NUR210CH18

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Author:
TomWruble
ID:
202042
Filename:
NUR210CH18
Updated:
2013-03-05 23:48:34
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nur210e2 Addictive Disorders
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Description:
Addictive Disorders
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  1. The nurse is caring for four patients. Which patient should be seen first, based upon substance-abuse risk potential?

    A. Female patient of Caucasian descent
    B. Male patient of Native American descent
    C. Male patient of African American descent
    D. Female patient of Japanese descent
    B. Male patient of Native American descent

    Males are diagnosed with substance abuse concerns at higher rates than females and are twice as likely to meet criteria for a drug use disorder. When compared to other ethnic groups in the general U.S. population, Native Americans and Alaskan Natives have the highest prevalence of alcohol dependence and are more likely to have used illicit substances.
    (this multiple choice question has been scrambled)
  2. Which patient behaviors should the nurse suspect as related to alcohol withdrawal?

    A. Hyper alert state, jerky movements, easily startled
    B. Tachycardia, diaphoresis, elevated blood pressure
    C. Peripheral vascular collapse, electrolyte imbalance
    D. Paranoid delusions, fever, fluctuating levels of consciousness
    A. Hyper alert state, jerky movements, easily startled

    Patients who are exhibiting hyper alertness, jerky movements, and are startled easily are most likely in a state of alcohol withdrawal, a condition which peaks in 24 to 48 hours after cessation or reduction of alcohol intake and then rapidly and dramatically disappears unless the withdrawal process progresses to alcohol withdrawal delirium.
    Tachycardia, diaphoresis, elevated blood pressure, peripheral vascular collapse, electrolyte imbalance, paranoid delusions, fever, and fluctuating levels of consciousness are associated with alcohol withdrawal delirium, a condition that is considered a medical emergency and can result in death if not treated.
    (this multiple choice question has been scrambled)
  3. The only class of commonly abused drugs that has a specific antidote is

    A. benzodiazepines.
    B. amphetamines.
    C. opiates.
    D. hallucinogens.
    C. opiates.

    The effects of opiates can be negated by a narcotic antagonist such as naloxone aka. Narcan.
    (this multiple choice question has been scrambled)
  4. Benzodiazepines are useful for treating alcohol withdrawal because they

    A. block cortisol secretion.
    B. increase dopamine release.
    C. decrease serotonin availability.
    D. bind to ã-aminobutyric acid–benzodiazepine receptors.
    D. bind to ã-aminobutyric acid–benzodiazepine receptors.

    Benzodiazepines act by binding to ã-aminobutyric acid–benzodiazepine receptor sites and produce a calming effect. Text page: 426
    (this multiple choice question has been scrambled)
  5. A client who is dependent on alcohol and drinks several six-packs of beer daily tells the nurse "Alcohol is no problem to me. I can quit anytime I want to." The nurse can assess this statement as indicating
    A. rationalization.
    B. denial.
    C. projection.
    D. reaction formation.
    B. denial.

    Believing one can control drug use despite addiction to the substance is based on denial (escaping unpleasant reality by ignoring its existence).Text page: 407
    (this multiple choice question has been scrambled)
  6. Which drug is most apt to have been ingested by a young woman who comes to the emergency department with the report that although she has no recollection of the incident, she believes she was sexually assaulted at a party?

    A. GHB
    B. Clonidine
    C. LAAM
    D. ReVia
    A. GHB

    The drugs most frequently used to facilitate a sexual assault (rape) are flunitrazepam (Rohypnol, "roofies"), a fast-acting benzodiazepine, and ã-hydroxybutyrate (It should read gamma(γ)-hydroxybutyrate)(GHB) and its congeners. They are odorless, tasteless, and colorless, mix easily with drinks, and can leave a person unconscious in a matter of minutes. Perpetrators use these drugs because they rapidly produce disinhibition and relaxation of voluntary muscles; they also cause the victim to have lasting anterograde amnesia for events that occur. Text page: 417
    (this multiple choice question has been scrambled)
  7. While helping an addicted individual plan for ongoing treatment, which of the following interventions is the first priority for a safe recovery?

    A. The client strives to maintain abstinence.
    B. Securing ongoing support from at least two family members.
    C. The client needs to be employed.
    D. A regular schedule of appointments with a primary care provider.
    A. The client strives to maintain abstinence.

    Abstinence is the safest treatment goal for all addicts. Abstinence is strongly related to good work adjustments, positive health status, comfortable interpersonal relationships, and general social stability. Text page: 420
    (this multiple choice question has been scrambled)
  8. Symptoms that would signal opioid withdrawal include

    A. synesthesia, depersonalization, and hallucinations.
    B. fatigue, lethargy, sleepiness, and convulsions.
    C. lacrimation, rhinorrhea, dilated pupils, and muscle aches.
    D. illusions, disorientation, tachycardia, and tremors.
    C. lacrimation, rhinorrhea, dilated pupils, and muscle aches.

    lacrimation - tears

    Symptoms of opioid withdrawal resemble the "flu," with runny nose, tearing, diaphoresis, muscle aches, cramps, chills, and fever. Text page: 414
    (this multiple choice question has been scrambled)
  9. Which of the drugs used by a polysubstance abuser is most likely to be responsible for withdrawal symptoms requiring both medical intervention and nursing support?

