Deck 12: Addictive Behaviors

Question 1

A patient admitted to the medical-surgical unit after a head injury caused by a fall has a blood alcohol concentration (BAC) of 220 mg/dl (0.22 mg%). The patient is alert and does not appear highly intoxicated. An appropriate nursing action is to

A) administer acetaminophen for headache.
B) monitor frequently for signs of withdrawal.
C) avoid the use of intravenous (IV) fluids.
D) maintain patient on NPO status.

Answer 1

monitor frequently for signs of withdrawal.

Question 2

A patient who currently uses heroin has elective surgery. To promote effective pain control postoperatively, the nurse will

A) give normal doses of opioid pain medication as needed for pain.
B) avoid use of opioids and use alternatives such as NSAIDs instead.
C) administer opioid analgesics on a regularly scheduled basis.
D) use sedative medications along with nonopioid analgesics.

Answer 2

administer opioid analgesics on a regularly scheduled basis.

Question 3

A patient who is alcohol-intoxicated must undergo emergency surgery for abdominal trauma. The nurse recognizes that during the perioperative period the patient

A) will require an increased dose of the general anesthetic medication.
B) is likely to develop withdrawal symptoms within a few hours after surgery.
C) needs frequent monitoring for bleeding and respiratory complications.
D) should be stimulated every hour to prevent prolonged postoperative sedation.

Answer 3

needs frequent monitoring for bleeding and respiratory complications.

Question 4

An agitated individual is brought to the emergency department by friends who state that the patient took a hallucinogenic drug at a party and then tried to jump from a second-story window. The priority nursing diagnosis for the patient is

A) disturbed thought process related to drug effects.
B) risk for injury related to altered perception.
C) ineffective health maintenance related to drug use.
D) powerlessness related to loss of behavioral control.

Question 5

During assessment of a patient's use of abused substances, the nurse recognizes that individuals with substance dependence

A) often deny the degree of dependence on substances by claiming to be able to control their addictive behaviors.
B) usually like to emphasize the importance of abused substances in their social and personal relationships.
C) are motivated to enter rehabilitation when they develop serious physical illnesses related to substance abuse.
D) must be evaluated by using reports by family members concerning the patient's use of substances.

Question 6

A disoriented and agitated patient has come to the emergency department after using methamphetamine. Vital signs are blood pressure 162/98, heart rate 142 and irregular, and respirations 32. The most important intervention by the nurse is to

A) monitor the patient's ECG and vital signs.
B) reorient the patient at frequent intervals.
C) obtain a health history including prior drug use.
D) keep the patient in a quiet and darkened room.

Question 7

When working with a patient who has recently stopped using amphetamines, the nurse will advise the patient to avoid friends who use amphetamines because

A) being around those friends will cause cue-induced craving.
B) social situations will increase the likelihood of relapse.
C) friends will be likely to offer the patient amphetamines.
D) it will be easier to purchase amphetamines from these friends.

Question 8

An older patient who has been taking alprazolam (Xanax) calls the clinic asking for a refill of her prescription 1 month before the Xanax should be depleted. The best response by the nurse to the patient is

A) "I will ask the doctor to prescribe a few more pills, but you will not be able to get any more for another month."
B) "The prescription cannot be refilled for another month. What happened to all of your pills?"
C) "Do you have any muscle cramps and tremors if you don't take the medication frequently?"
D) "I am concerned that you may be over-using the Xanax. Let's make an appointment for you to see the doctor today."

Question 9

A patient admitted with chest pain who is a pack-a-day smoker tells the nurse, "I am just not ready to quit smoking yet." The most appropriate response by the nurse is

A) "This would be a really good time to quit."
B) "Are you familiar with the nicotine patch?"
C) "Your smoking is the cause of your chest pain."
D) "What do you think keeps you from quitting?"

