Ch 19 - prepu addiction

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When a client is working toward the prevention of an alcohol
abuse relapse, the nurse is acting in a therapeutic role when doing Helping the client identify positive coping mechanisms
what?
Safe alcohol withdrawal usually is accomplished with the admin-
Benzodiazepines
istration of which medication classification?
The nurse is counseling a group of clients recovering from sub-
stance abuse about the nature of denial. Which intervention
Teach them to question why they feel threatened.
should the nurse teach the clients to use to help them gain insight
into their denial?
When discussing methadone treatment with a client, the nurse
It decreases the severity of heroin withdrawal symptoms.
should include what?
A nurse is caring for a client who uses phencyclidine (PCP). PCP
Hallucinogen
is classified as which type of substance?
A 52-year-old client has a history of alcohol dependence and is
admitted to a detoxification unit. The client has tremors, is anxious,
has a pulse that has risen from 98 to 110 beats/min, has blood
Risk for injury
pressure that has risen from 140/88 to 152/100 mm Hg, and has a
temperature 0.6º above normal. The client is slightly diaphoretic.
Which nursing diagnosis would be the priority?
A client drinks 24 oz. of vodka every day, having gradually in-
creased to this level over the past 2 to 3 years. The client continues
to maintain a job and functions well in activities of daily living, Tolerance
relationships, and other aspects of social life. Which term should
the nurse use to describe this drinking behavior?
The mental health nurse is preparing a presentation about pre-
scription drug abuse to a local community group. When describ-
Adolescents
ing the incidence, which age group would the nurse identify as
experiencing an increase?
A nurse is conducting a class for a group of high school students
about marijuana use and abuse. The nurse determines that the
Use of marijuana does not lead to addiction.
class needs further discussion when they state which of the
following?
High doses of alcohol produce which effect? Vomiting
Safety is the nursing priority for a client who is at risk for alcohol
Observation for symptoms, vital signs, seizure and fall precau-
withdrawal. A care plan for the client who is in withdrawal must
tions, medications as ordered
include which nursing interventions?
Suspicion that a nursing professional is impaired by a substance Having several clients complain that their pain medication is not
abuse problem is most supported by which situation? working
The mental health nurse should focus on preventative efforts
including educational interventions related to the abuse of pre- Both genders between the age of 12 and 17
scription drugs on which client group?
When assessing a client diagnosed with chronic alcoholism, the
nurse addresses potential memory dysfunction by reviewing the Thiamine
client's serum level of what?
Which term describes a situation that occurs when very small
amounts of alcohol intoxicates the person after continued heavy Tolerance break
drinking?
Ecstasy is an example of which type of substance? Hallucinogen
Which medication is used to prevent alcohol withdrawal symp-
Lorazepam (Ativan)
toms?
The nurse is performing a history and physical examination on a
client with chronic alcoholism. The client has a history of gastritis,
esophagitis, elevated liver enzymes, cardiomyopathy, and pan- All the conditions are attributable to the alcohol abuse
creatitis. Which of these conditions are attributable to the client's
history of alcohol abuse?

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The nurse in an outpatient rehabilitation program is speaking
with a group of clients who have recently recovered from alcohol
Help them to identify appropriate diversional activities.
abuse. Which issue should the nurse raise before the clients leave
for the day?
A client with chronic alcoholism has been found to have Kor-
sakoff's psychosis. This irreversible complication is characterized Thiamine, or vitamin B1, deficiency
by what?
A client enters the emergency room exhibiting tremors, agitation,
and restlessness. Upon assessment, the client's blood pressure is
160/90, pulse is 110, and respirations are 22. It has been 36 hours Delirium tremens
since the client's last drink of alcohol. The nurse would suspect
which conditions to be occurring?
A 30-year-old client has been brought to the emergency depart-
ment by emergency medical services with an apparent heroin
Neurological and respiratory assessments
overdose. In the immediate care of this client, what assessments
should the nurse prioritize?
A 47-year-old client has been admitted to the hospital after being
found unconscious in a park. Upon regaining consciousness, the
client admits to heavy alcohol use over many years. Assessment Imbalanced nutrition: less than body requirements related to
reveals a low body mass index, low electrolyte levels, and im- chronic alcohol intake
paired skin integrity. Vital signs are within normal ranges. What
nursing diagnosis should be prioritized in the care of this client?
Which factor would contraindicate the use of disulfiram in the
The client had six drinks a few hours ago.
treatment of a client who has an alcohol use disorder?
In a person who abuses alcohol or is a chronic drinker, alcohol
withdrawal syndrome usually begins within which time frame from 12 hours
abrupt discontinuation or an attempt to decrease consumption?
Which is an example of a benzodiazepine? Diazepam
A client has been prescribed naltrexone for treatment of alcohol
dependence. The nurse has explained the drug's purpose to the
Reduces the appeal of alcohol
client. The nurse determines that the client has understood the
instructions when the client identifies which about the drug?
A client is receiving methadone maintenance therapy. After teach-
ing the client about this treatment, the nurse determines that the "I should eat small frequent meals if I get nauseated."
education was successful when the client states what?
A client is prescribed disulfiram as part of the alcohol treatment
program to prevent relapse. The client asks the nurse, "How will
"It can help to prevent you from drinking."
this drug help me?" Which response by a nurse would be most
appropriate?
The client was diagnosed with cocaine abuse at age 30. When
the client was 23, the client was diagnosed with major depressive The client most likely has a dual diagnosis since she has both a
episode, and has continued to have depression off and on since substance dependence and depression.
then. Which statement would reflect this situation?
A client is admitted to the emergency department for intoxication
with alcohol. The client has an unsteady gait, myopathy, and neu-
ropathy and cannot remember past or recent events. When treat- Wernicke-Korsakoff syndrome
ed with thiamine, the client's symptoms greatly improve. Which
condition was the client likely experiencing?
A client is admitted to the detoxification unit on Sunday evening.
The client discloses that the client's last alcoholic drink was just
Monday morning
before the client was admitted to the unit. When can the nurse
expect that the client's alcohol withdrawal symptoms will begin?
The mental health nurse recognizes that genetic intolerance of
Asians
alcohol has been documented among which ethnic group?
Disulfiram has been prescribed for a client receiving treatment for
Avoid all products containing alcohol
alcoholism. Which should be included in the client's plan of care?

