Question 1

A nurse is caring for a client who displays addiction behavior toward the use of alcohol.The client states to the nurse,"I have been in jail twice for driving under the influence." When planning care for this client,which behavioral therapy is most appropriate?
A) Positive reinforcement
B) Negative reinforcement
C) Positive punishment
D) Negative punishment

Accepted Answer

A) Consequences that lead to a decrease in undesirable behavior are referred to as punishment. Positive punishment is the addition of a negative consequence if the undesirable behavior occurs; for example, the addict who drives under the influence is jailed or fined. Negative punishment is the removal of a positive reward if the undesirable behavior occurs; for example, the addict who does not show up for work loses his job. Consequences that lead to an increase in a particular behavior are referred to as reinforcement. Positive reinforcement provides a reward for the desired behavior, such as the pleasant sensation, or high, that comes from the use of a substance. Negative reinforcement removes a negative stimulus to increase the chances that the desired behavior will occur. An example of negative reinforcement is when the family of an addict refuses to support the behavior that results from use of the substance.
B) Consequences that lead to a decrease in undesirable behavior are referred to as punishment. Positive punishment is the addition of a negative consequence if the undesirable behavior occurs; for example, the addict who drives under the influence is jailed or fined. Negative punishment is the removal of a positive reward if the undesirable behavior occurs; for example, the addict who does not show up for work loses his job. Consequences that lead to an increase in a particular behavior are referred to as reinforcement. Positive reinforcement provides a reward for the desired behavior, such as the pleasant sensation, or high, that comes from the use of a substance. Negative reinforcement removes a negative stimulus to increase the chances that the desired behavior will occur. An example of negative reinforcement is when the family of an addict refuses to support the behavior that results from use of the substance.
C) Consequences that lead to a decrease in undesirable behavior are referred to as punishment. Positive punishment is the addition of a negative consequence if the undesirable behavior occurs; for example, the addict who drives under the influence is jailed or fined. Negative punishment is the removal of a positive reward if the undesirable behavior occurs; for example, the addict who does not show up for work loses his job. Consequences that lead to an increase in a particular behavior are referred to as reinforcement. Positive reinforcement provides a reward for the desired behavior, such as the pleasant sensation, or high, that comes from the use of a substance. Negative reinforcement removes a negative stimulus to increase the chances that the desired behavior will occur. An example of negative reinforcement is when the family of an addict refuses to support the behavior that results from use of the substance.
D) Consequences that lead to a decrease in undesirable behavior are referred to as punishment. Positive punishment is the addition of a negative consequence if the undesirable behavior occurs; for example, the addict who drives under the influence is jailed or fined. Negative punishment is the removal of a positive reward if the undesirable behavior occurs; for example, the addict who does not show up for work loses his job. Consequences that lead to an increase in a particular behavior are referred to as reinforcement. Positive reinforcement provides a reward for the desired behavior, such as the pleasant sensation, or high, that comes from the use of a substance. Negative reinforcement removes a negative stimulus to increase the chances that the desired behavior will occur. An example of negative reinforcement is when the family of an addict refuses to support the behavior that results from use of the substance.

Question 2

A nurse working in the emergency department is caring for a client who has overdosed on cocaine.The nurse receives a prescription to administer an antipsychotic medication from the healthcare provider.Which symptom would this medication help to manage? Select all that apply.
A) Alkaline urine
B) Decreased deep tendon reflexes
C) Hyperpyrexia
D) Respiratory distress
E) CNS depression

