Substance Abuse
What does the term "dual diagnosis" refer to in the context of substance use disorders?
A) Having two different types of substance use disorders
B) Substance use disorder co-occurring with mental health issues
C) Substance use disorder co-occurring with a physical illness
D) Diagnosing two people with the same disorder simultaneously
Correct Answer: B) Substance use disorder co-occurring with mental health issues
What is the primary treatment for caffeine overdose?
A) Insulin therapy
B) Hydration and supportive care
C) Antidepressant medication
D) Surgical intervention
Correct Answer: B) Hydration and supportive care
Which medications may be used to manage severe agitation in hallucinogen intoxication?
A) Fluoxetine and alprazolam
B) Haloperidol and lorazepam
C) Sertraline and diazepam
D) Risperidone and clonazepam
Correct Answer: B) Haloperidol and lorazepam
A patient with a history of intravenous drug use presents with track marks, drowsiness, and impaired memory and attention. Which physical finding should the nurse anticipate?
A. Hypertension
B. Increased respiratory rate
C. Pinpoint pupils
D. Increased bowel sounds
Answer: C. Pinpoint pupils
Rationale: Pinpoint pupils are indicative of opioid use. The other symptoms (track marks, drowsiness, impaired memory, and attention) also point towards opioid use, making pinpoint pupils the expected physical finding.
Which environmental factors are associated with an increased risk of substance use disorders? (Select all that apply.)
A) Chronic stressors
B) Lack of parental supervision
C) High educational resources
D) Impaired support
Correct Answers: A) Chronic stressors, B) Lack of parental supervision, D) Impaired support
What is a common feature of process addictions?
A) They involve occasional use of substances
B) They activate reward and pleasure pathways in the brain
C) They are always related to physical activities
D) They do not lead to any form of impairment
Correct Answer: B) They activate reward and pleasure pathways in the brain
What are the physical symptoms of cannabis withdrawal? (Select all that apply.)
A) Abdominal pain and shakiness
B) Increased appetite and weight gain
C) Sweating and fever
D) Euphoria and hyperactivity
Correct Answers: A) Abdominal pain and shakiness, C) Sweating and fever
Which physical symptom is specifically associated with PCP intoxication?
A) Hyperacusis (sensitivity to sound)
B) Mydriasis (pupil constriction)
C) Increased appetite
D) Bradycardia
Correct Answer: A) Hyperacusis (sensitivity to sound)
After administering naloxone to a patient, the nurse observes an increase in respirations and pupil dilation. What is the most appropriate next step?
A. Administer an additional dose of naloxone
B. Monitor the patient for withdrawal symptoms
C. Prepare the patient for discharge
D. Administer a sedative to calm the patient
Answer: B. Monitor the patient for withdrawal symptoms
Rationale: After naloxone administration, monitoring for withdrawal symptoms is crucial as the reversal of opioid effects can precipitate acute withdrawal symptoms.
What are the withdrawal symptoms associated with inhalant use? (Select all that apply.)
A) Coma and cardiac arrhythmia
B) Gastrointestinal upset and hyperactivity
C) Bronchospasm and psychosis
D) Improved judgment and decision-making
Correct Answers: A) Coma and cardiac arrhythmia, C) Bronchospasm and psychosis
Why is it important for all nurses to understand substance use disorders?
A) They are easy to treat and manage
B) They are common and complex, requiring comprehensive understanding for effective care
C) They only affect a small population
D) They are unrelated to mental health issues
Correct Answer: B) They are common and complex, requiring comprehensive understanding for effective care
How long after cessation do cannabis withdrawal symptoms typically peak?
A) Immediately
B) 12-24 hours
C) About a week
D) One month
Correct Answer: C) About a week
What long-term effects can result from chronic inhalant use? (Select all that apply.)
A) Dementia and psychosis
B) Enhanced cognitive function
C) Stupor and unconsciousness
D) Improved physical health
Correct Answers: A) Dementia and psychosis, C) Stupor and unconsciousness
In managing a patient with an opioid overdose, the nurse aspirates secretions and ventilates the patient. Which of the following additional actions should the nurse take to ensure airway patency?
A. Administer naloxone via intranasal route
B. Perform a complete neurological assessment
C. Administer an antiemetic
D. Insert a nasogastric tube
Answer: A. Administer naloxone via intranasal route
Rationale: Administering naloxone is essential in opioid overdose management to reverse respiratory depression and restore airway patency. The intranasal route is one effective method of administration.
