Chapter 28, 30, 31. Nov 22 test Flashcards
Drug of abuse, a medication, or a toxin
Substance
Ingesting (eating, drinking, injecting, or inhaling) of any chemical that affects the body
Substance use
Excessive use of a substance that differs from societal norms
Substance abuse
This occurs when an individual depends on a substance to provide pleasure or relief
Habituation
This occurs when a user must take his or her usual dose of the drug to prevent the onset of withdrawal signs and symptoms
Substance (chemical) dependency
When the dependence on the substance is physical
Addiction
An addiction to alcohol
Alcoholism
This occurs when an addicted individual is not using an addictive substance
Abstinence
This syndrome is the result of excessive alcohol use during pregnancy
Fetal alcohol syndrome (FAS)
It is estimated that ___% of pregnant women still use alcohol during pregnancy despite huge educational efforts about the effects of alcohol on the fetus
20%
Is there any safe drug for pregnant women?
No
People with serious mental illness who also are addicted to or use chemicals are said to have a ____ _______?
dual diagnosis
These are central nervous system (CNS) depressants
Narcotics
This drug is a white, bitter-tasting powder that is usually put into solution and injected
Heroin
This drug is found in every supermarket. It is the main active ingredient in coffee, black teas, most cola drinks, and other bottled beverages
Caffeine
This drug is a potent natural stimulant. It is available “on the street” as a white, crystalline powder that is commonly contaminated with local anesthetics or sugar
Cocaine
The drugs were originally pharmaceutically manufactured medicines to treat depression, narcolepsy, hyperactivity in children, and obesity. Today they are available only by prescription, but many are illegally manufactured. They are strong stimulants with addictive properties
Amphetamines
This drug was originally developed for use as an animal tranquilizer. When taken by humans, it produces feelings of being separated from one’s body and environment (dissociation).
Phencyclidine (PCP)
A return of the psychedelic experience after the drug has worn off, can occur with the use of hallucinogens
Flashbacks
A term applied to the hemp plant, Cannibis sativa, which grows wild in many tropical and temperate climates all over the world
Cannabis (marijuana)
These drugs, also called “club drugs” are substances “created by underground chemists who alter the molecular structures of existing drugs.” These drugs, such as MDMA (ecstasy), STP, and “ice” are easily available across the United States
Designer drugs
One of the most effective painkillers available
Morphine
A semisynthetic narcotic made from opium. Commonly called Dilaudid
Hydromorphone
These stimulants are commonly abused by elderly people and people who are trying to lose weight
Laxatives and diuretics
volatile substances or chemical gases
inhalants
The inhalant substance being directly inhaled from the container
huffing
A legal inhalant
Nicotine
Some people can use various chemicals to change the way they feel, but the use does not affect their ability to perform the activities of daily life
Substance use
This occurs when use of the chemical becomes more important than the activities of daily living
Substance abuse
During this stage of addiction, individuals are able to use and enjoy their chosen substance. A desire to repeat the first pleasurable experience leads to a frequent pattern of use. One begins to prefer being “high” to other activities
early stage
During this stage of addiction, the intoxicating episodes increase as the body attempts to compensate by adapting to the substance. Tolerance develops as increased amounts of the chemical are needed to produce the same effects that one dose once produced
middle (crucial) stage
In this stage of addiction, tolerance for the chemical is usually quite high. The need for the substance now leads to a loss of control over one’s behavior. Without the chemical, life is miserable. Daily living becomes a nightmare, and all waking effort and energy are focused on obtaining and using the now required substance
chronic (late) stage
Defined as a state of maladaptive behavioral or psychological changes resulting from exposure to certain chemicals
Intoxication
This occurs when the body has adjusted to living and functioning with the substance in its system
Physical tolerance
This develops when individuals feel that they cannot function without the use of their chosen chemical
Psychological tolerance
The process of withdrawing from a substance under medical supervision
detoxification
This drug is used to treat heroin addiction. It has been administered to ease the effects of withdrawing from heroin, but methadone itself is addicting, and it is difficult to “detox” from this drug
methadone
This is a medication taken daily by nonpracticing (dry) alcoholics. It causes very unpleasant physical reactions when combined with alcohol, including intense headache, flushing, nausea, vomiting, low blood pressure, and blurred vision
Disulfiram (Antabuse)
This is the recurrence of substance-abusing behaviors after a significant period of abstinence
Relapse
People are ______, which means they are sociable and in need of the company of others
gregarious
______ is defined as the composite of behavioral traits and attitudes that identify one as an individual
Personality
The knowledge that a loved person or object continues to exist, even though it is out of sight
Object constancy
Is a sudden change in personality a normal sign of aging?