Accepted Answer

A) Antipsychotic medications are used in the treatment of clients who have overdosed on crack or cocaine. These medications help to manage the hyperpyrexia, respiratory distress, acidic urine, and convulsions associated with the overdose. CNS depression and decreased deep tendon reflexes do not occur in acute cocaine overdose.
B) Antipsychotic medications are used in the treatment of clients who have overdosed on crack or cocaine. These medications help to manage the hyperpyrexia, respiratory distress, acidic urine, and convulsions associated with the overdose. CNS depression and decreased deep tendon reflexes do not occur in acute cocaine overdose.
C) Antipsychotic medications are used in the treatment of clients who have overdosed on crack or cocaine. These medications help to manage the hyperpyrexia, respiratory distress, acidic urine, and convulsions associated with the overdose. CNS depression and decreased deep tendon reflexes do not occur in acute cocaine overdose.
D) Antipsychotic medications are used in the treatment of clients who have overdosed on crack or cocaine. These medications help to manage the hyperpyrexia, respiratory distress, acidic urine, and convulsions associated with the overdose. CNS depression and decreased deep tendon reflexes do not occur in acute cocaine overdose.
E) Antipsychotic medications are used in the treatment of clients who have overdosed on crack or cocaine. These medications help to manage the hyperpyrexia, respiratory distress, acidic urine, and convulsions associated with the overdose. CNS depression and decreased deep tendon reflexes do not occur in acute cocaine overdose.

Question 3

A nurse manager in the intensive care unit (ICU)notes a pattern for a staff nurse who excessively "wastes" narcotics,and the manager suspects the staff nurse may be impaired.Which clinical situation may have contributed to the staff nurse's problem?
A) Caring for clients who require IV medications
B) Easy access to prescription drugs
C) Easy access to client care areas
D) Caring for clients who require numerous oral medications

Accepted Answer

A) Easy access to prescription drugs presents an at-risk situation for nurses who abuse substances. The other situations are common for all nurses and do not necessary pose an increased risk for substance abuse.
B) Easy access to prescription drugs presents an at-risk situation for nurses who abuse substances. The other situations are common for all nurses and do not necessary pose an increased risk for substance abuse.
C) Easy access to prescription drugs presents an at-risk situation for nurses who abuse substances. The other situations are common for all nurses and do not necessary pose an increased risk for substance abuse.
D) Easy access to prescription drugs presents an at-risk situation for nurses who abuse substances. The other situations are common for all nurses and do not necessary pose an increased risk for substance abuse.

Question 4

The nurse is providing care to a client with alcohol and opioid dependency.A family member states,"I don't understand why Naltrexone treatment is prescribed because it causes a high too,right?" Which response by the nurse is appropriate?
A) "Naltrexone will cause your daughter to become violently ill if she drinks alcohol or abuses drugs."
B) "Naltrexone is less potent than the street drugs your daughter is currently taking and therefore safer."
C) "Naltrexone diminishes the cravings your daughter will feel for alcohol and opioids."
D) "Naltrexone will prevent your daughter from getting drunk when she drinks."

Accepted Answer

A) Naltrexone diminishes the cravings for alcohol and opioids. Disulfiram, not naltrexone, will cause a person to become violently ill when alcohol is consumed.
B) Naltrexone diminishes the cravings for alcohol and opioids. Disulfiram, not naltrexone, will cause a person to become violently ill when alcohol is consumed.
C) Naltrexone diminishes the cravings for alcohol and opioids. Disulfiram, not naltrexone, will cause a person to become violently ill when alcohol is consumed.
D) Naltrexone diminishes the cravings for alcohol and opioids. Disulfiram, not naltrexone, will cause a person to become violently ill when alcohol is consumed.

Question 5

A client who is attending a Narcotics Anonymous (NA)program asks the nurse what the most important initial goal of attending the meetings is.When responding to the client,which will the nurse take into account?
A) To admit to having a problem
B) To learn problem-solving skills
C) To take a moral inventory of self
D) To make amends to people they have hurt

