Question 1

What is a priority outcome for the client who has chronic alcoholism with liver damage?

Accepted Answer

Involvement in Alcoholics Anonymous (AA) is a priority outcome as it supports the client in achieving sobriety, which is crucial for preventing further liver damage and improving overall health.

Question 2

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?" What is the best response by the nurse?

Accepted Answer

BThe symptoms described by the mother, such as staying up late (which could be misinterpreted as insomnia) and using Visine for red eyes, could be indicative of marijuana use, as marijuana can cause red eyes and changes in sleep patterns. Additionally, these symptoms could also suggest depression, as changes in sleep patterns and behaviors are common in depressed individuals. The nurse's response should open up possibilities for further investigation into these areas without making definitive diagnoses, hence options A and B are appropriate. Options C and D are less likely based on the information provided, as cocaine use and needing glasses are not as directly related to the symptoms described.

Question 3

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? Select all that apply.

Accepted Answer

B) There is a recognized genetic component to addiction, indicating that individuals may have a predisposition to addictive behaviors based on their genetic makeup. C) Addiction is characterized by a compulsion to use substances that alter mood, reflecting the psychological aspect of addiction. E) Substance abuse is influenced by a variety of complex variables, including biological, psychological, and social factors, acknowledging the multifaceted nature of addiction.

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?

Accepted Answer

Cardiac arrest is the most likely cause of death in cocaine overdose due to the stimulant effect of cocaine on the heart, which can lead to arrhythmias and eventually cardiac arrest. Impurities in the cocaine or other potential complications such as rhabdomyolysis or bowel ischemia can also contribute to the overdose, but cardiac arrest is the most common cause of death.

Question 5

The client comes to the emergency department and tells the nurse "I have been off my drugs for 3 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?

Accepted Answer

Withdrawal from Alprazolam (a benzodiazepine) can be life-threatening, involving symptoms like seizures, severe anxiety, tremors, and potentially fatal complications, thus requiring immediate medical attention.

Question 6

The client 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?

Accepted Answer

Slurred speech, memory loss, and personality changes are common signs of mild brain damage and should be closely observed by the parents. Nausea, vomiting, dizziness, irregular pulse, fainting, anger, depression, cold extremities, and dyspnea may also occur but are not specific signs of brain damage in this situation.

Question 7

The client has been abusing alcohol for several years and tells the nurse, "I used to drink a mickey (375 mL) of whiskey every day. Now I get sick and pass out after just two drinks." What does the nurse correctly recognize about this client?

Accepted Answer

The client's inability to tolerate a large amount of alcohol and experiencing symptoms after only two drinks suggests liver damage, as the liver is responsible for metabolizing alcohol. This is a common consequence of long-term alcohol abuse.

Question 8

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. What is the best response by the nurse?

Accepted Answer

"Huffing" refers to the intentional inhalation of certain chemicals to achieve a high. Nail polish remover contains chemicals such as acetone that can be dangerous if inhaled in large amounts. Answer choice D is the best response as it directly addresses the behavior and its potential danger.

Question 9

The client 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?

Accepted Answer

Pentobarbital (Nembutal) is a barbiturate medication that can cause life-threatening withdrawal symptoms, including seizures, coma, and death. The nurse should be prepared to manage potentially severe withdrawal and monitor the client closely. Room searches and management of depression and suicidal thoughts may also be necessary, but the priority at this time is the potential for life-threatening withdrawal.

Question 10

The client is withdrawing from opioids. Which symptom best describe(s) the results of the nurse's assessment? Select all that apply.

Accepted Answer

Withdrawal from opioids typically results in symptoms such as diaphoresis (excessive sweating), dilated pupils (rather than pinpoint, which is a sign of opioid use), and gastrointestinal symptoms like abdominal cramping and pain. Hypotension is less specifically associated with opioid withdrawal.

Question 11

The client is post -op, day 1 after an abdominal hysterectomy and 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 caring for this client says to another nurse "She really doesn't look like she is in pain, maybe she is an addict." What is the best response by the other nurse?

Accepted Answer

Pain is subjective and the nurse should trust the client's report of pain. Making assumptions about the client's level of pain based on their appearance is not appropriate. Additionally, questioning whether the client is an addict is not relevant or appropriate to addressing their pain management needs. The nurse should administer the prescribed pain medication.

Question 12

The adolescent client is in a drug rehabilitation program. The mother of this client 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?

Accepted Answer

A physical addiction to alcohol means that the body has become dependent on alcohol and will experience specific withdrawal symptoms when it is stopped. It is important to monitor the client for withdrawal symptoms and provide appropriate medical interventions as needed.

Question 13

The client has been prescribed disulfiram (Antabuse) to discourage a return to drinking alcohol. The client 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 client?

Accepted Answer

Disulfiram (Antabuse) works by causing unpleasant physical reactions when alcohol is consumed, including headache, nausea, and vomiting. If the client has resumed drinking after stopping the medication, these symptoms are likely to occur. Confusion and fine tremors may be seen with alcohol withdrawal, but the question does not mention withdrawal or cessation of drinking. An absence of symptoms is not expected if the client has resumed drinking while still prescribed the medication. Severe hyperglycemia and dry skin are not associated with disulfiram (Antabuse).

Question 14

The client has an extensive history of alcoholism. He is having coronary bypass surgery. While caring for this patient post -operatively the nurse notes that the client requires higher -than -usual amounts of the drug. The nurse correctly evaluates this response as what phenomenon?

Accepted Answer

Cross-tolerance occurs when tolerance to one substance results in tolerance to another substance. In this case, the client's history of alcoholism has likely led to a tolerance to sedatives, including anesthesia, necessitating higher doses for effectiveness.

Question 15

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

Accepted Answer

Combining smoking with the use of oral contraceptives significantly increases the risk of cardiovascular events, such as heart attacks, especially in women over 35. This risk factor is more immediate and life-threatening than the others listed, making it the most important information to include in a teaching plan.

Quiz 12: Substances of Addiction