No
A gross disturbance in social behavior with no impairment in mental state
psychopath
The biological bases that underlie moods, energy levels, and attitudes
temperament
_______ disorders are defined as long-standing, maladaptive patterns of behaving and relating.
Personality
What disorders are categorized as the “eccentric” cluster
Paranoid, Schizoid, Schizotypal
What disorders are categorized as the “erratic” cluster
Antisocial, Borderline, Histrionic, Narcissistic
What disorders are categorized as the “fearful” cluster
Avoidant, Dependent, Obsessive-compulsive
A suspicious system of thinking that includes delusions of persecution and grandeur
Paranoia
Individuals with this type of personality disorder lack the willingness to become involved in close relationships
Schizoid personality disorder
Individuals with this type of personality disorder have the same pattern of avoiding people, but behaviors here are characterized by distortions and eccentricities. These individuals often have ideas of reference and they commonly find special, personal messages in everyday events
Schizotypal personality disorder
Odd, strange, or peculiar actions
Eccentricities
Incorrect perceptions of causal events as having great or significant meaning
Ideas of reference
Lying
Deceit
Controlling others for one’s own purposes by influencing them in unfair or false ways
Manipulation
This personality disorder can be summarized as a pattern of instability in mood, thinking, self-image, behavior, and personal relationships. Intense fears of being abandoned motivate these persons to avoid being alone
Borderline personality disorder
Acting without forethought or regard to the consequences
Impulsivity
This personality disorder is a pattern of excessive emotional expression accompanied by attention-seeking behaviors
Histrionic personality disorder
This personality disorder is characterized by a pattern of grandiosity and the need to be admired
Narcissistic personality disorder
In this personality disorder, anxiety is related to a fear of rejection and humiliation. To prevent possible rejection, individuals narrow their interests to a small range of activities
Avoidant personality disorder
This personality disorder is associated with separation and abandonment. People with this problem carry a deep fear of rejection, which expresses itself as the need to be cared for
Dependent personality disorder
Individuals with this personality disorder focus their anxiety on uncertainty about the future. They are extremely orderly and so preoccupied with details that they actually accomplish very little. This disorder is also considered an anxiety disorder
Obsessive-compulsive personality disorder
Many individuals with personality disorders also suffer from substance abuse or other mental health problems. These individuals are categorized as having a ____ _____
dual diagnosis
The inability to recognize reality, relate to others, and cope with life’s demands
psychosis
The most common psychosis is _______, a group of related disorders characterized by disordered thinking, perceptions, and behaviors
Schizophrenia
What are the 5 sub-types of schizophrenia?
Catatonic, disorganized, paranoid, undifferentiated, and residual
False sensory inputs with no external stimuli
Hallucinations
False perceptions of real stimuli
Illusions
An inability to recognize familiar objects or people
Agnosia
Fixed false ideas that are not based in reality
Delusions
A loss of ego boundaries with an inability to tell where one’s body ends and the environment begins
Derealization
The repeating of the same idea in response to different questions
Perseveration
A lack of ability to produce new thoughts or follow a train of thought
Poverty of thought
A lack of concern, interest, or feelings
apathy
Medications that are used to treat psychoses are called _______ or neuroleptic drugs
antipsychotic
An inability to sit still
Akathisia
Absence of movement
Akinesia
Slowing of body movements and a diminished mental state
Bradykinesia
Characterized by involuntary abnormal skeletal muscle movements
Dyskinesia
Impaired muscle tone
Dystonia
Drug-induced condition that produces involuntary, repeated movements of the muscles of the face, trunk, arms, and legs
Tardive dyskinesia
The client drinks at least 12 colas everyday. Today, he is unable to obtain his cola and is becoming more irritated and physically uncomfortable with each hour. The client is experiencing signs of:
addiction
Children who are smaller at birth, have small heads (microcephaly) and fail to develop normally have characteristics of:
fetal alcohol syndrome (FAS)
The client has frequent drug reactions to, and side effects from, his medications. He is 72 years old and lives alone. What should he be assessed for?
