Week 4- Substance Abuse Flashcards
Which term relates to what is occurring in the patient with a substance abuse disorder who no longer responds to the effect of the substance?
Addiction
Tolerance
Withdrawal
Intoxication
Tolerance
Which drug classification are magic mushrooms considered?
Opioids
Stimulants
Cannabinoids
Hallucinogens
Hallucinogens
Which term is used to identify a syndrome that occurs after stopping the long-term use of a drug?
Enabling
Amnesia
Tolerance
Withdrawal
Withdrawal
Which substance abuse would the nurse inquire about with a patient diagnosed with mouth cancer?
Opium
Alcohol
Cocaine
Tobacco
Tobacco
Which drug prescribed to a patient for treatment of alcohol addiction may be associated with intense vomiting, respiratory difficulty, and mental confusion?
Disulfiram
Phenobarbital
Chlordiazepoxide
Acamprosate calcium
Disulfiram
Disulfiram is used for the maintenance of alcohol abstinence. However, the medication should be taken consistently to maintain the alcohol aversion. Alcohol consumption while on disulfiram leads to a toxic reaction that results in symptoms such as intense nausea, vomiting, respiratory difficulty, and mental confusion. Chlordiazepoxide is used to reduce withdrawal agitation and can cause sedation and seizures. Phenobarbital could result in sedation. Acamprosate calcium causes side effects such as itching, diarrhea, and intestinal gas.
Which chemical in tobacco causes addiction?
Opium
Nicotine
Cocaine
Cannabinoids
Nicotine
Which nursing diagnosis is the most appropriate for a patient who exhibits impulsiveness and experiences a loss of relationships and occupation because of a focus on alcohol use?
Risk for injury
Hopelessness
Risk for suicide
Ineffective coping
Risk for suicide
The nursing diagnosis that is most appropriate for a patient who exhibits impulsiveness and experiences a loss of relationships and occupation because of a focus on alcohol use is risk for suicide. The impulsive behavior is the key component that may result in the patient harming themselves. A patient at risk for injury exhibits signs that include impairment, overdose, withdrawal from substances, and hallucinations. A patient who displays hopelessness presents with a lack of initiative, is passive, and reports seeing no alternatives or personal control. Signs and symptoms of a patient with ineffective coping include the decreased use of social support, destructive behavior toward themselves and others, inadequate problem solving, poor concentration, and a reported inability to cope.
Which schedule of drugs has a high potential for abuse, are considered dangerous, and are only available by prescription?
Schedule I
Schedule II
Schedule III
Schedule V
Schedule II
Which drug represents part of an aversive therapy approach to treatment of addiction?
Disulfiram
Naltrexone
Quetiapine fumarate
Acamprosate calcium
Disulfiram
When taking disulfiram, an individual who ingests alcohol will experience a toxic reaction that causes intense nausea and vomiting, headache, sweating, flushed skin, respiratory difficulties, and confusion. These symptoms are intended to create an aversion to the use of alcohol. Naltrexone, quetiapine fumarate, and acamprosate calcium are medications prescribed to reduce discomfort associated with withdrawal.
Which condition is suspected when a patient is brought to the emergency department with tachycardia, hypertension, hyperthermia, dilated pupils, and heightened reflexes?
Opioid withdrawal
Opioid intoxication
Alcohol withdrawal
Stimulant withdrawal
Opioid withdrawal
Opioid withdrawal manifests as a set of physiological symptoms that begin to occur when the concentration of opium decreases in the patient’s bloodstream. It is characterized by tachycardia, hypertension, and hyperthermia. These symptoms are not caused by opioid intoxication, alcohol withdrawal, or stimulant withdrawal. Opioid intoxication is characterized by decreased heart rate, blood pressure, body temperature, body reflexes, and pinpoint pupils. Alcohol withdrawal is characterized by restlessness, irritability, impairment in functioning, and trembling. Stimulant withdrawal is characterized by depression, poor concentration, and paranoia.
Which need has the highest priority when caring for a patient who is intoxicated from alcohol?
Self-esteem needs
Safety and security
Physiological stability
Cultural preferences
Safety and security
Which information given by the nurse is appropriate about disulfiram?
“You may experience adverse effects if you consume alcohol.”
“You may experience nausea during the course of medication.”
“You may experience seizures during the course of medication.”
“You may experience sedation during the course of medication.”
“You may experience adverse effects if you consume alcohol.”
Which drug would the nurse suspect the patient is abusing when multiple injection marks are observed on the arm?
Opium
Cocaine
Hashish
Marijuana
Cocaine
Cocaine is a stimulant and is administered by snorting, smoking, or injecting. Opium is an opioid that is swallowed or smoked. Hashish is a cannabinoid that is smoked or swallowed. Marijuana is a cannabinoid that is smoked or swallowed.
Which type of drug causes increased mental alertness?
Alcohol
Opioids
Stimulants
Cannabinoids
Stimulants
Which information is important for the nurse to understand when initiating the use of naltrexone prescribed for alcohol relapse prevention?
The tablets will be taken three times a day.
Medication can begin on the fifth day of abstinence from alcohol.
