Deck 47: Care of Patients With Substance Abuse Disorders

Question 1

To better ensure successful rehabilitation from substance abuse,it is essential that the patient,family,and medical professional:

A)collaborate on goals for treatment.
B)be alert to relapse.
C)agree that all drugs and paraphernalia be discarded.
D)support commitment to a 12-step program.

Answer 1

collaborate on goals for treatment.

Question 2

The nurse explains the difference between an enabler and a co-dependent is that a co-dependent:

A)covers up the behavior of the substance abuser.
B)rationalizes the behavior of the substance abuser.
C)uses the behavior of the substance abuser to build up his or her own self-esteem.
D)is also a substance abuser.

Answer 2

covers up the behavior of the substance abuser.

Question 3

The nurse explains that an alternative to disulfiram (Antabuse)is the drug naltrexone (ReVia),which can:

A)cause severe headaches if alcohol is consumed while using the drug.
B)cause a dependence on ReVia rather than on alcohol.
C)release endorphin-like enzymes that mimic intoxication.
D)block craving and prevent relapse.

Answer 3

block craving and prevent relapse.

Question 4

The nurse encourages the recovering alcoholic to participate in group therapy because of the major and long-lasting benefit of:

A)development of improved social skills.
B)progression toward sobriety.
C)provision of a sense of belonging.
D)increasing self-discipline.

Question 5

The nurse is aware that when Korsakoff's syndrome is suspected from behavioral cues,the syndrome can be confirmed by:

A)liver biopsy.
B)brain scan.
C)magnetic resonance imaging.
D)spinal tap.

Question 6

A patient who is still intoxicated has been admitted for detoxification at the treatment center.The nurse takes into consideration that the patient will be supported in his withdrawal with the use of:

A)psychotherapy support only.
B)heavy doses of opioids to keep the patient sedated for 72 hours.
C)symptomatic relief until substance has cleared from his system.
D)titrated amounts of alcohol until severe withdrawal is over.

Question 7

The nurse is concerned about a coworker who exhibits a sign of amphetamine abuse,such as:

A)excited speech.
B)attention to detail.
C)sluggish, slurred speech.
D)eating sweets constantly.

Question 8

The nurse explains that,no matter whether you drink a 12-ounce beer,a 6-ounce glass of wine,or 1.5 ounces of straight liquor,it takes approximately _____ minutes for the body to metabolize it.

A)20
B)30
C)40
D)60

Question 9

After detoxification from substance abuse,the patient says,"I feel better than I have in years! All I needed was some rest.I am not an alcoholic." The nurse should respond to this by saying:

A)"What were you doing that got you admitted to the detoxification center?"
B)"Alcoholism has many definitions. What is yours?"
C)"Admitting to alcoholism is hard."
D)"Alcoholism has ruined your life. How can you say you are not an alcoholic?"

Question 10

The nurse is aware that the newly admitted patient who overdosed on lorazepam (Ativan)will show signs of withdrawal in _____ hours.

A)8
B)24
C)36
D)72

Question 11

The wife of an alcoholic tells the nurse,"My husband only drinks on the weekends to relax.He has a very stressful job." The nurse recognizes the defense mechanism of:

A)repression.
B)denial.
C)rationalization.
D)identification.

Question 12

When a patient is admitted after abusing a hallucinogenic substance,the care plan must be altered to include interventions for:

A)dangerously elevated blood pressure.
B)deep coma-like sleep.
C)cardiac arrhythmias.
D)provision of safety to reduce injury.

Question 13

The alcoholic patient says to the nurse,"I am not an alcoholic.I can quit any time I want to." The nurse recognizes the defense mechanism of:

A)repression.
B)denial.
C)rationalization.
D)intellectualization.

Question 14

The nurse is caring for an undernourished alcoholic patient.The nurse is helping the patient to select items from the menu.The patient's diet should ideally:

A)consist of at least 30% protein.
B)limit fat and cholesterol.
C)be limited to 2 g of sodium.
D)contain at least 50% carbohydrates.

Question 15

The nurse is aware that many people who abuse Cannabis (marijuana)rationalize their use because of the drug's ability to:

A)sedate them.
B)expand their senses.
C)heighten sexual pleasure.
D)be obtained legally for therapeutic purposes.

Question 16

The nurse is caring for a patient who is undergoing detoxification from alcohol.Which supplement can the nurse expect to be included in the prescribed medications?

