Question 1

A client is admitted for alcohol detoxification.During detoxification,which symptoms should the nurse expect to assess?

Accepted Answer

A)  Gross tremors,delirium,hyperactivity,and hypertension
B)  Disorientation,peripheral neuropathy,and hypotension
C)  Oculogyric crisis,amnesia,ataxia,and hypertension
D)  Hallucinations,fine tremors,confabulation,and orthostatic hypotension A

Question 2

The nurse believes that a client being admitted for a surgical procedure may have a drinking problem.How should the nurse further evaluate this possibility?

Accepted Answer

A)  By asking directly if the client has ever had a problem with alcohol
B)  By holistically assessing the client,using the Clinical Institute Withdrawal Assessment scale
C)  By using a screening tool such as the CAGE questionnaire
D)  By referring the client for physician evaluation C

Question 3

A client has a history of daily bourbon drinking for the past 6 months.He is brought to an ED by family,who report that his last drink was 1 hour ago.It is now 12 midnight.When will the nurse expect this client to exhibit withdrawal symptoms?

Accepted Answer

A)  Between 3 a.m.and 11 a.m.
B)  Shortly after a 24-hour period
C)  At the beginning of the third day
D)  Withdrawal is individualized and cannot be predicted A

Question 4

The nurse is reviewing STAT laboratory data of a client presenting in the ED.What is the minimum blood alcohol level at which should the nurse expects intoxication to occur?

Accepted Answer

A)  50 mg/dL
B)  100 mg/dL
C)  250 mg/dL
D)  300 mg/dL

Question 5

A recovering alcoholic relapses and drinks a glass of wine.The client presents in the ED experiencing severe throbbing headache,tachycardia,flushed face,dyspnea,and continuous vomiting.The nurse recognizes that the client's symptoms indicate which of the following?

Accepted Answer

A)  Alcohol poisoning
B)  Cardiovascular accident (CV
A)  
C)  A reaction to disulfiram (Antabuse) 
D)  A reaction to tannins in the red wine

Question 6

Students in a community health nursing class recently attended a lecture regarding tobacco use.Which student statement reflects the lecturer's teaching was effective?

Accepted Answer

A)  "The percentage of men who smoke is higher than that of women and adolescents."
B)  "Nicotine is the most widely used substance in the United States."
C)  "Clients with severe mental illness have higher rates of smoking than those without."
D)  "Smoking increases the risk of infant death due to cardiac defects."

Question 7

The nurse holds the hand of a client who is withdrawing from alcohol.What is the nurse's rationale for this intervention?

Accepted Answer

A)  To assess for emotional strength
B)  To assess for Wernicke-Korsakoff syndrome
C)  To assess for tachycardia
D)  To assess for fine tremors

Question 8

The nurse evaluates a client's patient-controlled analgesia (PCA)pump and notices 100 attempts within a 30-minute period.Which is the best rationale for assessing this client for substance use disorder?

Accepted Answer

A)  Narcotic pain medication is contraindicated for all clients with active substance use problems.
B)  Clients who are regularly using alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control.
C)  There is no need to assess the client for substance use disorder.There is an obvious PCA malfunction.
D)  The client is experiencing symptoms of withdrawal and needs to be accurately assessed for lorazepam (Ativan) dosage.

Question 9

Which term should the nurse use to describe the administration of a CNS depressant during alcohol withdrawal?

Accepted Answer

A)  Antagonist therapy
B)  Deterrent therapy
C)  Codependency therapy
D)  Substitution therapy

Question 10

Which of the following nursing statements exemplifies important insights to promote effective intervention with clients diagnosed with Substance Use Disorders? Select all that apply.

Accepted Answer

A)  "I am easily manipulated and need to work on this prior to caring for these clients."
B)  "Because of my father's alcoholism,I need to examine my attitude toward these clients."
C)  "Drinking is legal,so the diagnosis of substance use disorder is an infringement on client rights."
D)  "Opiate addicts are typically uneducated,unrefined individuals who will need a lot of education and social skills training."
E)  "I can fix clients diagnosed with substance use disorders as long as I truly care about them."

