substance misuse (before midterm) Flashcards
A 38-year-old male has been using the “cold turkey” approach to stop smoking. Although he hasn’t smoked for 6 months, he tells the nurse that he still feels strong cigarette cravings and wonders whether he will ever get over the cravings. Which statement is true?
a. The cravings will never stop.
b. The cravings may persist for months to years.
c. The cravings indicate that he has been using nicotine.
d. The cravings indicate that he is about to experience nicotine withdrawal.
ANS: B
Cigarette cravings may persist for months after nicotine withdrawal. “The cravings will never stop”, “The cravings indicate that he has been using nicotine,” and “The cravings indicate that he is about to experience nicotine withdrawal” are false statements.
A patient in a rehabilitation centre is beginning to experience opioid withdrawal symptoms. What would you expect to be ordered for this patient’s treatment?
a. diazepam (Valium®)
b. methadone hydrochloride
c. disulfiram (Antabuse®) protocol
d. Antidepressant therapy
ANS: B
Opioid withdrawal can be managed with either methadone or clonidine hydrochloride (Catapres®). Diazepam and disulfiram are used for treatment of alcoholism. Antidepressant therapy is used for smoking-cessation programs.
If an individual drinks alcohol while on disulfiram (Antabuse) therapy, which will most likely occur? a. Euphoria
b. Vomiting
c. Hypertension
d. Hypoventilation
ANS: B
Nausea and copious vomiting occur, and occur quickly, when disulfiram is used with alcohol.
A patient has been taking naltrexone (ReVia®) as part of the treatment for addiction to heroin. Which statement is true in this case?
a. Naltrexone will prevent the patient’s cravings for opioid drugs.
b. Naltrexone will work as a safer substitute for the heroin until the patient
completes withdrawal.
c. The patient will experience hypertension and severe nausea if the patient takes
heroin while on naltrexone.
d. If opioid drugs are used while taking naltrexone, euphoria is not produced; thus,
the drug’s effects are lost.
ANS: D
Naltrexone works to eliminate the euphoria that occurs with opioid drug use. Therefore, the reinforcing effect of the drug is lost when the drug is taken while an opioid is being used.
During a substance abuse lecture for teenage girls, the nurse is asked about “roofies.” This slang term refers to what substance? a. Cocaine
b. flunitrazepam
c. hydromorphone
d. Methamphetamine
ANS: B
Flunitrazepam (Rohypnol®) is a benzodiazepine that has recently gained popularity as a recreational drug. It is commonly called “roofies” and is also known as the “date rape” drug.
A 29-year-old male is admitted to the Critical Care Unit with the following symptoms: restlessness, hyperactive reflexes, talkativeness, confusion, dry mouth, and excessive sweating. The nurse suspects that he may be experiencing the effects of taking which substance?
a. Opiates
b. Alcohol
c. Stimulants
d. Depressants
ANS: C
The adverse effects listed in the example may occur with the use of stimulants and are commonly an extension of their therapeutic effects.
Chronic use of alcohol may result in which condition?
a. Renal failure
b. Stroke
c. Korsakoff’s psychosis
d. Alzheimer’s disease
ANS: C
Chronic use of alcohol may lead to a variety of serious neurological and mental disorders, such as Korsakoff’s psychosis and Wernicke’s encephalopathy, in addition to cirrhosis.
A patient is being treated for ethanol abuse.
What should the nurse tell this patient about disulfiram (Antabuse) therapy?
a. Do not smoke cigarettes while on this drug.
b. Several common over-the-counter (OTC) substances contain alcohol.
c. This drug will cause the same effects as the alcohol did but without the euphoric
effects.
d. Any type of mouthwash or cough medicine can be used because they contain
alcohol only in small amounts.
ANS: B
Using disulfiram along with alcohol-containing OTC products will elicit severe adverse reactions. As little as 7 mL of alcohol may cause symptoms in a sensitive person
Which is the main substance of misuse among older adults?
a. Cigarettes
b. Alcohol
c. OTC medications
d. Prescription medications
ANS: B
The proportion of older adults within society is increasing. Alcohol remains the main substance of misuse among this part of the population. Cigarette smoking and polypharmacy with prescription and OTC medications are also concerns, but alcohol is the main substance of misuse.
Which statement is true in regard to drugs used in cigarette smoking cessation programs?
a. Slow chewing of nicotine gum releases an immediate dose of nicotine.
b. Acute relief from withdrawal symptoms is most easily achieved with the use of
the transdermal patch.
c. Patient adherence is higher with transdermal patches than with nicotine gum.
d. Nicotine gum can be used only up to six times a day.
ANS: C
In a cigarette smoking cessation program, patient adherence is higher with the use of transdermal patches than with nicotine gum. Acute relief from nicotine withdrawal symptoms is more easily achieved with the use of the gum than with the patch. Rapid chewing of the gum produces an immediate dose of nicotine, and nicotine gum can be used whenever the patient has a strong urge to smoke.
During a party, a guest who is on disulfiram (Antabuse) therapy drinks half a glass of wine. The party guest will quickly experience which symptoms? (Select all that apply.)
a. Euphoria
b. Vomiting
c. Diarrhea
d. Pallor
e. Flushed skin
f. Sweating
g. Hypoventilation
ANS: B, E, F
Vomiting, flushed skin, and sweating occur when disulfiram is taken with even small amounts of alcohol. Other symptoms include a throbbing sensation in the head and neck, hyperventilation, confusion, nausea, vertigo, and blurred vision. Euphoria, diarrhea, pallor, and hypoventilation do not occur in this situation.
