Question 1

The nurse is conducting a health history for a client and wants to determine the client's alcohol use.What question from the nurse will provide the greatest amount of information?
A) "Are you a heavy drinker?"
B) "How many alcoholic beverages do you drink each day?"
C) "Is alcohol use a concern for you?"
D) "Drinking doesn't cause any problems for you, does it?"

Accepted Answer

A) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained.
B) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a "yes" or "no," such as those in the other options, will limit the information obtained.
C) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained.
D) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained.

Question 2

The nurse is conducting a class in the community regarding alcohol use to a group of college seniors.During the class a participant admits to frequently using alcohol.Which is the priority action of the nurse?
A) Initiate a community assessment of the campus.
B) Contact the campus nurse and refer the student.
C) Notify campus security to watch for driving under the influence.
D) Complete a crisis assessment.

Accepted Answer

A) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student's permission. There is no evidence that the student is driving under the influence.
B) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student's permission. There is no evidence that the student is driving under the influence.
C) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student's permission. There is no evidence that the student is driving under the influence.
D) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student's permission. There is no evidence that the student is driving under the influence.

Question 3

The client with a history of alcohol abuse is being discharged for a treatment facility.Which prescription does the nurse anticipate for this client?
A) Disulfiram
B) Naloxone
C) Bupropion hydrochloride
D) Varenicline

Accepted Answer

A) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. Naloxone is administered to clients who overdose on opiates. Bupropion hydrochloride and varenicline are both medications to assist with smoking cessation.
B) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. Naloxone is administered to clients who overdose on opiates. Bupropion hydrochloride and varenicline are both medications to assist with smoking cessation.
C) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. Naloxone is administered to clients who overdose on opiates. Bupropion hydrochloride and varenicline are both medications to assist with smoking cessation.
D) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. Naloxone is administered to clients who overdose on opiates. Bupropion hydrochloride and varenicline are both medications to assist with smoking cessation.

Question 4

A client with alcoholism is receiving court-ordered care in a residential treatment facility.After alcohol is discovered in the client's room,the client states,"It is not mine." Which responses by the nurse are appropriate in this situation? Select all that apply.
A) "You will lose your day pass privileges for this Sunday."
B) "We have a video of you accepting the alcohol from your brother."
C) "What do you think about sharing this at AA tonight?"
D) "You won't be allowed to go to dinner tonight."
E) "You have violated our behavior contract."

Accepted Answer

A) Used with care and a calm attitude, confrontation interferes with the client's ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
B) Used with care and a calm attitude, confrontation interferes with the client's ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
C) Used with care and a calm attitude, confrontation interferes with the client's ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
D) Used with care and a calm attitude, confrontation interferes with the client's ability to use denial or rationalization. Losing privileges is a consequence of the violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
E) Used with care and a calm attitude, confrontation interferes with the client's ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.

Question 5

The employee health nurse is providing care to an employee who was injured on the job.The client has a history of drug addiction and is currently enrolled in a 12-step recovery program.In order to determine whether the employee was impaired at the time of the accident,which diagnostic tool will the nurse use?
A) Liver enzymes
B) Stool guaiac
C) Urine toxicology testing
D) Hair testing

Accepted Answer

A) Urine toxicology testing will determine whether the employee had drugs in his system during the shift in which the injury occurred. Hair testing can detect substance use for up to 90 days and is not an accurate tool to determine whether the employee was impaired at the time of the injury. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood.
B) Urine toxicology testing will determine whether the employee had drugs in his system during the shift in which the injury occurred. Hair testing can detect substance use for up to 90 days and is not an accurate tool to determine whether the employee was impaired at the time of the injury. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood.
C) Urine toxicology testing will determine whether the employee had drugs in his system during the shift in which the injury occurred. Hair testing can detect substance use for up to 90 days and is not an accurate tool to determine whether the employee was impaired at the time of the injury. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood.
D) Urine toxicology testing will determine whether the employee had drugs in his system during the shift in which the injury occurred. Hair testing can detect substance use for up to 90 days and is not an accurate tool to determine whether the employee was impaired at the time of the injury. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood.

