Care of patient with an Addictive Personality

Question 1

A 60-year-old man was admitted for cholecystitis that resulted in a cholecystectomy. On his third day of hospitalization, he begins to sweat profusely, tremble, and has a blood pressure of 160/100. Based on these findings, the nurse assesses for

Answer 1

withdrawal problems.

Question 2

The nurse recognizes that alcohol addiction is predicable if the age of onset is:

Answer 2

14 or younger

-Forty-four percent of those who start drinking at the age of 14 or younger will develop alcoholism.

Question 3

Alcohol is involved in motor vehicle accidents, suicides, and homicides. Approximately how many deaths each year are related to alcohol consumption?

Answer 3

100,000

Question 4

If the nurse’s assessment reveals low stress tolerance, negative self-image, and depression, the nurse concludes the patient is a(n):

Answer 4

addictive personality user.
-Common traits have been identified in people with addiction, including low stress tolerance and dependency; these individuals are grouped under the term addictive personality.

Question 5

The nurse counsels the “recreational” user that drugs that make the user feel good have the potential to become progressively addicting until the abuser exhibits:

Answer 5

loss of control over use.

Question 6

When a patient tells the nurse that he has tried to stop his drug habit, but he doesn’t feel “normal” without it, the nurse recognizes the patient is in which stage of dependence

Answer 6

Middle

-In the middle stage, the user shows signs of withdrawal with abstinence and must use the drug to feel normal.

Question 7

The nurse counsels the patient in the late stage of dependence that recovery may not be possible without:

Answer 7

receiving treatment for substance abuse.

-Very few people in the late stage of dependence will recover without treatment.

Question 8

The nurse recognizes that there may be a genetic tendency toward alcoholism because sons of alcoholic fathers have what percentage risk of developing alcoholism?

Answer 8

30% to 50%

Question 9

When a patient inquires how alcohol acts so quickly on his system, the nurse answers that the effect is felt quickly because alcohol is:

Answer 9

metabolized into ethanol rapidly.

-Alcohol is not digested or converted into glycogen, but it is metabolized quickly by the liver to ethanol.

Question 10

The nurse reminds a group of high school students that most states have laws limiting blood alcohol levels of drivers, which is usually:

Answer 10

0.10%.

Question 11

When a pregnant adolescent tells the nurse that she “only drinks a little,” the nurse responds that the amount necessary to cause an adverse effect in an infant is:

Answer 11

two drinks a day.

Question 12

The nurse assesses an alcoholic patient carefully for signs of withdrawal that usually appear as early as how many hours after cessation of alcohol intake?

Answer 12

6 hours

Question 13

While performing an initial assessment on a newly admitted alcoholic patient, the nurse can best ensure honest answers by:

Answer 13

having a nonjudgmental attitude.

Question 14

During the detoxification period, the nurse designs interventions to:

Answer 14

keep the patient safe from aspiration and seizure.
-Care for the addicted patient starts with detoxification and is focused on keeping the patient safe from the symptoms of withdrawal.

Question 15

During the rehabilitation phase, the entire health team is focused on assisting the patient to:

Answer 15

abstain from drug use.

-After detoxification, rehabilitation starts, which is focused on abstaining from drug use.

Question 16

To decrease disorientation during the detoxification period, the nurse should:

Answer 16

use nightlights and remove extra furniture from the room.

Question 17

The nurse explains that Alcoholics Anonymous (AA) consists of abstinent alcoholics who help other alcoholics become and stay sober. The foundation of AA is:

Answer 17

a 12-step program.

Question 18

The nurse instructs an alcoholic patient that consuming alcohol while taking disulfiram (Antabuse) will result in severe:

Answer 18

nausea.

Question 19

If the patient tells the nurse, “I’m not an alcoholic. I can stop whenever I want to,” the nurse’s most therapeutic response is:

Answer 19

“Hasn’t alcohol use interfered with your employment?”

Question 20

When a patient denies any problems related to addiction, the nurse’s most therapeutic response is:

Answer 20

“Can you think of any time your behavior created an unpleasant situation in your life?”

Question 21

The nurse teaches a young woman about the dangers of which drug that is often used in date rape?

Answer 21

Rohypnol

-Rohypnol has been abused as a date-rape drug and has not been approved for use in the United States.