The patient needs to be opiate-free for 10 days before starting the medication.
The patient must avoid all alcohol and substances such as cough syrup and mouthwash containing alcohol.
The patient needs to be opiate-free for 10 days before starting the medication.
Which further physical assessment finding can be anticipated when a patient presents to the clinic stating, “I don’t feel good. I think I drank too much coffee, and my heart feels like it is pounding”?
Agitation
Tachypnea
Restlessness
Muscle twitching
Muscle twitching
The nurse can anticipate muscle twitching during the assessment of the patient. Caffeine intoxication is characterized by several physical and behavioral symptoms. A behavioral symptom associated with caffeine intoxication is agitation. Tachypnea is not a typical finding in patients experiencing caffeine intoxication. Restlessness is another behavioral symptom of caffeine intoxication.
Which symptom is most likely to be present in an alcohol-dependent patient who is experiencing uncomplicated moderate alcohol withdrawal?
Shakes
Seizures
Blackouts
Hallucinations
Shakes
Which type of substance abuse is suspected when nasal damage is present in a patient with a drug addiction?
Opium
Cocaine
Hashish
Lysergic acid diethylamide (LSD)
Cocaine
Which cognitive-behavioral therapy is indicated in a patient with an addiction?
Enhance motivation in the patient.
Allow a sustainable recovery lifestyle.
Break the denial behavior of the patient.
Identify irrational core beliefs in the patient.
Identify irrational core beliefs in the patient.
Which type of facility would best support the needs of an impaired patient who needs long-term help related to hallucinogen abuse?
Halfway house
Partial hospitalization
Intensive outpatient program
Residential rehabilitation center
Residential rehabilitation center
Which statement provides accurate information after a patient states, “I have been smoking pot for several years to help me sleep, and I want to quit”?
“You may experience insomnia and disturbing dreams.”
“Marijuana has very little effect on the quality of your sleep.”
“You will be provided a prescription for an antianxiety medication.”
“You should not experience any symptoms if you only smoke it at night.”
“You may experience insomnia and disturbing dreams.”
Which intervention would be a priority when caring for a hospitalized patient with a history of cocaine abuse?
Promote sleep in the patient.
Assist the patient in setting goals.
Encourage hygiene practices in the patient.
Develop a therapeutic relationship with the patient.
Promote sleep in the patient.
Which response is appropriate when teaching a patient about a prescription for naltrexone?
“It will keep you from experiencing flashbacks.”
“It helps prevent relapse by reducing your drug cravings.”
“It helps your mood so that you don’t feel the need to do drugs.”
“It is a sedative that will help you sleep at night so you are more alert and able to make good decisions.”
“It helps prevent relapse by reducing your drug cravings.”
Which symptom suggests the use of marijuana by a patient?
Hallucinations and sweating
Violent behavior and psychosis
Disorientation and memory loss
Increased heart rate and appetite
Increased heart rate and appetite
A client admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The client is now shaky, irritable, anxious, diaphoretic, and reports nightmares. The pulse rate is 130 beats/minute. The client shouts, “Bugs are crawling on my bed. I’ve got to get out of here.” What is the most accurate assessment of this situation?
The client may have sustained a head injury before admission.
The client is attempting to obtain attention by manipulating staff.
The client is having an acute psychosis.
The client has symptoms of alcohol withdrawal delirium.
The client has symptoms of alcohol withdrawal delirium.
Which symptoms of withdrawal from opioids should the nurse assess for?
mood lability, incoordination, fever, and drowsiness.
nausea, vomiting, diaphoresis, anxiety, and hyperreflexia.
excessive eating, constipation, and headache.
dilated pupils, tachycardia, elevated blood pressure, and elation.
nausea, vomiting, diaphoresis, anxiety, and hyperreflexia.
Which features should be present in a therapeutic milieu for a client experiencing a hallucinogen overdose?
Stimulating and colorful
Confrontational and challenging
Active and bright
Simple and safe
Simple and safe
The treatment team discusses the plan of care for a client diagnosed with schizophrenia and daily cannabis abuse who is having increased hallucinations and delusions. To plan effective treatment, the team should consider what intervention?
provide long-term care for the client in a residential facility.
consider each diagnosis primary and provide simultaneous treatment.
withdraw the client from cannabis, then treat the schizophrenia.
first treat the schizophrenia, then establish goals for substance abuse treatment.
consider each diagnosis primary and provide simultaneous treatment.
Both diagnoses should be considered primary and receive simultaneous treatment. Comorbid disorders require longer treatment and progress is slower, but treatment may occur in the community.
Which goal for treatment of alcohol use disorder should the nurse address first?
Develop a peer support system.
Achieve physiological stability.
Learn about addiction and recovery.
Develop alternate coping strategies.
Achieve physiological stability.
Family members of an individual undergoing a residential alcohol rehabilitation program ask, “How can we help?” What is the nurse’s best response?
“Use search and destroy tactics to keep the home alcohol free.”
“It’s important that you visit your family member on a regular basis.”
“Alcoholism is a lifelong disease. Relapses are expected.”
