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Which of the following nursing assessment findings are consistent with alcohol withdrawal? A. Patient is diaphoretic, constipated, cannot eat his lunch, p = 70, BP = 140/85, T = 101°F B. Patient is agitated and tremulous, p = 100, BP = 110/70, T = 101°F C. Patient is disoriented when awake, sleeping on and off throughout the shift, skin cool and dry, T = 98.4°F D. Patient is vomiting, tremulous, having difficulty sleeping, p = 100, BP = 160/95, T = 99°F -Correct answer D. Patient is vomiting, tremulous, having difficulty sleeping, p = 100, BP = 160/95, T = 99°F The nurse would expect to find which of the following diagnostic criteria in a patient with a substance use disorder? Select all that apply. A. Cravings B. Tolerance C. Conditioning D. Withdrawal E. Genetics -Correct answer A. Cravings B. Tolerance D. Withdrawal Which of the following complications would the nurse expect to find with cirrhosis of the liver? Select all that apply. A. Gastritis B. Ascites C. Hepatic encephalopathy D. Esophageal varices E. Portal hypotension -Correct answer A. Gastritis B. Ascites C. Hepatic encephalopathy D. Esophageal varices E. Portal hypotension You suspect a newborn has fetal alcohol syndrome, but the mother has denied alcohol use during pregnancy. What should the nurse assess for in the newborn? Select all that apply. A. Larger head circumference B. Thick upper lip C. Short nose D. Small midface E. Low nasal bridge -Correct answer C. Short nose
D. Small midface E. Low nasal bridge Which of the following is true in regard to anxiolytics? Select all that apply. A. Multiple anxiolytics used together can cause excessive sedation and even death. B. Anxiolytics have the potential for abuse. C. Anxiolytics can cause other similar medications to work more effectively. D. Anxiolytics can cause a psychological need for the substance. E. Anxiolytics should be avoided in alcohol withdrawal -Correct answer A. Multiple anxiolytics used together can cause excessive sedation and even death. B. Anxiolytics have the potential for abuse. C. Anxiolytics can cause other similar medications to work more effectively. D. Anxiolytics can cause a psychological need for the substance. Can you differentiate the substance-related and addictive disorders? Drag and drop relevant clinical manifestations, assessment findings, and other pertinent data for each disorder. Characteristics of codependency: A. Relinquishes personal identity B. Sets clear boundaries C. Forgoes own needs to take care of others D. Never feels good enough E. Does not need approval from others F. Usually happy with oneself G. Has a stable functional family H. Feels responsible for fixing problems of others -Correct answer A. Relinquishes personal identity C. Forgoes own needs to take care of others D. Never feels good enough H. Feels responsible for fixing problems of others Can you differentiate the substance-related and addictive disorders? Drag and drop relevant clinical manifestations, assessment findings, and other pertinent data for each disorder. Effects of opioid use disorder: A. Euphoria B. Drowsiness C. Respiratory depression D. Diarrhea E. Increased sexual function
Can you differentiate the substance-related and addictive disorders? Drag and drop relevant clinical manifestations, assessment findings, and other pertinent data for each disorder. Symptoms in phases of alcohol use disorder: A. Phase 1 - alcohol is used to relive everyday stress B. Phase 1 - tolerance begins to develop C. Phase 2 - blackouts occur D. Phase 2 - not worried about drinking E. Phase 3 - still has control F. Phase 3 - periods of binge drinking G. Phase 4 - withdrawal symptoms occur when not drinking H. Phase 4 - feels helpless and depressed -Correct answer A. Phase 1 - alcohol is used to relive everyday stress B. Phase 1 - tolerance begins to develop C. Phase 2 - blackouts occur F. Phase 3 - periods of binge drinking G. Phase 4 - withdrawal symptoms occur when not drinking H. Phase 4 - feels helpless and depressed Can you differentiate the substance-related and addictive disorders? Drag and drop relevant clinical manifestations, assessment findings, and other pertinent data for each disorder. Physical effects of chronic alcohol use disorder: A. Wernicke-Korasakoff syndrome B. Cardiomyopathy C. Esophagitis D. Hepatitis E. Esophageal varices F. Leukopenia G. Thrombocytopenia H. Pancreatitis -Correct answer A. Wernicke-Korasakoff syndrome B. Cardiomyopathy C. Esophagitis D. Hepatitis E. Esophageal varices F. Leukopenia G. Thrombocytopenia H. Pancreatitis