Concurrent substance abuse
Roxie had been sober for 6 months. Last week her best friend came to visit and they celebrated with 5 gin and tonics. Roxie has experienced:
Relapse
One begins to prefer being high to other activities during which stage of addiction?
The early stage
Every chemical ingested by a pregnant woman poses a potential danger to her unborn child. This is especially true during:
1) labor and delivery
2) 1st trimester of pregnancy
3) 2nd trimester of pregnancy
4) 3rd trimester of pregnancy
2) 1st trimester of pregnancy
The first step in treatment for substance abuse requires that the person recognize:
1) the need for help
2) That he or she is in denial of the problem
3) How ill the substance is making him or her
4) The need for continued use of the substance
1) the need for help
Key interventions for clients with substance-related problems include:
1) Focusing on the client’s past problems
2) Implementing problem-solving measures for the client
3) Informing the client of punishment measures should he or she break rules in the treatment setting
4) Assisting the client’s family by encouraging them to become involved in the treatment process and in group counseling
4) Assisting the client’s family by encouraging them to become involved in the treatment process and in group counseling
The unique pattern of thoughts, attitudes, values, and behaviors that each person develops when adapting to a particular environment and its standards is called the:
1) Ego
2) Person
3) Personality
4) Continuum of social responses
3) Personality
The client is a heavy drinker. He is frequently in bar fights because every time he visits a tavern, someone is “always picking a fight with me.” He has been given the diagnosis of paranoid personality disorder. He is also categorized as having a:
1) Dual diagnosis
2) Schizoid personality
3) Problem with fighting
4) Histrionic personality
1) Dual diagnosis
Care providers must keep in mind their own therapeutic boundaries and must communicate with each other frequently to prevent the client from:
1) Splitting the care team
2) Manipulating the care team
3) Having delusions of grandeur
4) Manipulating the environment
1) Splitting the care team
Infants who experience nurturing environments develop the ability to:
Trust others
The staff notices that the 80 year old client’s behavior is changing. Although he once was outgoing and talkative, he now sits sullenly in his chair. Investigation of the client’s personality change is based on the premise that:
Personality patterns remain intact until death
The client automatically assumes that everyone is out to harm, deceive, or exploit her. She often feels deeply injured by others, even when no evidence exists. Her behavior is described as:
Paranoid
The central feature of one of our most pressing mental health problems today is a pervasive pattern of disregard for, and violation of, the rights of others. This personality disorder is called:
Antisocial
The nurse is planning goals for a male client with the diagnosis of personality disorder. What is the main goal of the client’s therapy?
To become aware of how his behavior affects his life
The client lives so completely in a world of her own that she doesn’t eat, breathe, or drink regularly. She is considered to be:
Psychotic
The client has become unable to recognize formerly familiar objects and people in his environment. The client is experiencing:
Agnosia
The client is hostile, angry, and suspicious. He thinks that the staff is trying to poison him. He is classified as:
Paranoid
The client who is taking a low potency anti-psychotic med should be informed by the nurse that the most common side effects are:
Urinary retention, blurred vision, and dry mouth
Positive symptoms of schizophrenia include:
Hallucinations, bizarre behaviors, and speech problems
People who experience psychotic disorders lose:
1) The will to continue
2) Contact with reality
3) The ability to comply with treatment
4) Contact with intellectual functions
2) Contact with reality
Drugs that treat individuals with schizophrenia interrupt neurotransmitter pathways in the brain, producing an effect throughout the entire nervous system that is
1) Calming
2) Numbing
3) Satifying
4) Stimulating
1) Calming
The client has been taking lithium and fluoxetine (Prozac) for almost a week. During today’s assessment, the nurse notes a temperature of 39 degrees C, muscle rigidity, and confusion. The client’s signs and symptoms suggest:
1) Dystonic reactions
2) Bradykinetic side effects
3) Extrapyramidal side effects
4) Neuroleptic malignant syndrome
4) Neuroleptic malignant syndrome
