Deck 11: Substance Abuse

Question 1

The patient has smoked a pack of cigarettes per day for 20 years.The patient also takes oral contraceptives.In implementing a teaching plan,what is the most important information for the nurse to include?
1)"You are at a higher risk for a heart attack than nonsmokers."
2)"The nicotine will decrease the effectiveness of your birth control pills."
3)"You are at a higher risk for developing diabetes than smokers who do not use birth control pills."
4)"You are at a higher risk for emphysema than nonsmokers."

Answer 1

1

Question 2

When an individual wants to stop using a drug but can't,she would be suffering from
1)psychological dependence.
2)substance dependence.
3)physical dependence.
4)withdrawal syndrome.

Answer 2

2

Question 3

What is a priority outcome for the patient who has chronic alcoholism with liver damage?
1)The patient will switch to a safer drug,like a benzodiazepine.
2)The patient will become involved in Alcoholics Anonymous (AA).
3)The patient will keep all appointments with the doctor treating his liver damage.
4)The patient will learn to drink more responsibly.

Answer 3

2

Question 4

The patient is admitted to the in-patient substance abuse unit.She tells the nurse she has been buying "yellow jackets" (pentobarbital,[Nembutal])on the street,but hasn't had any for a few days.What is the best plan by the nurse at this time?
1)Prepare to manage the depression and suicidal thoughts the patient will have.
2)Prepare to do frequent room searches,as the patient's friends will most likely bring drugs in for her.
3)Prepare to manage a withdrawal that could be life threatening.
4)Prepare to manage a withdrawal that will likely be minimal.

Question 5

During a health history,the nurse should use therapeutic communication when asking about substance abuse.Which of the following is essential to establish a trusting nurse-patient relationship?
1)Informing the patient that substance abuse is a sin
2)Avoiding communicating disapproval of indicated substance abuse
3)Ensuring that the patient's mother and father are at the bedside
4)Avoiding shocked facial expressions

Question 6

The patient comes to the emergency department and tells the nurse,"I have been off my drugs for 3 days." The nurse assesses the patient for withdrawal symptoms associated with the category of drug used.Withdrawal from which drug,if taken by the patient,should cause the nurse the most concern?
1)Heroin
2)Alprazolam (Xanax)
3)Cocaine
4)Marijuana

Question 7

The nurse is managing care for a group of substance abusers.The patients have completed group education about the disease of addiction.The nurse determines that learning has occurred when the patients make which statements? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"A heroin addict can die from heroin withdrawal."
2)"Substance abuse depends on complex variables."
3)"Most addicts became addicted from pain medication in a hospital."
4)"Addiction includes a compulsion to use a mood-altering substance."
5)"There is most likely a genetic component to addiction."

Question 8

The patient has an extensive history of alcoholism.He is having coronary bypass surgery.While administering anesthesia,the certified nurse anesthetist notes that the patient requires higher-than-usual amounts of the drug.The nurse correctly evaluates this response as what phenomenon?
1)The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this patient.
2)The patient has developed a paradoxical reaction to the anesthesia,and will require a different drug.
3)The patient has developed a resistance to the anesthesia,so it will not work very well.
4)The patient had developed cross-tolerance to the anesthesia,and will require higher amounts.

Question 9

The patient has been prescribed disulfiram (Antabuse)to discourage a return to drinking alcohol.The patient tells the nurse that after stopping disulfiram (Antabuse)for a week,he returned to drinking alcohol.What will the nurse most likely assess in the patient?
1)Headache,nausea,and vomiting
2)Confusion and fine tremors
3)An absence of symptoms,as the drug was discontinued
4)Severe hyperglycemia and dry skin

Question 10

Which of the following drugs is least likely to produce physical dependence or tolerance?
1)Marijuana
2)Morphine
3)Nicotine
4)Ethyl alcohol

Question 11

The nurse would expect to see which of the following withdrawal symptoms from an alcoholic patient?
1)Lethargy,constipation,light sensitivity,and weight loss
2)Anxiety,seizures,hearing loss,and alopecia
3)Tremors,anxiety,confusion,and delirium
4)Abdominal pain,chills,pupil dilation,and lethargy

Question 12

The mother of an adolescent patient 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?" What is the best response by the nurse?
1)"He might be depressed;insomnia is common with depression."
2)"Sounds like he is smoking marijuana,and I would talk to him."
3)"Sounds like he is using cocaine;I have seen this before."
4)"Yes,that is a great idea,he may need some glasses."

Question 13

The patient is a 10-year-old child admitted to the emergency department after "huffing" gasoline.The physician suspects mild brain damage.What signs will the nurse teach the parents to observe for after they take the child home?
1)Slurred speech,memory loss,and personality changes
2)Depression,cold extremities,and dyspnea
3)Nausea,vomiting,and dizziness
4)Irregular pulse,fainting,and anger

Question 14

The patient 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.What is the best response by the nurse?
1)"Your daughter may be 'huffing';that is really scary."
2)"Your daughter may be 'huffing' or inhaling the remover."
3)"Your daughter may be 'huffing' or drinking small amounts of the remover."
4)"Your daughter may be 'huffing' or rubbing the remover on her skin."

