Deck 20: Substance-Related and Addictive Disorders

Question 1

The nurse is caring for a patient who requires an opiate medication for chronic pain associated with a previous injury. The patient tells the nurse, "Even though I don't feel like I'm addicted to the medication, I get tremors in my hands if I miss a dose." What is the nurse's best response?

A) "You may be addicted to the medication, but not necessarily physically dependent."
B) "You may be physically dependent on the medication, but not necessarily addicted."
C) "The symptoms you describe are indicative of addiction, whether you feel you are or not."
D) "The symptoms you describe relate to your disease state and are not normal."

Answer 1

"You may be physically dependent on the medication, but not necessarily addicted."

Question 2

The nurse is caring for a patient who presented to the emergency department with acute hallucinogenic intoxication. What manifestations will the nurse expect to see during the assessment of this patient? Select all that apply.

A) Tremors
B) Sweating
C) Constricted pupils
D) Tachycardia
E) Dilated pupils

Answer 2

Tremors
Sweating
Tachycardia
Dilated pupils

Question 3

The nurse is caring for a patient who has abused alcohol for many years. On assessment, the nurse notes that the patient has alterations in movement coordination. This suggests that which area of the brain is likely damaged due to the patient's long-term use of alcohol?

A) Hippocampus
B) Cerebellum
C) Cerebral cortex
D) Frontal lobe

Answer 3

Cerebellum

Question 4

The novice psychiatric-mental health nurse begins working at an outpatient substance abuse treatment facility that specializes in SBIRT. What does the nurse learn is the core concept behind SBIRT's approach to substance abuse intervention and treatment?

A) It employs the cognitive approach utilizing rational emotive behavior therapy.
B) It helps clinicians recognize when individuals are able to acknowledge the impact of drug use on their lives and their willingness to change behaviors that support drug use.
C) It may be used to help individuals identify and address problems in life that arise from substance use/misuse or abuse.
D) It asks individuals to examine their own actions and accept responsibility.

Question 5

The nurse is caring for a patient with a substance abuse disorder and addiction who is being treated at a Level III treatment facility for substance detoxification. What nursing intervention is most likely to be the focus of care at this level of treatment?

A) Providing daily outpatient care and monitoring
B) Providing a referral to a halfway house in the patient's community
C) Providing the patient with intensive medical and psychiatric care
D) Providing safe, round-the-clock care that supports wellness and recovery

Question 6

The nurse is caring for a patient with a substance use disorder who is addicted to heroin. The nurse understands that areas of the brain and nervous system have been connected to substance abuse and addiction. What is true regarding the nervous system and substance abuse and addiction? Select all that apply.

A) Changes in neuroanatomy cause the behavior seen in addiction.
B) Addictive substances act on the mesolimbic system of the brain.
C) Addictive substances stimulate surges of dopamine.
D) Addictive substances act on the mesocerebral system of the brain.
E) Changes in neurochemistry cause behaviors seen in addiction.

Question 7

The nurse is providing patient education about addiction. Which statement by the patient demonstrates that the patient has understood the teaching?

A) "Addiction is a biopsychosocial problem."
B) "Addiction is an emotional attachment."
C) "Addiction is a behavioral habit."
D) "Addiction is a moral disease."

Question 8

The nurse is working at an outpatient substance abuse treatment facility that specializes in the administration of methadone. The nurse is giving a patient education session. What will the nurse explain is the goal of methadone treatment?

A) To address the physiological symptoms associated with dependency of opioids/opiates
B) To address the craving associated with withdrawal from opioids/opiates
C) To address the craving associated with withdrawal from amphetamines
D) To address the physiological symptoms associated with dependency of amphetamines

Question 9

The nurse is caring for a patient with substance use disorder. The patient asks if there is a difference between substance use disorder and addiction. How will the nurse explain how substance use disorder differs from addiction?

A) Substance use disorder refers to chemical dependency; addiction does not.
B) Substance use disorder is a diagnostic term; addiction is an active disease state.
C) Substance use disorder does not refer to chemical dependency; addiction does.
D) Substance use disorder is an active disease state; addiction is a diagnostic term.

Question 10

The nurse is caring for a patient who is an intravenous drug user. The nurse anticipates the need for assessment for which cardiac complication?

A) Cardiac tamponade
B) Myocardial infarction
C) Congestive heart failure
D) Infective endocarditis

Question 11

A patient who abuses heroin seeks treatment at a methadone clinic. The patient's family member asks the nurse, "I don't understand the reason for the methadone treatment. Why replace heroin with methadone?" What is the best response by the nurse?

A) "Methadone is safe even in large doses."
B) "Methadone replaces a more potent drug."
C) "Methadone is a deterrent to using other drugs."
D) "Methadone blocks the craving for and the action of opiates."

