T2 - Substance-Related & Addictive Disorders (Josh)

Question 1

Addiction is a — — disorder

Answer 1

Substance-Use Disorder

Question 2

Mr. White has been admitted after binge drinking. His wife reports that he has been a heavy drinker for a # of yrs. Lab reports reveal he has a blood alcohol level of 250 mg/dL. He is placed on chemical addiction unit for detox. When would the first signs of alcohol withdrawal symptoms be expected?

a) several hrs after last drink
b) 2-3 days after last drink
c) 4-5 days after last drink
d) 6-7 days after last drink

Answer 2

a) several hrs after last drink

- 4-12 hrs

Question 3

If operating an automobile, what is considered intoxication?

What is normally considered intoxication?

Answer 3

80 g/dL (0.08%)

100-200 mg/dL

Question 4

Intoxication is – — disorder

Answer 4

Substance-Induced Disorder

Question 5

Drugs for ETOH Withdrawal (ATI)

Answer 5

Diazepam

Lorazepam

Carbamazepine

Clonidine

Chlordiazepoxide

Question 6

A nurse is providing teaching to the family of a client who has a substance use disorder. Which of the following statements by a family member indicates need for further teaching?

a) We need to understand that she is not responsible for her disorder
b) Eliminating any codependent behavior will promote recovery
c) She should participate in an Al-anon group to help her recover
d) The primary goal of her treatment is abstinence from substance use

Answer 6

c) She should participate in an Al-anon group to help her recover
- Al-anon is for the family, not the client
- AA is for the client

Question 7

Signs of Opioid Withdrawal

Answer 7

dysphoric mood

n/v

muscle aches

lacrimation or rhinorrhea

pupil dilation

piloerection

sweating

diarrhea

yawning

fever

insomnia

Question 8

What is the most common ego defense mechanism used by alcoholics?

Answer 8

denial

Question 9

A nurse is caring for a client who has ETOH use disorder. The client is no longer experiencing withdrawal manifestations. Which of the following meds should the nurse anticipate administering to assist the client w/ maintaining abstinence?

a) Chlordiazepoxide
b) Buproprion
c) Disulfrium
d) Carbamazepine

Answer 9

c) Disulfrium

Question 10

Alcohol intoxication occurs at

Answer 10

100-200 mg/dL

Question 11

What are some complications from cirrhosis of the liver?

Answer 11

Portal HTN

Ascites

Esophageal Varices

Hepatic Encephalopathy

Question 12

Withdrawal is a — — disorder

Answer 12

Substance-Induced Disorder

Question 13

When could ETOH Withdrawal Delirium occur?

Answer 13

2-3 days after cessation

lasts for 2-3 days

it is a medical emergency

Question 14

Dan, who has been admitted to the ETOH rehab unit after being fired for drinking on the job states to the nurse, ‘I don’t have a problem w/ ETOH. I can handle booze better than anyone I know. My boss is a jerk! I haven’t missed more days than my coworkers.’

The nurses best response is..

a) Maybe your boss is mistaken
b) You’re here b/c your drinking was inerferring w/ your work
c) Get real! Youre a boozer and you know it!
d) Why do you think your boss sent you here?

Answer 14

b) You’re here b/c your drinking was inerferring w/ your work

Question 15

Features of Fetal Alcohol Syndrome (FAS)

Answer 15

small eye opening

small head circumference

skin folds at corner of ey

small midface

short nose

thin upper lip

indistinct groove b/t lip

Question 16

Complicated ETOH withdrawal can progress to –

Answer 16

Alcohol Withdrawal Delirium

Question 17

Alcohol withdrawal occurs within — of cessation/reduction in ETOH.

Answer 17

4-12 hours

Question 18

– is identified by confusion, loss of recent memory, and confabulation in alcoholics.

Answer 18

Korsakof’s Psychosis

Question 19

Is Opioid withdrawal life-threatening?

Answer 19

Not usually, but it IS unpleasant

self-limiting to 7-10 days

Question 20

Which of the following meds is the physician most likely to order for a client experiencing ETOH withdrawal?

a) Haloperidol
b) Chlordiazepoxide
c) Methadone
d) Phenytoin

Answer 20

b) Chlordiazepoxide

Question 21

Drugs for ETOH Abstinence (ATI)

Answer 21

Disulfrium

Naltrexone

Acamprosate

Question 22

What is the most serious form of thiamine deficiency in alcoholics?

Answer 22

Wernicke’s Encephalopathy

Question 23

A nurse is planning a staff education program on substance use in older adults. Which of the following is appropriate for the nurse to include?

a) Older adults require higher doses of a substance to achieve its desired effect
b) Older adults commonly use rationalization to cope w/ a substance use disorder
c) Older adults are at a higher risk for substance use following retirement
d) Older adults develop substance use to mask signs of dementia

Answer 23

c) Older adults are at a higher risk for substance use following retirement

Question 24

Drugs for Opioid Withdrawal (ATI)

Answer 24

Methadone

Clonidine

Buprenorphine

Question 25

How long do ETOH withdrawal symptoms last?

Answer 25

start 4-12 hrs and peak after 24-48 hrs, then suddenly disappear

Question 26

A nurse is assessing a client who has ETOH use disorder and is experience withdrawal. Which of the following is an expected finding? (SATA)

a) Bradycardia
b) Fine tremors in both hands
c) Hypotension
d) Vomiting
e) Restlessness

Answer 26

b) Fine tremors in both hands
d) Vomiting
e) Restlessness

Question 27

Dan has been admitted to the ETOh rehab unit. Dan’s drinking buddies come for a visit, and when they leave, the nurse smells ETOH on Dan’s breath. Which is the best intervention w/ Dan at this time?

a) Search his room
b) Ask, ‘Have you been drinking Dan?’
c) Send a urine specimen to the lab for drug screening
d) Tell Dan, ‘These guys cannot come to the unit to visit you again’

Answer 27

c) Send a urine specimen to the lab for drug screening

Question 28

Symptoms of ETOH withdrawal include:

a) euphoria, hyperactivity, and insomnia
b) depression, suicidal ideation, and hypersomnia
c) diaphoresis, n/v, and tremors
d) unsteady gait, nystagmus, and profound disorientation

Answer 28

c) diaphoresis, n/v, and tremors

Question 29

A nurse is planning care for a client who is experiencing Benzo withdrawal. Which of the following is the priority intervention?

a) Orient the client frequently to time, place and person
b) Offer fluids and nourishing diet as tolerated
c) Implement seizure precautions
d) Encourage participation in group therapy sessions

Answer 29

c) Implement seizure precautions