Question 15

The patient 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 patient?
1)The patient's symptoms are related to hyperglycemia;he may have pancreatic damage.
2)The patient may have liver damage,resulting in an inability to metabolize large amounts of alcohol.
3)The patient is in denial and is most likely minimizing the amount of alcohol he consumes.
4)The patient has brain damage from the alcohol and cannot remember how much he consumes.

Question 16

The adolescent patient is in a drug rehabilitation program.The mother of this patient says to the nurse,"The doctor said my son has a physical addiction to alcohol.What does this mean?" What is the best response by the nurse?
1)"His brain remembers the euphoria he had with alcohol,and he has a craving to return to it."
2)"He will have an intense craving for alcohol;this is best managed in group therapy."
3)"His body is used to alcohol;he will have specific withdrawal symptoms when it is stopped."
4)"He will have feelings of depression when stopping alcohol;we need to monitor him for suicide."

Question 17

The patient is withdrawing from opioids.Which symptom best describe(s)the results of the nurse's assessment? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Abdominal cramping and pain
2)Hypotension
3)Pinpoint pupils
4)Dilated pupils
5)Diaphoresis

Question 18

A hospice patient has been receiving oral pain medication for several weeks.The patient started with 4 mg of the drug,and each week has had to increase the amount by 2-3 mg to obtain adequate pain relief.The nurse recognizes that the patient
1)has developed immunity to the drug.
2)has developed a tolerance to the drug.
3)has developed a physiologic addiction to the drug.
4)has developed a psychological addiction to the drug.

Question 19

The patient had been abusing cocaine for several years.Recently,the patient snorted cocaine that was much purer than was thought,resulting in an overdose.The patient died in the emergency department.What does the nurse recognize as the most likely cause of death?
1)Cardiac arrest
2)Rhabdomyolysis
3)Impurities in the cocaine
4)Bowel ischemia

Question 20

Which of the following profiles would have the greatest risk for developing a drug addiction?
1)A 30-year-old female who is pregnant and lives in an apartment in a small town (lower middle class)
2)A 45-year-old female with diabetes who lives in a house in the country (middle class)
3)A 21-year-old male with insomnia who lives in a college dormitory (wealthy)
4)A 70-year-old retired male with congestive heart failure who lives in his house in a large city (fixed income)

Question 21

The nurse is reinforcing factors that contribute to addiction to a group of patients recovering from addiction and their family members.Which statement made by a patient or family member would indicate the need for additional teaching? Credit will be given only if all correct choices and no incorrect choices are selected.
1)"I'm not likely to have any more problems with addiction since neither of my parents had a problem with addiction."
2)"I can still see my friends as long as I stay away from alcohol."
3)"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."
4)"I realize now that I was just looking for ways to help me feel good about myself."
5)"After a while,it just seemed even though I was not in pain,I would still want to take the pain pills."

Question 22

The nurse is preparing care for a patient diagnosed with substance abuse of a Schedule I drug.Which drugs are Schedule I drugs? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Heroin
2)Marijuana
3)LSD
4)Cocaine
5)Diazepam (Valium)

Question 23

A patient is admitted with complications of long-term abuse of anabolic steroids.Which of the following patient histories should not surprise the nurse? Credit will be given only if all correct choices and no incorrect choices are selected.
1)A 23-year-old personal trainer
2)A 17-year-old senior high school baseball player
3)A 35-year-old weightlifter
4)A 32-year-old professional football player
5)A 21-year-old downhill skier preparing for the Olympics

Question 24

A patient suffering from tachycardia and palpitations would most likely be experiencing the signs of drug toxicity from which of the following?
1)Nicotine
2)Alcohol
3)Benzodiazepines
4)Marijuana

Question 25

A patient has been abusing an antianxiety medication.Which assessment by the nurse would confirm this is psychological dependence instead of physical dependence? Credit will be given only if all correct choices and no incorrect choices are selected.
1)The patient's history reveals the long-term use of high doses of an antianxiety medication.
2)The patient describes the "need" to use the antianxiety medication despite not feeling anxious.
3)The patient describes feeling nauseous with abdominal cramping.
4)The patient tells you her family has "disowned" her because of her need for the antianxiety medication.
5)The patient complains she has not slept in days,feels anxious,and tired.

Question 26

A nurse is preparing to admit a patient suspected of overdose.The nurse knows to suspect which drugs as being the most commonly abused? Credit will be given only if all correct choices and no incorrect choices are selected.
1)Methylphenidate (Ritalin)
2)Nicotine
3)Marijuana
4)Amobarbital (Amytal)
5)Secobarbital (Seconal)