“Make your loved one responsible for the consequences of behavior.”
“Make your loved one responsible for the consequences of behavior.”
Often, the addicted individual has been enabled when others picked up the pieces for him or her. The individual never faced the consequences of his or her own behaviors, all of which relate to taking responsibility. Learning to face those consequences is part of the recovery process. The other options are codependent behaviors or are of no help.
Police bring a client to the emergency department after an automobile accident. The client demonstrates poor coordination and slurred speech, but the vital signs are normal. The blood alcohol level is 300 mg/dL (0.30 g/dL). Considering the relationship between the assessment findings and blood alcohol level, which conclusion is most probable?
The client has a high tolerance to alcohol.
The client has ingested both alcohol and sedative drugs recently.
The client rarely drinks alcohol.
The client has been treated with disulfiram.
The client has a high tolerance to alcohol.
A nontolerant drinker would have sleepiness and significant changes in vital signs with a blood alcohol level of 300 mg/dL (0.30 g/dL). The fact that the client is moving and talking shows a discrepancy between blood alcohol level and expected behavior and strongly indicates that the client’s body is tolerant. If disulfiram and alcohol are ingested together, an entirely different clinical picture would result. The blood alcohol level gives no information about ingestion of other drugs.
A client diagnosed with an antisocial personality disorder was treated several times for substance abuse, but each time the client relapsed. Which treatment approach is most appropriate?
12-step self-help program
1-week detoxification program
Long-term outpatient therapy
Residential program
Residential program
A hospitalized client diagnosed with alcohol use disorder believes the window blinds are snakes trying to get in the room. The client is anxious, agitated, and diaphoretic. The nurse can anticipate the health care provider will prescribe what medication intervention?
antipsychotic, such as olanzapine or thioridazine.
sedative, such as lorazepam or chlordiazepoxide.
monoamine oxidase inhibitor antidepressant, such as phenelzine.
narcotic analgesic, such as hydromorphone.
sedative, such as lorazepam or chlordiazepoxide.
Sedation allows for safe withdrawal from alcohol. Benzodiazepines are the drugs of choice in most regions because of their high therapeutic safety index and anticonvulsant properties. The client’s highest needs related to a need for calming.
A nurse cares for a client experiencing an opioid overdose. Which focused assessment has the highest priority?
Cardiovascular
Neurological
Respiratory
Hepatic
Respiratory
Opioid overdose causes respiratory depression. Respiratory depression is the primary cause of death among opioid abusers. The assessment of the other body systems is relevant but not the priority.
What is the priority nursing intervention when caring for a client after an overdose of amphetamines?
Use warmers to maintain body temperature.
Awaken the client every 15 minutes.
Monitor vital signs.
Observe for depression.
Monitor vital signs.
An overdose of stimulants, such as amphetamines, can produce respiratory and circulatory dysfunction as well as hyperthermia. Concentration is impaired. This client will be hypervigilant; it is not necessary to awaken the client.
A client admitted to an alcohol rehabilitation program tells the nurse, “I’m actually just a social drinker. I usually have a drink at lunch, two in the afternoon, wine with dinner, and a few drinks during the evening.” The client is using which defense mechanism?
Introjection
Denial
Projection
Rationalization
Denial
Which medication to maintain abstinence would most likely be prescribed for clients diagnosed with an addiction to either alcohol or opioids?
Methadone
Disulfiram
Bromocriptine
Naltrexone
Naltrexone
A hospitalized Client diagnosed with alcohol use disorder believes spiders are spinning entrapping webs in the room. The client is fearful, agitated, and diaphoretic. Which nursing intervention is indicated?
Force fluids
Check the client every 15 minutes
One-on-one supervision
Keep the room dimly lit
One-on-one supervision
A client is thin, tense, jittery, and has dilated pupils. The client says, “My heart is pounding in my chest. I need help.” The client allows vital signs to be taken but then becomes suspicious and says, “You could be trying to kill me.” The client refuses further examination. Abuse of which substance is most likely?
Heroin
phencyclidine (PCP)
Barbiturates
Amphetamines
Amphetamines
The physical symptoms are consistent with central nervous system (CNS) stimulation. Suspicion and paranoid ideation are also present. Amphetamine use is likely. PCP use would probably result in bizarre, violent behavior. Barbiturates and heroin would result in symptoms of CNS depression.
Which assessment findings are likely for an individual who recently injected heroin?
Muscle aching, dilated pupils, tachycardia
Heightened sexuality, insomnia, euphoria
Anxiety, restlessness, paranoid delusions
Drowsiness, constricted pupils, slurred speech
Drowsiness, constricted pupils, slurred speech
A client undergoing alcohol rehabilitation decides to begin disulfiram therapy. Client teaching should include the need to (Select all that apply.)
avoid breathing fumes of paints, stains, and stripping compounds.
avoid alcohol-based skin products.
maintain an adequate dietary intake of sodium.
avoid aged cheeses.
read labels of all liquid medications.
wear sunscreen and avoid bright sunlight.
avoid breathing fumes of paints, stains, and stripping compounds.
avoid alcohol-based skin products.
read labels of all liquid medications.