    A. Marijuana
    B. Opiates
    C. Hallucinogens
    D. Barbiturates
    D. Barbiturates

    Withdrawal from central nervous system depressants is complicated, requiring carefully titrated detoxification with a similar drug. Abrupt withdrawal can lead to death. Text page: 410
    (this multiple choice question has been scrambled)
  10. A client has been using cocaine intranasally for 4 years. Two months ago she started freebasing. For the past week she has locked herself in her apartment and has used $8000 worth of cocaine. When brought to the hospital she was unconscious. Nursing measures should include

    A. induction of vomiting.
    B. monitoring of opiate withdrawal symptoms.
    C. administration of ammonium chloride.
    D. Correct observation for hyperpyrexia and seizures.
    D. Correct observation for hyperpyrexia and seizures.

    Hyperpyrexia and convulsions are dangerous symptoms seen in central nervous system stimulant overdose. Text page: 413
    (this multiple choice question has been scrambled)
  11. T/F: Opiate overdose results in lowered blood pressure with a drop in pulse rate along with respiratory depression.
    False: rise in pulse
  12. A client was in an automobile accident. Although he has the odor of alcohol on his breath, his speech is clear and he is alert and answers questions posed to him. The law enforcement officer requests that the emergency department staff draw a blood sample for blood alcohol level determination. The level is determined to be 0.30 mg%. What conclusion can be drawn?

    A. No conclusions can be drawn from the data.
    B. The client ate a high-fat meal before drinking.
    C. The client has a high tolerance to alcohol.
    D. The client has a decreased tolerance to alcohol.
    C. The client has a high tolerance to alcohol.

    A nontolerant drinker would evidence staggering, ataxia, confusion, and stupor at this blood alcohol level. Text page: 412

    0.05 mg% 1-2 drinks Changes in mood and behavior; impaired judgment

    0.10 mg% 5-6 drinks Clumsiness involuntary motor activity; legal level of intoxication in most states

    0.20 mg% 10-12 drinks Depressed function of entire motor area of the brain, causing staggering and ataxia (failure of muscular coordination); emotional liability

    0.30 mg% 15-18 drinks Confusion, stupor

    0.40 mg% 20-24 drinks coma

    0.50 mg% 25-30 drinks Death due to respiratory depression
    (this multiple choice question has been scrambled)
  13. A client brought to the emergency department at the university hospital after PCP ingestion tries to run up and down the hallway. The nursing intervention that would be most therapeutic is

    A. obtaining an order for seclusion and close observation.
    B. taking him to the gym on the psychiatric unit.
    C. assigning a psychiatric technician to "talk him down."
    D. administering naltrexone as needed per hospital protocol.
    A. obtaining an order for seclusion and close observation.

    Aggressive, violent behavior is often seen with PCP ingestion. The client will respond best to a safe, low-stimulus environment such as that provided by seclusion until the effects of the drug wear off.

    Talking down is never advised because of the client's unpredictable violent potential.

    Naltrexone is an opiate antagonist. Text page: 415
    (this multiple choice question has been scrambled)
  14. A teaching need is revealed when a client taking disulfiram states

    A. "I usually treat heartburn with antacids."
    B. "Most over-the-counter cough syrups are OK for me to use."
    C. "I take ibuprofen or acetaminophen for headache."
    D. "I have had to give up using aftershave lotion."
    B. "Most over-the-counter cough syrups are OK for me to use."

    The client taking disulfiram has to avoid hidden sources of alcohol. Many cough syrups contain alcohol. Text page: 426
    (this multiple choice question has been scrambled)
  15. The most helpful message to transmit about relapse to the recovering alcoholic client is that lapses

    A. can be learning situations to prolong sobriety.
    B. result from lack of good situational support.
    C. are an indicator of treatment failure.
    D. are caused by physiological changes.
    B. result from lack of good situational support.

    Relapses can point out problems to be resolved and can result in renewed efforts for change. Text Page: 424
    (this multiple choice question has been scrambled)
  16. Addiction is
    a chronic relapsing condition.

    Relapse is one of the criteria for Dx of addiction.
  17. Signs of Alcohol poisoning
    • Inability to arouse individual
    • Cool or clammy skin
    • Respirations less than 10 per minute
    • Cyanosis under fingernails or gums
    • emesis while semiconscious or unconscious
  18. Treatment of Alcohol poisoning

    or any CNS depressant: barbiturates, benzodiazepines, etc.
    Carefully titrated detoxification with similar drug, e.g. alcohol for alcohol
  19. % of nurses that abuse alcohol or drugs

    % of nurses whose abuse seriosly affects their ability to provide safe nursing care
    10%

    6%
  20. Aim of substance abuse treatment...
    seld-responsibility, NOT compliance

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