The Nervous System Substance Use Disorder

Question 1

A patient has elevated blood pressure, elevated temperature, and dilated pupils.

Which class of drugs should the nurse suspect has caused these symptoms?
a) Hallucinogens
b) Inhalants
c) Sedatives
d) Cannabinoids

Answer 1

a) Hallucinogens

Question 2

A patient seeks treatment for alcohol dependence.

Which medication should the nurse anticipate being prescribed for this patient?
a) Naloxone
b) Methylphenidate
c) Naltrexone
d) Varenicline

Answer 2

c) Naltrexone

Question 3

A patient with chronic alcoholism wants to take milk thistle.

Which response should the nurse make?
a) “That’s a good idea since it helps protect the liver.”
b) “It’s best to ask your healthcare provider about it before taking it.”
c) “It can be safely taken when using alcohol.”
d) “It’s better than a prescribed drug because there are no side effects.”

Answer 3

b) “It’s best to ask your healthcare provider about it before taking it.”

Question 4

A patient is experiencing confusion, irregular pulse, runny nose, and crusty nostrils.

Which reason should the nurse suspect is causing this patient’s symptoms?
a) Dementia
b) Amphetamine use
c) Lysergic acid diethylamide (LSD) overdose
d) Cocaine use

Answer 4

d) Cocaine use

Question 5

A patient in group therapy for alcohol abuse reports that fatigue and trembling hands are interfering with work.

Which statement should the nurse include when responding to this patient?
a) “Fatigue and trembling are signs of acute withdrawal, and we may need to talk with your healthcare provider about inpatient treatment.”
b) “These symptoms are common during alcohol withdrawal, and they’ll subside quickly.”
c) “Are you taking any other drugs that would cause this kind of fatigue?”
d) “You should end your alcohol consumption gradually so that you don’t have these symptoms.”

Answer 5

a) “Fatigue and trembling are signs of acute withdrawal, and we may need to talk with your healthcare provider about inpatient treatment.”

Question 6

A patient expresses fear of relapse after acute alcohol withdrawal.

Which treatment should the nurse prepare teaching for this patient?
a) Readmission to a rehabilitation facility
b) Administration of acetaldehyde
c) Group therapy
d) Administration of an antipsychotic medication

Answer 6

c) Group therapy

Question 7

A patient reports not desiring cigarettes after starting varenicline.

Which reason should the nurse identify as causing the patient’s response to the medication?
a) Increases the blood level of nicotine
b) Reduces the symptoms of nicotine withdrawal
c) Decreases the release of epinephrine in the brain
d) Decreases the likelihood of withdrawal symptoms

Answer 7

b) Reduces the symptoms of nicotine withdrawal

Question 8

A patient is brought to the emergency department after taking lysergic acid diethylamide (LSD).

Which symptoms should the nurse expect?
a) Lethargy and sleepiness
b) Slurred speech and impaired motor coordination
c) Anxiety and pain
d) Visions and hallucinations

Answer 8

d) Visions and hallucinations

Question 9

A patient is diagnosed with alcohol abuse.

Which laboratory value should the nurse closely monitor in this patient?
a) Liver studies
b) Urinalysis
c) Blood cultures
d) White blood cell count

Answer 9

a) Liver studies

Question 10

A patient states that a prescribed sedative is no longer working.

Which response should the nurse make?
a) “Let’s consult with your healthcare provider about a stronger drug.”
b) “Increasing the dosage will result in addiction.”
c) “You may be developing tolerance to the sedative, so a dosage increase may be necessary.”
d) “Increasing the dosage is not in compliance with the Controlled Substances Act.”

Answer 10

c) “You may be developing tolerance to the sedative, so a dosage increase may be necessary.”

Question 11

During a follow-up visit, a patient asks for the dosage of a sleeping medication be increased.

Which consideration should the nurse make when assessing the patient’s need for increased medications?
a) Sleeping pills are not addictive, and there is no need for concern.
b) Addiction often begins with a legitimate need for the prescribed medication.
c) A good night’s sleep is important for effective function, so an increased dosage may be beneficial.
d) Therapeutic use of scheduled medications is a major cause of addiction in society.

Answer 11

b) Addiction often begins with a legitimate need for the prescribed medication.

Question 12

Upon discharge from an alcohol abuse treatment facility, a patient reports looking forward to seeing old drinking buddies.

Which response should the nurse make?
a) “Let’s hope that your friends are supportive of your newfound abstinence.”
b) “Perhaps you can all celebrate your discharge from the treatment facility.”
c) “Those friends are a bad influence, and you shouldn’t see them again.”
d) “You may want to postpone that visit for a while so that you’re not tempted to drink.”

Answer 12

d) “You may want to postpone that visit for a while so that you’re not tempted to drink.”

Question 13

A patient who is unresponsive is reported to have taken two containers of diazepam (Valium) as a suicide attempt.

On which body system should the nurse focus when assessing this patient?
a) Respiratory
b) Cardiovascular
c) Gastrointestinal
d) Renal

Answer 13

a) Respiratory

Question 14

A patient being treated for alcohol abuse is prescribed disulfiram (Antabuse).

Which statement should the nurse include when teaching about this medication?
a) “You can still use alcohol pads to clean wounds.”
b) “Mouthwashes containing alcohol are acceptable and necessary for oral hygiene.”
c) “You need to avoid all forms of alcohol.”
d) “You don’t need to worry about adverse effects after you take your last dose.”

Answer 14

c) “You need to avoid all forms of alcohol.”