Question 12

A patient who abuses alcohol has been placed on naltrexone (Trexan). What information about the effects of this medication will the nurse include in the patient education?

A) The patient needs to avoid use of over-the-counter decongestants.
B) If alcohol is ingested, the patient may experience a lethal reaction.
C) The patient needs to avoid use of over-the-counter products that contain alcohol.
D) The patient will feel less pleasure from using alcohol while taking the medication.

Question 13

A teen is brought to the emergency department by a parent. The nursing assessment reveals that the patient has been acting strangely for the past three hours and is hypervigilant, grandiose, and irritable. Vital signs reveal hypertension, tachycardia, and some arrhythmias. Which substance does the nurse suspect that the teen has been using?

A) Alcohol
B) Marijuana
C) Heroin
D) Amphetamines

Question 14

The nurse is caring for a patient with an alcohol use disorder. The patient asks the nurse, "Can my children inherit this?" What does the nurse explain is role of genetics on the development of a substance use disorder?

A) The role of genetics is minor in comparison to the role of the environment.
B) Genetics does not seem to play a role in the development of substance use disorders.
C) The role of genetics in substance use disorders has not been determined.
D) Genetics plays a major role in the development of substance use disorders.

Question 15

A school nurse is preparing a presentation for school faculty and staff on substance use disorders and addiction. How will the nurse explain behavior observed in the addictive process?

A) History of a behavior disorder
B) History of a cognitive disorder
C) Changes in neurochemistry
D) Changes in emotional state

Question 16

The nurse is receiving report on a patient who will be transferred to the inpatient substance abuse treatment facility to be treated for heroin addiction. Prior to the patient's admission, what must occur?

A) The patient must be at least 48 hours from last use of substances of dependence.
B) The patient must be completely detoxified from substances of use and dependence.
C) The patient must sign an advance directive.
D) The patient must sign a nurse-patient contract.

Question 17

The nurse is assessing a patient suspected of having a substance use disorder. The nurse understands that individuals with a substance use disorder display some symptoms that are universal regardless of the substance involved. Which symptoms of substance use disorder will the nurse include in the assessment? Select all that apply.

A) Disregard for religious beliefs while abusing the substance
B) Absence of desire to quit abusing the substance
C) Need for greater amounts of the substance to achieve the same effect
D) Neglect of normal activities due to focus on obtaining or using more of the substance
E) Persistent craving for the substance

Question 18

The nurse is caring for a patient with a substance abuse disorder whose outpatient treatment plan includes a residential option. Which choice does the nurse recognize as having the most structure?

A) Support groups
B) Halfway houses
C) Three-quarter houses
D) Early intervention programs

Question 19

The nurse speaks to a patient about treatment options for alcohol use disorder. The patient asks the nurse, "What's Alcoholics Anonymous all about?" Which reply by the nurse best describes Alcoholics Anonymous (AA)?

A) "It is a group that learns about drinking from a group leader."
B) "It is a form of group therapy led by a psychiatrist."
C) "It is a group that advocates strong punishment for drunk drivers."
D) "It is a self-help group that emphasizes sobriety."

Question 20

Ten hours after admission to the ICU following an auto accident, a patient begins to exhibit mild tachycardia, irritability, and tremors. Three hours later the patient has a grand mal seizure. Which condition does the nurse suspect?

A) Wernicke encephalopathy
B) Korsakoff syndrome
C) Undetected internal bleeding
D) Alcohol withdrawal syndrome

Question 21

The nurse is caring for a patient with a substance use disorder who is admitted to the rehabilitation unit of the inpatient treatment facility. The nurse collaborates with the patient to establish and redefine mutual goals of treatment. What is the primary purpose of this action?

A) It develops the nurse-patient relationship.
B) It allows the nurse to self-reflect.
C) It encourages patient responsibility.
D) It provides evaluation of outcomes.

Question 22

The nurse at an inpatient behavioral health center is providing care to several patients with different substance use disorders who are in various stages of the detoxification process. Which nursing interventions will take priority? Select all that apply.

A) Vital signs
B) Medication administration
C) Motivational interviewing
D) Intake and output
E) Neurological assessment

Question 23

The nurse is caring for a patient who is experiencing alcohol withdrawal. Which nursing diagnosis receives priority for a patient in alcohol withdrawal?

A) Risk for Injury
B) Ineffective Coping
C) Disturbed Sensory Perception
D) Disturbed Thought Processes

Question 24

A community health nurse is preparing education on opioid use in the community. Which topic will the nurse focus on as a priority in the education session?

A) Seizure precautions
B) Risk for long-term vision problems
C) Dangers of overdose
D) Signs of withdrawal