substance abuse disorders – Flashcards
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Which individual would have the lowest potential for alcohol dependency?
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A 20-year-old Asian woman.
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The nurse is working with a 45-year-old client who has abused alcohol since age 20. Related to this client's stage of psychosocial development, what developmental data would the nurse expect to assess?
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The client may have trouble establishing intimate relationships.
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Using the principles of biological theory, what contributing factor puts a client at risk for alcoholism?
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The client is a child of an alcoholic parent
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Using the principles of social learing theory, what contributing factor puts a client at risk for alcoholism?.
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2. The client was raised in a home where substance use was the norm. 3. The client is from a family that culturally accepts the use of substances. 4. The client experiences pleasure when a substance is used and subsequently driven to repeat the use.
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Which nursing statement focuses on the personality factors that are implicated in the predisposition to the abuse of substances?
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"A tendency toward addictive behaviors increases as low self-esteem, passivity, and an inability to relax or defer gratification increase."
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. From a biochemical perspective, what factor is implicated in the predisposition to the abuse of substances?
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Animal tests show that injections of the morphine-like substance that is produced by alcohol results in addicted test animals.
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. A client diagnosed with substance dependence states to the nurse, "My wife causes me to abuse methamphetamines. She uses and expects me to." This client is using which defense mechanism?
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Projection.
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A client admitted for chest pain related to cocaine abuse states, "This is nothing but a little indigestion. What is all the fuss about?" This client is using which defense mechanism?
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Denial.
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A client who has recently relapsed from alcohol abstinence is seen in the out-patient mental health clinic. The client states, "I don't know what all the fuss is about. Can't I have a few drinks now and then?" Which nursing diagnosis applies to this client?
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Ineffective denial.
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Which assessment data should the nurse gather when confirming a diagnosis of substance dependence?
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A need for markedly increased amounts of the substance to achieve desired effect
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While performing an intake interview, the nurse learns that the client drinks to avoid early morning "shakes." The nurse recognizes this behavior as characteristic of which assessment?
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Substance dependence.
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The emergency medical service brings an intoxicated client to the emergency department, after the client has been hit by a car while walking on the side of the road. The client states, "How did I get here? Who brought me to the hospital?" Which is the client most likely experiencing?
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A blackout
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What situation places an individual at highest risk for mood and behavioral changes related to alcohol consumption?
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A 180-lb college student drinking four beers in a 1-hour period
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Which of the following are parts of the CAGE questionnaire screening tool? Select all that apply.
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1. Have you ever felt you should cut down on your drinking? 2. Have people annoyed you by criticizing your drinking? 3. Have you ever felt guilty about your drinking? 4. Have you ever had a drink in the morning to steady your nerves?
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A client with a long history of alcoholism recently has been diagnosed with WernickeKorsakoff syndrome. Which symptom should the nurse expect to assess?
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Loss of short-term and long-term memory and the use of confabulation
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A client with a long history of alcohol abuse is seen in the emergency department. The client complains of extreme muscle pain, swelling and weakness of extremities, and reddish-tinged urine. What lab value related to this client's symptoms would the nurse expect to assess?
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An elevated creatine phosphokinase
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A client on an in-patient psychiatric unit is overheard stating, "I blew some snow yesterday while I was out on a pass with my family." What would the nurse expect to assess as a positive finding in this client's urine drug screen?
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Cocaine.
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The following clients are waiting to be seen in the emergency department. Which client should the nurse assess first?
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A cocaine abuser with chest pain.
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A client diagnosed with alcohol dependency states that his wife complains about his alcoholism, but continues to stock his bar with large quantities of bourbon. The nurse suspects codependency. Which characteristic would the nurse expect the wife to exhibit that would be indicative of this problem?
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The wife is a "people pleaser" and would do almost anything to gain approval.
