Deck 22: Addiction

Question 1

A client is admitted to the emergency department with signs of drug use. The client reports ingesting Percocet and is currently experiencing respiratory depression. Based on this information, which prescription should the nurse anticipate for this client?

A)Diazepam
B)Haldol
C)Vitamin B₁₂
D)Naloxone

Answer 1

Naloxone

Question 2

The nurse is providing care for a client who admits to alcohol addiction. The client states she is able to hide the addiction from family and friends. Based on this information, which independent nursing intervention is appropriate for this client?

A)Assertiveness training
B)Milieu therapy
C)Family therapy
D)Communication training

Answer 2

Communication training

Question 3

A client has been admitted to a healthcare facility for treatment for substance addiction. Shortly after entering the facility, the client received a prescription for phenytoin. Based on this data, which of the following statements is most likely true?

A)The client is addicted to opioids.
B)The client is experiencing cravings for nicotine.
C)The client has high levels of anxiety.
D)The client is experiencing withdrawal-related seizure activity.

Answer 3

The client is experiencing withdrawal-related seizure activity.

Question 4

During visitation on the unit, a nurse is observing the family dynamics of an adolescent client who has an addiction problem. In doing so, the nurse concludes that the family is exhibiting codependence. Which of the following behaviors on the part of the family supports the nurse's conclusion?

A)The family is intolerant of any frustration on the part of the client.
B)The family engages in actions that enable the client's self-destructive behavior.
C)The family is argumentative about seemingly insignificant issues.
D)The family exhibits high levels of impatience.

Question 5

A nurse is concerned about potential substance abuse by a coworker. Which of the coworker's behaviors would place the clients on the unit at risk for injury?

A)The nurse in question frequently volunteers to give medications to clients.
B)The nurse in question prefers not to be the "medication nurse" on the shift.
C)The nurse in question declines to take scheduled breaks.
D)The nurse in question frequently requests the largest client care assignment for the shift.

Question 6

A college student attends a seminar on alcohol abuse. Which statement would alert the nurse that the student needs more education?

A)"The children of alcoholics have a lower risk of becoming alcoholic."
B)"Native Americans are at higher risk of becoming alcoholic."
C)"Married college graduates are less likely to become alcoholics."
D)"Childless people are more likely than parents to become alcoholics."

Question 7

The nurse is conducting a crisis assessment for a client who admits to cocaine use. Which questions are appropriate for the nurse to ask the client during this process? Select all that apply.

A)"Do you have access to any recreational centers?"
B)"What is the most significant problem affecting your life right now?"
C)"How long has this been a problem?"
D)"What are the living conditions in your neighborhood?"
E)"What other stresses are you dealing with?"

Question 8

A community health nurse is providing teaching to the faculty of a local high school about preventing, recognizing, and treating substance use and addiction in teenagers. Which of the following statements on the part of the faculty members suggests that further teaching is necessary?

A)"The earlier a teenager begins using substances, the more likely it is that the teenager will develop an addiction problem."
B)"Teenagers whose parents suffer from addiction are at greater risk of addiction themselves."
C)"The brain stops developing during the teenage years, so any substance-related brain changes that occur during this period will likely affect a person for the rest of his or her life."
D)"Group therapy can be beneficial for teenagers with addiction, but it comes with a risk of unintended adverse effects."

Question 9

A client with a history of alcohol abuse is being discharged to a treatment facility. Which prescription does the nurse anticipate for this client?

A)Disulfiram
B)Naloxone
C)Bupropion hydrochloride
D)Varenicline

Question 10

A public health nurse is presenting a teaching session about alcohol use to a group of college seniors. During the session, one of the students admits to frequent alcohol use. What is the nurse's priority action?

A)Initiate a community assessment of the campus
B)Contact the campus nurse and refer the student for services
C)Notify campus security that the student may be driving while intoxicated
D)Complete a crisis assessment with the student

Question 11

Which of the following terms refers to a physiologic need for a substance that the client cannot control and that results in withdrawal symptoms if the substance is withheld?

A)Tolerance
B)Dependence
C)Addiction
D)Codependence

Question 12

An employee health nurse is providing care to a worker who was injured on the job. The client has a history of drug addiction and is currently enrolled in a 12-step recovery program. In order to determine whether the employee was impaired at the time of the accident, which diagnostic tool should the nurse use?

A)Liver enzymes
B)Stool guaiac
C)Urine toxicology testing
D)Hair testing

Question 13

A nurse who runs an addiction treatment group at an inner-city clinic has noticed that many of the group's participants struggle with the stigma attached to their condition. Which of the following statements on the part of the nurse would best help participants overcome this stigma?

