouse tells the primary care NP that the patient has been taking oxycodone for postoperative pain.The NP notes a respiratory rate of 8 to 10 breaths per minute.The NP should:

A) activate the emergency medical service (EMS) and administer oxygen.
B) administer oral methadone (Dolophine).
C) administer intramuscular naltrexone (ReVia).
D) administer sublingual buprenorphine (Subutex).

Answer 3

administer intramuscular naltrexone (ReVia).

Question 4

At an annual well-woman examination,the primary care nurse practitioner (NP)asks a patient about alcohol consumption.The woman reports she usually consumes six glasses of wine per week and occasionally will consume three or four glasses at a party.The NP smells alcohol on the woman's breath.The woman says she is hung over today.The NP should:

A) order liver function tests (LFTs) and a complete blood count.
B) question her further about her nightly alcohol consumption-ask what size her wine glasses are.
C) consider her at high risk for alcoholism.
D) refer her to treatment for alcohol abuse.

Question 5

The primary care NP prescribes disulfiram to a patient who has stopped drinking but continues to have cravings for alcohol.The NP must counsel the patient to:

A) abstain from alcohol completely.
B) report a garlic taste in the mouth.
C) stop taking the drug after a few months.
D) increase the drug dose after several months.

Question 6

A patient who is an alcoholic is seen in the clinic,and the primary care NP admits the patient to the hospital for acute withdrawal.The patient has elevated liver enzymes.The NP should expect the inpatient provider to prescribe:

A) lorazepam (Ativan).
B) diazepam (Valium).
C) acamprosate (Campral).
D) chlordiazepoxide (Librium).