Drug Induced

Question 1

Which of the following assessment findings indicates to the nurse the need for more sedation for a client withdrawing from alcohol dependence?

1. Steadily increasing vital signs.
2. Mild tremors and irritability.
3. Decreased respirations and disorientation.
4. Stomach distress and inability to sleep.

Answer 1

how/hide explanation
Strategy: Determine the cause of each answer choice and how it relates to alcohol withdrawal.

(1) correct—indication that the client is approaching delirium tremens, which can be avoided with additional sedation
(2) describes normal mild withdrawal symptoms
(3) would contraindicate giving more sedation
(4) describes expected symptoms of alcohol withdrawal, which will subside as the alcohol is excreted from the body

Question 2

The nurse knows which of the following observations is indicative of chronic cocaine use?

1. Nasal septum disruption.
2. Lack of coordination.
3. Constricted pupils.
4. Craving for sweets and carbohydrates.

Answer 2

Show/hide explanation
Strategy: Determine how each answer choice relates to cocaine.

(1) correct—chronic inhalation creates sores, burns, disruption of mucous membranes, and holes in the nasal septum
(2) barbiturate abusers typically suffer from lack of coordination
(3) narcotic abusers demonstrate constricted pupils
(4) clients who abuse marijuana, hashish, and/or THC experience cravings for sweets and carbohydrates

Question 3

A client comes to the health clinic and tells the nurse that the client has taken acetaminophen (Aspirin-Free Excedrin) daily for 5 months. The nurse is MOST concerned by which of the following lab results?

1. AST (SGOT) 30 units/L, ALT (SGPT) 27 units/L.
2. Hgb 16.2 g/dL, Hct 46%.
3. WBC 7,000/mm3.
4. BUN 9 mg/dL.

Answer 3

Show/hide explanation
Strategy: Determine how each answer choice relates to acetaminophen.

(1) correct—can cause liver damage, normal AST (formerly SGOT) 8 to 20 units/L, normal ALT (formerly SGPT) 8 to 20 units/L
(2) normal Hgb male 13.5–17.5 g/dL, female 12–16 g/dL, normal Hct male 41 to 53%, female 36 to 46%
(3) normal WBC 5,000 to 10,000/mm3
(4) normal BUN 7 to 18 mg/dL

Question 4

Which of the following symptoms are MOST likely to be observed by the nurse when a client is withdrawing from heroin?

1. Severe cravings, depression, fatigue, hypersomnia.
2. Depression, disturbed sleep, restlessness, disorientation.
3. Nausea and vomiting, tachycardia, coarse tremors, seizures.
4. Runny nose, yawning, fever, muscle and joint pain, diarrhea.

Answer 4

Show/hide explanation
Strategy: Think about the cause of each symptom and how it relates to narcotic withdrawal.

(1) describes cocaine withdrawal
(2) describes amphetamine withdrawal
(3) describes barbiturate withdrawal
(4) correct—narcotic withdrawal is very much like the symptoms of the flu

Question 5

The nurse cares for a client with a long history of alcohol and drug dependence. It is MOST important for the nurse to include which of the following as part of the discharge planning?

1. Refer to a social service agency for assistance with housing.
2. Refer to an aftercare center in the community.
3. Encourage participation in Alcoholics Anonymous (AA) meetings with a sponsor.
4. Ask the client to obtain a prescription for an antidepressant medication.

Answer 5

Show/hide explanation
Strategy: All answers are implementations. Determine the outcome of each answer choice. Is it desired?

(1) may be of some help, but will not directly provide support necessary to maintain sobriety
(2) may be of some help, but will not directly provide support necessary to maintain sobriety
(3) correct—self-help groups have greatest success rate as a sustained support system in the community
(4) is information to indicate client depressed