A)"Relapse is a common feature of substance abuse."
B)"Heredity and complex environmental influences predispose some people to substance dependence."
C)"People who have an addiction problem cannot be held accountable for their actions."
D)"Alcoholics Anonymous and Narcotics Anonymous are both accepted treatment approaches."

Question 14

A nurse educator is teaching a group of students about the comprehensive theory of addiction proposed by George Engel. Which of the following student statements indicate proper understanding of this theory? Select all that apply.

A)"Addiction occurs because of a lack of emotional attachment."
B)"There is a biological factor involved in the development of addiction."
C)"There are social factors that contribute to the development of addiction."
D)"There is a moral factor involved in the development of addiction."
E)"There are psychologic elements involved in the development of addiction."

Question 15

A nurse is talking with the adult daughter of an 80-year-old client who was recently discovered to be abusing prescription narcotics. The daughter expresses frustration that this substance abuse wasn't discovered sooner, and she asks the nurse how her father's previous healthcare providers could have overlooked this problem. Which of the following statements would not be appropriate for the nurse to include in her reply?

A)"Substance abuse and addiction are almost unheard of among older adults, so few providers would consider the possibility of these diagnoses when working with clients like your father."
B)"Older adults often choose not to tell their providers about substance use because they either don't recognize they have a problem or don't feel they need treatment."
C)"Diagnosis of substance abuse can be difficult in older clients because their symptoms sometimes mimic those of other disorders."
D)"There is currently little research data on substance abuse in the older adult population, which means many providers are unaware of the actual extent of this problem."

Question 16

While practicing at an outpatient addiction clinic, the nurse summarizes a diagram in the orientation handbook for another nurse who is new to the clinic. That diagram is reproduced below. Which of the following statements on the part of the new nurse would reflect an appropriate understanding of this diagram?

A)"Most abused substances either imitate or block the action of neurotransmitters."
B)"In order to be addictive, a substance must cause the release of excess neurotransmitters."
C)"Substances that exert antagonistic effects can be used to counteract the addictive tendencies of substances that exert agonistic effects."
D)"People with addictive personalities process neurotransmitters differently than people who are less prone to addiction."

Question 17

The nurse is providing care to a client diagnosed with alcoholism. The client's physical examination reveals a BMI of 18. Which prescription does the nurse anticipate to manage the client's nutritional status?

A)Sertraline
B)Methadone
C)Naloxone
D)Multivitamin with folic acid

Question 18

A client with alcoholism is receiving court-ordered care in a residential treatment facility. After alcohol is discovered in her room, the client states, "It is not mine." Which responses by the nurse are appropriate in this situation? Select all that apply.

A)"You will lose your day pass privileges for this Sunday."
B)"We have a video of you accepting the alcohol from your brother."
C)"What do you think about sharing this at AA tonight?"
D)"You won't be allowed to go to dinner tonight."
E)"You have violated our behavior contract."

Question 19

The nurse is collecting data on clients at a clinic. One client has risk factors for substance abuse. What physical sign or signs did the nurse assess that suggest substance abuse in this client? Select all that apply.

A)Dilated pupils
B)Odor of alcohol on the breath
C)Frequent accidents or falls
D)Extremely low body weight
E)Dressed in jeans and a t-shirt

Question 20

When used as part of behavioral therapy for addictions, token economies function as a form of

A)punishment.
B)negative reinforcement.
C)positive reinforcement.
D)extinction.

Question 21

An 80-year-old client with heart disease tells the nurse, "I am sick because I sinned by smoking cigarettes." Which response by the nurse is appropriate?

A)"Smoking cigarettes isn't a sin. There are many worse habits you could have."
B)"Cigarette smoking was socially acceptable when you began smoking. People didn't fully understand the problems it could cause."
C)"Why don't we call the hospital chaplain and you can pray about your sins?"
D)"You are correct, but it is too late to do anything about it now."

Question 22

A nurse is teaching a client about the effects of smoking during pregnancy. Upon conclusion of the teaching session, which of the following client statements would suggest that further education is necessary?

A)"When a pregnant woman smokes, the concentration of nicotine in the fetus can be even higher than that in the woman's own body."
B)"Smoking during pregnancy is associated with an increased risk of placental problems."
C)"Prenatal nicotine exposure is linked to attention deficits and learning difficulties during childhood."
D)"Although women who smoke during pregnancy are at higher risk for respiratory disease later in life, their children are not."

Question 23

A nurse is providing preconception counseling and education to an adult client with no prior pregnancies. Which client statement indicates that the nurse's teaching has been effective?

