A
The nurse has provided group education on the topic of addiction. Which statements made
by the clients indicate an understanding of the information?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. "Heroin addicts often die from heroin withdrawal."
2. "Substance abuse depends on complex variables."
3. "Most addicts became addicted from pain medication in a hospital."
4. "Addiction includes a compulsion to use a mood-altering substance."
5. "There is most likely a genetic component to addiction."
2,4,5
1. While extremely unpleasant, withdrawal from opioids is typically not life threatening.
2. Substance abuse depends on multiple, complex, interacting variables.
3. Prescription drugs rarely cause addiction when used according to accepted medical
protocols.
4. Addiction is an overwhelming compulsion that drives someone to repetitive drug-taking
behavior, despite serious health and social consequences.
5. Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents.
A client states to the nurse, "I used to drink a pint of whiskey every day. Now I get sick and pass out after just two drinks." Which should the nurse be concerned with?
1. Pancreatic damage
2. Liver damage
3. The patient is in denial and is most likely minimizing the amount of alcohol he or she consumes.
4. The patient has brain damage from the alcohol and cannot remember how much he or she consumes.
2
1. While patients with alcoholism frequently have pancreatic damage, the symptoms described are related to the inability of the liver to metabolize the alcohol.
2. Alcoholism is a common cause of cirrhosis, a debilitating, and often fatal, failure of the liver to perform its vital functions, such as metabolism of alcohol.
3. While patients with alcoholism are frequently in denial and tend to minimize the amount of alcohol they consume, the symptoms described are related to the inability of the liver to metabolize the alcohol.
4. While patients with alcoholism frequently have brain damage, the symptoms described are related to the inability of the liver to metabolize the alcohol.
The nurse is providing education to a client that has smoked 1 pack of cigarettes daily for
the past few years and is currently prescribed oral contraceptives. Which statement should
the nurse include in the teaching?
1. "You are at a higher risk for a heart attack than nonsmokers."
2. "The nicotine will decrease the effectiveness of your birth control pills."
3. "You are at a higher risk for developing diabetes than smokers who do not use birth control pills."
4. "You are at a higher risk for emphysema than general smokers."
1
1. The client that smokes and takes oral contraceptives has an increased risk of a fatal heart attack.
2. There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives.
3. There is no evidence to support a correlation among diabetes, smoking, and oral contraceptives.
4. Smokers are at higher risk for emphysema. The use of oral contraceptives does not increase the risk.
A client tells the nurse he or she would like to stop taking methamphetamines but cannot
stop. Which should the nurse recognize the client is experiencing?
1. Psychological dependence
2. Substance dependence
3. Physical dependence
4. Withdrawal syndrome
2
1. There is no indication the client has drug seeking behaviors, therefore, it is unknown if there is a psychological dependence on the drug.
2. When a client has an overwhelming desire to take a drug and cannot stop, this condition is referred to as substance dependence.
3. There is no indication the client is experiencing any symptoms when they do not take the drug.
4. The statement made by the client indicates the intent to stop using the drug.
Which drug toxicity is a client experiencing that exhibits tachycardia and palpitations?
1. Nicotine
2. Alcohol
3. Benzodiazepines
4. Marijuana
1
1. Signs of nicotine toxicity include heart palpitations, tachydysrhythmias, confusion, depression, and seizures.
2. Signs of alcohol toxicity include somnolence and CNS depression.
3. Signs of benzodiazepine toxicity include somnolence and confusion.
4. Signs of marijuana toxicity include euphoria and paranoia.
A client asks the nurse what a "physical addiction to alcohol" means. Which response should the nurse provide the client?
1. "The brain remembers the euphoria experienced with alcohol, and there is a craving for it."
2. "There is an intense craving for alcohol, but the craving can be best managed through group therapy."
3. "The body becomes used to alcohol and if it is abruptly stopped withdrawal symptoms occur."
4. "Feelings of depression occur if the use of alcohol is stopped."
3
1. Alcohol does produce euphoria, but a craving for the substance is not a medical issue.
2. Psychological dependence, or craving, does not involve physical withdrawal symptoms.
3. Over time, the body's cells become accustomed to the presence of the unnatural substance. Specific, physical withdrawal symptoms will occur; the patient needs to be medically withdrawn from the substance.