Can you differentiate the substance-related and addictive disorders? Drag and drop relevant clinical manifestations, assessment findings, and other pertinent data for each disorder. Substance use disorder predisposing factors: A. Culture and ethnicity B. Depression C. Conditioned response D. Punitive superego E. Fixation in anal stage of psychosexual development F. Irrational thinking G. Role modeling H. Genetics -Correct answer A. Culture and ethnicity B. Depression C. Conditioned response D. Punitive superego F. Irrational thinking G. Role modeling H. Genetics Can you differentiate the substance-related and addictive disorders? Drag and drop relevant clinical manifestations, assessment findings, and other pertinent data for each disorder. Diagnostic criteria of substance use disorder: A. Withdrawal B. Tolerance C. Control D. Risky use E. Cravings F. Socially outgoing G. Recurrent use H. Codependency -Correct answer A. Withdrawal B. Tolerance C. Control D. Risky use E. Cravings G. Recurrent use Which of the following nursing implications arises from the fact that the majority of individuals with a substance use disorder have a dual diagnosis of mental illness?
D. The Early Alcoholic Phase -Correct answer B. The Crucial Phase Opioids and large doses of anxiolytics tend to have the same effects on the body. Which one(s) do they have in common? Select all that apply. A. Euphoria B. Mood changes C. Hypertension D. Drowsiness E. Respiratory depression -Correct answer D. Drowsiness E. Respiratory depression A client is admitted for alcohol detoxification. During detoxification, which symptoms should the nurse expect to assess? A. Disorientation, peripheral neuropathy, and hypotension. B. Oculogyric crisis, amnesia, ataxia, and hypertension. C. Gross tremors, delirium, hyperactivity, and hypertension. D. Hallucinations, fine tremors, confabulation, and orthostatic hypotension. -Correct answer C. Gross tremors, delirium, hyperactivity, and hypertension. A parent has consulted the school nurse because she is concerned about her 16-year- old son and the possibility of drug abuse. What indication of substance abuse in adolescents should the nurse plan to teach the mother? A. Improved academic performance. B. Introducing new friends to family. C. Headaches D. Unexplained moodiness. -Correct answer D. Unexplained moodiness. A client who has been on the unit for two (2) weeks relates a 15-year history of polysubstance abuse with several detoxifications followed by relapses. The client mentions that when he is released from the hospital, he tries to "get on with my life and put this other stuff in the past." The nurse identifies an appropriate outcome as being that client will: A. View recovery is a lifelong process occurring a day at a time. B. Discuss childhood factors that impact on his drug use. C. Recognize his need for methadone maintenance. D. Identify reasons for past episodes of noncompliance. -Correct answer A. View recovery is a lifelong process occurring a day at a time. A priority nursing diagnosis for a 25-year-old client admitted to a drug rehabilitation program 4 days ago for chronic cocaine abuse would be:
A. Risk for self-directed violence related to hyperactivity. B. Risk for self-directed violence related to suicidal depression. C. Risk for noncompliance related to chronic drug use. D. Disturbed sensory perception related to stimulant drug use. -Correct answer B. Risk for self-directed violence related to suicidal depression. A 19-year-old client has been admitted to the ED after snorting heroin with her boyfriend. She has pinpoint pupils and is unconscious. The client's priority nursing diagnosis is: A. Risk for imbalanced fluid volume. B. Ineffective breathing pattern. C. Disturbed sensory perception. D. Impaired physical mobility. -Correct answer B. Ineffective breathing pattern. A client recently discharged from an alcohol rehabilitation program is brought to the hospital in a state of prostration with severe throbbing headache, tachycardia, a beet- red face, dyspnea, and continuous vomiting. The client's significant other states the client got sick about 15 minutes after drinking a glass of wine. The nurse should be guided in assessment by the suspicion that the client: A. Is exhibiting symptoms of cross dependence. B. Is having a stroke. C. Has alcohol intoxication. D. Is reacting to disulfiram (Antabuse). -Correct answer D. Is reacting to disulfiram (Antabuse). The most effective nursing approach to deal with denial in a client who abuses substances is: A. confronting the client regarding his or her hopeless life situation. B. discussing the addictive personality. C. having the client identify the effects of substance use on his or her life. D. describing the physiologic effects of substances on the body. -Correct answer C. having the client identify the effects of substance use on his or her life. During the admission interview, a patient mentions to the nurse that he had increased the amount of oxycodone because the smaller dose "just wasn't doing it for me anymore." The nurse assesses this phenomenon as resulting from: A. tolerance. B. withdrawal. C. intoxication. D. relapse. -Correct answer A. tolerance.
