Deck 22: Substance Abuse

Question 1

A client tells the nurse he or she would like to stop taking methamphetamines but cannot stop. Which should the nurse recognize the client is experiencing?

A) Psychological dependence
B) Substance dependence
C) Physical dependence
D) Withdrawal syndrome

Answer 1

Substance dependence

Question 2

Which symptoms should the nurse anticipate are associated with alcohol withdrawal?

A) Lethargy, constipation, light sensitivity, and weight loss
B) Anxiety, seizures, hearing loss, and alopecia
C) Tremors, anxiety, confusion, and delirium
D) Abdominal pain, chills, pupil dilation, and lethargy

Answer 2

Tremors, anxiety, confusion, and delirium

Question 3

A client asks the nurse what a "physical addiction to alcohol" means. Which response should the nurse provide the client?

A) "The brain remembers the euphoria experienced with alcohol, and there is a craving for it."
B) "There is an intense craving for alcohol, but the craving can be best managed through group therapy."
C) "The body becomes used to alcohol and if it is abruptly stopped withdrawal symptoms occur."
D) "Feelings of depression occur if the use of alcohol is stopped."

Answer 3

"The body becomes used to alcohol and if it is abruptly stopped withdrawal symptoms occur."

Question 4

A client asks the nurse for information about cannabis infused edibles. Which information should the nurse be prepared to discuss? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Delayed onset
B) Longer duration of action
C) Physical dependence
D) Higher risk of unintentional overdose
E) Large doses are associated with psychedelic high

Question 5

Which drug is least likely to produce physical dependence or tolerance?

A) Marijuana
B) Morphine
C) Nicotine
D) Ethyl alcohol

Question 6

The nurse is providing education to a client that has smoked 1 pack of cigarettes daily for the past few years and is currently prescribed oral contraceptives. Which statement should the nurse include in the teaching?

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

Question 7

A client with alcoholism prescribed disulfiram (Antabuse) tells the nurse that he or she stopped taking the prescription a week prior and have begun drinking again. Which assessment finding should the nurse anticipate?

A) Headache, nausea, and vomiting
B) Confusion and fine tremors
C) An absence of symptoms
D) Severe hyperglycemia

Question 8

The nurse is preparing to assess a client that is withdrawing from opioids. Which assessment findings should the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Abdominal cramping
B) Orthostatic hypotension
C) Hot, dry skin
D) Violent yawning
E) Agitation

Question 9

A family member of a deceased client that overdosed on cocaine asks the nurse how he or she died. Which should the nurse recognize is the most likely cause of the death of the client?

A) Cardiac arrest
B) Rhabdomyolysis
C) Drug impurity
D) Aneurysm

Question 10

A client states to the nurse, "I used to drink a pint of whiskey every day. Now I get sick and pass out after just two drinks." Which should the nurse be concerned with?

A) Pancreatic damage
B) Liver damage
C) The patient is in denial and is most likely minimizing the amount of alcohol he or she consumes.
D) The patient has brain damage from the alcohol and cannot remember how much he or she consumes.

Question 11

The nurse has provided group education on the topic of addiction. Which statements made by the clients indicate an understanding of the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

Question 12

A client tells the nurse he or she has been taking "yellow jackets" (pentobarbital, [Nembutal]) but has not had any for a few days. Which should the nurse recognize is the highest priority?

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

Question 13

Which phenomena occurs when a client with a history of alcoholism requires higher than usual amounts of opioids for pain relief?

A) Physical dependence
B) Paradoxical reaction
C) Resistance to opioids
D) Cross tolerance

Question 14

A parent expressed concern that his or her adolescent son is up late at night, is listless, and frequently uses eye drops for his bloodshot eyes. Which statement should the nurse include in the discussion with the parent?

A) "He might be depressed; insomnia is common with depression."
B) "He could be smoking marijuana."
C) "Sounds like he is using cocaine."
D) "Your son could be studying too hard."

Question 15

The nurse assesses a client suspected of hallucinogen toxicity. Which assessment findings support the nurse's suspicion? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Somnolence
B) Confusion
C) Panicked reactions
D) Blurred vision
E) Respiratory depression

Question 16

A client receiving a pain prescription for several weeks has required an increase of the dosage to adequately manage symptoms. Which should the nurse recognize has occurred?

