Deck 21: Addictive Behaviors and Genetic Linkages

Question 1

Which situations would the nurse characterize as indicating substance abuse rather than dependence?

A)The client reports that her boyfriend left her because she drinks so much.
B)The client reports being fired from three jobs this year due to tardiness after binge drinking.
C)The client reports needing more marijuana to feel "high."
D)The client has been arrested twice for purchasing methamphetamine.
E)The client has ruined three shirts due to overspraying paint while huffing.

Answer 1

The client reports that her boyfriend left her because she drinks so much.
The client reports being fired from three jobs this year due to tardiness after binge drinking.
The client has ruined three shirts due to overspraying paint while huffing.

Question 2

Which situations would the nurse interpret as indicating the client has a true substance dependence problem rather than a substance abuse issue?

A)At every clinical visit the client initiates a discussion about her need to stop using drugs.
B)The client reports,"I'm going back to my plan of drinking only on weekends."
C)The client states,"I'm trying to quit using sleeping pills but I can't do it.Without them I'm awake all night."
D)The client reports that his parents have "kicked me out of the house" for repeatedly coming home drunk.
E)The client was arrested for shoplifting cigarettes at a convenience store.

Answer 2

At every clinical visit the client initiates a discussion about her need to stop using drugs.
The client reports,"I'm going back to my plan of drinking only on weekends."
The client states,"I'm trying to quit using sleeping pills but I can't do it.Without them I'm awake all night."

Question 3

A client says,"I am so afraid I will become an alcoholic.Both my mom and dad drank heavily throughout my childhood." How should the nurse respond?

A)"You are aware of your potential for alcoholism,so you probably will not develop the disorder."
B)"There may be some genetic component to alcoholism,so you should take care."
C)"If it is genetic,there is not much you can do about it."
D)"With your family history of alcoholism,you might consider healthier ways to manage stressors."
E)"You could focus on staying strong and healthy rather on your risk for alcoholism."

Answer 3

"There may be some genetic component to alcoholism,so you should take care."
"With your family history of alcoholism,you might consider healthier ways to manage stressors."
"You could focus on staying strong and healthy rather on your risk for alcoholism."

Question 4

The nurse is discussing potential therapy with a client who has abused alcohol and cocaine.Which planning is indicated?

A)The focus of the initial therapy must be to reduce the client's abuse of cocaine because it is illegal.
B)Therapy for alcohol addiction should be addressed first as it is the more easily obtainable of the two substances.
C)Because the client is a polysubstance abuser,it is much more likely that genetics are the cause of the addictions,so inpatient therapy is indicated.
D)Both of these addictions should be addressed simultaneously.

Question 5

The nurse suspects that a child has fetal alcohol syndrome (FAS).Which assessments would lead to this suspicion?

A)The child's facial features are not normally proportional.
B)The child cannot sit still or stay on task.
C)The child's legs are bowed from the knees to the ankles.
D)The parents report the child is behind grade level in all school subjects.
E)The client has a heart murmur.

Question 6

The nurse working in an alcohol addiction program would evaluate which statement as true regarding genetics and alcohol abuse?

A)Alcoholism is likely caused by a single genetic factor.
B)Once science identifies the common genetic profile leading to alcoholism,this addiction can be treated more successfully.
C)Our knowledge of how genetics impacts the development of alcoholism is minimal,but is increasing.
D)Alcoholism is likely unrelated to any genetic etiology.

Question 7

A mother is concerned because her teenage son's father and grandfather are alcoholics.How should the nurse respond to this concern?

A)"You should have genetic testing done for your son."
B)"You are a strong parent,and that will overcome any genetic or environmental tendency toward alcoholism."
C)"Regardless of what genetic testing might reveal,your son will need assistance in developing healthy stress responses."
D)"Genetics is such a strong determinant of alcohol abuse that no interventions are likely to help."

Question 8

A client has many relatives in the three-generation pedigree who are or were substance abusers.The client says,"I don't understand all the emphasis on what my ancestors did.I don't abuse anything." How should the nurse respond?

A)"We are trying to develop screening tests for substance abuse tendency,and your family history is very interesting to us."
B)"Your history would help guide medication therapy if you ever became a substance abuser."
C)"Knowing your family history gives you advance notice to improve your coping skills and learn to manage your stress."
D)"We can give you medications to prevent your becoming a substance abuser."

Question 9

A client who is a substance abuser is described as "disinhibited" in a clinical planning conference.How should the nurse interpret this information?

A)The client is antisocial.
B)The client lacks the ability to respond flexibly to circumstances.
C)The client's substance abuse has caused brain damage.
D)The client does not respond to reward activation in the brain.

Question 10

The nurse is planning to help a client with smoking cessation.What is the most helpful plan for this client?

A)Have the client tested for a genetic tendency toward heavy smoking.
B)Enroll the client in a hotline support group for smoking cessation.
C)Discuss the health effects of smoking at each clinic visit.
D)Include the client's family in discussions about smoking cessation.

Question 11

The nurse has taken a position in a clinic in an area where fetal alcohol syndrome (FAS)is prevalent.What information should the nurse's manager provide?

A)FAS is found mostly in the economically disadvantaged population.
B)The most common cause of intellectual disorders that are not inherited is the use of alcohol by the pregnant woman.
C)FAS is common but occurs only when the mother is a very heavy drinker.
D)Children with FAS may be at risk for addictions.
E)FAS is caused by a created genetic disease.

Question 12

The nurse assesses that a newborn is of low birth weight,has distinctively malformed facial features,and is irritable and inconsolable.The nurse would review the mother's admission interview for which information?

A)Did the mother consume alcohol during the pregnancy?
B)Was preeclampsia a problem in the pregnancy?
C)Did the mother have problems becoming pregnant?
D)Does either the mother or father have heart defects?

Question 13

During a research study,an African-American woman was found to have a TT genotype.What information should the nurse provide?

A)"You will never need to worry about becoming an alcoholic,because your genes will protect you."
B)"You may wish to take steps to minimize stressors in your life."
C)"I have some information for you on how to maximize your coping skills."
D)"Your genetic profile makes it almost inevitable that you will become a substance abuser."
E)"You have a genotype that would make you vulnerable to substance abuse if you were not African-American."

Question 14

Which finding would the nurse attribute to withdrawal in a client who has substance dependence?

A)The client presented to the clinic and asked for help "so I can stop wrecking my life."
B)The client is sitting quietly in a rocking chair in the corner.
C)The client asks the same question repeatedly.
D)The client complains of a headache.

Question 15

A client who is addicted to opioids says,"I don't know how I got myself hooked on drugs.I just can't seem to resist them.Could I have inherited this from my mother? She was a junkie." How should the nurse respond?

A)"Opioid addictions are not inherited."
B)"Not much research has been done regarding opioid drug addiction and inheritance."
C)"Despite the research,the medical community is still not certain about drug addiction and inheritance."
D)"Because you are unable to resist the temptation of opioids,it is likely that you have a genetic tendency toward abuse."