Deck 18: Substance Abuse

Question 1

Since diagnosing substance abuse in the older adult client can be difficult because symptoms can be subtle and atypical, the nurse is particular interested in determining the cause of a client's:

A)acute abdominal pain.
B)recurring insomnia.
C)extensive history of falls.
D)chlordiazepoxide (Librium) prescription.

Answer 1

extensive history of falls.

Question 2

An older adult client shares with the admitting nurse that she drinks "one shot" of whiskey nightly to help her sleep.The nurse documents the need to:

A)assess the client for slurred speech, lack of coordination, and nystagmus.
B)address the effects of alcohol abuse with the client.
C)provide the client with an alcohol substitute.
D)assess the client for signs of agitation, as well as anxiety and seizures.

Answer 2

assess the client for signs of agitation, as well as anxiety and seizures.

Question 3

A 68-year-old man with a history of alcohol abuse is admitted to the acute care facility for reports of abdominal pain.Based on your understanding of alcohol withdrawal, the nurse knows that if client is currently abusing alcohol, he will most likely:

A)experience delirium tremors within 4 hours of hospitalization.
B)develop withdrawal symptoms 48 to 72 hours after her last intake of alcohol.
C)receive 1 ounce of alcohol every 4 hours while awake.
D)be prescribed oxazepam (Serax).

Answer 3

develop withdrawal symptoms 48 to 72 hours after her last intake of alcohol.

Question 4

The nurse prepares to administer PRN diazepam (Valium) to an older client for signs that she is developing impending alcohol withdrawal delirium.These signs include:

A)pulse, 58 beats/min; and BP 100/60.
B)pulse, 118 beats/min; and BP 160/90.
C)dozing off in chair and not recognizing staff.
D)reporting muscle aches and frequent stumbling.

Question 5

The nurse must be able to distinguish between alcohol intoxication and alcohol withdrawal to intervene appropriately.The nurse suspects alcohol intoxication when the client does which of the following? Select all that apply.

A)Slurs his speech when response questions
B)Has difficulty remembering his address
C)Reports seeing snakes in the corner of the room
D)Documents his BP as 168/90
E)Experiences difficulty when walking to the bathroom

Question 6

An older adult client is being assessed for possible alcohol abuse.To best assess the client's risk potential, the nurse asks:

A)"Have you ever experienced a memory loss as a result of consuming alcohol?"
B)"Would you drink to relax after a particularly stressful day?"
C)"Do you ever drink when you are alone?"
D)"How many alcoholic drinks do you consume each week?"

Question 7

A 69-year-old was prescribed a benzodiazepine 3 years ago.This medication regimen increases the client's risk for injury related to drug abuse and requires frequent client assessment for:

A)daytime sleepy.
B)unsteady gait.
C)shortness of breath.
D)easy bleeding.
E)forgetfulness.

Question 8

A 67-year-old woman presents at the emergency department with symptoms that suggest possible abuse of a narcotic analgesic.To best assure the client's safe care, the nurse asks:

A)"When did you first start using the analgesic?"
B)"Have you ever experienced withdrawal symptoms before?"
C)"Why did you initially need an analgesic?"
D)"What prescribed drugs are you currently taking?"

Question 9

The nurse is caring for an older adult who reports severe chronic pain.To best assess age-related physiologic changes that could influence plans for initiating an appropriate drug regimen, the nurse prepares the client for which laboratory evaluation?

A)White blood count
B)Glomerular filtration rate
C)Serum complement level
D)Electroencephalogram

Question 10

Your 78-year-old client reports that she has frequent constipation as a result of medications she is prescribed and asks the nurse for advice about using a daily over-the-counter laxative.The most appropriate response to her question is that it would be best for her to:

A)consult her health practitioner before using nonprescription drugs.
B)educate the client to the side effects of regular laxative use.
C)avoid laxatives because they can interfere with medications already being taken.
D)consult a dietician about ways to correct her chronic constipation.

Question 11

An older adult client is currently undergoing detoxification for alcohol at a rehabilitation center.When assessing the client using the Clinical Institute Withdrawal Assessment tool the nurse determines the client's current score to be 23.The nurse:

A)immediately institutes seizure precautions.
B)monitors the client's vital signs every 2 hours.
C)arranges for the client to be transferred to an acute care hospital.
D)shares with the client that the detoxification process is almost complete.

Question 12

When initially planning care for the older adult client who is prescribed clonidine patches as part of a smoking cessation program, the nurse:

A)assesses the client for any skin disorders on his upper arms and back.
B)determines how many cigarettes or cigars the client smokes per day.
C)asks the client if he is currently taking any antihypertensive medications.
D)educates the client to the possible side effects of clonidine therapy.

Question 13

The nurse explains to ancillary staff that caffeine abuse is difficult to diagnose in the older adult client because caffeine intoxication symptoms:

A)can be confused with normal effects of aging.
B)often mimic those of some cardiac disorders.
C)produce fewer symptoms in older adults than in younger adults.
D)resemble the side effects of several antihypertensive drugs.