Alcohol
On the first day of a client's alcohol detoxification, which nursing intervention should take priority?
A. Strongly encourage the client to attend 90 Alcoholics Anonymous meetings in 90 days.
B. Educate the client about the biopsychosocial consequences of alcohol abuse.
C. Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol.
D. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.
C
The priority nursing intervention for this client should be to administer ordered chlordiazepoxide (Librium) in a dosage according to protocol. Chlordiazepoxide (Librium) is a benzodiazepine and is often used for substitution therapy in alcohol withdrawal. Substitution therapy may be required to reduce life-threatening effects of the rebound stimulation of the central nervous system that occurs during withdrawal.
The patient tells the nurse that he has used cannabis regularly for the last 20 years. What should the nurse expect to find in the history and physical assessment (select all that apply)?
1. Gastric ulcers
2. Violent behavior
3. Productive cough
4. Memory impairment
5. Crackles in the lungs
6. Coronary artery disease
3. Productive cough
4. Memory impairment
5. Crackles in the lungs
A patient is experiencing withdrawal from opioids. A nurse expects to see which assessment finding most commonly associated w/acute opioid withdrawal?
a) elevated BP
b) decreased pulse
c) lethargy
d) constipation
a) elevated BP
A patient who overdosed on oxycodone is given naloxone. When assessing the patient, the healthcare provider would anticipate which of these clinical manifestations of opioid withdrawal?
A. Bradycardia and hyporthermia
B. Irritability and nausea
C. Hyperthermia and euphoria
D. Depressed respirations and somnolence
B. Irritability and nausea
The healthcare provider would expect to observe irritability and nausea. Heart rate and blood pressure will be baseline or elevated, and temperature will be unchanged.
A patient is brought to the emergency department by a family member. The patient has been agitated for the past several hours and has alternated between grandiosity and expressing a desire to commit suicide. Upon examination, the patient is diaphoretic, hypertensive, and tachycardic. Intoxication with which of the following substances would contribute to these symptoms?
A. Methamphetamine
B. Benzodiazepine
C. Marijuana
D. Alcohol
A. Methamphetamine
Alcohol abuse-induced thiamine deficiency can cause which of the following?
1. Wolf-Hirschhorn syndrome
2. Lewy body dementia
3. Agnosia
4. Wernicke-Korsakoff syndrome
4. Wernicke-Korsakoff syndrome
Wernicke-Korsakoff syndrome is caused by a severe deficiency in thiamine, often seen in severe alcohol dependency. It is characterized by visual disturbances, ataxia, and altered consciousness.
Which physical effect is the nurse most likely to be concerned about when caring for a client who has had long-term marijuana use?
a. Constipation
b. Cardiac dysrhythmia
c. Abdominal pain
d. Respiratory tract damage
D
Respiratory tract damage occurs from smoking the drug and is the greatest physical concern among chronic users.
A client diagnosed with alcohol dependence is submitted to your unit. He states that he is interested in using Naltrexone(Revia) to treat his dependence. He has several co-morbidities which he is concerned will interfere with him being prescribed Naltrexone. In which of the following illnesses would the use of naltrexone be contraindicated?
1. COPD
2. Asthma
3. Renal Disease
4. Liver Disease
4. Liver Disease
A nurse is caring for a client who has a history of opioid and heroin abuse and monitoring for signs of withdrawal. Which clinical manifestations are associated with heroin and opioid withdrawal. (select all that apply)
a. compulsive itching
b. diaphoresis
c. yawning and sneezing
d. insomnia
e. cramps and diarrhea
a. compulsive itching
b. diaphoresis
c. yawning and sneezing
d. insomnia
e. cramps and diarrhea
Emergency medical personnel bring an unconscious patient to the emergency department. The patient's pupils are pinpoint and respirations are depressed. Intoxication of which of the following substances could contribute to these clinical signs?
A. Methamphetamine
B. Methadone
C. Cocaine
D. Ecstasy
B. Methadone
A chronic alcoholic is admitted to the medical unit for pneumonia. Which medication would the nurse expect the health-care provider to prescribe to prevent delirium tremors?
1. chlordiazepoxide (Librium)
2. Thiamine (vitamin B1)
3. disulfiram (antabuse)
4. fluoxetine (Prozac)
1. chlordiazepoxide (Librium)
A patient is admitted to the unit during your shift. He admits using synthetic marijuana prior to his arrival in the ED. Which of the following may be observed in this patient? Select all that apply.
1. Tachycardia
2. Hypertension
3. Hypotension
4. Seizures
5. Agitation
1. Tachycardia
2. Hypertension
4. Seizures
A client detoxifying from alcohol requires medication to treat the withdrawal. The nurse observes coarse hand tremors and diaphoresis. How should the nurse first react to this observation? Select all that apply.
1. Assess level of consciousness
2. Explain the concepts of withdrawal to the client
3. Administer ordered thiamine and folic acid
4. Determine the most recent blood alcohol level
5. Assess the vital signs
1. Assess level of consciousness
5. Assess the vital signs
A nurse is monitoring an 18 year old who is experiencing heroin withdrawal. What symptoms might the nurse observe?