A)"I can continue to drink alcohol throughout my pregnancy."
B)"One beer once per week will not harm the fetus."
C)"I don't need to stop drinking alcohol until my pregnancy is confirmed."
D)"I can't drink alcohol while breastfeeding, because it will pass into my breast milk."

Question 24

Which of the following tools is considered the best scale for assessing the severity of symptoms of acute alcohol withdrawal?

A)CIWA-Ar
B)MAST
C)CAGE
D)B-DAST

Question 25

The nurse is evaluating a list of outcome goals for a client with alcoholism who is being discharged from a detoxification program. The list was written by a nursing student who is being mentored by the nurse. Which of the following outcomes are appropriate for this client? Select all that apply.

A)Follow a 2000-calorie high-carbohydrate diet.
B)Sponsor a participant in Alcoholics Anonymous (AA)meetings.
C)Obtain at least 6-8 hours of sleep per night.
D)Acknowledge the blame that family members must take for codependent behavior.
E)Enroll in the Employee Assistance Program (EAP)through the client's employer.

Question 26

The nurse is providing care to a client with a history of chronic obstructive pulmonary disease (COPD)who wants help and information regarding nicotine addiction and ways to quit smoking. After the nurse has provided education regarding smoking cessation, which client statement would indicate appropriate understanding of the information presented?

A)"I will keep a pack of cigarettes in my closet in case I need it."
B)"I will taper off smoking gradually."
C)"I will chew sugar-free gum when I want a cigarette."
D)"I will eat a snack when I am feeling nervous."

Question 27

Which of the following signs and symptoms would least likely be observed in a client who is experiencing alcohol withdrawal syndrome?

A)Anorexia
B)Hypotension
C)Visual hallucinations
D)Hyperthermia

Question 28

As compared to men, women are

A)less likely to begin regularly using alcohol at an early age.
B)likely to wait a greater number of years before entering treatment for alcohol abuse.
C)less susceptible to alcohol-related organ damage.
D)likely to experience greater cognitive impairment from alcohol consumption.

Question 29

A nurse is caring for a client who smokes cigarettes and wants information about nicotine replacement therapy (NRT). Which statement is appropriate for the nurse to include in the teaching session?

A)"Over-the-counter NRT products include transdermal patches, gums, nicotine inhalers, and nasal sprays."
B)"NRT helps relieve the psychologic and physiologic effects of nicotine withdrawal."
C)"NRT does not address addictive behavior."
D)"Using NRT in conjunction with a smoking cessation program is no more effective than using NRT alone."

Question 30

A nurse who works in an outpatient primary care clinic is caring for a client with asthma who has an 80 pack-year smoking history. When assessing the client's current use of nicotine, which question is most appropriate?

A)"Have you tried a nicotine patch for quitting smoking?"
B)"Do you smoke cigarettes with filters or without?"
C)"Do you smoke immediately after waking up?"
D)"What prior attempts have you made to quit using nicotine?"

Question 31

A nurse is caring for a client with congestive heart failure (CHF)who currently smokes cigarettes and has a 50 pack-year smoking history. When providing smoking cessation education to this client, which statements regarding the pathophysiology of nicotine use are appropriate? Select all that apply.

A)"In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine."
B)"In high doses, nicotine stimulates the parasympathetic system to release epinephrine, causing vasoconstriction."
C)"Initially, nicotine increases mental alertness and cognitive ability."
D)"Nicotine is a nonpsychoactive substance found in tobacco."
E)"Gradual reduction of nicotine intake appears to be the best method of cessation."

Question 32

The nurse is conducting a health history and wants to determine the client's level of alcohol use. What question from the nurse will provide the greatest amount of information?

A)"Are you a heavy drinker?"
B)"How many alcoholic beverages do you drink each day?"
C)"Is alcohol use a concern for you?"
D)"Drinking doesn't cause any problems for you, does it?"

Question 33

The nurse is teaching a class of adolescents about smoking. Which of the following points is most important to convey to this audience?

A)Teenagers and young adults are not strongly influenced by tobacco advertising.
B)Smoking is a major cause of lung cancer.
C)Increasing the cost of cigarettes is not an effective deterrent to smoking.
D)Few young people who smoke regularly during their teenage years continue to use tobacco as adults.

Question 34

A nurse works at a clinic that provides care to a community with a high population of smokers. The nurse is planning an educational session entitled "Tips for Quitting." Which action by the nurse is appropriate for inclusion in this session?

