Substance Use Disorder

Question 1

sustained moderation is most difficult with these substances

Answer 1

smoking, alcohol, opiods

Question 2

most important question during an assessment of substance abuse

Answer 2

when did you last use?

Question 3

why is it important to know when someone last used, particularly with alcohol

Answer 3

determines when you can expect withdraw symptoms

alcohol = 24-48 hrs. post use

Question 4

initial assessment/screen questions (2)

Answer 4

In past year, have you ever drank or used drugs more than you meant to?
Have you felt you wanted to cut down on drinking or drug use in past year?

Question 5

CAGE AID screening tool questions

Answer 5

C: Have you ever felt the need to cut down?
A: Have people annoyed you by criticizing your use?
G: Have you ever felt guilty about use?
E: Have you ever felt need for an eye opener in morning?

Question 6

2 neuropsychiatric syndromes r/t alcohol

Answer 6

wernicke’s - confusion

korsikoff’s syndrome - memory loss - permanent

Question 7

to reverse s/s of wernicke’s

Answer 7

vitamin b - thiamine

Question 8

is korsikoffs syndrome reversible

Answer 8

no

Question 9

to determine drug use type/amount

Answer 9

urine toxicology or blood alcohol level

Question 10

defense mechanisms r/t substance use disorders

Answer 10

denial - I can stop whenever I want
projection - blame behaviors on someone else
rationalization - I’m more effective when i drink
all or none thinking - can’t stop once you start drinking

Question 11

alcohol withdraw s/s

Answer 11

autonomic hyperactive response - increased VS, bilateral hand tremors

Question 12

primary treatment for alcohol withdraw

Answer 12

benzo

Question 13

alcohol delirium s/s

Answer 13

altered LOC

Question 14

Mr. Stewart’s blood alcohol level (BAL) is 0.31%. Even though he has a BAL of 0.31%, Mr. Stewart is alert and oriented, not slurring his speech or giving any other outward signs of intoxication. The difference between Mr. Stewart’s BAL and his behavior indicates the development of what symptom of physical dependence?

Answer 14

tolerance - needs more of a substance to illicit same reaction

Question 15

normal alcohol level

Answer 15

.08

Question 16

trt approach for alcohol withdraw

Answer 16

sedate pt. for calmness

Question 17

trt approach for seizures r/t alcohol withdraw

Answer 17

dilantin - anticonvulsants

Question 18

drugs used to maintain abstinence

Answer 18

antibuse - if pt. drinks they become very ill

Question 19

relapse is part of recovery, t or f

Answer 19

true

Question 20

Jessie is attending AA meetings three times a week for the past 6 weeks. She has been sober during this time and visits bi-weekly the community mental health outpatient clinic. Jessie’s nurse counselor wants to talk with her about the AA meetings. Which initial question or statement is most appropriate?

Answer 20

D.“Tell me about the last AA meeting you attended.”

Question 21

most therapeutic approach you can have for substance abusers

Answer 21

empathy and support with firmness. confront abusers

Question 22

Jessie has missed three sessions at the mental health center and sporadically attends AA meetings. She is drinking heavily this weekend and has sustained a 2
-inch gash in her forehead after swerving off the road into a shallow ditch. She is taken by rescue to the ED. You are her nurse. She tells you, “I hope I just go to
sleep and never wake up.” What is your best intervention?

Answer 22

D. Stay with Jessie, call the supervisor, and arrange for

continuous monitoring.

Question 23

During the third week of treatment, the spouse of a patient in an alcoholism rehabilitation program says, “After discharge, I’m sure everything will be just fine.” Which remark by the nurse will be most helpful to the spouse?

Answer 23

B.“Although sobriety solves some problems, new ones

may emerge as one adjusts to living without alcohol.”

Question 24

why keep things simple in the beginning of treatment plans

Answer 24

pt is sick - when feeling better gradually incorporate insight therapy and CBT - teach damage to body systems

Question 25

SMART therapies alternative to 12 step programs

Answer 25

science based recovery - being accountable without spiritual component

Question 26

A patient comes to an outpatient appointment obviously intoxicated. The nurse should:

Answer 26

D.tell the patient, “We cannot see you today because

you’ve been drinking.”

Question 27

Select the most appropriate outcome for a patient completing the fourth alcohol detoxification program in 1 year. Before discharge, the patient will

Answer 27

B. I see the need for ongoing treatment

Question 28

A nurse can assist a patient and family in which aspects of substance abuse relapse prevention? Select all that apply.

Answer 28

A.Rehearsing techniques to handle anticipated stressful
situations
C.Assisting the patient to identify life skills needed for
effective coping
E.Teaching the patient about the physical changes to
expect as the body adapts to functioning without substances