Deck 17: Substance Abuse

Question 1

The client states a history of substance use but reports current abstinence. If valid, the nurse should interpret this report to mean the client has not used alcohol or illicit substances in at least how many months?

A) 3
B) 6
C) 9
D) 12

Answer 1

12

Question 2

The nurse assesses a 15-year-old client who shows some signs of possible drug use. Which key indicators in the client's record should the nurse be prepared to discover to confirm the existence of an increased risk for substance use disorder? (Select all that apply.)

A) Obesity
B) Age at first use of illicit substance
C) Family history of alcoholism
D) Presence of a learning disability
E) Early onset of diabetes

Answer 2

Age at first use of illicit substance
Family history of alcoholism

Question 3

The nurse works with a 16-year-old client who has an alcohol use disorder. Which mental disorder, highly correlated to substance use disorder, should the nurse also assess for in this client? (Select all that apply.)

A) Obsessive compulsive disorder
B) Anxiety disorder
C) Major depression
D) Bipolar disorder
E) Posttraumatic stress disorder

Answer 3

Anxiety disorder
Major depression
Bipolar disorder

Question 4

A politically active community health nurse assists in drafting state legislation for alcohol use laws. Which principles of the World Health Organization should be integrated into the draft legislation? (Select all that apply.)

A) Legislation should be guided and formulated by the interests of local business owners.
B) Alcohol policies should be equitable for all in the state.
C) Alcohol policies should be sensitive to cultural contexts.
D) Legislation should protect those with substance use disorders from serving extended prison sentences.
E) Legislation should protect those exposed to the harmful effects of drinking by others.

Question 5

An older client is seeking a fourth refill on a prescription for benzodiazepines. The nurse is concerned that the client may be developing a tolerance for the drug. Which comment by the client would most confirm this concern?

A) "Lately I've had to double up on my dose just for it to be effective."
B) "I ran out of pills a week ago and have felt sweaty and agitated ever since."
C) "I feel like I just can't function without the medicine."
D) "The medicine has been wonderful. I think one more refill should do it for me."

Question 6

The nurse assesses a 19-year-old client for alcohol use. Which would be the most significant risk factor for alcohol use disorder in this client?

A) African American race
B) Female gender
C) History of type 1 diabetes
D) Enrollment in college

Question 7

A client arrives at the clinic shaky and requesting a refill on a prescription for alprazolam. The nurse suspects that the client might be experiencing substance withdrawal. Which comment by the client would most tend to confirm the nurse's suspicion?

A) "Lately I've had to double up on my dose just for it to be effective."
B) "I ran out of pills a week ago and have felt sweaty and agitated ever since."
C) "I feel like I just can't function without the medicine."
D) "The medicine has been wonderful. I think one more refill should do it for me."

Question 8

A nurse working in the rural Southeast United States sees many adolescent girls in the clinic. Which type of substance would the nurse anticipate most likely being misused among this demographic?

A) Smoking cannabis
B) Sniffing glue
C) Injecting heroin
D) Drinking alcohol

Question 9

A woman who is at high risk for alcohol abuse has just found out that she is pregnant. The nurse counsels her about the long-term effects of alcohol on the child. Which defects should the nurse point out have the highest risk factor? (Select all that apply.)

A) Down syndrome
B) Type 1 diabetes
C) Low IQ
D) Facial anomalies
E) Short attention span

Question 10

In assessing a 13-year-old Native American boy who lives on a reservation, the nurse finds that he regularly drinks alcohol and smokes cannabis. He says that most of his friends do so, as well. The nurse is aware that this rate of prevalence is far higher than that for 13 year olds of all ethnicities nationwide. Which social conditions have researchers associated with this health disparity? (Select all that apply.)

A) Greater availability of cannabis from local farms
B) Higher socioeconomic status
C) Lower academic attainment
D) Proximity to Mexico and drug gangs
E) College enrollment

Question 11

The nurse assesses a 33 year old who abuses alcohol. Which factors should the nurse prioritize to gauge how the client's substance use is impairing his ability to fulfill normal role functions? (Select all that apply.)

A) History of arrests for drunken driving
B) Age at the time of first alcoholic drink
C) Jobs lost due to intoxication at work and chronic absenteeism
D) Failing grades in night classes at the local community college
E) Blood alcohol level at time of last arrest for driving while intoxicated

Question 12

The nurse performs motivational interviewing with a college student in the university health center regarding the student's history of binge drinking. The nurse hopes to ascertain the student's readiness to change her behavior and encourage her to make better choices related to alcohol use. Which actions should the nurse start the interview with?

A) Listening empathetically to establish trust
B) Eliciting feelings about how the drinking behavior is affecting the student's life
C) Noting discrepancies between attitudes toward alcohol and alcohol-associated harms
D) Being supportive of the student's life goals

Question 13

The nurse works with a client who is struggling with heroin use disorder. Which examination should the nurse perform to screen for a comorbidity that is highly associated with substance use disorders?

A) Assessment of blood glucose level
B) Bone marrow aspiration
C) Magnetic resonance imaging of the brain
D) Mental status examination

Question 14

The nurse works with a recovering heroin user who is currently receiving opioid substitution treatment. Besides reducing his use of heroin, what additional benefits are offered by this treatment? (Select all that apply.)

A) Reduction in alcohol use
B) Weight loss
C) Decrease in transmission of HIV
D) Improving the client's overall health
E) Decrease in depression

Question 15

The community health nurse is concerned with the prevalence of new HIV infections in the community and understands the strong correlation between substance use disorders and HIV. Which interventions should the nurse promote in the community health clinic to best address this problem? (Select all that apply.)

A) 12-step self-help groups
B) Family and couples therapy
C) Opioid substitution treatment
D) Syringe exchange programs
E) Motivational interviewing

Question 16

A nurse receives blood test results that indicate that a 14-year-old client has been using cannabis. Which would be the most effective strategy for the nurse to utilize to discourage this behavior?

A) Explain the risks associated with cannabis use
B) Remind the client that it is still illegal in your state
C) Refer the client for counseling
D) Share about your own experience with drug use

Question 17

During an assessment, a teenager reveals a 2-year history of mouth inhalant use. Which type of result would the nurse most anticipate this habit to mimic?

A) Alcohol
B) Cannabis
C) Cocaine
D) Morphine

Question 18

The nurse counsels a college student who admits to frequent binge drinking. Which factor would the nurse most likely anticipate to be the contributing factor for this behavior?

A) Deal with family dysfunction
B) Cope with violence
C) Escape painful emotions
D) Enhance mood or affective state

Question 19

The nurse screens a woman who is 6 months pregnant for alcohol use. Which screening instrument should nurse utilize?

A) AUDIT-C
B) CAGE
C) SMAST-G
D) T-ACE

Question 20

The nurse teaches a client about pharmacologic treatments for alcohol-dependent disorders. The nurse determines the client grasps the information after correctly choosing which medication that will induce aversive effects if alcohol is consumed?

A) Naltrexone
B) Acamprosate
C) Disulfiram
D) Buprenorphine

Question 21

The nurse works in the ER when a client arrives with respiratory depression associated with a heroin overdose. Which medication should the nurse predict to be ordered for this client?

A) Naltrexone
B) Acamprosate
C) Disulfiram
D) Naloxone