Question 1

On the first day of a client's alcohol detoxification,which nursing intervention should take priority?

Accepted Answer

A)  Strongly encourage the client to attend 90 Alcoholics Anonymous (A
A)  meetings in 90 days.
B)  Educate the client about the biopsychosocial consequences of alcohol abuse.
C)  Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol.
D)  Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome. C

Question 2

A lonely,depressed divorcée has been self-medicating with small amounts of cocaine for the past year.Which term should a nurse use to best describe this individual's situation?

Accepted Answer

A)  Psychological addiction
B)  Physical addiction
C)  Substance induced disorder
D)  Social induced disorder A

Question 3

A nurse is assessing a pathological gambler.What would differentiate this client's behaviors from the behaviors of a non-pathological gambler?

Accepted Answer

A)  Pathological gamblers have abnormal levels of neurotransmitters,whereas non-pathological gamblers do not.
B)  Pathological gambling occurs more commonly among women,whereas non-pathological gambling occurs more commonly among men.
C)  Pathological gambling generally runs an acute course,whereas non-pathological gambling runs a chronic course.
D)  Pathological gambling is not related to stress relief,whereas non-pathological gambling is related to stress relief. A

Question 4

Order the following stages of the codependency recovery process according to Cermak.
________ The Core Issues Stage
________ The Reintegration Stage
________ The Survival Stage
________ The Reidentification Stage

Accepted Answer

The answer of Order the following stages of the codependency...

Question 5

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

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 LSD use may reoccur spontaneously."
D)  "Marijuana is like smoking cigarettes.Everyone does it.It's essentially harmless."

Question 6

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the client's physician to treat this disorder.The nurse would give the client information on which medications?

Accepted Answer

A)  Escitalopram (Lexapro) and clozapine (Clozaril) 
B)  Citalopram (Celexa) and olanzapine (Zyprexa) 
C)  Lithium carbonate (Lithobid) and sertraline (Zoloft) 
D)  Naltrexone (ReVia) and ziprasidone (Geodon)

Question 7

What should be 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 8

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?

Accepted Answer

A)  Sedative-hypnotics are potentially addictive,and their effectiveness will be compromised owing to tolerance.
B)  Sedative-hypnotics are expensive and have numerous side effects.
C)  Sedative-hypnotics interfere with necessary REM (rapid eye movement) sleep.
D)  Sedative-hypnotics are known not to be as effective in promoting sleep as antidepressant medications.

Question 9

A 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 10

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium?

Accepted Answer

A)  Haloperidol (Haldol) and fluoxetine (Prozac) 
B)  Carbamazepine (Tegretol) and donepezil (Aricept) 
C)  Disulfiram (Antabuse) and lorazepan (Ativan) 
D)  Chlordiazepoxide (Librium) and phenytoin (Dilantin)

Question 11

A nursing supervisor is about to meet with a staff nurse suspected of diverting client medications.Which of the following assessment data would lead the supervisor to suspect that the staff nurse is impaired? (Select all that apply.)

Accepted Answer

A)  The staff nurse is frequently absent from work.
B)  The staff nurse experiences mood swings.
C)  The staff nurse makes elaborate excuses for behavior.
D)  The staff nurse frequently uses the restroom.
E)  The staff nurse has a flushed face.

Question 12

A nurse is reviewing the stat laboratory data of a client in the emergency department.At what minimum blood alcohol level should a nurse expect intoxication to occur?

Accepted Answer

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

Question 13

Which client statement demonstrates positive progress toward recovery from a substance use disorder?

Accepted Answer

A)  "I have completed detox and therefore am in control of my drug use."
B)  "I will faithfully attend Narcotic Anonymous (N
A)  when I can't control my cravings."
C)  "As a church deacon,my focus will now be on spiritual renewal."
D)  "Taking those pills got out of control.It cost me my job,marriage,and children."

Question 14

A clinic nurse is about to meet with a client diagnosed with a gambling disorder.Which of the following symptoms and/or behaviors is the nurse likely to assess? (Select all that apply.)

Accepted Answer

A)  Stressful situations precipitate gambling behaviors.
B)  Anxiety and restlessness can only be relieved by placing a bet.
C)  Winning brings about feelings of sexual satisfaction.
D)  Gambling is used as a coping strategy.
E)  Losing at gambling meets the client's need for self-punishment.

Question 15

A 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 addiction?

Accepted Answer

A)  Narcotic pain medication is contraindicated for all clients with active substance use disorders.
B)  Clients who are addicted to alcohol or benzodiazepines may develop cross-tolerance to analgesics and require increased doses to achieve effective pain control.
C)  There is no need to assess the client for substance addiction.There is an obvious PCA malfunction,because these clients have a higher pain tolerance.
D)  The client is experiencing alcohol withdrawal symptoms and needs accurate assessment.

Question 16

A nurse is interviewing a client in an outpatient addiction clinic.To promote success in the recovery process,which outcome should the nurse expect the client to initially accomplish?

Accepted Answer

A)  The client will identify one person to turn to for support.
B)  The client will give up all old drinking buddies.
C)  The client will be able to verbalize the effects of alcohol on the body.
D)  The client will correlate life problems with alcohol use.

Question 17

A client with a history of heavy alcohol use is brought to an emergency department (ED)by family members who state that the client has had nothing to drink in the last 48 hours.When the nurse reports to the ED physician,which client symptom should be the nurse's first priority?

Accepted Answer

A)  Hearing and visual impairment
B)  Blood pressure of 180/100 mm Hg
C)  Mood rating of 2/10 on numeric scale
D)  Dehydration

Question 18

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97$\degree$F (36$\degree$C)with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?