Question 10

A patient with alcohol dependence is admitted to the hospital following an episode of hematemesis. Twenty-four hours after admission, the patient becomes very tremulous and anxious. An appropriate intervention by the nurse is to

A) promote oral intake to 3000 ml/day.
B) administer opioids to provide sedation.
C) provide a calm, quiet, well-lit environment.
D) restrain the patient with vest and arm restraints.

Question 11

During physical assessment of a patient who has a chronic upper respiratory infection and sinus headaches, the nurse finds nasal sores and necrosis of the nasal septum. The nurse should ask the patient specifically about the use of

A) heroin.
B) cocaine.
C) tobacco.
D) marijuana.

Question 12

A patient with a history of heavy alcohol use is seen at the clinic with acute gastritis. Which statement by the patient indicates that the patient is in the contemplation stage of change?

A) "Alcohol has never bothered my stomach. I think it's likely that I have the flu."
B) "I am older and wiser now, and I know I can change my drinking behavior."
C) "I think my drinking is affecting my stomach, but maybe some drugs will help."
D) "People say that I drink too much, but I really feel pretty good most of the time."

Question 13

During physical assessment of a patient with chronic alcohol abuse, the nurse identifies a pathophysiologic change related to alcohol on finding

A) hypotension.
B) hyperthermia.
C) hepatomegaly.
D) bradycardia.

Question 14

All the following medications are ordered for a patient admitted with a blood alcohol concentration of 0.22 mg%. Which one will the nurse give first?

A) Thiamine (vitamin B1) 100 mg
B) Lorazepam (Ativan) 1 mg
C) Folic acid (Vitamin B9) 0.4 mg
D) Dextrose 5% in 0.45 saline

Question 15

A 19-year-old patient comes to the emergency room with severe chest pain and agitation. Which action should the nurse take first?

A) Ask about any use of stimulant drugs.
B) Listen to the patient's breath sounds.
C) Check the patient's blood pressure and pulse.
D) Assess orientation to person, place, and time.

Question 16

A patient who is admitted to the hospital for treatment of large abscesses of both anterior thighs admits to using fentanyl (Sublimaze) illegally. The nurse will monitor the patient for manifestations of withdrawal such as

A) tachycardia, convulsions, and delirium.
B) diaphoresis, diarrhea, and lacrimation.
C) depression, irritability, and disorientation.
D) gross tremor, hallucinations, and seizures.

Question 17

Based on the incidence of smoking, the community health nurse should focus interventions on which of the following groups when developing a plan to prevent tobacco use?

A) elementary school children.
B) high school students.
C) first time parents.
D) middle-aged adults.

Question 18

A patient has a history of opioid abuse and is hospitalized after a fall down a flight of stairs. After a visit by a friend, the nurse finds the patient unresponsive with pinpoint pupils. Which of these ordered medications will the nurse administer?

A) Clonidine (Catapres)
B) Methadone (Dolphine)
C) Naloxone (Narcan)
D) Diazepam (Valium)

Question 19

A nurse who is assigned to care for a patient who has been admitted with an opiate overdose tells the nursing supervisor, "This is a waste of my time. The patient will be back on the needle right after being discharged." The most appropriate response by the nursing supervisor is

A) "Your lack of professionalism will make it difficult for you to provide adequate care."
B) "You know we are obligated to provide appropriate care no matter how we feel."
C) "Since you feel so strongly, perhaps you should be assigned to care for a different patient."
D) "It is important to recognize these feelings and then figure out how to deal with them."

Question 20

A patient hospitalized for elective surgery stopped smoking 2 days before admission as advised by the nurse. When planning postoperative care, the nurse should include measures to

A) improve sleep.
B) decreased appetite.
C) prevent fatigue.
D) enhance appetite.

Question 21

A 20-year-old patient who has inhaled cocaine is admitted to the emergency department with palpitations and shortness of breath. All the following orders are received. Which one will the nurse accomplish first?

A) Obtain 12-lead ECG.
B) Start O₂ at 4 L/min.
C) Draw blood for drug screening.
D) Infuse normal saline at 100 ml/hr.