4. Depression may accompany physical withdrawal, but physical signs are what medical management require.
The nurse is preparing to assess a client that is withdrawing from opioids. Which
assessment findings should the nurse anticipate?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Abdominal cramping
2. Orthostatic hypotension
3. Hot, dry skin
4. Violent yawning
5. Agitation
1,2,4,5
1. Symptoms of opioid withdrawal include abdominal cramping.
2. Orthostatic hypotension occurs during opioid withdrawal.
3. Diaphoresis is associated with opioid withdrawal.
4. Signs of opioid withdrawal include violent yawning.
5. Signs of opioid withdrawal include agitation.
A client with alcoholism prescribed disulfiram (Antabuse) tells the nurse that he or she
stopped taking the prescription a week prior and have begun drinking again. Which
assessment finding should the nurse anticipate?
1. Headache, nausea, and vomiting
2. Confusion and fine tremors
3. An absence of symptoms
4. Severe hyperglycemia
1
1. Alcohol sensitivity continues for up to 2 weeks after disulfiram has been discontinued. If alcohol is consumed while taking disulfiram (Antabuse), the patient becomes violently ill within 5 to 10 minutes. Symptoms include headache, shortness of breath, nausea, and vomiting.
2. Confusion and fine tremors are not side effects of the combined use of alcohol and disulfiram.
3. Alcohol sensitivity continues for up to 2 weeks after disulfiram has been discontinued.
4. Severe hyperglycemia and dry skin are not side effects of the combined use of alcohol and disulfiram.
Which symptoms should the nurse anticipate are associated with alcohol withdrawal?
1. Lethargy, constipation, light sensitivity, and weight loss
2. Anxiety, seizures, hearing loss, and alopecia
3. Tremors, anxiety, confusion, and delirium
4. Abdominal pain, chills, pupil dilation, and letharg
3
1. Lethargy, constipation, light sensitivity, and weight loss are not commonly associated with alcohol withdrawal.
2. Anxiety, seizures, hearing loss, and alopecia are not commonly associated with alcohol withdrawal.
3. Common withdrawal symptoms associated with alcohol include tremors, fatigue, anxiety, abdominal cramping, hallucinations, confusion, seizures, and delirium.
4. Abdominal cramping may occur, but chills, pupil dilation, and lethargy are not
commonly associated with alcohol withdrawal.
Which prescription should the nurse anticipate administering to a client experiencing acute
alcohol withdrawal?
1. Varenicline (Chantix)
2. Naltrexone (ReVia, Vivitrol)
3. Disulfiram (Antabuse)
4. Diazepam (Valium)
4
1. Varenicline is prescribed to treat nicotine withdrawal.
2. Naltrexone is prescribed to treat on opioid overdose.
3. Disulfiram is prescribed to discourage alcohol relapses.
4. Benzodiazepines are the preferred treatment for acute alcohol withdrawal. Diazepam is a benzodiazepine used to treat acute alcohol withdrawal.
Which phenomena occurs when a client with a history of alcoholism requires higher than
usual amounts of opioids for pain relief?
1. Physical dependence
2. Paradoxical reaction
3. Resistance to opioids
4. Cross tolerance
4
1. Physical dependence occurs when the body adapts to repeated use of the substance by altering normal physiology.
2. A paradoxical reaction is referring to the opposite of the anticipated effect occurring.
3. Resistance refers to the immune system and infections and should not be used
interchangeably with tolerance.
4. With chronic alcohol use, the liver adapts and metabolizes alcohol at a faster rate. More of the substance is required to achieve the same effect. This is a phenomenon known as cross-tolerance. This patient has a tolerance to alcohol, so he or she will require additional anesthesia for surgery since both drugs are CNS depressants.
A client asks the nurse what physiological effects occur if he or she quit smoking. Which
should the nurse include in the education?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Headaches
2. Depression
3. Increased appetite
4. Nausea
5. Insomnia
1,3,4,5
1. Headaches are associated with nicotine withdrawal.
2. Depression is not associated with nicotine withdrawal.
3. Increased appetite is a symptom associated with nicotine withdrawal.
4. Nausea is a symptom of nicotine withdrawal.
5. Insomnia is a symptom of nicotine withdrawal.
A client tells the nurse he or she would like a prescription to help stop smoking. Which
should the nurse anticipate the healthcare provider will prescribe?