A client with schizophrenia tells the nurse that he is the president of the United States, and no logical reasoning with the client convinces him otherwise. The client is experiencing a:
1) Mutism
2) Delusion
3) Neologism
4) Flight of ideas
2) Delusion
The breathing in of volatile substances has become popular with adolescents and young adults because such inhalants are: (select all that apply)
1) Harmless
2) Illegal
3) Undetectable
4) Legal
5) Inexpensive
6) Expensive
7) Easily obtained
4) Legal
5) Inexpensive
7) Easily obtained
Which are signs and symptoms most commonly associated with heroin use? (Select all that apply)
1) Clammy skin
2) Sweating
3) Euphoria
4) Constricted pupils
5) Drowsiness
3) Euphoria
4) Constricted pupils
5) Drowsiness
It is important for the nurse to ensure that the client understands the physical reactions associated with drinking alcohol while taking disulfiram (Antabuse). Which of the following are reactions that may result from ingesting alcohol while taking Antabuse? (Select all that apply)
1) Headache
2) HBP
3) Nausea
4) Double vision
5) Chills
6) Vomiting
7) Blurred vision
1) Headache
3) Nausea
6) Vomiting
7) Blurred vision
_______ is the drug of choice in the treatment of heroin addiction to ease the effects of withdrawl from the drug
Methadone
When the body physically needs or is dependent on a substance, the individual is said to be _______ to the substance
Addicted
Which are the characteristics of a personality disorder (Select all that apply)
1) Depression
2) Out-of-control sexual behaviors
3) Inflexible and maladaptive behaviors
4) Social sensitivity
5) Behaviors that cause significant functional impairment
6) Difficulties with interpersonal relations
3) Inflexible and maladaptive behaviors
5) Behaviors that cause significant function impairment
6) Difficulties with interpersonal relations
Personality disorders that are considered to be in the erratic cluster include (Select all that apply)
1) Paranoid
2) Antisocial
3) Borderline
4) Obsessive-compulsive
5) Avoidant
6) Narcissistic
7) Histrionic
2) Antisocial
3) Borderline
6) Narcissistic
7) Histrionic
A characteristic trait of an individual with ____-_____ _______ disorder is that his or her anxiety is focused on uncertainty of future events
obsessive-compulsive personality
An individual with an ______ personality disorder relies on deceit and manipulation to get his or her way
antisocial
__________ ____ _____ are central nervous system alterations that are characterized by abnormal involuntary movement disorders caused by antipsychotic medications and leading to an imbalance between two neurotransmitters (dopamine and acetylcholine) in portions of the brain
extrapyramidal side effects
When the nurse expels the air from the blood pressure cuff, the client claims she can hear someone crying, she is having an _______
illusion
The client who has taken an antipsychotic for years develops involuntary, repeated movements of the muscles of the face, trunk, arms, and legs. The client has which of the following?
1) Neuroleptic malignant syndrome
2) Akinesia
3) Tardive dyskinesia
4) Drug-induced parkinsonism
3) Tardive dyskinesia
Which of the following medications has an increased risk of extrapyramidal side effects (EPSEs)?
1) Chlorpromazine (Thorazine)
2) Haloperidol (Haldol)
3) Lorazepam (Ativan)
4) Diazepam (Valium)
2) Haloperidol (Haldol)
A client with schizophrenia is prescribed an antipsychotic medication. The nurse should include what information when educating the client?
1) Avoid thyroid replacement
2) Avoid vitamins
3) Avoid acetaminophen
4) Avoid alcohol
4) Avoid alcohol
A client has few friends, odd behaviors, hallucinations, and some disorganized behavior. The client is in which stage of schizophrenia?
1) Prodromal
2) Prepsychotic
3) Residual
4) Remission
2) Prepsychotic
Which of the following characteristics of schizophrenia is a negative symptom?
1) Withdrawl
2) Bizarre behavior
3) Hallucinations
4) Speech problems
1) Withdrawl
A person with schizophrenia as difficulty identifying and describing emotions. Which of the following describes this type of emotional problem?
1) Empathy
2) Apathy
3) Anhedonia
4) Alexithymia
4) Alexithymia
Which model or theory of schizophrenia is based on the concept of poor family relationships and the child’s failure to accomplish a developmental task?
1) Sociocultural theory
2) Psychological model
3) Stress/disease/trauma model
4) Possession theory
2) Psychological model
Which of the following is a risk factor for childhood schizophrenia?
1) Exposure to the influenza virus during pregnancy
2) Exposure to acetaminophen during pregnancy
3) Epinephrine chemical imbalance
4) Exposure to heroin during pregnancy
1) Exposure to the influenza virus during pregnancy
The most common psychosis is which of the following?
