Question 1

A patient has been admitted to the intensive care unit (ICU)after a weekend drinking binge.During the assessment,the nurse will observe for which problems in addition to alcohol withdrawal syndrome?

Accepted Answer

Excessive alcohol use increases the risk of trauma,hypothermia,and pancreatitis,which lead to ICU admissions.

Question 2

The nurse is asking an adolescent about illicit substance abuse.The adolescent answers,"Yes,I've used marijuana at parties with my friends." What is the next question the nurse should ask?

Accepted Answer

If a patient admits to use of illicit substances,the nurse should ask,"When was the last time you used drugs?" and "How much did you take that time?" The other questions may be considered accusatory and are not conducive to information-gathering at this time.

Question 3

A patient visits the clinic to ask about smoking cessation.He has smoked heavily for 30 years,and wants to stop "cold turkey." He asks the nurse,"What symptoms can I expect if I do this?" Which of these symptoms should the nurse share with the patient as possible symptoms of nicotine withdrawal? Select all that apply.

Accepted Answer

Symptoms of nicotine withdrawal include vasodilation, headaches, anger, irritability, frustration, anxiety, nervousness, awakening at night, difficulty concentrating, depression, hunger, impatience, and the desire to smoke. Sleepiness and sweating are not symptoms of nicotine withdrawal.

Question 4

A patient is brought to the emergency department.He is restless,has dilated pupils,is sweating,has a runny nose and tearing eyes,and complains of muscle and joint pains.His girlfriend thinks he has the flu,but she became concerned when his temperature went up to 103° F (39.4 °C)) She admits that he has been a heavy drug user, but he has been trying to stop on his own. The nurse suspects that the patient is experiencing withdrawal symptoms from which substance?

Accepted Answer

Withdrawal symptoms of opiates,such as heroin,are similar to the clinical picture of influenza,and include symptoms such as dilated pupils,lacrimation,runny nose,tachycardia,fever,restlessness,muscle and joint pains,and other symptoms.Withdrawal symptoms from alcohol,cocaine,and sedatives are described in Table 6-7.

Question 5

The nurse is assessing a patient who has been admitted for cirrhosis of the liver secondary to chronic alcohol use.During the physical assessment,the nurse looks for cardiac problems that are associated with chronic heavy use of alcohol,such as:

Accepted Answer

Chronic heavy use of alcohol is associated with hypertension,atrial fibrillation,and alcoholic cardiomyopathy,with an increase in left ventricular mass,dilation of ventricles,and wall thinning.Ventricular fibrillation,bradycardia,and mitral valve prolapse are not associated with chronic heavy use of alcohol.

Question 6

The nurse is conducting a class on alcohol and the effects of alcohol on the body.How many standard drinks (each containing 12 grams of alcohol)per day are associated with increased deaths from cirrhosis,cancers of the mouth,esophagus,and injuries in men?

Accepted Answer

In men,alcohol consumption of at least four standard drinks per day is associated with increased deaths from liver cirrhosis,cancers of the mouth,esophagus and other areas,and deaths from injuries and other external causes.

Question 7

The nurse has completed an assessment on a patient who came to the clinic for a leg injury.As a result of the assessment,the nurse has determined that the patient has "at risk" alcohol use.Which action by the nurse is most appropriate at this time?

Accepted Answer

If an assessment has determined that the patient has "at risk" drinking behavior,then the nurse should give a short but clear statement of assistance and concern.Simply giving out a phone number or referral to agencies may not be enough.

Question 8

A woman has come to the clinic to seek help with a substance abuse problem.She admits to using cocaine just before arrival.Which of these assessment findings would the nurse expect to find when examining this woman?

Accepted Answer

A cocaine user's appearance includes pupillary dilation,tachycardia or bradycardia,elevated or lowered blood pressure,sweating,chills,nausea,vomiting,and weight loss.The person's behavior includes euphoria,talkativeness,hypervigilance,pacing,psychomotor agitation,impaired social or occupational functioning,fighting,grandiosity,and visual or tactile hallucinations.

Question 9

A patient with a known history of heavy alcohol use has been admitted to the intensive care unit after he was found unconscious outside a bar.The nurse monitors him closely for symptoms of withdrawal.Which of these symptoms may occur during this time? Select all that apply.

Accepted Answer

Patients with a history of heavy alcohol use are at risk for withdrawal symptoms, which may occur within a few hours to a few days after drinking stops or significantly decreases. Common symptoms of alcohol withdrawal include coarse tremors of the hands, sweating, and transient hallucinations. Bradycardia may occur in severe cases, but it is not a common symptom. Somnolence may occur later in the withdrawal process, but it is not an immediate concern.

Question 10

During a session on substance abuse,the nurse is reviewing statistics with the class.For persons aged 12 years and older,which of these illicit substances was the one most commonly used?

Accepted Answer

In persons age 12 and older who reported past month use,marijuana (hashish)was the most commonly used illicit drug reported.

Question 11

When reviewing the use of alcohol by older adults,the nurse notes that older adults have several characteristics that can increase the risk of alcohol use.Which would increase the bioavailability of alcohol in the blood for longer periods of time in the older adult?

Accepted Answer

Decreased liver and kidney functioning increase the bioavailability of alcohol in the blood for longer time periods.Aging people experience decreased muscle mass (not increased),which also increases the alcohol concentration in the blood because there is less tissue for the alcohol to be distributed to over time.Blood pressure and cardiac output are not factors regarding bioavailability.

Question 12

A woman who has just discovered that she is pregnant is in the clinic for her first obstetric visit.She asks the nurse,"How many drinks a day is safe for my baby?" The nurse's best response is:

Accepted Answer

No amount of alcohol has been determined to be safe for pregnant women.The potential adverse effects of alcohol use for the fetus are well known;women who are pregnant should be screened for alcohol use,and abstinence should be recommended.

Question 13

The nurse is reviewing aspects of substance abuse in preparation for a seminar.Which of these statements illustrates the concept of "tolerance" to an illicit substance? The person:

Accepted Answer

The concept of tolerance to a substance indicates that the person requires an increased amount of the substance to produce an effect.Abuse indicates that the person needs to use the substance daily to function,and the person is unable to stop using it.Dependence is an actual physiologic dependence on the substance.Withdrawal occurs when cessation of the substance produces a syndrome of physiologic symptoms.

Question 14

During an assessment,the nurse asks a female patient,"How many alcoholic drinks do you have a week?" Which answer by the patient would indicate "at risk" drinking?

Accepted Answer

For women,having seven or more drinks a week or three or more drinks per occasion is considered "at risk" drinking,according to the National Institute on Alcohol Abuse and Alcoholism.

Quiz 6: Substance Use Assessment

A patient has been admitted to the intensive care unit (ICU) after a weekend drinking binge.During the assessment,the nurse will observe for which problems in addition to alcohol withdrawal syndrome?