Question 6

A nurse educator is a teaching a group of students about the comprehensive theory of addiction by George Engel.Which statements indicate that the students understand the theory? Select all that apply.
A) "Addiction occurs due to a lack of emotional attachment."
B) "There is a biological factor involved in the development of addiction."
C) "There are social factors that contribute to the development of addiction."
D) "There is a moral factor involved in the development of addiction."
E) "There is a psychological factor involved in the development of addiction."

Accepted Answer

A) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
B) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
C) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
D) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
E) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.

Question 7

A college student attends a seminar on alcohol abuse.Which statement would alert the nurse that the student needs more education?
A) "The children of alcoholics are less likely to become alcoholics."
B) "Native Americans are more likely to become alcoholics."
C) "Married college graduates are less likely to become alcoholics."
D) "Childless people are more likely to become alcoholics than parents."

Accepted Answer

A) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.
B) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.
C) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.
D) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.

Question 8

The nurse is conducting a crisis assessment for a client who admits to cocaine use.Which questions are appropriate for the nurse to ask the client during this process? Select all that apply.
A) "Are recreational centers available?"
B) "What is the most significant stress/problem occurring in your life right now?"
C) "How long has this been a problem?"
D) "What are the living conditions of the neighborhood?"
E) "What other stresses do you have in your life?"

Accepted Answer

A) When conducting a crisis assessment for a client who admits to using an illegal substance that is associated with addiction, the nurse will ask the client about the most significant stress occurring in life right now; how long the problems has been occurring; and the other stresses in the client's life. Asking about recreational centers and the living conditions of the neighborhood are more appropriate when conducting a community crisis assessment.
B) When conducting a crisis assessment for a client who admits to using an illegal substance that is associated with addiction, the nurse will ask the client about the most significant stress occurring in life right now; how long the problems has been occurring; and the other stresses in the client's life. Asking about recreational centers and the living conditions of the neighborhood are more appropriate when conducting a community crisis assessment.
C) When conducting a crisis assessment for a client who admits to using an illegal substance that is associated with addiction, the nurse will ask the client about the most significant stress occurring in life right now; how long the problems has been occurring; and the other stresses in the client's life. Asking about recreational centers and the living conditions of the neighborhood are more appropriate when conducting a community crisis assessment.
D) When conducting a crisis assessment for a client who admits to using an illegal substance that is associated with addiction, the nurse will ask the client about the most significant stress occurring in life right now; how long the problems has been occurring; and the other stresses in the client's life. Asking about recreational centers and the living conditions of the neighborhood are more appropriate when conducting a community crisis assessment.
E) When conducting a crisis assessment for a client who admits to using an illegal substance that is associated with addiction, the nurse will ask the client about the most significant stress occurring in life right now; how long the problems has been occurring; and the other stresses in the client's life. Asking about recreational centers and the living conditions of the neighborhood are more appropriate when conducting a community crisis assessment.

Question 9

The nurse is evaluating outcome goals written by a student for a client diagnosed with alcoholism who is being discharged from a detoxification program.Which outcomes are appropriate for this client? Select all that apply.
A) Follow a 2000-calorie high-carbohydrate diet.
B) Sponsor a participant in Alcoholics Anonymous (AA) meetings.
C) Obtain at least 6-8 hours of sleep per night.
D) Acknowledge the blame that family members must take for codependent behavior.
E) Enroll in the Employee Assistance Program (EAP) through his employer.

Accepted Answer

A) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the client's employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
B) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the client's employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
C) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the client's employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
D) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the client's employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
E) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the client's employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.

Question 10

The nurse is conducting a health promotion class to adolescents regarding smoking.Which point is most important to convey to this audience?
A) Teens are not strongly influenced by tobacco advertising.
B) Smoking causes lung cancer.
C) Cost is no deterrent to smoking.
D) Alcohol use is strongly associated with smoking.

Accepted Answer

A) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.
B) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.
C) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.
D) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.

