Question 1

The population health nurse is completing a history on a client who has been referred to a substance abuse clinic. Which client statements indicate a problem with abuse of a psychoactive substance? (Select all that apply.)

Accepted Answer

2. General indicators that a person has a problem with abuse of a psychoactive substance include frequent intoxication, preoccupation with obtaining and using the substance, binge use, change in personality or mood, withdrawal, problems with family members related to use of the substance, problems with friends or neighbors, problems on the job, and conflicts with law enforcement officials. The best answers include the response that the client cannot get along with people at work and that he has had conflict with law enforcement officials. Unemployment, negative drug testing, and not marrying are not indicators that a person has a problem with abuse of psychoactive substances.

Question 2

The population health nurse is teaching a class about substance abuse. A portion of the class discusses the desirable initial effects of some of the substances. Which substances should be cited as producing a euphoric initial effect? (Select all that apply.)

Accepted Answer

2. PCP causes heightened sensitivity to stimuli, mood elevation, a sense of omnipotence, and relaxation. Cocaine produces euphoria, a sense of competence, increased energy, and clarity of thought. Nicotine produces feelings of well-being, increases mental acuity and ability to concentrate, and heightens one's sense of purpose. Amphetamines produce feelings of euphoria, energy, confidence, increased ability to concentrate, and improved physical performance. Inhalants usually produce a sense of euphoria, loss of inhibition, and excitement.
4. PCP causes heightened sensitivity to stimuli, mood elevation, a sense of omnipotence, and relaxation. Cocaine produces euphoria, a sense of competence, increased energy, and clarity of thought. Nicotine produces feelings of well-being, increases mental acuity and ability to concentrate, and heightens one's sense of purpose. Amphetamines produce feelings of euphoria, energy, confidence, increased ability to concentrate, and improved physical performance. Inhalants usually produce a sense of euphoria, loss of inhibition, and excitement.
5. PCP causes heightened sensitivity to stimuli, mood elevation, a sense of omnipotence, and relaxation. Cocaine produces euphoria, a sense of competence, increased energy, and clarity of thought. Nicotine produces feelings of well-being, increases mental acuity and ability to concentrate, and heightens one's sense of purpose. Amphetamines produce feelings of euphoria, energy, confidence, increased ability to concentrate, and improved physical performance. Inhalants usually produce a sense of euphoria, loss of inhibition, and excitement.

Question 3

City council asks the population health nurse to assist with preventing the relapse of substance abuse by community members returning from rehabilitation. What actions should the nurse take to help these community members? (Select all that apply.)

Accepted Answer

1. Population health nurses can assist clients with substance abuse problems to identify triggers for relapse and to develop strategies for dealing with them. They can also assist in the development of relapse prevention groups that provide clients with the support of others in dealing with their relapse issues. They may also help to motivate family members and significant others to participate in relapse prevention, educating both clients and significant others about relapse, its causes, and prevention strategies. Alerting law officials about the release of community members from rehabilitation will not help prevent the relapse of substance abuse.
3. Population health nurses can assist clients with substance abuse problems to identify triggers for relapse and to develop strategies for dealing with them. They can also assist in the development of relapse prevention groups that provide clients with the support of others in dealing with their relapse issues. They may also help to motivate family members and significant others to participate in relapse prevention, educating both clients and significant others about relapse, its causes, and prevention strategies. Alerting law officials about the release of community members from rehabilitation will not help prevent the relapse of substance abuse.
4. Population health nurses can assist clients with substance abuse problems to identify triggers for relapse and to develop strategies for dealing with them. They can also assist in the development of relapse prevention groups that provide clients with the support of others in dealing with their relapse issues. They may also help to motivate family members and significant others to participate in relapse prevention, educating both clients and significant others about relapse, its causes, and prevention strategies. Alerting law officials about the release of community members from rehabilitation will not help prevent the relapse of substance abuse.
5. Population health nurses can assist clients with substance abuse problems to identify triggers for relapse and to develop strategies for dealing with them. They can also assist in the development of relapse prevention groups that provide clients with the support of others in dealing with their relapse issues. They may also help to motivate family members and significant others to participate in relapse prevention, educating both clients and significant others about relapse, its causes, and prevention strategies. Alerting law officials about the release of community members from rehabilitation will not help prevent the relapse of substance abuse.

Question 4

A mother is concerned that her son is demonstrating some behaviors that place him at risk for substance abuse. Which behavior should the population health nurse explain that contributes to problems of substance abuse?

Accepted Answer

4. Personality traits that may place one at risk for substance abuse include rebelliousness and nonconformity that may lead to substance abuse as an expression of defiance or as an escape from the constraints and expectations of the adult world. Other common traits in abusers are a greater tolerance of deviant behavior, a poor self-concept, and passive surrender to belief in their own inevitable failure in life.

Question 5

The population health nurse is planning approaches to help community students cope with substance use. Which approaches should the nurse use to meet this goal? (Select all that apply.)

Accepted Answer

1. Strategies to develop effective coping include teaching coping strategies to individual clients/families, advocating for incorporation of coping skills into school curricula, and developing and implementing programs to foster effective coping skills. Prevention strategies include educating individual clients regarding substance use risks and controlling access to substances of abuse.
4. Strategies to develop effective coping include teaching coping strategies to individual clients/families, advocating for incorporation of coping skills into school curricula, and developing and implementing programs to foster effective coping skills. Prevention strategies include educating individual clients regarding substance use risks and controlling access to substances of abuse.
5. Strategies to develop effective coping include teaching coping strategies to individual clients/families, advocating for incorporation of coping skills into school curricula, and developing and implementing programs to foster effective coping skills. Prevention strategies include educating individual clients regarding substance use risks and controlling access to substances of abuse.