1. Disulfiram (Antabuse)
2. Bupropion (Zyban)
3. Naltrexone (ReVia, Vivitrol)
4. Dextroamphetamine (Dexedrine)
2
1. Disulfiram is prescribed to discourage alcohol relapses.
2. Bupropion is prescribed to help reduce the cravings and symptoms of nicotine
withdrawal.
3. Naltrexone is an opioid antagonist that reduces the craving experienced by clients who are alcohol dependent.
4. Dextroamphetamine is prescribed for the treatment of attention-deficit/hyperactivity disorder and narcolepsy.
A client receiving a pain prescription for several weeks has required an increase of the
dosage to adequately manage symptoms. Which should the nurse recognize has occurred?
1. Immunity
2. Tolerance
3. Physiologic addiction
4. Psychological addiction
2
1. The term immunity is not associated with the requirement of an increase in the dosage of a prescription.
2. Drug tolerance occurs when the body adapts to a substance after repeated
administration.
3. A physiological addiction occurs when the body becomes addicted to the prescription.
4. A psychological addiction is reflected by an emotional need for the substance.
The nurse has provided education to a client about abuse of methylphenidate. Which
response by the client indicates further teaching is required?
1. "The prescription produces relaxation."
2. "The prescription heightens the awareness."
3. "The prescription gives them more energy."
4. "The prescription produces a euphoria."
1
1. Methylphenidate is a CNS stimulant that does not produce relaxation.
2. Methylphenidate is a CNS stimulant resulting in a heightened awareness.
3. Methylphenidate is a CNS stimulant resulting in an increased energy level.
4. Methylphenidate is a CNS stimulant that, when abused, produces a euphoria.
A client tells the nurse "I am going to get clean. I haven't had any drugs or any alcohol for 2
days." Which substance should the nurse anticipate can result in life threatening
withdrawal?
1. Heroin
2. Alcohol
3. Cocaine
4. Marijuana
2
1. Withdrawal from heroin is very unpleasant, but it is not life threatening.
2. Alcohol withdrawal syndrome is severe and may be life threatening.
3. Withdrawal from cocaine is uncomfortable, but it is not life threatening.
4. There is virtually no withdrawal from marijuana.
A client tells the nurse he or she has been taking "yellow jackets" (pentobarbital,
[Nembutal]) but has not had any for a few days. Which should the nurse recognize is the
highest priority?
1. Prepare to manage the client's depression.
2. Prepare to do frequent room searches, as the client's friends will most likely bring drugs in for him or her.
3. Prepare to manage a withdrawal that could be life threatening.
4. Prepare to manage the client's pain.
3
1. Withdrawal from barbiturates are life threatening; therefore, the client's physical condition will be a priority over the psychological condition.
2. Performing room searches is not the highest priority.
3. Barbiturates are central nervous depressant (CNS) drugs. Withdrawal symptoms resemble those of alcohol withdrawal and may be life threatening.
4. Pain is not associated with withdrawal from barbiturates and is not life threatening.
The nurse is caring for a client suspected of an opioid overdose. Which prescription should
the nurse anticipate administering?
1. Methadone (Dolophine)
2. Methylphenidate (Ritalin)
3. Naloxone (Narcan)
4. Bupropion (Zyban)
3
1. Methadone is a synthetic opioid that is used in the treatment of heroin addiction.
2. Methylphenidate is a CNS stimulate widely prescribed to children with ADHD.
3. Naloxone is used to reverse the effects of an opioid overdose.
4. Bupropion is used for the treatment of nicotine withdrawal.
Which drug is least likely to produce physical dependence or tolerance?
1. Marijuana
2. Morphine
3. Nicotine
4. Ethyl alcohol
1
1. Although psychological dependence is very high with marijuana, it has minor to no withdrawal symptoms.
2. Morphine produces withdrawal symptoms.
3. Nicotine produces withdrawal symptoms.
4. Ethyl alcohol produces withdrawal symptoms.
The nurse is assessing a client who has taken LSD. Which assessment finding should the
nurse anticipate?