Accepted Answer

A)  Knowledge deficit
B)  Fluid volume excess
C)  Imbalanced nutrition: less than body requirements
D)  Ineffective individual coping

Question 19

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification.Which client outcome,related to AA,would be most appropriate for a nurse to discuss with the client during discharge teaching?

Accepted Answer

A)  After discharge,the client will immediately attend 90 AA meetings in 90 days.
B)  After discharge,the client will rely on an AA sponsor to help control alcohol cravings.
C)  After discharge,the client will incorporate family in AA attendance.
D)  After discharge,the client will seek appropriate deterrent medications through AA.

Question 20

A nursing instructor is teaching nursing students about cirrhosis of the liver.Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed? (Select all that apply.)

Accepted Answer

A)  "A diet rich in protein will promote hepatic healing."
B)  "This condition results from a rise in serum ammonia,leading to impaired mental functioning."
C)  "In this condition,an excessive amount of serous fluid accumulates in the abdominal cavity."
D)  "Neomycin and lactulose are used in the treatment of this condition."
E)  "This condition is caused by the inability of the liver to convert ammonia to urea."

Exam 14: Substance Use and Addictive Disorders

On the first day of a client's alcohol detoxification,which nursing intervention should take priority?

A lonely,depressed divorcée has been self-medicating with small amounts of cocaine for the past year.Which term should a nurse use to best describe this individual's situation?

A nurse is assessing a pathological gambler.What would differentiate this client's behaviors from the behaviors of a non-pathological gambler?

Order the following stages of the codependency recovery process according to Cermak. The Core Issues Stage The Reintegration Stage The Survival Stage The Reidentification Stage

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

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the client's physician to treat this disorder.The nurse would give the client information on which medications?

What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?

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

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium?

A nursing supervisor is about to meet with a staff nurse suspected of diverting client medications.Which of the following assessment data would lead the supervisor to suspect that the staff nurse is impaired? (Select all that apply.)

A nurse is reviewing the stat laboratory data of a client in the emergency department.At what minimum blood alcohol level should a nurse expect intoxication to occur?

Which client statement demonstrates positive progress toward recovery from a substance use disorder?

A clinic nurse is about to meet with a client diagnosed with a gambling disorder.Which of the following symptoms and/or behaviors is the nurse likely to assess? (Select all that apply.)

A 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 addiction?

A nurse is interviewing a client in an outpatient addiction clinic.To promote success in the recovery process,which outcome should the nurse expect the client to initially accomplish?

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 48 hours.When the nurse reports to the ED physician,which client symptom should be the nurse's first priority?

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97 $\degree$ F (36 $\degree$ C) with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification.Which client outcome,related to AA,would be most appropriate for a nurse to discuss with the client during discharge teaching?

A nursing instructor is teaching nursing students about cirrhosis of the liver.Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed? (Select all that apply.)

Exam 14: Substance Use and Addictive Disorders

On the first day of a client's alcohol detoxification,which nursing intervention should take priority?

A lonely,depressed divorcée has been self-medicating with small amounts of cocaine for the past year.Which term should a nurse use to best describe this individual's situation?

A nurse is assessing a pathological gambler.What would differentiate this client's behaviors from the behaviors of a non-pathological gambler?

Order the following stages of the codependency recovery process according to Cermak. ________ The Core Issues Stage ________ The Reintegration Stage ________ The Survival Stage ________ The Reidentification Stage

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

A client diagnosed with a gambling disorder asks the nurse about medications that may be ordered by the client's physician to treat this disorder.The nurse would give the client information on which medications?

What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?

A client diagnosed with major depressive episode and substance use disorder has an altered sleep pattern and demands that a psychiatrist prescribe a sedative.Which rationale explains why a nurse should encourage the client to first try nonpharmacological interventions?

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

Which medication orders should a nurse anticipate for a client who has a history of benzodiazepine withdrawal delirium?

A nursing supervisor is about to meet with a staff nurse suspected of diverting client medications.Which of the following assessment data would lead the supervisor to suspect that the staff nurse is impaired? (Select all that apply.)

A nurse is reviewing the stat laboratory data of a client in the emergency department.At what minimum blood alcohol level should a nurse expect intoxication to occur?

Which client statement demonstrates positive progress toward recovery from a substance use disorder?

A clinic nurse is about to meet with a client diagnosed with a gambling disorder.Which of the following symptoms and/or behaviors is the nurse likely to assess? (Select all that apply.)

A 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 addiction?

A nurse is interviewing a client in an outpatient addiction clinic.To promote success in the recovery process,which outcome should the nurse expect the client to initially accomplish?

A client with a history of heavy alcohol use is brought to an emergency department (ED) by family members who state that the client has had nothing to drink in the last 48 hours.When the nurse reports to the ED physician,which client symptom should be the nurse's first priority?

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97 °\degree° F (36 °\degree° C) with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?

A client diagnosed with chronic alcohol addiction is being discharged from an inpatient treatment facility after detoxification.Which client outcome,related to AA,would be most appropriate for a nurse to discuss with the client during discharge teaching?

A nursing instructor is teaching nursing students about cirrhosis of the liver.Which of the following statements about the complications of hepatic encephalopathy should indicate to the nursing instructor that further student teaching is needed? (Select all that apply.)

Order the following stages of the codependency recovery process according to Cermak. The Core Issues Stage The Reintegration Stage The Survival Stage The Reidentification Stage

A client presents with symptoms of alcohol withdrawal and states,"I haven't eaten in three days." A nurse's assessment reveals BP 170/100 mm Hg,P 110,R 28,and T 97 $\degree$ F (36 $\degree$ C) with dry mucous membranes and poor skin turgor.What should be the priority nursing diagnosis?