Accepted Answer

A) The initial outcome for clients in substance abuse programs is to admit they have a problem with drugs or alcohol. Clients will be unable to participate fully in a recovery program until they can admit that they have a substance abuse problem, admit the extent of that problem, and acknowledge how abuse has impacted their lives. Learning problem-solving skills is a later outcome for a substance abuse program. Taking a moral inventory and making amends are the fourth and eighth steps of Narcotics Anonymous and would not be initial outcomes.
B) The initial outcome for clients in substance abuse programs is to admit they have a problem with drugs or alcohol. Clients will be unable to participate fully in a recovery program until they can admit that they have a substance abuse problem, admit the extent of that problem, and acknowledge how abuse has impacted their lives. Learning problem-solving skills is a later outcome for a substance abuse program. Taking a moral inventory and making amends are the fourth and eighth steps of Narcotics Anonymous and would not be initial outcomes.
C) The initial outcome for clients in substance abuse programs is to admit they have a problem with drugs or alcohol. Clients will be unable to participate fully in a recovery program until they can admit that they have a substance abuse problem, admit the extent of that problem, and acknowledge how abuse has impacted their lives. Learning problem-solving skills is a later outcome for a substance abuse program. Taking a moral inventory and making amends are the fourth and eighth steps of Narcotics Anonymous and would not be initial outcomes.
D) The initial outcome for clients in substance abuse programs is to admit they have a problem with drugs or alcohol. Clients will be unable to participate fully in a recovery program until they can admit that they have a substance abuse problem, admit the extent of that problem, and acknowledge how abuse has impacted their lives. Learning problem-solving skills is a later outcome for a substance abuse program. Taking a moral inventory and making amends are the fourth and eighth steps of Narcotics Anonymous and would not be initial outcomes.

Question 6

A client is admitted to the emergency department after overdosing on phencyclidine piperidine (PCP).Based on this actions,which actions are appropriate by the nurse? Select all that apply.
A) Obtain materials to assist with lavage.
B) Initiate an IV.
C) Initiate seizure precautions.
D) Induce vomiting.
E) Administer ammonium chloride.

Accepted Answer

A) The client has taken an overdose of phencyclidine piperidine (PCP), which can produce an adrenaline-like response, or "speed" reaction. PCP overdose is associated with possible hypertensive crisis, respiratory arrest, hyperthermia, and seizures. The client will require an IV line. The client will need to have seizure precautions such as padded side rails initiated. The client may also be given ammonium chloride to acidify the urine to help excrete the drug. Vomiting is induced for overdoses of alcohol, barbiturates, and benzodiazepines. Lavage would be an inappropriate treatment for inhalation of any substance. Narcan is a narcotic antagonist administered for opiate overdose.
B) The client has taken an overdose of phencyclidine piperidine (PCP), which can produce an adrenaline-like response, or "speed" reaction. PCP overdose is associated with possible hypertensive crisis, respiratory arrest, hyperthermia, and seizures. The client will require an IV line. The client will need to have seizure precautions such as padded side rails initiated. The client may also be given ammonium chloride to acidify the urine to help excrete the drug. Vomiting is induced for overdoses of alcohol, barbiturates, and benzodiazepines. Lavage would be an inappropriate treatment for inhalation of any substance. Narcan is a narcotic antagonist administered for opiate overdose.
C) The client has taken an overdose of phencyclidine piperidine (PCP), which can produce an adrenaline-like response, or "speed" reaction. PCP overdose is associated with possible hypertensive crisis, respiratory arrest, hyperthermia, and seizures. The client will require an IV line. The client will need to have seizure precautions such as padded side rails initiated. The client may also be given ammonium chloride to acidify the urine to help excrete the drug. Vomiting is induced for overdoses of alcohol, barbiturates, and benzodiazepines. Lavage would be an inappropriate treatment for inhalation of any substance. Narcan is a narcotic antagonist administered for opiate overdose.
D) The client has taken an overdose of phencyclidine piperidine (PCP), which can produce an adrenaline-like response, or "speed" reaction. PCP overdose is associated with possible hypertensive crisis, respiratory arrest, hyperthermia, and seizures. The client will require an IV line. The client will need to have seizure precautions such as padded side rails initiated. The client may also be given ammonium chloride to acidify the urine to help excrete the drug. Vomiting is induced for overdoses of alcohol, barbiturates, and benzodiazepines. Lavage would be an inappropriate treatment for inhalation of any substance. Narcan is a narcotic antagonist administered for opiate overdose.
E) The client has taken an overdose of phencyclidine piperidine (PCP), which can produce an adrenaline-like response, or "speed" reaction. PCP overdose is associated with possible hypertensive crisis, respiratory arrest, hyperthermia, and seizures. The client will require an IV line. The client will need to have seizure precautions such as padded side rails initiated. The client may also be given ammonium chloride to acidify the urine to help excrete the drug. Vomiting is induced for overdoses of alcohol, barbiturates, and benzodiazepines. Lavage would be an inappropriate treatment for inhalation of any substance. Narcan is a narcotic antagonist administered for opiate overdose.

