Deck 8: Pharmacology of Substance Abuse

Question 1

The client comes to the Emergency Department and tells the nurse, "I have been off my drugs for three days." The nurse assesses the client for withdrawal symptoms associated with the category of drug used.Withdrawal from which drug, if taken by the client, should cause the nurse the most concern?
1)Heroin
2)Alprazolam (Xanax)
3)Marijuana
4)Cocaine

Answer 1

2

Question 2

The client has been abusing alcohol for several years, and tells the nurse, "I used to drink a pint of whiskey every day.Now I get sick and pass out after just two drinks." What does the nurse correctly recognize about this client?
1)The client could have liver damage, resulting in an inability to metabolize large amounts of alcohol.
2)The client's symptoms are related to hyperglycemia; he might have pancreatic damage.
3)The client is in denial, and most likely is misrepresenting the amount of alcohol he consumes.
4)The client has brain damage from the alcohol, and cannot remember how much he consumes.

Answer 2

1

Question 3

The nurse is managing care for a group of substance abusers.The clients have completed group education about the disease of addiction.The nurse determines that learning has occurred when the clients make which statements? Select all that apply.
1)"A heroin addict can 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."

Answer 3

2, 4, 5

Question 4

The client tells the nurse that her 12-year-old child asks to use her nail polish remover several times a day.When her friends come to visit, this seems to occur more frequently.What is the best response by the nurse?
1)"Your daughter might be 'huffing,' or inhaling the remover."
2)"Your daughter might be 'huffing'; that is really scary."
3)"Your daughter might be 'huffing,' or drinking small amounts of the remover."
4)"Your daughter might be 'huffing,' or rubbing the remover on her skin."

Question 5

The client is withdrawing from opioids.Which symptoms best describe the results of the nurse's assessment? Select all that apply.
1)Diaphoresis
2)Dilated pupils
3)Abdominal cramping and pain
4)Hypotension
5)Pinpoint pupils

Question 6

The client has smoked a pack of cigarettes per day for twenty years.The client also takes oral contraceptives.In implementing a teaching plan, what is the most important information for the nurse to include?
1)"You are at a greater risk for emphysema than are nonsmokers."
2)"You are at a greater risk for a heart attack than are nonsmokers."
3)"The nicotine will decrease the effectiveness of your birth control pills."
4)"You are at a greater risk for developing diabetes than are smokers who do not use birth control pills."

Question 7

The adolescent client is in a drug rehabilitation program.The mother of this client says to the nurse, "The doctor said my son has a physical addiction to alcohol.What does this mean?" What is the best response by the nurse?
1)"He will have feelings of depression when stopping alcohol; we need to monitor him for suicide."
2)"He will have an intense craving for alcohol; this is best managed in group therapy."
3)"His body is used to alcohol; he will have specific withdrawal symptoms when it is stopped."
4)"His brain remembers the euphoria he had with alcohol, and he has a craving to return to it."

Question 8

The client is admitted to the inpatient substance abuse unit.She tells the nurse she has been buying "yellow jackets" (pentobarbital, or Nembutal)on the street, but hasn't had any for a few days.What is the best plan by the nurse at this time?
1)Prepare to manage the depression and suicidal thoughts the client will have.
2)Prepare to do frequent room searches, as the client's friends will most likely bring drugs in for her.
3)Prepare to manage a withdrawal that will likely be minimal.
4)Prepare to manage a withdrawal that could be life-threatening.

Question 9

What is a priority outcome for the client who has chronic alcoholism with liver damage?
1)The client will keep all appointments with the doctor treating his liver damage.
2)The client will learn to drink more responsibly.
3)The client will switch to a safer drug, like a benzodiazepine.
4)The client will become involved in Alcoholics Anonymous (AA).

Question 10

The client has an extensive history of alcoholism.He is having coronary bypass surgery.While administering anesthesia, the certified nurse anesthetist notes that the client requires greater-than-usual amounts of the drug.The nurse correctly evaluates this response as what phenomenon?
1)The client has developed a paradoxical reaction to the anesthesia, and will require a different drug.
2)The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this client.
3)The client has developed a resistance to the anesthesia, so it will not work very well.
4)The client had developed cross-tolerance to the anesthesia, and will require greater amounts.

Question 11

The client had been abusing cocaine for several years.Recently, the client snorted cocaine that was much purer than was thought, resulting in an overdose.The client died in the Emergency Department.What does the nurse recognize as the most likely cause of death?
1)Bowel ischemia
2)Impurities in the cocaine
3)Cardiac arrest
4)Rhabdomyolysis

Question 12

The client is a 10-year-old child admitted to the Emergency Department after "huffing" gasoline.The physician suspects mild brain damage.What signs will the nurse teach the parents to observe for after they take the child home?
1)Depression, cold extremities, and dyspnea
2)Irregular pulse, fainting, and anger
3)Slurred speech, memory loss, and personality changes
4)Nausea, vomiting, and dizziness

Question 13

The mother of an adolescent client says to the nurse, "I think my son is staying up too late studying, and I see him using Visine eye drops all the time for his red eyes.Should I have his vision checked?" What is the best response by the nurse?
1)"Yes, that is a great idea, he might need some glasses."
2)"It sounds like he could be smoking marijuana, and I would talk to him."
3)"He might be depressed; insomnia is common with depression."
4)"Sounds like he is using cocaine; I have seen this before."

Question 14

The client is postop, day 1 after an abdominal hysterectomy, and is requesting morphine sulfate intravenous (IV), which is prescribed.The client rates her pain as 8 out of 10, with 10 being the most intense.The nurse caring for this client says to another nurse, "She really doesn't look like she is in pain.Maybe she is an addict." What is the best response by the other nurse?
1)"Maybe you could tell her to do some distraction techniques first."
2)"I would give the morphine; pain is subjective, and we don't know her history."
3)"I would hold the medication until she looks like she is in pain."
4)"You could call the doctor and get an order for an oral medication."