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Substance-related And Addictive Disorders

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Question 1
Free
Multiple Choice

A patient with a history of daily alcohol abuse was hospitalized at 0200 today. When would the nurse expect withdrawal symptoms to peak?

Choose correct answer/s
A

Between 0800 and 1000 today (6 to 8 hours after drinking stopped)

B

Between 0200 tomorrow and hospital day 2 (24 to 48 hours after drinking stopped)

C

About 0200 on hospital day 3 (72 hours after drinking stopped)

D

About 0200 on hospital day 4 (96 hours after drinking stopped)

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Question 2
Free
Multiple Choice

A woman in the last trimester of pregnancy drinks 8 to 12 ounces of alcohol daily. The nurse plans for the delivery of an infant who is:

Choose correct answer/s
A

jaundiced.

B

dependent on alcohol.

C

healthy but underweight.

D

microcephalic and cognitively impaired.

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Question 3
Free
Multiple Choice

A patient was admitted one day ago with a hip fracture sustained in a fall while intoxicated. The patient points to the Buck's traction and screams, "Somebody tied me up with ropes." The patient is experiencing:

Choose correct answer/s
A

an illusion.

B

a delusion.

C

hallucinations.

D

hypnagogic phenomenon.

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Question 4
Free
Multiple Choice

A patient was admitted 48 hours ago for injuries sustained while intoxicated. The patient is shaky, irritable, anxious, and diaphoretic. The pulse rate is 130 beats per minute. The patient shouts, "Snakes are crawling on my bed. I've got to get out of here." What is the most accurate assessment of the situation? The patient:

Choose correct answer/s
A

is attempting to obtain attention by manipulating staff.

B

may have sustained a head injury before admission.

C

has symptoms of alcohol withdrawal delirium.

D

is having a recurrence of an acute psychosis.

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Question 5
Free
Multiple Choice

A patient admitted yesterday for injuries sustained in a fall while intoxicated believes snakes are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis?

Choose correct answer/s
A

Disturbed sensory perception

B

Ineffective coping

C

Ineffective denial

D

Risk for injury

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Question 6
Multiple Choice

A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe?

Choose correct answer/s
A
Monoamine oxidase inhibitor, such as phenelzine (Nardil)
B
Phenothiazine, such as thioridazine (Mellaril)
C
Benzodiazepine, such as lorazepam (Ativan)
D
Narcotic analgesic, such as morphine
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Question 7
Multiple Choice

A hospitalized patient, injured in a fall while intoxicated, believes spiders are spinning entrapping webs in the room. The patient is anxious, agitated, and diaphoretic. Which nursing intervention has priority?

Choose correct answer/s
A
Check the patient every 15 minutes.
B
Rigorously encourage fluid intake.
C
Provide one-on-one supervision.
D
Keep the room dimly lit.
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Question 8
Multiple Choice

A patient with a history of daily alcohol use says, "Drinking helps me cope with being a single parent." Which response by the nurse would help the individual conceptualize the drinking more objectively?

Choose correct answer/s
A
"Sooner or later, alcohol will kill you. Then what will happen to your children?"
B
"I hear a lot of defensiveness in your voice. Do you really believe this?"
C
"If you were coping so well, why were you hospitalized again?"
D
"Tell me what happened the last time you drank."
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Question 9
Multiple Choice

A patient asks for information about Alcoholics Anonymous (AA). Which is the nurse's best response?

Choose correct answer/s
A
"It is a self-help group with the goal of sobriety."
B
"It is a form of group therapy led by a psychiatrist."
C
"It is a group that learns about drinking from a group leader."
D
"It is a network that advocates strong punishment for drunk drivers."
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Question 10
Multiple Choice

Police bring a patient to the emergency department after an automobile accident. The patient is ataxic with slurred speech and mild confusion. The blood alcohol level is 400 mg/dl (0.40 mg %). Considering the relationship between behavior and blood alcohol level, which conclusion can the nurse draw? The patient:

Choose correct answer/s
A
rarely drinks alcohol.
B
has a high tolerance to alcohol.
C
has been treated with disulfiram (Antabuse).
D
has recently ingested both alcohol and sedative drugs.
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Question 11
Multiple Choice

A patient admitted to an alcoholism rehabilitation program says, "I'm just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and several drinks during the evening." The patient is using which defense mechanism?

