Chapter 12 Practice Questions Flashcards
When asked, What causes alcoholism? the nurses response will be based on the fact that:
a. The response to alcohol is a result of a brain-based disorder.
b. Alcoholism is believed to be an allergic response to the alcohol.
c. Every individual has the same susceptibility for developing alcoholism.
d. It is a physical response to alcohol but its etiology is not fully understood.
ANS: A
It has been determined that alcoholism is not an allergy but rather it is recognized as a partial brain-based disorder that some brains are more susceptible to than others.
Which patient response would support the conclusion that the patient has moved into the dark side of a narcotic addition?
a. Ive been abusing drugs for at least 10 years.
b. Drugs makes me feel good; that why I use them.
c. I dont like the way I feel when I dont use drugs.
d. Drugs are something that I can either take or leave
ANS: C
During beginning use (the light side), the feel good effects are dominant. As the individual becomes habituated to the drug, tolerance and withdrawal symptoms develop; this constitutes the dark side. The remaining options do not describe effects of drug use.
A substance use disorder (SUD) is a likely comorbid mental illness in which patient?
a. The soldier diagnosed with posttraumatic stress disorder
b. The teenager demonstrating symptoms of poor impulse control
c. The older adult diagnosed with early stage Alzheimers disease
d. The new mother exhibiting symptoms of postpartum depression
ANS: A
Posttraumatic stress disorder creates a risk for substance use or relapse. A total of 30% to 60% of persons with SUDs meet the criteria for comorbid posttraumatic stress disorder. The remaining options have not shown such a prevalence of comorbid relationship with SUDs.
Which group would be the target population for educational material on the dangers of binge drinking?
a. Full-time college students
b. Blue-collared young adults
c. Older widows and widowers
d. High school juniors and seniors
ANS: A
The highest prevalence of binge and heavy drinking is among young adults between the ages of 18 and 25 years, with the majority being full-time college students.
Which social factor has the greatest impact on the changing nature of alcohol abuse treatment?
a. Development of new pharmaceutical treatment options
b. Dramatic increase of alcoholism among young adult males
c. Raising cost of both inpatient and outpatient treatment programs
d. Womens substance abuse only recently acknowledge by society
ANS: D
The existence of an alcohol abuse problem among women has only been recently recognized and this has dramatically affected treatments and services being provided. Although the other options are true, they do not have the impact on treatment modalities as much as the correct option.
Which assessment data poses the greatest risk for injury in a patient who abuses alcohol?
a. Takes a baby aspirin each morning
b. Uses over-the-counter antihistamines for seasonal allergies
c. Has been taking a tricyclic antidepressant for more than 2 years
d. Took a narcotic for 1 week to manage postdental surgery pain
ANS: C
Tricyclic antidepressants are strictly contraindicated with alcohol consumption because of their potential effect on cardiac function. Although aspirin increases bleeding times and antihistamines and narcotics increase sedation, the outcome of combining alcohol and these drugs is not as dangerous as that of the correct option.
If an individual is admitted with a diagnosis of Wernicke-Korsakoffs syndrome, the nurse would expect to assess:
a. Peptic ulcer
b. Vivid illusions
c. Cognitive deficits
d. Auditory hallucinations
ANS: C
Wernicke-Korsakoffs syndrome includes a severe form of amnesia and an inability to learn new skills which reflects a cognitive impairment. The other options are not associated with the syndrome.
Which sociological aspect, vital to relapse prevention, is greatly affected when a patient is found to have a dual diagnosis of psychosis and alcoholism?
a. Ability to afford the cost of outpatient services
b. A supportive, reliable, accessible support system
c. Protection from both physical and emotional abuse
d. Access to reasonable housing and employment opportunities
ANS: B
Often individuals with this type of diagnosis have lost their support systems as a result of chronic mistreatment of their family and friends and an inability to maintain and recognize the importance of this aspect to their treatment plan. Although the remaining options impact relapse prevention, they are generally available when the patient is being supported appropriately.
