Deck 69: Substance Use Disorders in the Adult Population

Question 1

The patient with a history of alcohol abuse is being discharged to a treatment facility.Which prescription does the nurse anticipate for this patient?

A) Disulfiram
B) Naloxone
C) Bupropion hydrochloride
D) Varenicline

Answer 1

Disulfiram

Question 2

The employee health nurse is providing care to an employee who was injured on the job.The patient has a history of drug addiction and is currently enrolled in a 12-step recovery program.In order to determine whether the employee was impaired at the time of the accident,which diagnostic tool will the nurse use?

A) Liver enzymes
B) Stool guaiac
C) Urine toxicology testing
D) Hair testing

Answer 2

Urine toxicology testing

Question 3

The nurse assesses a patient with a history of alcoholism who is hospitalized with anorexia,dysphagia,odynophagia,and chest pressure after eating.Which nursing diagnosis is a priority for this patient?

A) Ineffective Coping
B) Imbalanced Nutrition: Less Than Body Requirements
C) Disturbed Sensory Perception
D) Disturbed Thought Processes

Answer 3

Imbalanced Nutrition: Less Than Body Requirements

Question 4

The nurse is caring for a patient who is an intravenous drug user.The nurse anticipates the need for assessment for which complication?

A) Cardiac tamponade
B) Myocardial infarction
C) Congestive heart failure
D) Infective endocarditis

Question 5

The nurse is completing a health history and determines the patient would benefit from teaching about substance abuse.Which patient statement does not support the need for this teaching?

A) "I drink alcohol with my friends on the weekends."
B) "I smoke cigarettes on a daily basis."
C) "I get good grades in school."
D) "I became sexually active at the age of 13."

Question 6

A patient is admitted to the emergency department with signs of drug use.The patient reports having ingested Percocet and is experiencing respiratory depression.Based on this data,which prescription does the nurse anticipate for this patient?

A) Diazepam
B) Haldol
C) Vitamin B₁₂
D) Naloxone

Question 7

The nurse is caring for a patient who requires an opiate medication for chronic pain associated with a previous injury.The patient tells the nurse,"Even though I don't feel like I'm addicted to the medication,I get tremors in my hands if I miss a dose." What is the nurse's best response?

A) "You may be addicted to the medication,but not necessarily physically dependent."
B) "You may be physically dependent on the medication,but not necessarily addicted."
C) "The symptoms you describe are indicative of addiction,whether you feel you are or not."
D) "The symptoms you describe relate to your disease state and are not normal."

Question 8

A patient who is attending a Narcotics Anonymous (NA)program asks the nurse what the most important initial goal of attending the meetings is.When responding to the patient,which indication will the nurse take into account?

A) To admit to having a problem
B) To learn problem-solving skills
C) To take a moral inventory of self
D) To make amends to people they have hurt

Question 9

The nurse is providing care to a patient with alcohol and opioid dependency.A family member states,"I don't understand why Naltrexone treatment is prescribed because it causes a high too,right?" Which response by the nurse is appropriate?

A) "Naltrexone will cause your daughter to become violently ill if she drinks alcohol or abuses drugs."
B) "Naltrexone is less potent than the street drugs your daughter is currently taking and therefore safer."
C) "Naltrexone diminishes the cravings your daughter will feel for alcohol and opioids."
D) "Naltrexone will prevent your daughter from getting drunk when she drinks."

Question 10

The nurse is planning to implement addiction treatment groups at the inner city clinic.Which knowledge regarding addictions and its related therapies will facilitate implementation of the groups?

A) Relapse is a common feature of substance abuse.
B) Hereditary,as well as complex environmental influences,predisposes one to substance dependence.
C) Patients with a substance dependence cannot be held accountable for their actions.
D) Alcoholics Anonymous (AA)
And Narcotics Anonymous (NA)
Are accepted treatment approaches.

Question 11

A college student is incoherent after taking "downers with beer." For which health problem should the nurse also observe for in this patient?

A) Hallucinations
B) Respiratory depression
C) Seizure activity
D) Signs of withdrawal

Question 12

The nurse is providing care to a patient diagnosed with alcoholism.The patient's physical examination reveals a BMI of 18.Which prescription does the nurse anticipate to manage the patient's nutritional status?

A) Sertraline
B) Methadone
C) Naloxone
D) Multivitamin with folic acid

Question 13

The nurse is caring for a patient who is diagnosed with cocaine addiction.For which additional disorder should the nurse assess this patient?

