Chapter 18: Psychoactive Substance Use and Treatment

Question 1

Addiction is best explained as
a. Occuring with games of chance such as roulette or poker
b. A chronic brain disease
c. A biopsychosocial phenomenon
d. The domain of neurobiologists

Answer 1

c. A biopsychosocial phenomenon

Question 2

The nurse is caring for a patient with an addictive disorder who is currently drug-free. The patient is experiencing repeated occurrences of vivid, frightening images and thoughts. Which term would the nurse use to document this finding?
a. Tolerance
b. Flashbacks
c. Withdrawal
d. Physical dependency

Answer 2

b. Flashbacks

Question 3

The condition most concerning for the nurse who is caring for a patient who abuses alcohol would be
a. Although the patient may develop or present with cirrhosis, the nurse must first plan care for prevention of self-harm.
b. Safety is always the priority when caring for patients. Ensuring safety includes completing a suicide risk assessment.
c. Wernicke’s encephalopathy may develop, but the nurse must first plan care for prevention of self-harm.
d. Korsakoff syndrome is not the priority of care.

Answer 3

b. Safety is always the priority when caring for patients. Ensuring safety includes completing a suicide risk assessment.

Question 4

Which patient response to the question, “Have you ever drunk more alcohol or used more drugs than you meant to?” should immediately cause the nurse to assess further?
a. No further assessment is immediately required.
b. Further assessment would be appropriate through the context of the general assessment; however, alcohol and drug use would not be the immediate priority.
c. Automatic responses such as “I figured you’d ask me about that” serve as red flags that further assessment must be done right away to provide clarification.
d. No further assessment is immediately required

Answer 4

c. Automatic responses such as “I figured you’d ask me about that” serve as red flags that further assessment must be done right away to provide clarification

Question 5

Which patient behaviours should the nurse suspect as being related to alcohol withdrawal?
a. Patients who are exhibiting hyperalertness and jerky movements and who startle easily are most likely in a state of alcohol withdrawal, a condition that peaks in 24 to 48 hours after cessation or reduction of alcohol intake and then rapidly and dramatically disappears unless the withdrawal process progresses to alcohol withdrawal delirium.
b. Tachycardia, diaphoresis, and elevated blood pressure are associated with alcohol delirium and are considered a medical emergency and can result in death if not treated.
c. Peripheral vascular collapse and electrolyte imbalance are associated with alcohol delirium and are considered a medical emergency and can result in death if not treated.
d. Paranoid delusions, fever, and fluctuating levels of consciousness are associated with alcohol delirium and are considered a medical emergency and can result in death if not treated.

Answer 5

a. Patients who are exhibiting hyperalertness and jerky movements and who startle easily are most likely in a state of alcohol withdrawal, a condition that peaks in 24 to 48 hours after cessation or reduction of alcohol intake and then rapidly and dramatically disappears unless the withdrawal process progresses to alcohol withdrawal delirium.

Question 6

A patient at your community mental health centre smokes up to a half a pack of cigarettes daily but has tried with limited success to cut back over the past two weeks. Today he asked the pharmacist about the various products that could aid his attempts to quit smoking in time for him to manage a long overseas flight next month and travel with friends who are allergic to smoke. What phase of change is this patient demonstrating?
a. At the precontemplative stage, people are not intending to take action in the foreseeable future, but this patient has a set goal.
b. Patients who are demonstrating contemplation would still be ambivalent about change, or “sitting on the fence,” and not preparing for a change within the next month.
c. This patient is demonstrating the preparation stage of change. He already has some experience with change and is further trying to change or “testing the waters” by inquiring about pharmacological products to aid his efforts and plans to act within the next month.
d. Patients who are involved in the action phase of behaviour change are already working toward desired behavioural change, including modification of environment, experiences, or behaviour. This patient is not yet at this stage.

Answer 6

c. This patient is demonstrating the preparation stage of change. He already has some experience with change and is further trying to change or “testing the waters” by inquiring about pharmacological products to aid his efforts and plans to act within the next month.