Which nursing intervention best demonstrates an understanding of the relationship between confirmed intravenous drug abuse and specific infections?
a. Screening the patient for hepatitis B virus (HBV)
b. Assessing the patient for potentially infected injection sites
c. Determining if the patient has ever been tested for human immunodeficiency virus (HIV)
d. Evaluating the patients understanding of the increased risk for developing sexually transmitted diseases
ANS: A
Injecting drug users have one of the highest HBV rates among all risk groups and account for at least half of all new HCV cases, so screening for such infections demonstrates that the nurse understands the severity of the problem. Although the other options reflect potential infection risks, they are not as commonly seen in patients with this diagnosis.
Which assessment data would bring into question a patients statement that, I have only a few drinks on special occasions.?
a. History of treatment for glaucoma
b. Fasting serum blood glucose level of 182 mg/dL
c. Patient reports numbness in hands and feet bilaterally
d. Red rash observed over neck, shoulders, and upper chest
ANS: C
Peripheral nerve deterioration in both hands and feet result from chronic alcohol intake. Peripheral neuropathy occurs in about 10% of alcoholics after years of heavy drinking causing the nurse to question the patients statement. The remaining options do not reflect symptomology generally associated with alcoholism.
Which intervention has priority when a nurse suspects a staff member of providing patient care while being impaired by alcohol or drugs?
a. Asking the staff member to explain their suspicious behavior
b. Adjust the staff members assignment to minimize patient contact
c. Providing the staff member with material regarding alcohol abuse and treatment
d. Reporting the staff members suspicious behavior to the nursing supervisor on duty
ANS: D
It is a professional obligation to report suspected impaired practice. The remaining options do not have prior in this situation since the concern is patient safety.
Which nursing intervention demonstrates an understanding regarding the primary form of substance use disorder among older adults?
a. Assessing the patients hands and feet for the presence of both numbness and tingling
b. Having the patient, describe your relationship with you adult children, co- workers, and friends.
c. Asking, Please identify for me all the medications both prescribed and over the counter you regularly take.
d. Evaluate the patients understanding of the possible health risks that alcohol and medication abuse has on ones health
ANS: C
Misuse of prescription medications is the most common form of drug abuse among older adults. This population is especially vulnerable because of the multiple drugs that are often prescribed for medical conditions. The remaining options do not help identify the presence of multiple medications.
Which assessment demonstrates the nurses understanding of the relationship between substance abuse and the development of symptoms characteristic of delirium?
a. Determining the patients age and gender
b. Evaluating the patients food and fluid intake over the last 48 hours
c. Observing the patient for fine tremors of the hands, especially the fingers
d. Determining the amount of caffeine the patient ingested in the last 24 hours
ANS: D
Some people who ingest large amounts of caffeine develop delirium. The remaining options are not relevant to caffeine ingestion or the abuse of any other substance.
Which protocol should guide the nurse responsible for administering pharmacologic interventions for a patient who is experiencing alcohol intoxication?
a. Medication interventions are based on the presence of withdrawal symptoms.
b. Medications are prescribed at appropriate intervals for at least one full week.
c. Symptoms are managed with medications for only the initial 24 hours of hospitalization.
d. Medications are introduced to treat grand mal seizures that may accompany withdrawal symptoms.
ANS: A
The course of intoxication is usually self-limiting to approximately 24 hours, after which withdrawal symptoms can occur for a time period unique to each patient. Treatment is directed by the symptoms the patient is experiencing, which generally emerge during the withdrawal stage. Seizures are among several serious symptoms that can occur during the withdrawal stage.
A patient 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 patients significant other states the patient got sick about 15 minutes after drinking a glass of wine. The nurse should be guided in assessment by the suspicion that the patient:
a. Is having a stroke
b. Has alcohol intoxication
c. Is reacting to disulfiram (Antabuse)
d. Is exhibiting symptoms of cross-dependence
ANS: C
The alcohol deterrent drug, Antabuse, commonly prescribed in recovering alcoholic treatment, causes this reaction when taken in combination with alcohol. Alcohol intoxication, stroke, and cross-dependence do not present with the listed prostration symptoms.
