Question 1

A patient tells the nurse that both of his parents are alcoholics and wonders about the likelihood of becoming an alcoholic as well. How should the nurse respond to the patient?

Accepted Answer

There is strong evidence supporting a genetic link for developing alcoholism, so the nurse should provide factual information to the patient. Option B may sound judgmental or dismissive, option C is not helpful and could cause unnecessary stress, and option D does not provide any information or support to the patient.

Question 2

A nurse is concerned about potential substance abuse by a coworker. What behavior warrants further investigation?

Accepted Answer

Wasting medications could indicate potential substance abuse, as the coworker may be using the medications for personal use rather than administering them to patients. The other behaviors may not necessarily indicate substance abuse.

Question 3

The nurse manager is concerned that one staff nurse is demonstrating signs of substance abuse. Which behaviors did the manager observe in the staff nurse?

Accepted Answer

Calling in sick frequently before scheduled days off, using the bathroom frequently, and excessive use of mouthwash can be signs of substance abuse in a healthcare setting. Volunteering for assignments and following up on patient care needs are not necessarily indicative of substance abuse.

Question 4

A patient with a history of chronic alcohol use is underweight and malnourished. What should the nurse expect to be prescribed to manage the patient's nutritional status?

Accepted Answer

Thiamine (vitamin B1) is often prescribed for patients with chronic alcohol use disorder who are malnourished and underweight. Chronic alcohol use can lead to a thiamine deficiency, which can result in neurological complications such as Wernicke's encephalopathy and Korsakoff's psychosis. Thiamine supplementation can help prevent or treat these complications and improve overall nutritional status. Diazepam is a benzodiazepine medication used to treat anxiety and alcohol withdrawal symptoms. Methadone is a medication used for opioid addiction treatment, and naloxone is used for opioid overdose reversal. Neither of these medications would be appropriate for managing malnutrition in a patient with a history of chronic alcohol use.

Question 5

The nurse is concerned that a colleague is experiencing depression from substance abuse. What does the nurse observe to make this assumption?

Accepted Answer

Leaving the unit and being unable to be located for long periods of time is a behavior commonly associated with substance abuse and depression.

Question 6

While analyzing data collected during an assessment, the nurse realizes that a patient's risk for alcohol abuse is low. What information did the nurse use to come to this conclusion?

Accepted Answer

Research has shown that individuals of Asian descent have lower rates of alcohol abuse compared to other ethnicities. The other factors presented do not necessarily indicate a lower risk of alcohol abuse.

Question 7

A patient admitted with seizures is diagnosed with a perforated nasal septum. The nurse realizes that this patient most likely has abused which substance?

Accepted Answer

Cocaine is a common cause of nasal septum perforation due to its vasoconstrictive effects, which can cause blood vessels in the nasal cavity to constrict and eventually rupture. Chronic cocaine use can lead to erosion and breakdown of the nasal septum, eventually resulting in a perforation.

Question 8

A patient is brought into the emergency department with a gunshot wound obtained while attempting to rob a convenience store. For which health problem should this patient be assessed?

Accepted Answer

Patients involved in criminal activities, such as robbery, may have a higher likelihood of drug and alcohol abuse, which can impair judgment and lead to risky behaviors.

Question 9

After a patient undergoes surgery, the nurse notes that the analgesics prescribed are not relieving the patient's pain. A review of the patient's medical records reveals a history of alcohol abuse. What inferences can the nurse make?

Accepted Answer

Alcohol abuse can lead to cross-tolerance with analgesics, meaning that the patient may require a higher dose of medication to achieve pain relief. This is particularly true for opioids, which should be used with caution in patients with a history of alcohol abuse. Options B and C are not supported by the information provided, and option D is not necessarily indicated based on the given facts.

Question 10

A patient comes into the emergency department wanting to be checked for sexual activity since she was out the other night at a rave and cannot remember what occurred. The nurse realizes that which addictive substance would cause this effect?

Accepted Answer

Ecstasy (MDMA) is known to cause memory loss or blackouts, especially when taken in high doses. The other substances listed may have other effects on the body, but are not typically associated with memory loss or blackouts.