Question 11

The nurse assesses a client with a history of alcoholism who is hospitalized with anorexia,dysphagia,odynophagia,and chest pressure after eating.Which nursing diagnosis is a priority for this client?
A) Ineffective Coping
B) Imbalanced Nutrition: Less Than Body Requirements
C) Disturbed Sensory Perception
D) Disturbed Thought Processes

Accepted Answer

A) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.
B) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.
C) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.
D) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.

Question 12

A client is admitted to the emergency department with signs of drug use.The client reports having ingested Percocet and is experiencing respiratory depression.Based on this data,which prescription does the nurse anticipate for this client? A) Diazepam B) Haldol C) Vitamin B₁₂ D) Naloxone

Accepted Answer

A) Percocet is a type of opiate. Naloxone is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B₁₂ is used to manage the neurologic symptoms that might accompany a nitrate overdose. B) Percocet is a type of opiate. Naloxone is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B₁₂ is used to manage the neurologic symptoms that might accompany a nitrate overdose. C) Percocet is a type of opiate. Naloxone is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B₁₂ is used to manage the neurologic symptoms that might accompany a nitrate overdose. D) Percocet is a type of opiate. Naloxone is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B₁₂ is used to manage the neurologic symptoms that might accompany a nitrate overdose.

Question 13

A client is admitted for the fourth time in 4 years for alcohol detoxification.When planning care for this client,the nurse will include which pathophysiology aspect of alcoholism due to its impact on client care?
A) Aging can impact the ability of the body to handle detoxification from alcohol and drugs.
B) The withdrawal may be greater this time.
C) The dependency might have been greater this time.
D) Increased difficulty with alcohol detoxification is likely the result of an addiction to another substance at the same time.

Accepted Answer

A) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.
B) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.
C) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.
D) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.

Question 14

The nurse is providing care to a client who admits to smoking 2 packs of per day for 34 years.The client also has a history of intermittent claudication,chronic bronchitis,and emphysema.After 6 weeks of smoking cessation the client reports,"yelling at my spouse" and "flying off the handle." Which effects of cigarette smoking are associated with the data collected from the client? Select all that apply.
A) Nicotine causes destruction of the alveoli.
B) The release of epinephrine causes vasoconstriction.
C) Dopaminergic processes are implicated in withdrawal symptoms.
D) Tar causes the mucus production seen in chronic bronchitis.
E) Tobacco use causes atherosclerosis.

Accepted Answer

A) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis.
B) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis.
C) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis.
D) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis.
E) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis.

Question 15

The nurse is providing care for a client of Asian descent who admits to an alcohol addiction.The client admits to being able to hide the addiction from family and friends.Based on this data,which independent nursing intervention is appropriate for this client?
A) Assertiveness training
B) Milieu therapy
C) Family therapy
D) Communication training

Accepted Answer

A) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.
B) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.
C) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.
D) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.

Question 16

The nurse is planning to implement addiction treatment groups at the inner city clinic.Which knowledge regarding addictions and its related therapies will facilitate implementation of the groups?
A) Relapse is a common feature of substance abuse.
B) Hereditary, as well as complex environmental influences, predisposes one to substance dependence.
C) Clients with a substance dependence cannot be held accountable for their actions.
D) Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are accepted treatment approaches.

Accepted Answer

A) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
B) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
C) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
D) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Question 17

During visitation on the unit,the nurse is observing the family dynamics of an adolescent client who has an addiction problem and recognizes that the family is experiencing behaviors consistent with codependence.Based on this data,which manifestation does the nurse anticipate from the client's family?
A) Frustration intolerance
B) Enabling
C) Argumentative behaviors
D) Impatience

Accepted Answer

A) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
B) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
C) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
D) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.

Question 18

An older adult client with heart disease tells the nurse,"I am sick because I sinned by smoking cigarettes." Which response by the nurse is appropriate?
A) "Smoking cigarettes isn't a sin. There are many worse habits you could have."
B) "Cigarette smoking was desirable when you began smoking. We didn't know about the problems it could cause."
C) "Why don't we call the hospital chaplain and you can pray about your sins?"
D) "You are correct, but it is too late to do anything about it now."