Question 6

The community is conducting a series of forums about alcoholism. What information should the forums include?

Accepted Answer

4. Alcohol use is the third leading cause of death in the United States, and contributes to 2.5 million deaths worldwide. Data from the Behavioral Risk Factor Surveillance System in 2009 indicted that nearly 42% of high school students reported current alcohol use. Almost a fourth of the population (23%) reported binge drinking.

Question 7

The nurse manager of a community health clinic is designing a process to implement brief interventions when assisting a client to resolve a substance abuse issue. Which components should the nurse include in this process? (Select all that apply.)

Accepted Answer

1. Key components of brief interventions include feedback related to personal risk, emphasizing client responsibility, providing options for reducing use, employing an empathetic counseling style, focusing on self-efficacy, and setting goals.
2. Key components of brief interventions include feedback related to personal risk, emphasizing client responsibility, providing options for reducing use, employing an empathetic counseling style, focusing on self-efficacy, and setting goals.
3. Key components of brief interventions include feedback related to personal risk, emphasizing client responsibility, providing options for reducing use, employing an empathetic counseling style, focusing on self-efficacy, and setting goals.
5. Key components of brief interventions include feedback related to personal risk, emphasizing client responsibility, providing options for reducing use, employing an empathetic counseling style, focusing on self-efficacy, and setting goals.

Question 8

The population health nurse is working in a methadone clinic. What type of intervention does this best describe?

Accepted Answer

1. Harm reduction is a health promotion approach to the control of substance abuse. It is an approach to drug use that focuses on moderation of substance use and minimization of its harmful effects. Providing methadone to heroin users is not a health restoration or illness prevention. Pharmacological intervention therapy is not an identified treatment approach to substance abuse.

Question 9

The population health nurse suspects that a community member was facilitated by the health care system to develop substance abuse. What information in the client's history caused the nurse to make this determination?

Accepted Answer

4. Many of the psychoactive substances with abuse potential originated within the health care system. Opioids are the drug of choice for relief of severe pain. Attending classes for a GED, cancelling physical examinations, and part-time employment are not health care system determinants for substance use.

Question 10

The population health nurse suspects that a client has psychoactive substance dependence. Which assessment made the nurse most suspicious?

Accepted Answer

4. Diagnosis of psychoactive substance dependence is based on increased tolerance to the substance, experience of characteristic withdrawal symptoms, increased substance use to decrease withdrawal symptoms, and increased time spent recovering from the effects.

Question 11

The population health nurse suspects that a client is experiencing nicotine withdrawal. What manifestations did the nurse use to make this clinical decision? (Select all that apply.)

Accepted Answer

1. Nervousness, increased appetite, sleep disturbances, and anxiety are manifestations of nicotine withdrawal. Disorientation is a manifestation of amphetamine withdrawal.
2. Nervousness, increased appetite, sleep disturbances, and anxiety are manifestations of nicotine withdrawal. Disorientation is a manifestation of amphetamine withdrawal.
4. Nervousness, increased appetite, sleep disturbances, and anxiety are manifestations of nicotine withdrawal. Disorientation is a manifestation of amphetamine withdrawal.
5. Nervousness, increased appetite, sleep disturbances, and anxiety are manifestations of nicotine withdrawal. Disorientation is a manifestation of amphetamine withdrawal.

Question 12

An adolescent who has been treated twice in the last three years for substance abuse has been warned by the court that further problems with the law will result in his incarceration. The population health nurse is trying to convince the client's mother to have the adolescent admitted to a local rehabilitative program. Which substance abuse treatment principle is the nurse implementing?

Accepted Answer

4. Even though each possible answer is a principle of treatment for substance abuse, the principle the nurse is working with is that treatment does not need to be voluntary to be effective. The nurse is not addressing that multiple episodes of treatment may be necessary. The nurse is not discussing medications that may be used in conjunction with other therapies. The nurse is not emphasizing that no single treatment is appropriate for all individuals.

Question 13

While interviewing the spouse of a client who is being treated for substance abuse, the population health nurse suspects codependence exists between the client and the spouse. What characteristic of codependence did the nurse assess?

Accepted Answer

3. Characteristics of codependence center on patterns of denial of feelings, low self-esteem, and compliance with others' desires over personal interests, and control of others.

Question 14

A client is beginning treatment for alcohol abuse. The population health nurse should ensure that the client is instructed on which types of medications used for this treatment? (Select all that apply.)

Accepted Answer

1. Disulfiram, acamprosate, and naltrexone may be used for alcohol dependence. Buprenorphine may be used for opioid addiction. Amitriptyline is a mood elevator and not indicated in the treatment of alcohol abuse.
2. Disulfiram, acamprosate, and naltrexone may be used for alcohol dependence. Buprenorphine may be used for opioid addiction. Amitriptyline is a mood elevator and not indicated in the treatment of alcohol abuse.
3. Disulfiram, acamprosate, and naltrexone may be used for alcohol dependence. Buprenorphine may be used for opioid addiction. Amitriptyline is a mood elevator and not indicated in the treatment of alcohol abuse.

Question 15

During an assessment the population health nurse learns that a client is using blue velvet. For which substance should the nurse plan care for this client?

Accepted Answer

3. A street name for opium is blue velvet. A street name for codeine is schoolboy. Demerol is referred to as demies, dolls, or dollies. Cocaine is referred to as coke, snow, uptown, flake, crack, bump, toot, c, or candy.

Quiz 29: Substance Abuse