A) Immunity
B) Tolerance
C) Physiologic addiction
D) Psychological addiction

Question 17

A client tells the nurse "I am going to get clean. I haven't had any drugs or any alcohol for 2 days." Which substance should the nurse anticipate can result in life threatening withdrawal?

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

Question 18

The nurse is caring for a client suspected of an opioid overdose. Which prescription should the nurse anticipate administering?

A) Methadone (Dolophine)
B) Methylphenidate (Ritalin)
C) Naloxone (Narcan)
D) Bupropion (Zyban)

Question 19

A client asks the nurse what physiological effects occur if he or she quit smoking. Which should the nurse include in the education? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Headaches
B) Depression
C) Increased appetite
D) Nausea
E) Insomnia

Question 20

A client tells the nurse he or she would like a prescription to help stop smoking. Which should the nurse anticipate the healthcare provider will prescribe?

A) Disulfiram (Antabuse)
B) Bupropion (Zyban)
C) Naltrexone (ReVia, Vivitrol)
D) Dextroamphetamine (Dexedrine)

Question 21

The nurse is providing education for a client who desires to stop taking heroin. Which information should the nurse include in the teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) "You are probably going to have some withdrawal symptoms, but there are medications that can help you."
B) "Expect to remain on methadone for quite a while."
C) "Methadone will produce the same high as the heroin you have been using."
D) "You will need a supply of syringes and needles for your methadone treatment."
E) "Methadone does not cause any withdrawal symptoms."

Question 22

The nurse has provided education to a client about abuse of methylphenidate. Which response by the client indicates further teaching is required?

A) "The prescription produces relaxation."
B) "The prescription heightens the awareness."
C) "The prescription gives them more energy."
D) "The prescription produces a euphoria."

Question 23

A client experiencing the effects from marijuana asks the nurse how long they will last. Which response should the nurse provide?

A) "It depends on how much you smoked."
B) "The effects can last up to 24 hours."
C) "The effects will last a few hours."
D) "It depends on your body weight."

Question 24

Which schedule does methcathinone (Cat) belong?

A) I
B) II
C) III
D) IV

Question 25

The nurse is assessing a client who has taken LSD. Which assessment finding should the nurse anticipate?

A) Hypotension
B) Increased temperature
C) Pinpoint pupils
D) Bradycardia

Question 26

Which information should the nurse include in the community education for marijuana? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) THC is the ingredient that causes most of the psychoactive effects.
B) Metabolites of marijuana can be detected in the urine for several days after last use.
C) Metabolites of marijuana can be detected in the body for months to years after last use.
D) Smoking marijuana can decrease the risk of glaucoma.
E) Smoking marijuana results in a greater accumulation of tar in the lungs than does cigarette smoking.

Question 27

Which drug toxicity is a client experiencing that exhibits tachycardia and palpitations?

A) Nicotine
B) Alcohol
C) Benzodiazepines
D) Marijuana

Question 28

A client tells the nurse he or shehas been abusing his or her antianxiety prescription. Which findings should the nurse recognize are related to a psychological dependence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The patient's history reveals the long-term use of high doses of an antianxiety prescription.
B) The client describes the "need" to use the antianxiety prescription despite not feeling anxious.
C) The client describes feeling nauseous with abdominal cramping.
D) The client states his or her family does not speak to him or her because of the need for the antianxiety prescription.
E) The client states he or she has not slept in days and feels very anxious and tired.

Question 29

A client must eliminate caffeine intake due to the contraindication with a newly prescribed medication. Which withdrawal symptoms should the nurse discuss with the client? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Depression
B) Insomnia
C) Weight gain
D) Urinary retention
E) Headache

Question 30

Which prescription should the nurse anticipate administering to a client experiencing acute alcohol withdrawal?

A) Varenicline (Chantix)
B) Naltrexone (ReVia, Vivitrol)
C) Disulfiram (Antabuse)
D) Diazepam (Valium)