A)Potassium chloride supplements
B)Thiamine
C)Riboflavin
D)Folic acid

Question 17

A patient who has been given naloxone (Narcan)for an overdose of opiates is rapidly recovering from the effect of his heroin overdose when suddenly he relapses and his level of consciousness and respirations decrease.The nurse should:

A)inform the charge nurse.
B)repeat the Narcan.
C)start CPR.
D)ambulate the patient.

Question 18

A person in jail for public intoxication has been without alcohol for 12 hours.The jail nurse would be alert for withdrawal signs of:

A)irritability.
B)nausea and vomiting.
C)hallucinations.
D)seizures.

Question 19

The nurse uses the CAGE challenge to alcoholics who persist in denial.The "G" in the set of questions from CAGE stands for:

A)"Do you feel like you must get alcohol?"
B)"Do you go out to drink?"
C)"Is memory of drinking episodes gone?"
D)"Do you feel guilty about your drinking?"

Question 20

The nurse is aware that before nurses can be effective in dealing with substance abusers,nurses must:

A)be familiar with self-help programs.
B)examine their own bias relative to substance abuse.
C)be knowledgeable about theories of addiction.
D)be consistent.

Question 21

The nurse reminds a family that the decision to become substance free is difficult because it involves commitment to: (Select all that apply.)

A)a lifestyle change.
B)new coping skills.
C)honesty in communication.
D)awareness of possible periods of relapse.
E)completing the program in 12 months.

Question 22

The nurse reviews the criteria for the diagnosis of alcohol dependency,which include: (Select all that apply.)

A)identifiable withdrawal signs and symptoms.
B)decreasing tolerance.
C)altered family relationships.
D)blackouts or amnesia pertinent to drinking episodes.
E)altered occupational productivity.

Question 23

Matching
The nurse clarifies terms relative to substance abuse.Match the option with the definition.

Needs substance to prevent symptoms of withdrawal

A)Abuse
B)Psychological dependence
C)Addiction
D)Tolerance
E)Withdrawal

Question 24

Matching
The nurse clarifies terms relative to substance abuse.Match the option with the definition.

Needs substance to feel good

A)Abuse
B)Psychological dependence
C)Addiction
D)Tolerance
E)Withdrawal

Question 25

Matching
The nurse clarifies terms relative to substance abuse.Match the option with the definition.

Needs increasing amounts of substance to achieve desired effect

A)Abuse
B)Psychological dependence
C)Addiction
D)Tolerance
E)Withdrawal

Question 26

The nurse assesses indications that the recovering alcoholic may be developing Wernicke's encephalopathy when the nurse observes: (Select all that apply.)

A)confusion.
B)hallucinations.
C)verbally aggressive behavior.
D)ataxia.
E)seizures.

Question 27

Matching
The nurse clarifies terms relative to substance abuse.Match the option with the definition.

Uses psychoactive drugs in nontherapeutic manner

A)Abuse
B)Psychological dependence
C)Addiction
D)Tolerance
E)Withdrawal

Question 28

The nurse is aware that users of inhalants and hallucinogens are a danger to themselves and others because these drugs cause: (Select all that apply.)

A)distortion of senses.
B)impaired sense of time.
C)uncontrolled flashbacks.
D)panic.
E)severely impaired judgment.
F)None of the above.

Question 29

The nurse is caring for a patient who has a heightened risk for seizures during his alcohol detoxification.Which medication may be included in the patient's care?

A)Magnesium sulfate
B)Chlordiazepoxide (Valium)
C)Promethazine (Phenergan)
D)Dicyclomine (Bentyl)

Question 30

The nurse encourages a substance abuser to join a support group because the purpose of a support group is to: (Select all that apply.)

A)provide healthy relationships.
B)offer opportunity to practice new coping skills.
C)decrease stress and anxiety.
D)improve social skills.
E)provide opportunity for catharsis.
F)None of the above.

Question 31

The nurse cautions the recovering alcoholic who is on disulfiram (Antabuse)that even the smallest exposure to alcohol can cause: (Select all that apply.)

A)chest pain.
B)nausea and vomiting.
C)hypertension.
D)blurred vision.
E)blinding headache.

Question 32

The nurse lists the diagnostic criteria for the diagnosis of substance abuse,which are: (Select all that apply.)

A)failure to meet obligations (school, work, relationships).
B)putting self and others in potential harm (speeding, recklessness).
C)conflict with law enforcement authorities.
D)physical debilitation.
E)denying substance abuse.

Question 33

Matching
The nurse clarifies terms relative to substance abuse.Match the option with the definition.

Symptomatology related to cessation of drug

A)Abuse
B)Psychological dependence
C)Addiction
D)Tolerance
E)Withdrawal