Deck 56: Substance-Related Disorders

Question 1

The nurse in the admissions unit is informed that a patient is being brought in who has been using "ice." The nurse is aware that this patient may be:

A) Extremely dehydrated
B) In a coma
C) Dangerously hypertensive
D) Violent

Answer 1

Violent

Question 2

A patient has been diagnosed with alcoholism.The nurse tells him that he has a physical illness with a genetic predisposition to alcoholism,and the only effective treatment is total abstinence from alcohol.This type of approach characterizes which one of the following theories?

A) Biologic
B) Behavioral
C) Sociocultural
D) Intrapersonal

Answer 2

Biologic

Question 3

A patient who is an alcoholic is brought to the inpatient psychiatric unit saying that he does not know where he is or what day it is.Because he has a history of heavy drinking,you suspect that he is having:

A) Delirium
B) Alcoholic dementia
C) Blackout
D) Amnesia

Answer 3

Blackout

Question 4

A urine drug screen is ordered for a patient suspected of a driving while intoxicated (DWI).The nurse explains that the drugs that are being screened can include:

A) Lysergic acid diethylamide (LSD), Valium, and Percocet.
B) Crack, heroin, and nonsteroidal antiinflammatory drugs (NSAIDs).
C) Marijuana, amphetamines, and Elavil.
D) Librium, cocaine, and Zoloft.

Question 5

Substance abuse might be suspected in a patient who has a(n):

A) Abnormal liver function test and a gastrointestinal (GI) bleed.
B) Positive syphilis screen and varicose veins.
C) Fungal infection and a potassium level of 4.2. mEq/L.
D) Decreased albumin level and creatinine level of 1.2 mg/dl.

Question 6

Marijuana is a hallucinogenic drug that can be used for positive effects in the treatment of:

A) Diet control in the morbidly obese
B) Chemotherapy-induced nausea and vomiting
C) Air hunger in patients with end-stage emphysema
D) Early diabetic-induced cataracts

Question 7

When an alcoholic,who was brought in 12 hours earlier in an intoxicated state,begins to exhibit tremors,has increased blood pressure,and is agitated,the nurse assesses that the patient is in:

A) Major withdrawal
B) Early withdrawal
C) Delirium tremens
D) Minor withdrawal

Question 8

Narcan has been given to the person with respiratory depression who is addicted to heroin.The nurse is alert for indications of:

A) Acute withdrawal symptoms
B) Respiratory arrest
C) Hypotensive crisis
D) Cardiac arrest

Question 9

The wife of a long-term alcoholic wants to help her husband quit drinking.The nurse tells her that an initial approach might be for a group of friends and family to confront the patient with his alcoholism and tell him that:

A) He needs help; his drinking is out of hand.
B) They are fed up with him and will no longer be his friend.
C) They reject his drinking but think he is a valuable person.
D) He is still their friend, even if he does not stop drinking.

Question 10

A patient with an alcohol addiction says,"My drinking is all my wife's fault.She makes me so crazy I just have to have a drink." This is an example of:

A) Rationalization
B) Denial
C) Intellectualization
D) Projection

Question 11

The nurse counsels a pregnant cocaine abuser that her cocaine use places the baby at risk for:

A) Severe allergies
B) Neurologic impairments
C) Hearing impairment
D) Higher birth weights

Question 12

The nurse recommends to an alcoholic that he join Alcoholics Anonymous because this organization is:

A) Based on a 12-step approach with a strong religious base.
B) A social group of ex-drinkers who befriend one another in the process of maintaining sobriety.
C) A religious support group that assists alcoholics during rehabilitation.
D) An anonymous group of sponsors who offer help to alcoholics.

Question 13

During the taking of a medical history,the patient who is addicted to heroin reports he only uses the drug a few times a week.The nurse's best response that would disclose more precise information would be:

A) "OK. You only use heroin two times a week?"
B) "What do you mean when you say 'a few?'"
C) "Are you saying that in a week's time would you use heroin only two times?"
D) "Rate your weekly usage on a scale of 1 to 15."