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Which of the following are effective ways to identify a substance-impaired nurse? Select all that apply
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1. The nurse may frequently administer medications to other nurses' clients. 2. High absenteeism if the substance source is outside of work area. 3. Denial of substance abuse problems. 4. A high incidence of incorrect narcotic counts. 5. Poor concentration and difficulty in meeting deadlines.
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What percentage of a single dose of alcohol is absorbed immediately into the bloodstream from which organ of the body?
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1. 20% is absorbed through the stomach wall
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Which statement is true regarding how the body processes alcohol?
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Rapidity of absorption is influenced by various factors, such as a full stomach.
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Which behavior reflects the prealcoholic phase of drinking progression?
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Alcohol is used to relieve the stress of life situations, leading to the development of tolerance
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The nurse is caring for a client on an in-patient substance abuse unit. Because of the client's alcohol abuse, the client has lost family, job, and driver's license. What phase of drinking pattern progression is this client experiencing?
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Crucial phase.
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. A nursing student is reviewing a client's chart. It is noted that the client is exhibiting signs of a drinking pattern in the early alcoholic phase. Which behavior would the student expect to note?
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Amnesia that occurs during or immediately after a period of drinking
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A client brought to the emergency department is observed to be sweating, has dilated pupils, and complains of muscle aches and abdominal cramping. A toxicology screen is ordered. The nurse would suspect these symptoms are indicative of withdrawal from which substance?
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Heroin.
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Three days after surgery to correct a perforated bowel, a client begins to display signs and symptoms of tremors, increased blood pressure, and diaphoresis. What should the nurse suspect?
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Withdrawal from alcohol or other central nervous system depressants.
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A newly admitted client with a long history of alcoholism complains of burning and tingling sensations of the feet. The nurse would recognize these symptoms as indicative of which condition?
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Peripheral neuropathy.
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A client with a long history of alcoholism presents in the emergency department with a sudden onset of muscle pain, swelling, and weakness, and reddish-tinged urine. What lab value would the nurse evaluate as evidence of this client's disorder?
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Increase in CPK
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A client has been diagnosed with Wernicke-Korsakoff syndrome. Which is an example of this client's use of confabulation?
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The client clearly discussed a field trip, when in reality no field trip occurred
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A client with a long history of alcohol dependence comes to the emergency department with shortness of breath and an enlarged abdomen. Which complication of alcoholism is this client experiencing, and what is the probable cause?
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Ascites resulting from cirrhosis of the liver
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. A client with a long history of alcohol dependence comes to the emergency department with frank hemoptysis. Which life-threatening complication of alcoholism is this client experiencing, and what is the probable cause?
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Hemorrhage of esophageal varices resulting from portal hypertension
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A client with a history of alcoholism is seen in the emergency department 2 days after a binge of excessive alcohol consumption. The nurse suspects pancreatitis. Which symptoms would support the nurse's suspicion?
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Constant, severe epigastric pain; nausea and vomiting; and abdominal distention.
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What substance stimulates the central nervous system?
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"Crack."
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The nurse is educating a client about how to avoid sources of stimulation. What produces the least significant stimulation to the central nervous system?
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Tequila shooter.
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All states had to conform to the __________ g/dL blood level standard of legal intoxication by 2004 or risk loss of federal highway funding.
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0.08
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A client is admitted to the emergency department and is tested for blood alcohol level (BAL). The client has a BAL of 0.10 g/dL. What is an accurate assessment of this lab value?
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The client is assessed as legally intoxicated.
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Which is the priority diagnosis for a client experiencing alcohol withdrawal?
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Risk for injury.
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A client with a long history of alcoholism has been recently diagnosed with alcoholic cardiomyopathy. Which nursing diagnosis would take priority?
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Altered perfusion R / T effects of alcoholism AEB decreased oxygen saturations
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Which is the priority diagnosis for a client experiencing cocaine withdrawal?
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Powerlessness.
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. Which is the priority nursing diagnosis for a client experiencing cocaine intoxication?