D. Older adults develop substance use to mask manifestations of dementia. -Correct answer C. Older adults are at an increased risk for substance use following retirement. A nurse is assessing a client who has alcohol use disorder and is experiencing withdrawal. Which of the following findings should the nurse expect? (Select all that apply.) A. Bradycardia B. Fine tremors of both hands C. Hypotension D. Vomiting E. Restlessness -Correct answer B. Fine tremors of both hands D. Vomiting E. Restlessness A nurse is planning care for a client who is experiencing benzodiazepine withdrawal. Which of the following interventions should the nurse identify as the priority? A. Orient the client frequently to time, place, and person. B. Offer fluids and nourishing diet as tolerated. C. Implement seizure precautions. D. Encourage participation in group therapy sessions. -Correct answer C. Implement seizure precautions. A nurse is caring for a client who has alcohol use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following medications should the nurse anticipate administering to assist the client with maintaining abstinence from alcohol? A. Chlordiazepoxide B. Bupropion C. Disulfiram D. Carbamazepine -Correct answer C. Disulfiram A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates an understanding of the teaching? (Select all that apply.) A. "We need to understand that our sibling is responsible for their disorder." B. "Eliminating codependent behavior will promote recovery." C. "Our sibling should participate in an Al‐Anon group to assist with recovery." D. "The primary goal of treatment is abstinence from substance use." E. "Our sibling needs to discuss personal feelings about substance use to help with recovery." -Correct answer B. "Eliminating codependent behavior will promote recovery."
D. "The primary goal of treatment is abstinence from substance use." E. "Our sibling needs to discuss personal feelings about substance use to help with recovery." A nurse is caring for a client who has cocaine use disorder and is experiencing severe effects of intoxication. Identify three expected findings. -Correct answer Objective:
- Seizures
- Extreme fever
- Tachycardia
- Hypertension Subjective:
- Hallucinations
- Chest pain A nurse is caring for a client who has cocaine use disorder and is experiencing severe effects of intoxication. Describe two nursing interventions. -Correct answer - Perform a nursing self‐assessment.
- Maintain a safe environment.
- Implement seizure precautions.
- Orient the client to time, place, and person.
- Create a low‐stimulation environment.
- Monitor the client's vital signs and neurologic status. A nurse is caring for a client who has cocaine use disorder and is experiencing severe effects of intoxication. Describe two forms of nonpharmacological therapy. -Correct answer - Cognitive behavioral therapies decrease anxiety and promote a change in behavior.
- Acceptance and commitment therapy promotes acceptance of the client and promotes a commitment to change.
- Relapse prevention therapy assists clients in identifying relapse and promotes self‐ control.
- Group therapy allows clients who have similar diagnoses to work together toward recovery.
- Family therapy allows the client and family members to work together toward recovery.
- Narcotics Anonymous provides a 12‐step program to promote recovery and abstinence from future substance use. A nurse is caring for a client who has cocaine use disorder and is experiencing severe effects of intoxication. Identify two client outcomes. -Correct answer - The client will verbalize coping strategies to use in times of stress.
- The client will remain substance‐free.
- The client will remain free from injury.
- The client will attend a 12‐step program regularly.