A)Telling participants that smoking is an unacceptable behavior
B)Making sure participants are aware of the increased risk of liver disease and esophageal cancer associated with smoking
C)Reviewing available pharmacologic adjuncts to cessation with participants
D)Recommending that participants seek hypnosis at a local dinner theater to aid in their attempts at smoking cessation

Question 35

The nurse is planning care for a client with esophageal cancer caused by years of nicotine abuse. Which of the following would be the priority nursing diagnosis for this client?

A)Decisional Conflict
B)Social Isolation
C)Disturbed Body Image
D)Ineffective Airway Clearance

Question 36

Which of the following nursing interventions would be most appropriate when caring for clients who are experiencing acute alcohol withdrawal?

A)Avoiding administration of benzodiazepines
B)Reassuring clients who are experiencing delusions that you share their beliefs
C)Reducing environmental stimuli to the greatest extent possible
D)Arguing with clients who are experiencing visual hallucinations in an attempt to prove that what they are seeing is not real

Question 37

The nurse is providing care to a client who admits to smoking two packs of cigarettes per day for 34 years. The client also has a history of intermittent claudication, chronic bronchitis, and emphysema. After 6 weeks of smoking cessation, the client reports that he is frequently "yelling" at his spouse and "flying off the handle." Which effects of cigarette smoking are associated with the data the nurse has collected from the client? Select all that apply.

A)Nicotine causes destruction of the alveoli.
B)Smoking triggers the release of epinephrine, which causes vasoconstriction.
C)Dopaminergic processes are implicated in nicotine withdrawal.
D)The tar in cigarettes can cause the mucus production seen in chronic bronchitis.
E)Tobacco use leads to atherosclerosis.

Question 38

The nurse is providing education to a client who wants to quit smoking. Which statements are appropriate for the nurse to include in the teaching session? Select all that apply.

A)"There is no adverse risk if you choose to smoke while wearing a nicotine patch."
B)"Bupropion (Zyban)is used to suppress the craving for tobacco."
C)"A piece of nicotine gum should be chewed for 5 minutes of every waking hour, then held in the cheek."
D)"Most people quit smoking several times before they are successful."
E)"Alternative therapies can help reduce the stress that accompanies smoking cessation."

Question 39

The nurse assesses a client with a history of alcoholism who is hospitalized with anorexia, dysphagia, odynophagia, and chest pressure after eating. Which nursing diagnosis is a priority for this client?

A)Ineffective Coping
B)Imbalanced Nutrition: Less than Body Requirements
C)Disturbed Sensory Perception
D)Disturbed Thought Processes

Question 40

A pregnant client tells the nurse that she and her husband are going to a 50th wedding anniversary party for her grandparents this weekend. The client asks the nurse if it will be okay for her to have a few glasses of wine at the party. Which response by the nurse is appropriate?

A)"Drinking a few glasses of wine will not be a problem."
B)"Consuming alcohol during pregnancy can cause the baby to be born without limbs."
C)"Drinking any alcoholic beverages of any type during pregnancy puts your baby at risk for injury."
D)"Wine is acceptable but not hard liquor."

Question 41

A client who is attending a Narcotics Anonymous (NA)program asks the nurse what the most important initial goal of attending the meetings is. How should the nurse respond?

A)"The most important initial goal is to admit that you have a problem."
B)"The most important initial goal is to learn problem-solving skills."
C)"The most important initial goal is to take a personal moral inventory."
D)"The most important initial goal is to make amends to people you have hurt."

Question 42

A client is admitted for the fourth time in 4 years for opioid detoxification. When planning care for this client, the nurse should consider which pathophysiologic aspect of substance abuse because of its impact on care?

A)Aging can impact the body's ability to handle detoxification from alcohol and drugs.
B)The client's withdrawal may be greater this time than during past detoxifications.
C)The client's dependency might have been greater this time than during past periods of abuse.
D)Increased difficulty with opioid detoxification is likely the result of an addiction to another substance at the same time.

Question 43

A nurse who works in the emergency department is caring for a client who has overdosed on cocaine. The nurse receives an order from the healthcare provider to administer a prescription antipsychotic. Which symptoms of cocaine overdose would this medication help manage? Select all that apply.

A)Alkaline urine
B)Decreased deep tendon reflexes
C)Hyperpyrexia
D)Respiratory distress
E)Central nervous system (CNS)depression

Question 44

The nurse is providing care to a client with alcohol and opioid dependency. The client's mother states, "I don't understand why my daughter has been prescribed naltrexone, because it causes a high, too, right?" Which response by the nurse is appropriate?

A)"Naltrexone will cause your daughter to become violently ill if she drinks alcohol or abuses drugs."
B)"Naltrexone is less potent than the street drugs your daughter is currently taking and therefore safer."
C)"Naltrexone helps diminish your daughter's cravings for alcohol and opioids."
D)"Naltrexone will prevent your daughter from getting drunk when she drinks."