1. Coma and convulsions
2. Yawning, cramps, and diarrhea
3. Seizures, tremors, and tachycardia
4. Nausea and fainting
2. Yawning, cramps, and diarrhea
Yawning, cramps, and diarrhea are common signs of heroin withdrawal.
The oldest and most widely used psychoactive drug in the world is:
a. Marijuana
b. Heroin
c. Alcohol
d. Cocaine
C
The oldest and most widely used psychoactive drug in the world is alcohol.
A patient who is taking disulfiram as part of an alcohol treatment program accidentally takes a dose of cough syrup that contains a small percentage of alcohol. The nurse expects to see which symptom as a result of acetaldehyde syndrome?
a) lethargy
b) copious vomiting
c) HTN
d) no ill effect because of the small amount of alcohol in the cough syrup
b) copious vomiting
Which of the following drugs is considered a central nervous system (CNS) depressant?
1. Atenolol
2. Marijuana
3. Cyclobenzaprine
4. All of these
4. All of these
All of the drugs listed are considered to be CNS depressants. While generally classified as a psychedelic, marijuana has multiple central depressant effects such as sedation and muscle relaxation. Also, alcohol is another commonly used depressant.
A patient experiencing ethanol withdrawal is beginning to show severe manifestations of delirium temens. the nurse will plan to implement which interventions for this patient? (select all that apply)
a) doses of an oral benzodiazepine
b) doses of an IV benzodiazepine
c) restraints if the patient becomes confused, agitated, or a threat to himself or others
d) thiamne supplementation
e) oral disulfiram (Antabuse) treatment
f) monitoring in the intensive care unit
b) doses of an IV benzodiazepine
c) restraints if the patient becomes confused, agitated, or a threat to himself or others
d) thiamne supplementation
f) monitoring in the intensive care unit
An emergency room nurse is assessing a 26 year old female patient who frequently uses opium. What symptoms would indicate that she is experiencing withdrawal?
1. Nausea, vomiting, and depression
2. Irritability, tremors, and seizures
3. Diaphoresis, seizures, and apathy
4. Fatigue, disorientation, and craving
4. Fatigue, disorientation, and craving
Fatigue, disorientation, and craving are common symptoms of opium withdrawal.
A nurse is providing education to a parent-teacher organization about substance use and abuse among children. Which information would the nurse most likely include in this presentation?
a. Inhalants are among the first drugs that young children use.
b. Implementing the DARE program is the most effective way to prevent drug-use.
c. Underage drinking is not a problem in most communities.
d. Early experimentation with substances decreases the likelihood of future abuse.
A
Inhalants are among the first drugs that young children use.
Which medical problems would a client with chronic alcohol abuse most likely experience? Select all that apply.
a. Gastrointestinal disturbances
b. Cardiac dysrhythmias
c. Depression
d. Organic brain syndrome
A, B, C, D
Gastrointestinal disturbances, cardiac dysrhythmias, depression, and organic brain syndrome are some effects of chronic alcohol abuse.
Marijuana (Cannabis sativa or C. indica) is the most widely used illicit drug in the United States. The nurse should be aware that marijuana has which of the following characteristics? (Select all that apply.)
A. Decreases appetite
B. May lead to tolerance
C. Is highly toxic
D. Has little quality control
E. Is a safe therapeutic agent
ANS: D
The nurse should determine that the client has a knowledge deficit related to substance abuse when the client compares marijuana to smoking cigarettes and claims it to be harmless. Cannabis is the second most widely abused drug in the United States.
A patient has been admitted to the ER after suspected overdose of benzodiazepines mixed w/alcohol. The patient is lethargic and cannot speak. The nurse expects which immediate measures to be implemented? (select all that apply)
a) prepare to administer naloxone (Narcan)
b) prepare to administer flumazenil
c) monitor patient for convulsions
d) prepare for potential respiratory arrest
e) apply restraints
b) prepare to administer flumazenil
c) monitor patient for convulsions
d) prepare for potential respiratory arrest
A patient who is addicted to heroin begins a methadone maintenance program. Which of the following statements made by the healthcare provider correctly explains the rationale for treating this patient's substance abuse disorder with methadone. (SATA)
A. "It isn't possible for you to become addicted to methadone."
B. "Methadone reduces the craving for heroin."
C. "It's much safer to give methadone in large doses."
D. "Methadone reduces the high that is felt with heroin."
E. "If you take heroin while on methadone you'll get sick."
B. "Methadone reduces the craving for heroin."
D. "Methadone reduces the high that is felt with heroin."
A patient is experiencing withdrawal from benzodiazepine dependence. The healthcare provider will monitor the patient for which of the following symptoms? (select all that apply.)
A. Hypersomnia
B. Tremors
C. Anxiety
D. Yawning
E. Seizures
B. Tremors
C. Anxiety
E. Seizures