A nurse is discussing the use of methadone with a newly licensed nurse. Which of the following statements by the newly licensed nurse indicates an understanding of the teaching? (Select all that apply.) A. "Methadone is a replacement for physical dependence to opioids." B. "Methadone reduces the unpleasant effects associated with abstinence syndrome." C. "Methadone can be used during opioid withdrawal and to maintain abstinence." D. "Methadone increases the risk for acetaldehyde syndrome." E. "Methadone must be prescribed and dispensed by an approved treatment center." - Correct answer A. "Methadone is a replacement for physical dependence to opioids." B. "Methadone reduces the unpleasant effects associated with abstinence syndrome." C. "Methadone can be used during opioid withdrawal and to maintain abstinence." E. "Methadone must be prescribed and dispensed by an approved treatment center." A nurse working in an outpatient clinic is teaching a client who has tobacco use disorder about the use of varenicline. What is the expected pharmacological action? -Correct answer - Varenicline is a nicotinic receptor agonist that promotes the release of dopamine to simulate the pleasurable effects of nicotine. A nurse working in an outpatient clinic is teaching a client who has tobacco use disorder about the use of varenicline. What is the therapeutic use of this drug? -Correct answer - Varenicline is used to reduce cravings for nicotine as well as the severity of withdrawal manifestations.
- Varenicline also reduces the incidence of relapse by blocking the desired effects of nicotine. A nurse working in an outpatient clinic is teaching a client who has tobacco use disorder about the use of varenicline. Identify at least three nursing interventions. -Correct answer - Instruct the client to take medication after a meal.
- Monitor blood pressure during treatment.
- Assess for diabetes mellitus.
- Monitor clients who have diabetes mellitus for loss of glycemic control.
- Advise the client to follow instructions for titration to minimize adverse effects.
- Advise the client to notify the provider if nausea, vomiting, insomnia, new‐onset depression, or suicidal thoughts occur.
- Determine if the client is a commercial truck or bus driver, air traffic controller, or airplane pilot. A client is admitted to the hospital after an extended period of binge alcohol drinking. His wife reports that he has been a heavy drinker for several years. Laboratory reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on the chemical addiction unit for detoxification. When would the first signs of alcohol withdrawal symptoms be expected to occur?
a. Several hours after the last drink b. 2 to 3 days after the last drink c. 4 to 5 days after the last drink d. 6 to 7 days after the last drink -Correct answer a. Several hours after the last drink Symptoms of alcohol withdrawal include: a. Euphoria, hyperactivity, and insomnia. b. Depression, suicidal ideation, and hypersomnia. c. Diaphoresis, nausea and vomiting, and tremors. d. Unsteady gait, nystagmus, and profound disorientation. -Correct answer c. Diaphoresis, nausea and vomiting, and tremors. Which of the following medications is the physician most likely to order for a client experiencing alcohol withdrawal syndrome? a. Haloperidol (Haldol) b. Chlordiazepoxide (Librium) c. Methadone (Dolophine) d. Cannabidiol (Epidiolex) -Correct answer b. Chlordiazepoxide (Librium) A client who has been admitted to the chemical dependence treatment unit after being discliplined for drinking on the job states to the nurse, "I don't have a problem with alcohol. I can handle my booze better than anyone I know." Which defense mechanism is the client using? a. Denial b. Projection c. Displacement d. Rationalization -Correct answer a. Denial A client who has been admitted to the alcohol rehabilitation unit after being fired for drinking on the job states to the nurse, "I don't have a problem with alcohol. My boss is a jerk! I haven't missed any more days than my coworkers." What is the nurse's best response? a. "Maybe your boss is mistaken, Dan." b. "You are here because your drinking was interfering with your work." c. "Get real! You're an alcoholic and you know it!" d. "Why do you think your boss is a jerk?" -Correct answer b. "You are here because your drinking was interfering with your work." A client who has been admitted to intensive outpatient treatment for substance use disorder arrives for group therapy and appears groggy with constricted pupils. The client
alcohol abuse. Which of these findings should the nurse include in reporting to the physician? (Select all that apply.) a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count. -Correct answer a. The client reports weak leg muscles, and his gait is unsteady. b. The client's abdomen is distended. c. The client reports he was coughing up some blood. d. The client reports he has double vision. e. Blood tests reveal a low white blood cell count. Which risk factors can the nurse suspect in a client who has been withdrawn from therapy of central nervous system (CNS) depressants? Select all that apply. A. Tachycardia B. Hypertension C. Hallucinations D. Suicidal ideation E. Intense feeling of lassitude -Correct answer A. Tachycardia B. Hypertension C. Hallucinations Which symptoms would the nurse expect to observe in a client with suspected inhalant intoxication? Select all that apply. A. Nystagmus B. Dysphoria C. Hyperactive reflexes D. Slurred speech E. Generalized muscle weakness -Correct answer A. Nystagmus D. Slurred speech E. Generalized muscle weakness A client who was recently diagnosed with peripheral neuropathy asks the nurse, "My fingers and toes are burning. How can I stop this pain?" How would the nurse respond to the client? A. "Abstinence from alcohol and better nutrition will help resolve your condition." B. "Consult a primary health-care provider. This may lead to permanent muscle wasting and paralysis." C. "The severity of the condition depends on the concentration of hepatic enzymes."