Question 11

A teenage patient brought to the emergency department by his parents was reported to have taken barbiturates with alcohol. For which adverse effect should the nurse assess this patient?

Accepted Answer

Barbiturates and alcohol both act as central nervous system depressants and when taken together, they can lead to severe respiratory depression, which can be life-threatening. Therefore, the nurse should assess the patient for any signs of respiratory distress or decreased respiratory rate. Seizure activity, signs of withdrawal or hallucinations are not typical adverse effects of barbiturates and alcohol use.

Question 12

A nurse consistently arrives to work wearing a long-sleeved blouse despite the temperature being in the 90s and the air humid. When colleagues mention her attire, the nurse becomes defensive and isolates herself from others. What does the nurse's behavior suggest?

Accepted Answer

The nurse's consistent choice of long-sleeved blouses despite hot weather and her defensive reaction when questioned may suggest substance abuse, as this behavior could be an attempt to conceal marks or scars associated with intravenous drug use.

Question 13

A patient is brought into the emergency department with dilated pupils, respiratory rate of six per minute, and seizure activity. What should the nurse prepare to administer to this patient?

Accepted Answer

The symptoms described are indicative of opioid overdose, for which naloxone (Narcan) is the appropriate antidote to reverse the effects, including respiratory depression.

Question 14

A patient tells the nurse that she started to have a glass of wine every evening at home after work to "unwind" and then realized that she cannot continue with her day unless she has the wine. The nurse realizes that this patient uses wine to

Accepted Answer

The fact that the patient cannot continue with her day unless she has the wine suggests that she is using it as a coping mechanism to deal with day-to-day problems. She may have developed a dependence on alcohol to manage stress and anxiety.

Question 15

A patient recovering from outpatient carpal tunnel surgery returns to the surgical center the next day and tells the nurse that she is having trouble attending to daily activities and the pain is "excruciating," so she wants stronger pain medication immediately. What should this patient's behavior suggest to the nurse?

Accepted Answer

The patient's request for stronger pain medication and description of the pain as "excruciating" could suggest a potential substance abuse problem, especially if the pain level is not typical for the procedure performed.

Question 16

A patient complaining of back pain tells the nurse that he needs several refills on any prescription since he takes the medication more frequently than prescribed. What should this information suggest to the nurse?

Accepted Answer

The patient's statement suggests that they are taking medication more frequently than prescribed, indicating a loss of control over consumption. This behavior may be indicative of drug abuse or addiction. It is important for the nurse to assess the patient's pain management needs and discuss alternative interventions or referral to a pain management specialist.

Question 17

A patient comes to the emergency department with a PCP overdose. Which intervention should the nurse anticipate will be needed?

Accepted Answer

Haloperidol (Haldol) may be used to manage severe agitation or psychosis in a patient with PCP overdose, as it can help control delusional or violent behavior. Naloxone (Narcan) is used for opioid overdoses, not PCP. Inducing vomiting is not recommended due to the risk of aspiration, and "talking down" may not be effective for severe agitation or psychosis.

Question 18

The mother of a patient admitted with alcohol abuse tells the nurse that alcohol is not consumed at home and the patient is adopted. What should the nurse suspect about the patient?

Accepted Answer

The fact that the patient is adopted and alcohol is not consumed at home suggests that the patient's biological parents might have a history of alcohol abuse, which could be a genetic or learned behavior passed down to the patient.

Question 19

A patient tells the nurse that he becomes very angry and abusive to his friends and family when he is unable to obtain an illegal substance. How should the nurse respond to this patient?

Accepted Answer

The nurse should suggest seeking treatment for the patient's behavior, as it is likely a result of substance abuse and could potentially harm the patient and those around them. The other options either make assumptions or ask irrelevant questions.

Question 20

A patient involved in a minor accident reports having used "crank" an hour ago. The patient denies having used the drug before. What manifestations can the nurse anticipate occurring with this patient?

Accepted Answer

Crank is a street name for methamphetamine, a stimulant that can cause insomnia and confusion, especially in someone who is not accustomed to its effects.

Quiz 6: Nursing Care of Patients With Problems of Substance Abuse