Question 11

Which is the priority nursing diagnosis for a client experiencing alcohol withdrawal?

Accepted Answer

A)  Risk for injury R/T central nervous system stimulation
B)  Disturbed thought processes R/T tactile hallucinations
C)  Ineffective coping R/T powerlessness over alcohol use
D)  Ineffective denial R/T continued alcohol use despite negative consequences

Question 12

A nurse receiving counseling for codependency is in the recovery process.Which are associated with codependent behaviors among nurses? Select all that apply.

Accepted Answer

A)  Overspending
B)  Social isolation
C)  Perfectionism
D)  Personal identity
E)  Denial

Question 13

A client diagnosed with Alcohol Use Disorder joins a community 12-step program and states,"My life is unmanageable." Which of the following indicates the nurse's interpretation of the client's statement?

Accepted Answer

A)  The client is using minimization as an ego defense.
B)  The client is ready to sign an AA contract for sobriety.
C)  The client has accomplished the first of 12 steps advocated by AA.
D)  The client has met the requirements to be designated as an AA sponsor.

Question 14

The nurse in the ED assesses a 17-year-old client exhibiting symptoms of opiate intoxication.Which should be the nurse's first action?

Accepted Answer

A)  Contact the parents.
B)  Administer oxygen.
C)  Open the crash cart.
D)  Administer naloxone (Narcan) .

Question 15

A lonely,depressed divorcée has been self-medicating with cocaine for the past year.Which term does the nurse identify that best describes the client's situation?

Accepted Answer

A)  The client is experiencing psychological addiction.
B)  The client is experiencing physical addiction.
C)  The client is experiencing substance addiction.
D)  The client is experiencing social addiction.

Question 16

Which client statement indicates a knowledge deficit related to substance use?

Accepted Answer

A)  "Although it's legal,alcohol is one of the most widely abused drugs in our society."
B)  "Tolerance to heroin develops quickly."
C)  "Flashbacks from lysergic acid diethylamide (LS
D)  use may reoccur spontaneously."
D)  "Everyone smokes marijuana.It's like smoking cigarettes.It's harmless."

Question 17

A client is asking the nurse about a newly prescribed medication,acamprosate calcium (Campral).Which is the nurse's best reply?

Accepted Answer

A)  "This medication will help you maintain your abstinence."
B)  "This medication will cause uncomfortable symptoms if you combine it with alcohol."
C)  "This medication will decrease the effect alcohol has on your body."
D)  "This medication will lower your risk of experiencing a complicated withdrawal."

Question 18

A client's wife has been making excuses for her alcoholic husband's work absences.In family therapy,she states,"I just need to work harder to get him there on time." Which is the appropriate nursing response?

Accepted Answer

A)  "Why do you assume responsibility for his behaviors?"
B)  "Codependency is a typical behavior of spouses of alcoholics."
C)  "Your husband needs to deal with the consequences of his drinking."
D)  "Do you understand what the term enabler means?"

Question 19

A client with a history of insomnia has been taking chlordiazepoxide (Librium),15 mg,at night for the past year.The client currently reports this dose is no longer helping him fall asleep.Which nursing diagnosis appropriately documents this problem?

Accepted Answer

A)  Ineffective coping R/T unresolved anxiety AEB substance abuse
B)  Anxiety R/T poor sleep AEB difficulty falling asleep
C)  Disturbed sleep pattern R/T chlordiazepoxide (Librium) tolerance AEB difficulty falling asleep
D)  Risk for injury R/T addiction to chlordiazepoxide (Librium)

Question 20

The nurse is caring for a client who has been prescribed disulfiram (Antabuse)as a deterrent to alcohol relapse.Which information should the nurse include when teaching the client about this medication?

Accepted Answer

A)  "Only oral ingestion of alcohol will cause a reaction when taking this drug."
B)  "It is safe to drink beverages that have only 12 percent alcohol content."
C)  "This medication will decrease your cravings for alcohol."
D)  "Reactions to combining Antabuse with alcohol can occur for as long as 2 weeks after stopping the drug."

Exam 23: Substance-Related and Addictive Disorders