A) Anxiety
B) Diabetes
C) Weight gain
D) Kidney stones

Question 14

The nurse is conducting a class in the community regarding alcohol use to a group of college seniors.During the class a participant admits to frequently using alcohol.Which is the priority action of the nurse?

A) Initiate a community assessment of the campus
B) Contact the campus nurse and refer the student
C) Notify campus security to watch for driving under the influence
D) Complete a crisis assessment

Question 15

A patient being treated for an alcohol use disorder asks the nurse,"Can my children inherit this?" Which response by the nurse is most appropriate?

A) "The role of genetics is minor in comparison to the role of the environment."
B) "Genetics does not seem to play a role in the development of substance use disorders."
C) "The role of genetics in substance use disorders has not been determined."
D) "Genetics plays a major role in the development of substance use disorders."

Question 16

The nurse is evaluating outcome goals written by a student for a patient diagnosed with alcoholism who is being discharged from a detoxification program.Which outcome is appropriate for this patient?

A) Follow a 2000-calorie high-carbohydrate diet
B) Sponsor a participant in Alcoholics Anonymous (AA)meetings
C) Obtain at least six to eight hours of sleep per night
D) Acknowledge the blame that family members must take for codependent behavior

Question 17

A patient is brought to the emergency department by a parent.The nursing assessment reveals that the patient has been acting strangely for the past three hours and is hypervigilant,grandiose,and irritable.Vital signs reveal hypertension,tachycardia,and some arrhythmias.Which substance does the nurse suspect that the patient has been using?

A) Alcohol
B) Marijuana
C) Heroin
D) Amphetamines

Question 18

A nursing instructor is teaching a class about the role of dopamine in substance abuse.Which student statement indicates appropriate understanding?

A) "The dopamine D₁ and dopamine D₂ receptors are responsible for co-occurring disorders."
B) "Dopamine increases opioid transmission,and this reinforces the cycle of substance abuse."
C) "Dopamine causes changes in brain neurotransmission that enhance the cycle of substance abuse."
D) "The dopamine D₃ receptor is involved in drug-seeking behaviors."

Question 19

The nurse is conducting a health history for a patient and wants to determine the patient's alcohol use.What question from the nurse will provide the greatest amount of information?

A) "Are you a heavy drinker?"
B) "How many alcoholic beverages do you drink each day?"
C) "Is alcohol use a concern for you?"
D) "Drinking doesn't cause any problems for you,does it?"

Question 20

After an assessment of a patient,a nursing student expresses a belief that drug addiction is not a real illness,as these patients "did it to themselves." Which response by the staff nurse is appropriate?

A) "Sometimes a patient doesn't show much effort."
B) "We are legally obligated to provide care."
C) "It is important to remain nonjudgmental when caring for any patient,even a drug addict."
D) "You are right.I don't know why we bother."

Question 21

Ten hours after admission to the ICU following an auto accident,a patient begins to exhibit mild tachycardia,irritability,and tremors.Three hours later the patient has a grand mal seizure.Which condition does the nurse suspect?

A) Wernicke encephalopathy
B) Korsakoff syndrome
C) Undetected internal bleeding
D) Alcohol withdrawal syndrome

Question 22

The nurse is caring for a patient with a substance use disorder who is admitted to the rehabilitation unit of the inpatient treatment facility.The nurse collaborates with the patient to establish and redefine mutual goals of treatment.What is the primary purpose of this action?

A) It develops the nurse-patient relationship.
B) It allows the nurse to self-reflect.
C) It encourages patient responsibility.
D) It provides evaluation of outcomes.

Question 23

The nurse is providing an educational seminar for the families of patients diagnosed with a substance use disorder.Which statement will the nurse include in the teaching session regarding the addictive process?

A) "Manifestations exhibited are similar to those exhibited with behavioral disorders."
B) "Manifestations exhibited are similar to those exhibited with cognitive disorders."
C) "Manifestations exhibited are caused by changes in neurochemistry."
D) "Manifestations exhibited are caused by changes in the emotional state."

Question 24

A patient addicted to heroin is prescribed methadone as part of the treatment process.The patient's spouse asks,"I don't understand the reason for the methadone treatment.Why replace heroin with methadone?" Which response by the nurse is accurate?

A) "Methadone is safe even in large doses."
B) "Methadone replaces a more potent drug."
C) "Methadone is a deterrent to using other drugs."
D) "Methadone blocks the craving for and the action of opiates."

Question 25

The nurse is caring for a patient who is experiencing alcohol withdrawal.Which is the priority nursing diagnosis for this patient?

A) Risk for Injury
B) Ineffective Coping
C) Disturbed Sensory Perception
D) Disturbed Thought Processes