1. Hypotension
2. Increased temperature
3. Pinpoint pupils
4. Bradycardia
2
1. LSD affects the central and autonomic nervous system resulting in hypertension.
2. LSD affects the central and autonomic nervous system resulting in an increased body temperature.
3. LSD affects the central and autonomic nervous system resulting in dilated pupils.
4. LSD affects the central and autonomic nervous system resulting in an increased heart rate.
A parent expressed concern that his or her adolescent son is up late at night, is listless, and
frequently uses eye drops for his bloodshot eyes. Which statement should the nurse include
in the discussion with the parent?
1. "He might be depressed; insomnia is common with depression."
2. "He could be smoking marijuana."
3. "Sounds like he is using cocaine."
4. "Your son could be studying too hard."
2
1. Depression in this patient is possible, but depressed patients do not always have red eyes that require the frequent use of eye drops.
2. Chronic use of marijuana is associated with a lack of motivation in achieving or pursuing life goals. One hallmark symptom of marijuana use is red or bloodshot eyes, caused by dilation of blood vessels. It is important for the parent to discuss this with the
adolescent.
3. Reddened or bloodshot eyes are not commonly seen with cocaine abuse but occur with the use of marijuana.
4. There is no indication the adolescent has been studying.
A family member of a deceased client that overdosed on cocaine asks the nurse how he or
she died. Which should the nurse recognize is the most likely cause of the death of the
client?
1. Cardiac arrest
2. Rhabdomyolysis
3. Drug impurity
4. Aneurysm
1
1. Overdose of cocaine can result in dysrhythmias, convulsions, stroke, or death due to cardiac and respiratory arrest.
2. Rhabdomyolysis is not associated with a cocaine overdose.
3. Although impurities in the cocaine could be toxic, overdose is much more likely to result in cardiac arrest.
4. Aneurysms are not associated with an overdose of cocaine.
The nurse assesses a client suspected of hallucinogen toxicity. Which assessment findings
support the nurse's suspicion?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Somnolence
2. Confusion
3. Panicked reactions
4. Blurred vision
5. Respiratory depression
2,3,4
1. Somnolence is not a symptom associated with hallucinogen toxicity.
2. Confusion is a symptom associated with hallucinogen toxicity.
3. Panicked reactions are a symptom associated with hallucinogen toxicity.
4. Blurred vision is a symptom associated with hallucinogen toxicity.
5. Respiratory depression is not a symptom associated with hallucinogen toxicity.
A client asks the nurse for information about cannabis infused edibles. Which information
should the nurse be prepared to discuss?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. Delayed onset
2. Longer duration of action
3. Physical dependence
4. Higher risk of unintentional overdose
5. Large doses are associated with psychedelic high
1,2,4,5
1. Cannabis infused edibles have a delayed onset.
2. Cannabis infused edibles have a longer duration of action.
3. Cannabis infused edibles do not have an increased risk of physical dependence.
4. Cannabis infused edibles have a higher risk of unintentional overdose.
5. Cannabis infused edibles when taken in large doses are associated with psychedelic high.
A client tells the nurse he or shehas been abusing his or her antianxiety prescription. Which
findings should the nurse recognize are related to a psychological dependence?
Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select
all that apply.
1. The patient's history reveals the long-term use of high doses of an antianxiety
prescription.
2. The client describes the "need" to use the antianxiety prescription despite not feeling
anxious.
3. The client describes feeling nauseous with abdominal cramping.
4. The client states his or her family does not speak to him or her because of the need for
the antianxiety prescription.
5. The client states he or she has not slept in days and feels very anxious and tired.
1,2,4
1. Psychological dependence usually requires the use of relatively high doses of antianxiety prescription over a prolonged period of time.
2. Psychological dependence is the "need" or desire to continue taking a drug when there is a lack of physical symptoms.
3. Physical dependence produces physical signs of discomfort when the agent is
discontinued. This is not true of psychological dependence.
4. To continue the use of the antianxiety drug at the risk of jeopardizing relationships is indicative of psychological dependence.
5. Physical dependence produces physical signs of discomfort when the agent is
discontinued. This is not true of psychological dependence.