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Which drug reverses opioid toxicity? Naloxone
An appropriate goal for a client newly admitted to the unit for
Verbalize feeling safe and comfortable.
alcohol withdrawal is what?
A nursing student is aware that which accounts for more deaths,
illnesses, and disabilities across the life span than any other Substance abuse disorders
preventable condition?
A client who is abusing substances is to undergo brief interven-
tion. The nurse understands that this technique is most effective Short history of drug use
for a client who exhibits which symptoms?
A group of nursing students is reviewing information about nu-
tritional supplementation used during alcohol detoxification. The
Naloxone
students demonstrate the need for additional review when they
identify which of the following as being used?
A client with opioid addiction is prescribed methadone mainte-
nance therapy. When explaining this treatment to the client, which The drug helps to satisfy the craving for the opioid.
of the following would the nurse need to keep in mind?
The psychiatric nurse managing the care of a client experiencing
alcohol withdrawal instructs unit staff to anticipate that the client Tactile hallucinations
may experience which neurological response?
According to the psychodynamic theory regarding addiction, it is
Asking the client to describe the client's childhood relationship
most important that the nurse assesses the client with an alcohol
with the client's parents
use disorder by considering what?
The nurse is providing support to a client's child regarding the par-
ent's alcohol use disorder. When integrating the disease concept "Your parent's alcohol use problem is a chronic disease but can
treatment approach about this type of disorder, which statement be treated."
by the nurse would be most effective?
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A client can expect symptoms of alcohol withdrawal to begin how
many hours after the last drink?
Symptoms of withdrawal usually begin 4 to 12 hours after cessa-
tion or marked reduction of alcohol intake.
While conducting an admission interview with a client, the nurse
suspects the client may be in alcohol withdrawal. Which screening
CIWA-Ar
tool can help the nurse identify the severity of withdrawal symp-
toms?
Traditional methods of treatment have not been very successful
Which statement about clients with a dual diagnosis is accurate?
for these clients.
A nurse who started recovering from alcohol abuse 3 months ear-
lier is ready to return to work. When speaking with the therapist,
the nurse states the nurse is nervous about how coworkers will Situational low self-esteem related to medical condition
respond to the nurse now that "they all know I'm a drunk." Which
diagnosis best targets the problem implicit in the nurse's remarks?
A client has entered treatment for alcohol dependency at the
client's spouse's insistence. The client's spouse has threatened
to leave the marriage unless the client seeks treatment. The client
"What negative consequences have resulted from your drinking?"
admits that the client drinks every day, but that the drinking is well
in control. The nurse recognizes the client's comments as denial.
What is the best response by the nurse?
A client is in treatment for depression and alcohol abuse. The
client is unwilling to confront substance abuse issues, stating the
client uses alcohol to ease feelings of depression. The client's
spouse reports that the spouse often has to care for the client
The spouse will refrain from the enabling the client's drinking
when the client is hung over, calling in sick for the client and doing
behaviors.
what the spouse can to help the client catch up with household or
job responsibilities. The nurse diagnoses the client's family with
dysfunctional family processes. The nurse and clients develop
a plan of care. Which goal indicates an understanding of the
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family situation and the linkages between the diagnosis and the
outcomes?
Approximately what percentage of U.S. adults have substance
22%
use disorders?
A client admitted for acute alcohol intoxication begins to experi-
ence mild sweating, tachycardia, fever, and nausea and vomiting. Chlordiazepoxide
Of the following, the drug treatment of choice would be what?
Which statement most accurately describes the etiology of sub- Substance-related disorders result from the interplay of biologic,
stance-related disorders? genetic, and psychosocial factors.
A nurse is assessing a client with bizzare and aggressive behav-
ior in the emergency department. Upon questioning, the client's
partner discloses that the client had been smoking PCP. While in
the emergency department, the client continues to exhibit signs The client will be physically safe and without injury.
of PCP-induced psychosis and has required physical restraints.
What nursing outcome should the nurse prioritize in the care of
this client?
A client with a history of alcohol abuse is participating in a 12-step
Alcoholics Anonymous (AA) program. The nurse determines that "I realize that there is a higher power that can help me."
the client is at step 2 when stating what?
A client is brought to the emergency department by a friend who Chest pain
tells the staff that the friend thinks the client has overdosed on Seizures
cocaine. Which findings would help support this situation? Select Respiratory depression
all that apply. Cardiac dysrhythmia
A nurse suspects that a client is experiencing alcohol withdrawal
Elevated temperature
based on assessment of which of the following?
Lorazepam