D. "Consider avoiding green peas and oatmeal in your diet." -Correct answer A. "Abstinence from alcohol and better nutrition will help resolve your condition." Which phase of alcohol abuse is characterized by the use of alcohol to relieve the everyday stress and tensions of life? A. Crucial phase B. Chronic phase C. Prealcoholic phase D. Early alcoholic phase -Correct answer C. Prealcoholic phase Which behavioral symptoms will be observed in a child with fetal alcohol syndrome? Select all that apply. A. Passive behavior B. Learning disabilities C. Intellectual disability D. Ineffective communication E. Absence of judgmental skills -Correct answer B. Learning disabilities C. Intellectual disability D. Ineffective communication A client who uses drugs says, "I am not a drug addict. I can stop any time I want." Which nursing intervention would the nurse most likely apply in this client? A. Identifying recent maladaptive behaviors B. Conveying an attitude of acceptance to the client C. Developing a trusting relationship with the client D. Correcting misconceptions about substance abuse -Correct answer D. Correcting misconceptions about substance abuse A client who is a smoker says, "Smoking relaxes me. It is not harmful." Which nursing intervention is the priority for this client? A. Teaching about substitution therapy B. Including significant others in teaching C. Assessing the client's level of knowledge D. Providing information about physical effects of smoking on the body -Correct answer C. Assessing the client's level of knowledge The nurse is educating a client on disulfiram therapy about necessary precautions. Which statement of the client would most likely indicate effective learning? A. "I should avoid alcohol." B. "I should avoid cocaine."
Which action would neomycin produce when a client with alcoholic use disorder is treated for hepatic encephalopathy? A. Suppresses urinary function B. Reduces intestinal ammonia C. Eliminates protein in the diet D. Induces complete abstention from alcohol in the client -Correct answer B. Reduces intestinal ammonia Which medication can be used as a form of self-medication to alleviate depression? A. Phenobarbital B. Chlordiazepoxide C. Desipramine D. Amphetamine -Correct answer D. Amphetamine Which of the following has been implicated in the predisposition to substance abuse? a)Hereditary factor b)Fixation in the adolescent stage of psychosexual development c)Punitive ego d)Narcissistic and dependent personality traits -Correct answer a)Hereditary factor A client is brought to the emergency department. The client is aggressive, has slurred speech, and impaired motor coordination. Blood alcohol level is 347 mg/dL. Among the physician's orders is thiamine. Which is the rationale for this intervention? a)To prevent nutritional deficits b)To prevent pancreatitis c)To prevent alcoholic hepatitis d)To prevent Wernicke's encephalopathy -Correct answer d)To prevent Wernicke's encephalopathy A client diagnosed with chronic alcoholism says to the nurse, "I'm tired of using and I want to stop. Is there a medication that can help me maintain sobriety?" About which medication would the nurse provide information? a)Carbamazepine (Tegretol) b)Clonidine (Catapres) c)Disulfiram (Antabuse) d)Folic acid (Folvite) -Correct answer c)Disulfiram (Antabuse)