Question 15

A patient with chronic pain works full-time and takes prescribed pain medications around the clock.

Which conclusion should the nurse make about this patient?
a) Addiction
b) Physical dependence
c) The need to change the pain medication
d) That alternative therapies should be started

Answer 15

b) Physical dependence

Question 16

The nurse learns that an older patient uses medical marijuana.

Which condition should the nurse suspect in this patient?
a) Macular degeneration
b) Nephritis
c) Muscular dystrophy
d) Glaucoma

Answer 16

d) Glaucoma

Question 17

A patient is addicted to oxycodone.

Which user factor should the nurse recognize as contributing to the patient’s addiction?
a) Diagnosis of osteoarthritis with chronic pain
b) Cost of oxycodone
c) Ease of oral administration
d) Close friend who is a substance abuser

Answer 17

a) Diagnosis of osteoarthritis with chronic pain

Question 18

A college student reports using marijuana on weekends.

Which envionmental factor should the nurse consider as influencing this patient’s drug using behavior?
a) Previous experience with drugs
b) Genetic
c) Peer influence
d) Health problem requiring a drug

Answer 18

c) Peer influence

Question 19

A patient reports using many drugs to help relieve unrelenting spinal nerve pain.

Which drug should the nurse identify that needs a prescription to obtain?
a) Lysergic acid diethylamide (LSD)
b) Alprazolam (Xanax)
c) Phencyclidine hydrochloride (PCP)
d) Nitrous oxide

Answer 19

b) Alprazolam (Xanax)

Question 20

A new colleague has a fear of causing a patient to become addicted because of the large amounts of morphine being given for severe pain.

Which information should the nurse include when responding?
a) “Healthcare providers do not consider dependency when prescribing pain medications.”
b) “It is appropriate to question any order for high doses of medications that can lead to addiction.”
c) “If truly concerned about the potential of dependency, nurses should withhold the medication.”
d) “Nurses should administer pain medications as prescribed to provide patient relief without concern for causing dependency.”

Answer 20

d) “Nurses should administer pain medications as prescribed to provide patient relief without concern for causing dependency.”

Question 21

A college student reports using lysergic acid diethylamide (LSD) repeatedly.

Which medication should the nurse anticipate to help this patient withdraw from the hallucinogen?
a) No specific medication
b) Oxazepam (Serax)
c) Methadone
d) Chewing gum

Answer 21

a) No specific medication

Question 22

A patient is prescribed varenicline to aid with smoking cessation.

Which information should the nurse include when teaching about this medication?
a) “Take a dose when you want to have a cigarette.”
b) “You will still crave cigarettes with this medication.”
c) “You should have less symptoms of nicotine withdrawal.”
d) “This medication is rarely prescribed but works for some people.”

Answer 22

c) “You should have less symptoms of nicotine withdrawal.”

Question 23

A patient who was taking morphine for cancer pain reports the pain is not controlled after switching to hydromorphone (Dilaudid).

Which explanation should the nurse consider for this pain management issue?
a) The patient could be addicted to opioids, resulting in inadequate pain relief.
b) The patient could have cross-tolerance between morphine and hydromorphone (Dilaudid).
c) The patient’s cancer has progressed to the point at which relief is not possible.
d) The patient has become resistant to opioids and will need other pain relievers to manage pain.

Answer 23

b) The patient could have cross-tolerance between morphine and hydromorphone (Dilaudid).

Question 24

A patient hesitates to commit to treatment for a substance abuse disorder.

Which response should the nurse make?
a) “Even if you don’t remain in treatment, you should be fine if you have a supportive family.”
b) “As long as you just diminish your use of drugs, you’ll eventually recover from this addiction.”
c) “This is temporary, because as soon as you’re clean, no further follow-up is necessary.”
d) “Successful treatment of substance abuse requires your commitment to continuing treatment.”

Answer 24

d) “Successful treatment of substance abuse requires your commitment to continuing treatment.”

Question 25

Which of the following best represents tolerance?
1. Compulsive use despite serious consequences
2. Physical or psychological symptoms that occur with lack of substance use
3. The need for increased amounts of a substance to produce the same effect
4. Repeated use of a substance socially or recreationally

Answer 25

3. The need for increased amounts of a substance to produce the same effect

Question 26

Which of the following best represents addiction?
1. Compulsive use despite serious consequences
2. Physical or psychological symptoms that occur with lack of substance use
3. The need for increased amounts of a substance to produce the same effect
4. Repeated use of a substance socially or recreationally

Answer 26

1. Compulsive use despite serious consequences

Question 27

Which of the following best represents dependence?
1. Compulsive use despite serious consequences
2. Physical or psychological symptoms that occur with lack of substance use
3. The need for increased amounts of a substance to produce the same effect
4. Repeated use of a substance socially or recreationally

Answer 27

4. Repeated use of a substance socially or recreationally

Question 28

Which of the following opioids are associated with the current opioid epidemic?
**Select all that apply.
1. Heroin
2. Oxycodone
3. Fentanyl
4. Hydrocodone

Answer 28

1. Heroin
2. Oxycodone
3. Fentanyl
4. Hydrocodone

Question 29

Which of the following medications is not used for alcohol use disorder?
1. Acamprosate
2. Disulfiram
3. Buprenorphine/naloxone
4. Naltrexone

Answer 29

3. Buprenorphine/naloxone

Question 30

Which of the following is a stimulant drug?
**Select all that apply.
1. MDMA
2. Nicotine
3. Alcohol
4. Lorazepam
5. Mescaline

Answer 30

1. MDMA
2. Nicotine