An older adult client with liver disease is experiencing alcohol Antianxiety and sedating drugs, such as benzodiazepines, are
withdrawal. Based on the nurse's understanding of drug therapy, titrated downwardly over several days as a substitution for the
which of the following would the nurse expect to be prescribed? alcohol. Chlordiazepoxide (Librium) and diazepam (Valium) have
longer half-lives and smoother tapers. Lorazepam (Ativan) is bet-
ter for the older adult and people with liver impairment. Fluoxetine
is not used.
It is a legal medication.
Which statements identify positive aspects of methadone as a
It is controlled by a health care provider.
substitute for heroin? Select all that apply.
It is available in tablet form.
A client with a long history of alcohol abuse is hospitalized. The
client's last drink was 12 noon. The nurse would anticipate symp- 12 midnight
toms of withdrawal occurring no later than what time?
A client is admitted to the emergency department after using
MDMA (Ecstasy). The nurse identifies this drug as belonging to Hallucinogen
what class?
Diarrhea
Clonidine is most effective for which symptom of opioid withdraw-
Clonidine is most effective against nausea, vomiting, and diarrhea
al?
but produces modest relief from muscle aches, anxiety, and rest-
lessness.
Which is used as a first-line treatment for alcohol withdrawal? Benzodiazepines
After a long history of intravenous heroin use, a client has ex-
pressed willingness to stop using heroin. The nurse would expect
Methadone
the client to receive which medication to decrease the severity of
withdrawal?
Which are effects of alcohol withdrawal syndrome? Select all that Hand tremors
apply. Seizures

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Increased pulse
Delirium tremens
A nurse is implementing a brief intervention with a client who
Negotiating a conversation with the client about the need to
is abusing alcohol. The nurse most likely would be involved with
change
which action?
Marked diaphoresis
A client is experiencing severe alcohol withdrawal. Which would
Auditory hallucinations
the nurse most likely assess? Select all that apply.
Gross uncontrollable tremors
A client is brought to the emergency department after having
Seizures
overdosed on cocaine. When assessing the client, which would
Cardiac arrhythmias
a nurse expect to find? Select all that apply.
The nurse is providing care to a client who has abused alcohol
for several years and is monitoring the client for signs of alcohol
12
withdrawal, anticipating that they would begin within how many
hours after the client has the last drink?
A nurse is describing the effects of inhalants to a group of high Slurred speech
school students attending a substance abuse prevention class. Hallucinations
Which effects would the nurse include in the description? Select Euphoria
all that apply. Dizziness
People addicted to alcohol and drugs have a rate of suicide that
15
is what percentage higher than that of the general population?
A nurse is preparing an educational session for family members Substance abuse is an illness like any other.
affected by substance abuse. Which point should the nurse in- An individual with substance abuse issues typically cannot use
clude in the session? Select all that apply. drugs socially.
A client is brought to the emergency department after having
overdosed on cocaine. When assessing the client, what findings
Seizures
would the nurse associate with cocaine overdose rather than
merely cocaine intoxication? Select all that apply.
A nurse is conducting a seminar with a local parent group about
substance use and abuse. The nurse determines that the seminar
Alcohol
was successful when the group identifies which substance as the
most abused in the United States?
The ingestion of mood-altering substances stimulates which neu-
rotransmitter pathway in the limbic system to produce a "high" that Dopamine
is a pleasant experience?
A client can expect symptoms of alcohol withdrawal to begin how
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many hours after the last drink?
Wernicke's encephalopathy is a degenerative brain disorder char-
Thiamine
acterized by which type of deficiency?
An older adult client with liver disease is experiencing alcohol
withdrawal. Based on the nurse's understanding of drug therapy, Lorazepam
which of the following would the nurse expect to be prescribed?

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