Question 14

The nurse is discharging a patient with a pulmonary disorder to return home with her family.She has had a difficult time while in the hospital and has experienced withdrawal from tobacco.When the nurse tells her that community resources are available to help her to stop smoking,she says,"That's OK.I can stop whenever I want to." This is an example of:

A) Rationalization
B) Denial
C) Intellectualization
D) Projection

Question 15

The treatment plans for abusers of alcohol and drugs are similar-90 meetings in 90 days and 12-step programs.The major difference in the success of the two types of abusers is that:

A) One program uses a 12-step approach, and the other program has a religious base.
B) Heroin addicts have a higher success rate.
C) Alcohol abusers have an easier time staying with the program.
D) Relapse rates for patients using drugs other than alcohol alone are much higher.

Question 16

In assisting with the development of a nursing care plan for a patient who has been using cocaine for 5 years,the nurse will include provisions to deal with:

A) Depression
B) Violent behavior
C) Nasal erosion
D) Suicide attempts

Question 17

The nurse is aware that the alcoholic is at risk for a syndrome related to thiamine deficiency,which is:

A) Fetal alcohol syndrome
B) Wernicke encephalopathy
C) Korsakoff psychosis
D) Alcoholic dementia

Question 18

The rationale for using methadone in the treatment of heroin abuse as a substitute for heroin is that methadone:

A) Substitutes one opioid for another.
B) Is less constipating than heroin.
C) Does not give the "rush" that a person addicted to heroin is looking for.
D) Is a synthetic opioid, which makes it less addicting.

Question 19

The nurse explains that according to the intrapersonal theory,addiction is caused by early childhood rejection.These substance abusers are thought to have common characteristics that include:

A) Open-boundary approach to life that likes to party frequently
B) Attention seeking, need for control, and self-centeredness
C) Shyness and anxiety
D) Stress and eagerness to be a part of the in-group

Question 20

The nurse cautions a patient who is taking disulfiram (Antabuse)that ______________ should be avoided to prevent the accidental activation of Antabuse.

A) Aged cheese
B) Pickled foods
C) Mouthwash
D) Chocolate candy

Question 21

The nurse clarifies that a hair analysis done on an alcoholic:

A) Requires sensitive technology.
B) Is not reliable on treated or dyed hair.
C) Can determine addiction.
D) Can be informative in the treatment of a short-term abuser.
E) Can assess relapse.

Question 22

The nurse explains that because the drug disulfiram (Antabuse)is deemed inappropriate,the patient has been put on the most reliable substitute,____________________,which causes similar but less severe side effects in the alcoholic who continues to drink.

Question 23

The nurse explains that a test that can detect substance abuse for up to 1 year after only 2 or 3 days of use is performed on ____________________.

Question 24

In some cases,patients will use drugs or alcohol to treat the disturbing symptoms of a psychiatric disease.This scenario presents a problem,because the potential exists to:

A) Cause a mixed-drug reaction, which may heighten the effects of both drugs.
B) Decrease psychiatric symptoms, which makes the psychiatric condition harder to treat.
C) Cause an accidental overdose by mixing alcohol with anxiolytic medications, antipsychotic medications, or antidepressant agents.
D) Cause an increase in psychiatric symptoms, because the psychiatric drugs become less effective in the presence of alcohol.

Question 25

The nurse clarifies that when a urine sample is needed for screening in a case of DWI or other crime,the specimen should:

A) Be collected and witnessed by a staff member of the same gender.
B) Be documented with a chain-of-custody form and signed by all who handle the specimen.
C) Be kept under secure conditions if temporary storage is necessary.
D) Never be out of sight until someone from law enforcement takes it.
E) Be placed in a specially marked container.

Question 26

An implementation that can be used to help prevent relapse in a patient who has a substance abuse problem is:

A) Self hypnosis
B) Imagery
C) Stress management
D) Blocking

Question 27

A nursing diagnosis that is appropriate for a patient with substance abuse is:

A) Anxiety
B) Chronic or situational low self-esteem
C) Risk for delayed development
D) Acute confusion

Question 28

The adolescent is extremely vulnerable to substance abuse because the adolescent:

A) Is egocentric.
B) Can use good judgment.
C) Has poor impulse control.
D) Is aware of possible consequences.
E) Wants peer identification.

Question 29

The nurse documents signs of Wernicke encephalopathy in a patient with long-term alcoholism.These signs include:

A) Confabulation
B) Ataxia
C) Delirium
D) Decreasing level of consciousness
E) Projectile vomiting

Question 30

The nurse takes into consideration that alcohol abuse in the older adult may place them at risk for:

A) Falls
B) Malnutrition
C) Respiratory infections
D) Bone demineralization
E) Cirrhosis