1) Brief psychotic disorder
2) Delusional disorder
3) Schizophrenia
4) Schizoaffective disorder
3) Schizophrenia
A clients trait and attitudes make up his or her _____
personality
The nurse should expect which of the following if a child has FAS?
1) Lethargy
2) Intellectual impairment
3) Larger at birth
4) Large head
2) Intellectual impairment
The use of cocaine if higher in which group of people?
1) Hispanic Americans
2) Asian Americans
3) Caucasians
4) African Americans
4) African Americans
A person has drank a large amount of alcohol over a short time. Which of the following can result from ingesting a large amount of alcohol?
1) Cardiac dysrhythmias
2) Hypotension
3) Bradycardia
4) Increased body temp
1) Cardiac dysrythmias
A teenager is noted to have a heightened awareness of reality, feelings of depersonalization, unpredictable and sometimes violent behavior and flashbacks. The nurse suspects that the teenager is taking which of the following chemicals?
1) Heroin
2) Phencyclidine (PCP)
3) Cocaine
4) Cannabis
2) Phencyclidine (PCP)
The client has developed a high tolerance for cocaine. The need for the substance encompasses every waking hour, and without it, life is miserable. The client is in what stage of addiction?
1) Early stage
2) Middle stage
3) Chronic stage
4) Latent stage
3) Chronic stage
The first 12-step program, Alcoholics Anonymous is based on which model?
1) Psychiatric model
2) Sociocultural model
3) Medical model
4) Disease model
4) Disease model
A client is hospitalized for detoxification. A potentially serious complication of detoxification is which of the following?
1) Stroke
2) Seizure
3) Kidney failure
4) Liver failure
2) Seizure
A nonpracticing alcoholic is taking Antabuse for the treatment of substance addiction. If the medication is taken with alcohol, which of the following may occur?
1) Tachycardia
2) Low blood pressure
3) HBP
4) Diarrhea
2) Low blood pressure
Which of the following is associated with heroin use?
1) Clammy skin
2) Sweating
3) Constricted pupils
4) Panic
3) Constricted pupils
A client becomes antagonistic and emotional after consuming a large of amount alcohol. This client is _____
intoxicated
Feelings of morality and a strong sense of right and wrong begin to develop at what age?
1) 3 years of age
2) 4 years of age
3) 5 years of age
4) 6 years of age
4) 6 years of age
An older adult has a sudden onset of personality changes. Which of the following should the nurse suspect?
1) Normal sign of aging
2) Urinary tract infection
3) Depression
4) Loneliness
2) Urinary tract infection
Researchers have found that twins raised in separate environments have shown a consistency in temperament when tested. These findings are consistent with which theory of personality disorders?
1) Biological theory
2) Psychoanalytical theory
3) Behavioral theory
4) Sociocultural theory
1) Biological theory
A psychopath used charm, manipulates, intimidates, and uses violence to control others and satisfy his or her own selfish needs. This type of personality disorder occurs in which of the following groups?
1) Eccentric cluster
2) Histrionic cluster
3) Erratic cluster
4) Fearful cluster
3) Erratic cluster
What type of personality disorder includes ideas of reference, avoidance behaviors, belief in the paranormal, and paranoid ideations?
1) Schizotypal
2) Antisocial
3) Borderline
4) Schizoid
1) Schizotypal
A client has unrealistically inflated beliefs about his accomplishments and believes that he is extra important. These characteristics are described by which of the following disorders?
1) Dependent personality
2) Histrionic personality
3) Narcissistic personality
4) Borderline personality
3) Narcissistic personality
A client is known to be devoted to work, to have few leisure activities, to be extremely orderly, and to be uncertain about the future. This disorder is included in which cluster group?
1) Eccentric cluster
2) Functional cluster
3) Erratic cluster
4) Fearful cluster
4) Fearful cluster
The hallmark feature of psychopaths is which of the following?
1) Lack of commitment
2) Lack of initiative
3) Lack of influence
4) Lack of conscience
4) Lack of conscience
A client who is a monoamine oxidase inhibitor (MAOI) for her personality disorder should be instructed to avoid which of the following herbal preparations?
1) Kava-kava
2) Ginseng
3) Valerian root
4) Ginger
2) Ginseng
