Substance Abuse Flashcards
A patient diagnosed with an alcohol abuse disorder says, “Drinking helps me cope with being a single parent.” Which therapeutic response by the nurse would help the patient conceptualize the drinking objectively?
A. “Sooner, or later, alcohol will kill you. Then what will happen to your children?”
B. “I hear a lot of defensiveness in your life. Do you really believe this? “
C. “If you were coping so well, why were you hospitalized again?”
D. “Tell me what happened the last time you drank.”
D. “Tell me what happened the last time you drank.”
A client is admitted to the detoxification center for alcohol addiction. On the day after admission, the client develops hand tremors and asks the nurse about them. Which of the following is an appropriate nursing response?
A. They’re permanent changes because the alcohol has destroyed your nerves
B. They will persist for a few days now that you aren’t drinking
C. This is unusual. We will have to notify your provider immediately
D. These are very typical of the seizures that are associated with alcohol withdrawal
B. They will persist for a few days now that you aren’t drinking
The treatment team discusses the plan of care for a patient diagnosed with schizophrenia and daily cannabis abuse who is having increased hallucinations and delusions. To plan effective treatment, the team should:
A. Provide long-term care for the patient in a residential facility
B. Withdraw the patient from cannabis, then treat the schizophrenia
C. Consider each diagnosis primary and provide simultaneous treatment
D. First treat with schizophrenia, then establish goals for substance abuse treatment
C. Consider each diagnosis primary and provide simultaneous treatment
In the ED, a patient’s vitals are 66/40, pulse 140, respirations 8 and shallow. The nursing diagnosis is Ineffective breathing pattern related to depression of respiratory center secondary to narcotic intoxication. Select the priority outcome.
A. The patient will demonstrate effective coping skills and identify community resources for treatment of substance abuse within 1 week of hospitalization
B. Within 4 hours, vitals will stabilize, with BP above 90/60, pulse <100 bpm, and respirations at or above 12 breaths/min
C. The patient will correctly describe a plan for home care and achieving a drug-free state before release from the ED
D. Within 6 hours, the patient’s breath sounds will be clear bilaterally and throughout lung fields
B. Within 4 hours, vitals will stabilize, with BP above 90/60, pulse <100 bpm, and respirations at or above 12 breaths/min
Family members of an individual undergoing a residential alcohol rehabilitation program ask, “How can we help?” Select the nurse’s best response.
A. “It’s important that you visit your family member every day”
B. “Do not make any form of contact for the next few years”
C. “Use random search and destroy tactics to keep the home alcohol free”
D. “Empower your loved one to gain the responsibility and ownership of consequences”
D. “Empower your loved one to gain the responsibility and ownership of consequences”
Symptoms of withdrawal from opioids for which the nurse should assess include:
A. Dilated pupils, tachycardia, elevated BP, and elation
B. Nausea, vomiting, diaphoresis, anxiety, and hyperreflexia
C. Mood lability, incoordination, fever, and drowsiness
D. Excessive eating, constipation, and HA
B. Nausea, vomiting, diaphoresis, anxiety, and hyperreflexia
Select the priority outcome for a patient completing the fourth alcohol-detoxification program in the past year. Prior to discharge, the patient will:
A. State, “I know I need long-term treatment”
B. Use denial and rationalization in healthy ways
C. Identify constructive outlets for expression of anger
D. Develop a trusting relationship with one staff member
A. State, “I know I need long-term treatment”
When intervening with a patient who is intoxicated from alcohol, it is useful to first:
A. Let the patient sober up
B. Decide immediately on care goals
C. Ask what drugs, if any, has the patient recently used
D. Gain adherence by sharing your personal drinking habits with the patient
C. Ask what drugs, if any, has the patient recently used
You are caring for Mick, a 32-year-old patient with chemical addiction who will soon be preparing for discharge. A principle of counseling interventions that should be observed when caring for a patient with chemical addiction is to:
A. Praise the patient for compliant behavior
B. Communication that relapses are always possible
C. Confirm that the patient’s recovery is considered complete after discharge
D. Encourage Mick to resume his former friendships to regain a sense of normalcy
B. Communication that relapses are always possible
As you evaluate a patient’s progress, which treatment outcome would indicate a poor general prognosis for long-term recovery from substance abuse?
A. Patient demonstrates improved self-esteem
B. Patient demonstrates enhanced coping abilities
C. Patient demonstrates improved relationships with others
D. Patient demonstrates positive expectations for ongoing drug use
D. Patient demonstrates positive expectations for ongoing drug use
A client who has been depressed and suicidal started taking an SSRI antidepressant 2 weeks ago and is now ready to leave the hospital to go home. Which is a concern for the nurse as discharge plans are finalized?
A. The client may need a prescription for Benedryl to use for side effects
B. The nurse will evaluate the risk for suicide
C. The nurse will need to include teaching regarding the signs of NMS
D. The client will need regular laboratory work to monitor therapeutic drug levels
B. The nurse will evaluate the risk for suicide
The nurse is caring for a client with schizophrenia who is taking Thorazine hydrochloride. The client complains of restlessness, cannot sit still, and has muscle stiffness. Which would the nurse administer?
A. Haloperidol 5 mg PO
B. Benztropine 1 mg PO
C. Propranolol 20 mg PO
D. Trazodone 50 mg PO
B. Benztropine 1 mg PO
After a period of unsuccessful treatment with amitriptyline, a client diagnosed with depression is switched to tranylcypromine. Which statement by the client indicates the client understands the side effects of tranylcypromine?
A. “I need to increase my intake of sodium”
B. “I must refrain from strenuous exercise”
C. “I must refrain from eating aged cheese or yeast products”
D. “I should decrease my intake of foods containing sugar”
C. “I must refrain from eating aged cheese or yeast products”
A client diagnosed with major depression spends most of the day lying in bed with the sheet pulled over his head. Which approach by the nurse is most therapeutic?
A. Wait for the client o begin the conversation
B. Initiate contact with the client frequently
C. Sit outside the client’s room
D. Question the client until the client responds
B. Initiate contact with the client frequently
Which statement by a client taking Sertraline as prescribed by the HCP indicates to the nurse that further teaching about the medication is needed?
A. “I will continue to take my medication after a light snack”
B. “Taking trazodone at night will help me to sleep”
C. “My depression will be gone in about 5 to 7 days”
D. “I will not drink alcohol while taking trazodone”
C. “My depression will be gone in about 5 to 7 days”