Question 7

The nurse is completing a health history with an adolescent client and determines the client would benefit from teaching about substance abuse.Which client statements caused the nurse to come to this conclusion? Select all that apply.
A) "I drink alcohol with my friends on the weekends."
B) "I smoke cigarettes on a daily basis."
C) "I use my seat belt every time I ride in a car."
D) "I became sexually active at the age of 13."
E) "I get all A's and B's in school."

Accepted Answer

A) Early sexual activity, smoking cigarettes, and drinking alcohol are all risk factors for teenage substance abuse. Getting good grades and wearing a seat belt are not risk factors for substance abuse.
B) Early sexual activity, smoking cigarettes, and drinking alcohol are all risk factors for teenage substance abuse. Getting good grades and wearing a seat belt are not risk factors for substance abuse.
C) Early sexual activity, smoking cigarettes, and drinking alcohol are all risk factors for teenage substance abuse. Getting good grades and wearing a seat belt are not risk factors for substance abuse.
D) Early sexual activity, smoking cigarettes, and drinking alcohol are all risk factors for teenage substance abuse. Getting good grades and wearing a seat belt are not risk factors for substance abuse.
E) Early sexual activity, smoking cigarettes, and drinking alcohol are all risk factors for teenage substance abuse. Getting good grades and wearing a seat belt are not risk factors for substance abuse.

Question 8

After an assessment of a new client,a nursing student expresses a belief that drug addiction is not a real illness,as these clients "did it to themselves." Which response by the staff nurse is appropriate?
A) "Sometimes a client doesn't show much effort."
B) "We are legally obligated to provide care."
C) "It is important to remain nonjudgmental when caring for any client, even a drug addict."
D) "You are right. I don't know why we bother."

Accepted Answer

A) Nurses must provide a nonjudgmental attitude with their clients in order to promote trust and respect. Even if a client is not currently making much effort toward management of addiction disorders, the development of a trusting relationship with the nurse helps to set the stage for movement toward recovery in the future. Although it is true that nurses are legally obligated to provide care, this response is not client-focused and is therefore inappropriate.
B) Nurses must provide a nonjudgmental attitude with their clients in order to promote trust and respect. Even if a client is not currently making much effort toward management of addiction disorders, the development of a trusting relationship with the nurse helps to set the stage for movement toward recovery in the future. Although it is true that nurses are legally obligated to provide care, this response is not client-focused and is therefore inappropriate.
C) Nurses must provide a nonjudgmental attitude with their clients in order to promote trust and respect. Even if a client is not currently making much effort toward management of addiction disorders, the development of a trusting relationship with the nurse helps to set the stage for movement toward recovery in the future. Although it is true that nurses are legally obligated to provide care, this response is not client-focused and is therefore inappropriate.
D) Nurses must provide a nonjudgmental attitude with their clients in order to promote trust and respect. Even if a client is not currently making much effort toward management of addiction disorders, the development of a trusting relationship with the nurse helps to set the stage for movement toward recovery in the future. Although it is true that nurses are legally obligated to provide care, this response is not client-focused and is therefore inappropriate.

Question 9

A nurse is concerned about potential substance abuse by a coworker.Which of the coworker's behaviors would place the clients on the unit at risk for injury?
A) The nurse in question frequently volunteers to give medications to clients.
B) The nurse in question prefers not to be the "medication nurse" on the shift.
C) The nurse in question declines to take scheduled breaks.
D) The nurse in question frequently requests the largest client care assignment for the shift.