Accepted Answer

A) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.
B) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.
C) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.
D) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.

Question 19

The nurse is providing care to a client diagnosed with alcoholism.The client's physical examination reveals a BMI of 18.Which prescription does the nurse anticipate to manage the client's nutritional status?
A) Sertraline
B) Methadone
C) Naloxone
D) Multivitamin with folic acid

Accepted Answer

A) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Naloxone is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline is used to reduce anxiety and stabilize mood.
B) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Naloxone is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline is used to reduce anxiety and stabilize mood.
C) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Naloxone is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline is used to reduce anxiety and stabilize mood.
D) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Naloxone is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline is used to reduce anxiety and stabilize mood.

Question 20

While practicing at an outpatient addiction clinic,the nurse is summarizing a diagram in the orientation handbook for a new nurse who requires orientation.Which statement made by the new nurse most closely aligns with the meaning of this diagram? 
A) "Addiction involves an alteration in the amount of available neurotransmitters."
B) "Actions at the neurotransmitter level affecting addiction are not genetic."
C) "High self-esteem as a basis for pleasure seeking lowers neurotransmitter levels."
D) "An addictive personality is identified by differences in the processing of neurotransmitters."

Accepted Answer

A) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
B) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
C) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
D) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.

Quiz 22: Addiction

The nurse is conducting a health history for a client and wants to determine the client's alcohol use.What question from the nurse will provide the greatest amount of information?

The nurse is conducting a class in the community regarding alcohol use to a group of college seniors.During the class a participant admits to frequently using alcohol.Which is the priority action of the nurse?

The client with a history of alcohol abuse is being discharged for a treatment facility.Which prescription does the nurse anticipate for this client?

A client with alcoholism is receiving court-ordered care in a residential treatment facility.After alcohol is discovered in the client's room,the client states,"It is not mine." Which responses by the nurse are appropriate in this situation? Select all that apply.

A nurse educator is a teaching a group of students about the comprehensive theory of addiction by George Engel.Which statements indicate that the students understand the theory? Select all that apply.

A college student attends a seminar on alcohol abuse.Which statement would alert the nurse that the student needs more education?

The nurse is conducting a crisis assessment for a client who admits to cocaine use.Which questions are appropriate for the nurse to ask the client during this process? Select all that apply.

The nurse is evaluating outcome goals written by a student for a client diagnosed with alcoholism who is being discharged from a detoxification program.Which outcomes are appropriate for this client? Select all that apply.

The nurse is conducting a health promotion class to adolescents regarding smoking.Which point is most important to convey to this audience?

The nurse assesses a client with a history of alcoholism who is hospitalized with anorexia,dysphagia,odynophagia,and chest pressure after eating.Which nursing diagnosis is a priority for this client?

A client is admitted to the emergency department with signs of drug use.The client reports having ingested Percocet and is experiencing respiratory depression.Based on this data,which prescription does the nurse anticipate for this client?

A client is admitted for the fourth time in 4 years for alcohol detoxification.When planning care for this client,the nurse will include which pathophysiology aspect of alcoholism due to its impact on client care?

The nurse is providing care for a client of Asian descent who admits to an alcohol addiction.The client admits to being able to hide the addiction from family and friends.Based on this data,which independent nursing intervention is appropriate for this client?

The nurse is planning to implement addiction treatment groups at the inner city clinic.Which knowledge regarding addictions and its related therapies will facilitate implementation of the groups?

An older adult client with heart disease tells the nurse,"I am sick because I sinned by smoking cigarettes." Which response by the nurse is appropriate?

The nurse is providing care to a client diagnosed with alcoholism.The client's physical examination reveals a BMI of 18.Which prescription does the nurse anticipate to manage the client's nutritional status?

While practicing at an outpatient addiction clinic,the nurse is summarizing a diagram in the orientation handbook for a new nurse who requires orientation.Which statement made by the new nurse most closely aligns with the meaning of this diagram?