Why might people with too much opioid antagonism be prone to self-medicating with opioid drugs?
A) They have high natural opioid activity
B) They have low natural opioid activity
C) They seek to balance the excessive antagonism
D) They are unaffected by opioid drugs
Correct Answer: C) They seek to balance the excessive antagonism
Which substances have potentially fatal withdrawal symptoms?
A) Opioids and stimulants
B) Alcohol and benzodiazepines
C) Cannabis and hallucinogens
D) Tobacco and caffeine
Correct Answer: B) Alcohol and benzodiazepines
Which symptoms are associated with a lethal caffeine overdose? (Select all that apply.)
A) Tachycardia and cardiac arrhythmias
B) Hyperthermia and bradycardia
C) Hypertension followed by hypotension
D) Gastrointestinal disturbances and muscle twitching
Correct Answers: A) Tachycardia and cardiac arrhythmias, C) Hypertension followed by hypotension
Which of the following is a common treatment for hallucinogen intoxication that also ensures patient and provider safety?
A) Talking down and reassurance
B) Immediate high-calorie feeding
C) Forced isolation
D) Administration of stimulants
Correct Answer: A) Talking down and reassurance
When assessing a patient with suspected opioid intoxication, the nurse notes slurred speech and altered mood. Which of the following additional findings would support the diagnosis of opioid intoxication?
A. Hyperactivity
B. Increased heart rate
C. Decreased bowel sounds
D. Increased memory retention
Answer: C. Decreased bowel sounds
Rationale: Decreased bowel sounds, along with slurred speech, altered mood, and other symptoms, support the diagnosis of opioid intoxication. Hyperactivity, increased heart rate, and increased memory retention are not consistent with opioid intoxication.
A nurse is administering clonidine (Catapres) to a patient in opioid withdrawal. What is the expected outcome of this medication?
A. Increased sweating and hot flashes
B. Reduced symptoms of withdrawal such as sweating, hot flashes, watery eyes, and restlessness
C. Increased euphoria and respiratory depression
D. Increased anxiety and prolonged detox process
Answer: B. Reduced symptoms of withdrawal such as sweating, hot flashes, watery eyes, and restlessness
Rationale: Clonidine reduces symptoms of withdrawal and can help ease sweating, hot flashes, watery eyes, and restlessness, as well as decrease anxiety and potentially shorten the detox process.
What is the primary risk associated with behavioral addictions?
A) They do not lead to any significant impairment
B) They can result in craving, sleep disruptions, anxiety, and depression
C) They are easier to manage than substance addictions
D) They only affect cognitive functions
Correct Answer: B) They can result in craving, sleep disruptions, anxiety, and depression
Which of the following is a common symptom of cannabis intoxication?
A) Enhanced motor skills
B) Depersonalization and derealization
C) Decreased appetite
D) Bradycardia
Correct Answer: B) Depersonalization and derealization
What behavioral changes might indicate hallucinogen intoxication?
A) Enhanced motor skills and coordination
B) Restlessness and agitation
C) Increased focus and attention
D) Reduced sensory perception
Correct Answer: B) Restlessness and agitation
A patient in the early stages of opioid withdrawal is prescribed buprenorphine (Suboxone). Which of the following should the nurse include in the patient teaching?
A. Buprenorphine can be used at any stage of opioid withdrawal
B. Buprenorphine should be used only after abstaining from opioids for 12 to 24 hours and in the early stages of withdrawal
C. Buprenorphine will induce euphoria similar to heroin
D. Buprenorphine does not have any side effects
Answer: B. Buprenorphine should be used only after abstaining from opioids for 12 to 24 hours and in the early stages of withdrawal
Rationale: Buprenorphine should be used only after abstaining from opioids for 12 to 24 hours and in the early stages of withdrawal to prevent acute withdrawal symptoms.
A patient undergoing opioid withdrawal is prescribed methadone. Which of the following is the primary purpose of this medication?
A. To increase the euphoria associated with opioid use
B. To decrease the pain of withdrawal and block the euphoric effect of drugs like heroin
C. To induce acute withdrawal symptoms
D. To treat constipation
Answer: B. To decrease the pain of withdrawal and block the euphoric effect of drugs like heroin
Rationale: Methadone is a synthetic opioid used to decrease the pain associated with withdrawal and to block the euphoric effects of drugs like heroin.