Question 22

A patient seems bewildered when he confides in the nurse that all of his friends and leisure time have been centered on a drug culture. The nurse’s best response would be:

Answer 22

“What other sort of activities might you enjoy?”

Question 23

When a patient is admitted with an overdose of a narcotic, the nurse anticipates an order for which drug to reverse the effects of the narcotic?

Answer 23

Narcan

Question 24

The nurse concludes that a significant goal of the care plan for an alcoholic patient has been met when the patient states:

Answer 24

“All my difficulties are related to my drinking.”

-A major goal for the successful treatment of alcoholics is to have them express responsibility for their behavior.

Question 25

While creating a methadone protocol for a patient rehabilitating from heroin addiction, the nurse explains that the patient will take methadone:

Answer 25

daily until stabilized, then gradually reduce the dose to zero
-Methadone is given daily until the patient is stabilized. The methadone is reduced gradually until the patient does not need to take any.

Question 26

When a 22-year-old patient presents in the emergency department with the characteristics of severe Parkinson’s, the nurse suspects an overdose of:

Answer 26

amphetamines.

Over time, dopamine depletion in the brain can cause Parkinson-like symptoms to occur in people who abuse amphetamines.

Question 27

A college student has brought his hallucinating roommate to the college clinic. The young man says his roommate has been experimenting with phencyclidine (PCP). The nurse recognizes that the hallucinations may last as long

Answer 27

6 to 12 hours.

Question 28

The mother of a young woman being treated for amphetamine overdose asks the nurse when the manifestations will subside. The nurse’s best answer is:

Answer 28

“The manifestations may be permanent.”

The manifestations of overdose to amphetamines are frequently permanent.

Question 29

When caring for a baby born to a drug-addicted mother, the nurse should include in her interventions to:

Answer 29

swaddle the baby closely.

-A baby born to a drug-addicted mother should be swaddled, placed in an area of low stimulation, and minimally handled.

Question 30

The nurse explains that the greatest problem with lysergic acid diethylamide (LSD) use is that the drug:

Answer 30

causes flashbacks.

-LSD causes flashbacks, or “bad trips,” unpredictably, and the flashbacks may occur years after ingestion of the drug.

Question 31

To decrease the damage of bruxism seen in a patient who has been abusing the drug ecstasy, the nurse should:

Answer 31

utilize a pacifier.
-The use of an infant pacifier will reduce the damage to the teeth for a patient who is manifesting bruxism (grinding of the teeth).

Question 32

When the nurse suspects a co-worker of abusing drugs while working, the nurse should:

Answer 32

report observations to a supervisor.

-The nurse’s observations should be reported objectively, preferably in writing, to the supervisor.

Question 33

When in a peer assistance program, the impaired nurse:

Answer 33

will be allowed to work with license intact.
-The peer assistance program allows the nurse to retain licensure and continue to work under supervision, although possibly in an area where access to controlled drugs is difficult.

Question 34

During the initial intake assessment of a drug user, the nurse will attempt to obtain which subjective data? (Select all that apply.)

Answer 34

a. Usual pattern of use
b. Specific drug
c. Amount of drug used
d. Time of last use

Question 35

When assessing an alcoholic patient, the nurse notes short-term memory loss, painful extremities, foot drop, and muttered incoherent responses to her questions. The nurse recognizes these symptoms as most likely related to a condition caused by long-term alcohol abuse, which is known as __________ syndrome.

Answer 35

Korsakoff
-Korsakoff syndrome is a permanent condition caused by long-term alcohol use. The patient mutters incoherently and experiences short-term memory loss, painful extremities, and foot drop.

Question 36

The nurse uses the CAGE questionnaire to assess a patient. The nurse suspects the patient is an alcoholic if there are affirmative answers for _____ items on the questionnaire

Answer 36

two
An affirmative answer on two or more questions on the CAGE questionnaire is reason to assess more closely for possible alcohol abuse.

Question 37

The nurse cautions that a person who chronically abuses drugs may experience mental impairment. The area of the brain that can be affected and permanently damaged is the ________ _________.

Answer 37

limbic system

The most commonly abused drugs act on the limbic system of the brain and can cause permanent damage.

Question 38

The nurse assesses a patient for which criteria of addiction? (Select all that apply.)

Answer 38

a. Excessive use of the substance
b. Decrease in social function
c. Uncontrollable consumption
d. Decrease in economic function
e. Psychological disturbances