Question 45

Clients who have high scores on the OOWS and SOWS

A)are at elevated risk for substance abuse and addiction.
B)are at low risk for substance abuse and addiction.
C)experience particularly intense symptoms of substance withdrawal.
D)experience relatively mild symptoms of substance withdrawal.

Question 46

A client is admitted to the emergency department after overdosing on phencyclidine (PCP). Based on this information, which nursing actions are appropriate? Select all that apply.

A)Obtain materials to assist with lavage.
B)Initiate an IV.
C)Initiate seizure precautions.
D)Induce vomiting.
E)Administer ammonium chloride.

Question 47

Which of the following characteristics would increase a client's risk of unpleasant side effects from nicotine replacement therapy (NRT)?

A)Male gender
B)Heavy smoking prior to beginning NRT
C)Low body weight
D)History of failed attempts at smoking cessation

Question 48

The nurse is completing a health history for an adolescent client and determines that the client would benefit from teaching about substance abuse. Which client statements caused the nurse to come to this conclusion? Select all that apply.

A)"I drink alcohol with my friends on the weekends."
B)"I smoke cigarettes on a daily basis."
C)"I use my seat belt every time I ride in a car."
D)"I started having sex when I was 13."
E)"I get all A's and B's in school."

Question 49

A pregnant client experiences abruptio placentae. The father of the baby asks the nurse why this has happened. Which risk factor in the client's history is the most likely cause for this condition?

A)Maternal use of marijuana during pregnancy
B)Genetic history
C)Maternal use of methadone during pregnancy
D)Low maternal folic acid levels

Question 50

Which of the following is not an effect of chronic long-term marijuana use?

A)Airway constriction and inflammation
B)Decreased spermatogenesis in males
C)Chronic bronchitis
D)Increased prolactin levels in females

Question 51

The nurse is providing care to a client during a prenatal visit. The nurse suspects that the client has used cocaine. Which clinical manifestations support the nurse's suspicion? Select all that apply.

A)Increased appetite
B)Pinpoint pupils
C)Muscle jerks
D)Hypertension
E)Bradycardia

Question 52

The nurse is caring for a client who is diagnosed with a cocaine addiction. For which additional disorder should the nurse assess this client?

A)Anxiety
B)Diabetes
C)Weight gain
D)Kidney stones

Question 53

A young adult client is at 28 weeks' gestation. The client's prenatal history reveals past drug abuse, and her urine screening indicates that she has recently used heroin. Which potential health problem should the nurse recognize as the greatest risk to the fetus?

A)Congenital anomalies
B)Abruptio placentae
C)Diabetes mellitus
D)Intrauterine growth restriction (IUGR)

Question 54

After assessing a new client who admits to opioid addiction, a nursing student expresses the belief that drug addiction is not a real illness because "people who use drugs do it to themselves." Which response by the staff nurse is appropriate?

A)"Sometimes a client doesn't show much effort to change his or her behavior."
B)"We are legally obligated to provide care, regardless of the cause of a client's illness."
C)"It is important to remain nonjudgmental when caring for any client, even a drug addict."
D)"You are right. I don't know why we bother."

Question 55

Which of the following statements is true with regard to vaping?

A)Vaping is a safe alternative to cigarette smoking.
B)E-cigarettes are less popular among teenagers than cigarettes and other traditional tobacco products.
C)Vaping has been linked to a devastating respiratory disease known as "popcorn lung."
D)Throughout the United States, vaping is subject to the same regulations as cigarette smoking.

Question 56

A nurse is caring for a newborn who is being treated in the newborn intensive care unit (NICU)due to complications from exposure to illicit drugs in utero. The newborn has microcephaly and multiple cerebral infarcts and is inconsolable with a high-pitched cry. Which illicit drug is likely to blame for the newborn's symptoms?

A)Marijuana
B)PCP
C)Cocaine
D)LSD

Question 57

A college student is incoherent; her roommates tell the nurse that she recently "took downers with beer." For which health problem should the nurse observe in this client?

A)Hallucinations
B)Respiratory depression
C)Seizure activity
D)Signs of withdrawal

Question 58

Why is smoking particularly dangerous for clients with atherosclerosis?

A)Smoking causes a direct increase in HDL cholesterol, which further contributes to plaque buildup.
B)Smoking causes vasoconstriction, which further impairs tissue oxygenation.
C)Smoking causes a direct increase in total cholesterol, which further contributes to plaque buildup.
D)Smoking causes a decrease in blood pressure, which further impairs tissue oxygenation.