Accepted Answer

A) Frequently volunteering to give medications or having excessive medication wasting could be a sign that a nurse is using or diverting drugs. The nurse who is unable or unwilling to manage a large client care assignment or who requests to administer medications could be a substance abuser. Taking frequent or lengthy breaks might signal substance abuse.
B) Frequently volunteering to give medications or having excessive medication wasting could be a sign that a nurse is using or diverting drugs. The nurse who is unable or unwilling to manage a large client care assignment or who requests to administer medications could be a substance abuser. Taking frequent or lengthy breaks might signal substance abuse.
C) Frequently volunteering to give medications or having excessive medication wasting could be a sign that a nurse is using or diverting drugs. The nurse who is unable or unwilling to manage a large client care assignment or who requests to administer medications could be a substance abuser. Taking frequent or lengthy breaks might signal substance abuse.
D) Frequently volunteering to give medications or having excessive medication wasting could be a sign that a nurse is using or diverting drugs. The nurse who is unable or unwilling to manage a large client care assignment or who requests to administer medications could be a substance abuser. Taking frequent or lengthy breaks might signal substance abuse.

Question 10

A college student is incoherent after taking "downers with beer." For which health problem should the nurse observe in this client?
A) Hallucinations
B) Respiratory depression
C) Seizure activity
D) Signs of withdrawal

Accepted Answer

A) Downers are central nervous system depressants. Barbiturates and alcohol are a lethal combination. The client who has ingested both items is at risk for varying degrees of sedation, up to coma and death. Seizure activity, signs of withdrawal, and signs of hallucinations do not pose as great a risk for this client as respiratory depression.
B) Downers are central nervous system depressants. Barbiturates and alcohol are a lethal combination. The client who has ingested both items is at risk for varying degrees of sedation, up to coma and death. Seizure activity, signs of withdrawal, and signs of hallucinations do not pose as great a risk for this client as respiratory depression.
C) Downers are central nervous system depressants. Barbiturates and alcohol are a lethal combination. The client who has ingested both items is at risk for varying degrees of sedation, up to coma and death. Seizure activity, signs of withdrawal, and signs of hallucinations do not pose as great a risk for this client as respiratory depression.
D) Downers are central nervous system depressants. Barbiturates and alcohol are a lethal combination. The client who has ingested both items is at risk for varying degrees of sedation, up to coma and death. Seizure activity, signs of withdrawal, and signs of hallucinations do not pose as great a risk for this client as respiratory depression.

Quiz 22: Addiction

A nurse is caring for a client who displays addiction behavior toward the use of alcohol.The client states to the nurse,"I have been in jail twice for driving under the influence." When planning care for this client,which behavioral therapy is most appropriate?

A nurse working in the emergency department is caring for a client who has overdosed on cocaine.The nurse receives a prescription to administer an antipsychotic medication from the healthcare provider.Which symptom would this medication help to manage? Select all that apply.

A nurse manager in the intensive care unit (ICU) notes a pattern for a staff nurse who excessively "wastes" narcotics,and the manager suspects the staff nurse may be impaired.Which clinical situation may have contributed to the staff nurse's problem?

The nurse is providing care to a client with alcohol and opioid dependency.A family member states,"I don't understand why Naltrexone treatment is prescribed because it causes a high too,right?" Which response by the nurse is appropriate?

A client who is attending a Narcotics Anonymous (NA) program asks the nurse what the most important initial goal of attending the meetings is.When responding to the client,which will the nurse take into account?

A client is admitted to the emergency department after overdosing on phencyclidine piperidine (PCP) .Based on this actions,which actions are appropriate by the nurse? Select all that apply.

The nurse is completing a health history with an adolescent client and determines the client would benefit from teaching about substance abuse.Which client statements caused the nurse to come to this conclusion? Select all that apply.

After an assessment of a new client,a nursing student expresses a belief that drug addiction is not a real illness,as these clients "did it to themselves." Which response by the staff nurse is appropriate?

A nurse is concerned about potential substance abuse by a coworker.Which of the coworker's behaviors would place the clients on the unit at risk for injury?

A college student is incoherent after taking "downers with beer." For which health problem should the nurse observe in this client?