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Risk for altered cardiac perfusion
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Which is the priority diagnosis for a client experiencing alcohol intoxication?
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Risk for aspiration.
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Which is true about the outcomes of nursing interventions for clients experiencing chemical dependence?
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Outcomes should be tailored to the individual's immediate needs and abilities
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A client who is exhibiting signs and symptoms of alcohol withdrawal is admitted to the substance abuse unit for detox. One of the nursing diagnoses for this client is ineffective health maintenance. Which is a long-term outcome for this diagnosis?
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The client's medical tests will show a reduced incidence of medical complications related to substance abuse within 6 months
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When the nurse is planning relapse prevention strategies for clients diagnosed with substance dependence, which should be the initial nursing approach?
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Keep the interventions simple
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Family members bring a client to the emergency department after a serious motor vehicle accident caused by the client driving under the influence of cocaine. The client states, "This is my first time using crack." Which nursing intervention would the nurse implement next?
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Validate this information with family members
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Which nursing intervention is appropriate for a client who has a nursing diagnosis of risk for injury R / T alcohol withdrawal?
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Provide the client with a quiet room free from environmental stimuli
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Ineffective denial is the nursing diagnosis that is appropriate at this time for a client who has relapsed into alcoholism. What is the priority nursing intervention to address this problem?
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Help the client analyze the effects of substance abuse on life situations
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A client is admitted for benzodiazepine dependence detox. This is the client's fourth detox, and the client's third detox was considered complicated. What would determine the nurse's priority intervention at this time?
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The nurse should monitor the client closely and initiate seizure precautions because the client will be at high risk for seizures.
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Which intervention takes priority when dealing with a client experiencing WernickeKorsakoff syndrome?
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Monitor parenteral vitamin B1.
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A client diagnosed with alcoholism is admitted to a substance abuse unit complaining of decreased exercise tolerance, lower extremity edema, arrhythmias, and dyspnea. Which nursing intervention would be appropriate for this client?
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Administering digoxin (Lanoxin) and furosemide (Lasix).
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A client on the substance abuse unit states, "I used to be able to get a 'buzz on' with a few beers. Now it takes a six pack." How should the nurse, in the role of teacher, address this remark?
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. By explaining the effects of tolerance and telling the client that this is a sign of alcohol dependence
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The nurse has given a client information on alcoholism recovery. Which client statement indicates that learning has occurred?
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"I realize that recovery is a lifelong process that comes about in steps."
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Which of the following are reasons for the success of 12-step programs such as Alcoholics Anonymous (AA)? Select all that apply
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1. 12-step programs break down denial in an atmosphere of support. 2. 12-step programs give clients feelings of belonging to a community
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What classification of drugs shares similar features with alcohol overdose and alcohol withdrawal?
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Anxiolytics.
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A client with a long history of alcohol abuse is showing signs of cognitive deficits. What drug would the nurse recognize as appropriate in assisting with this client's alcohol recovery?
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Naltrexone (ReVia).
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A client with a long history of heroin abuse is showing signs of cognitive deficits. What drug would the nurse recognize as appropriate in assisting with this client's recovery?
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Buprenorphine/naloxone (Suboxone)
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A client receives lorazepam (Ativan) because of a high Clinical Institute Withdrawal Assessment (CIWA) score. What is the rationale for this pharmacologic intervention?
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Lorazepam (Ativan) is substitution therapy to decrease the intensity of withdrawal symptoms
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The nurse is planning a teaching session for a client who has recently been prescribed disulfiram (Antabuse) as deterrent therapy for alcoholism. What statement indicates that the client has accurate knowledge of this subject matter?
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"I'll have to stop using my alcohol-based aftershave while I am taking the Antabuse."
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A fasting blood glucose level value is to a sliding scale insulin dosage as a Clinical Institute Withdrawal Assessment (CIWA) score is to:
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A lorazepam (Ativan) dosage
