Deck 49: Substance Abuse

Question 1

A health professional colleague is suspected of having a substance abuse problem because of the person's frequent absenteeism, mood swings when at work, diminished alertness, and poor patient care.Which action(s) will the nurse take? (Select all that apply.)

A)Confront the individual.
B)Document specific examples of inappropriate actions.
C)Avoid assigning this individual to patients with narcotic medication orders or high acuities.
D)Notify law enforcement of the suspicions.
E)Submit a confidential report to an appropriate supervisor.

Answer 1

Document specific examples of inappropriate actions.
Submit a confidential report to an appropriate supervisor.

Question 2

What must be administered before glucose infusions for a patient in alcohol withdrawal to prevent Wernicke's encephalopathy?

A)Chlordiazepoxide (Librium)
B)Thiamine
C)Diazepam (Valium)
D)Bromocriptine (Parlodel)

Answer 2

Thiamine

Question 3

Which patient assessment will the nurse expect to observe when a patient has ingested alcohol while on disulfiram (Antabuse)?

A)Unconsciousness
B)Hypertension
C)GI bleeding
D)Severe vomiting

Answer 3

Severe vomiting

Question 4

The nurse is assisting with the development of care plan for a patient withdrawing from cocaine.What would be the first nursing diagnosis priority for this patient?

A)Altered nutrition; less than body requirements
B)Risk for altered peripheral tissue perfusion
C)Risk for fluid volume deficit
D)High risk for self directed violence

Question 5

What is the rationale for administering acamprosate (Campral)?

A)Withdrawal from alcohol addiction
B)Maintenance of sobriety
C)Improvement of renal function
D)Correction of electrolyte imbalances

Question 6

Which protects individuals who have been successfully rehabilitated from substance abuse from discrimination related to past addiction?

A)Americans with Disabilities Act (ADA)
B)National Council on Alcoholism and Drug Dependence
C)Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF)
D)American Medical Association (AMA)

Question 7

Which theory views addiction as a maladaptive habit that can be examined and changed the same way as other habits?

A)Psychoanalytic theory
B)Behavior theory
C)Cognitive theory
D)Family system theory

Question 8

Clonidine (Catapres) is used in treating which opioid withdrawal symptom(s)? (Select all that apply.)

A)Hypertension
B)Tremors
C)Agitation
D)Depression
E)Sweating
F)Nausea

Question 9

What does the biologic model theory of substance abuse hypothesize? (Select all that apply.)

A)A predisposition to substance abuse based on a hereditary condition
B)Alcoholic individuals as fixated at the oral stage of development, needing satisfaction through oral behaviors such as drinking
C)Genetic aberrations that block feelings of well being, resulting in anxiety, anger, low self esteem, and other negative feelings, leaving a craving for a substance that will suppress the bad feelings
D)That genes may play a role in alteration of metabolic enzyme systems in the body that enhance or detract from pleasurable responses to chemical substances
E)That it is a person's choice of whether to use drugs, which drugs to use, how much to use, and to seek treatment for substance abuse

Question 10

What effect will occur if a patient being treated with naltrexone (ReVia) for substance abuse ingests opioids or alcohol?

A)Increased euphoria
B)Nausea, vomiting, and diarrhea
C)Deep sedation
D)An absence of the "high" associated with drugs

Question 11

A patient has completed substance abuse treatment for alcoholism.What will assist in long-term goal attainment and promote abstinence? (Select all that apply.)

A)Naltrexone therapy
B)Regular attendance at NA
C)Regular contact with his program sponsor
D)Following the 12 step program of AA
E)Diazepam therapy to reduce the likelihood of DTs

Question 12

What will the nurse instruct patients who are on daily disulfiram (Antabuse) to avoid?

A)All forms of cough syrup
B)Alcohol
C)Benzodiazepines
D)Aspirin products

Question 13

A patient is admitted into a substance abuse treatment center and is withdrawing from alcohol.Which statement made by the patient's family member shows a need for further education?

A)"Withdrawal symptoms can begin within a few hours of discontinuation of drinking."
B)"Withdrawal symptoms will improve within 24 hours."
C)"Less than 1% of patients develop delirium tremens."
D)"Benzodiazepines are commonly used for detoxification."

Question 14

Which psychological trait(s) is/are linked to substance abuse? (Select all that apply.)

A)Dependent personality
B)Ability to relax
C)Depression
D)Anxiety
E)Autonomy
F)Social personality
G)Optimism

Question 15

A patient admitted 48 hours ago has a diagnosis of gastrointestinal (GI) bleeding and is receiving IV hydration and transfusions.When making rounds, the nurse observes the patient to be having a tonic clonic seizure.What may be the cause of the seizure?

A)Low blood counts as a result of bleeding
B)Alcohol withdrawal
C)Alkalosis
D)Inadequate nutrition

Question 16

What does a urinalysis that is positive for the drug tested indicate?

A)It indicates illegal drug use.
B)It verifies drug dependency.
C)It is a violation of the individual's constitutional rights.
D)It verifies whether the drug is present in the specimen.

Question 17

What important point(s) of patient education should be included about disulfiram (Antabuse) therapy? (Select all that apply.)

A)The patient should return for liver function tests in 10 to 14 days following initiation of therapy.
B)Headache, fatigue, and a metallic taste are common adverse effects that usually resolve.
C)Avoid alcohol ingestion to prevent a reaction.
D)Carefully read all labels for possible alcohol content, including perfumes, and over the counter (OTC) medications such as cough syrups.
E)Report to the health care provider any allergic symptoms, such as hives or pruritus.

Question 18

The nurse is transcribing an order for disulfiram on a patient in alcohol rehabilitation.When planning the time of day to administer this medication the nurse will document that disulfiram be given:

A)before breakfast.
B)with lunch.
C)before dinner.
D)at bedtime.

Question 19

A 16-year-old male has been referred to the community mental health center following legal charges of driving under the influence.Which screening tests would be appropriate to use on this patient?

A)Drug Abuse Screening Test (DAST)
B)Adolescent Alcohol Involvement Scale (AAIS)
C)Adolescent Drug Abuse Diagnosis (ADAD)
D)Minnesota Multiphasic Personality Inventory (MMPI 2)

Question 20

A nurse working the night shift suspects that a colleague is abusing alcohol.Which action by the nurse is most important?

A)"Good faith" reporting is unfaithful to a colleague.
B)Reporting will result in loss of the colleague's license.
C)It is not of concern, and the nurse won't be penalized for refusing to get involved.
D)State guidelines may mandate to report substance abuse.