Choose correct answer/s
A
Rationalization
B
Introjection
C
Projection
D
Denial
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Question 12
Multiple Choice

A new patient in an alcoholism rehabilitation program says, "I'm just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and a few drinks in the evening." Which response by the nurse will help the patient view the drinking more honestly?

Choose correct answer/s
A
"I see," and use interested silence.
B
"I think you may be drinking more than you report."
C
"Being a social drinker involves having a drink or two once or twice a week."
D
"You describe drinking steadily throughout the day and evening. Am I correct?"
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Question 13
Multiple Choice

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

Choose correct answer/s
A
"It is good that you're supportive of your spouse's sobriety and want to help maintain it."
B
"Although sobriety solves some problems, new ones may emerge as one adjusts to living without alcohol."
C
"It will be important for you to structure life to avoid as much stress as possible. You will need to provide social protection."
D
"Remember that alcoholism is a disorder of self-destruction. You will need to observe your spouse's behavior carefully."
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Question 14
Multiple Choice

The treatment team plans care for a person diagnosed with schizophrenia and cannabis abuse. The person has recently used cannabis daily and is experiencing increased hallucinations and delusions. Which principle applies to care planning?

Choose correct answer/s
A
Consider each disorder primary and provide simultaneous treatment.
B
The person will benefit from treatment in a residential treatment facility.
C
Withdraw the person from cannabis, and then treat the schizophrenia.
D
Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
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Question 15
Multiple Choice

When working with a patient beginning treatment for alcohol abuse, what is the nurse's most therapeutic approach?

Choose correct answer/s
A
Empathetic, supportive
B
Strong, confrontational
C
Skeptical, guarded
D
Cool, distant
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Question 16
Multiple Choice

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

Choose correct answer/s
A
explore the patient's reasons for drinking today.
B
arrange admission to an inpatient psychiatric unit.
C
coordinate emergency admission to a detoxification unit.
D
tell the patient, "We cannot see you today because you've been drinking."
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Question 17
Multiple Choice

When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After 1 year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur?

Choose correct answer/s
A
Tolerance develops
B
The alcohol is less potent
C
Antagonistic effects occur
D
Hypomagnesemia develops
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Question 18
Multiple Choice

Which statement most accurately describes substance addiction?

Choose correct answer/s
A
A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance.
B
A disorder associated with tolerance to a substance as well as withdrawal symptoms if use is abruptly discontinued.
C
Behaviors associated with habitual use of a substance for the single purpose of altering one's mood, emotion, or state of consciousness.
D
A behavioral disorder associated with selected personality features.
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Question 19
Multiple Choice

A patient admitted for a heroin overdose received naloxone (Narcan). The patient's breathing pattern improved. Two hours later, the patient reports muscle aches, abdominal cramps, gooseflesh and says, "I feel terrible." Which analysis is correct?

Choose correct answer/s
A
The patient is exhibiting a prodromal symptom of seizures.
B
An idiosyncratic reaction to naloxone is occurring.
C
Symptoms of opiate withdrawal are present.
D
The patient is experiencing a relapse.
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Question 20
Multiple Choice

In the emergency department, a patient's vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats per minute (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone (Dilaudid). Select the priority outcome.

Choose correct answer/s
A
Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
B
The patient will be able to describe a plan for home care and achieve a drug-free state before being released from the emergency department.
C
The patient will attend daily meetings of Narcotics Anonymous within 1 week of beginning treatment.
D
The patient will identify two community resources for the treatment of substance abuse by discharge.
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