Substance-related Disorders | NCLEX Quiz 212

1. The community nurse practicing primary prevention of alcohol abuse would target which groups for educational efforts?

Adolescents in their late teens and young adults in their early twenties

Elderly men who live in retirement communities

Women working in careers outside the home

Women working in the home

High-risk groups for alcohol abuse include individuals between ages 18 and 25 and the unemployed.Option B: There is no evidence that elderly men in retirement communities have increased rates of alcohol abuse.Options C and D: Men have 2 to 3 times increased risk than women of abusing alcohol.

Explanation

High-risk groups for alcohol abuse include individuals between ages 18 and 25 and the unemployed.Option B: There is no evidence that elderly men in retirement communities have increased rates of alcohol abuse.Options C and D: Men have 2 to 3 times increased risk than women of abusing alcohol.

2. Kendall.the sister of a client with a substance-related disorder.tells the nurse she calls out sick for her sister Kylie occasionally when the latter has too much to drink and cannot work. This behavior can be described as:

Caretaking.

Codependent.

Helpful.

Supportive.

Enabling behaviors that inadvertently promote continued use of a substance by the person abusing substances is known as codependency.Option A: The sister’s behavior is not an example of caretaking or support. She is taking responsibility for the client’s behavior and allowing her to avoid the consequences of his abuse problem.Options C and D: The behavior is unhelpful and unsupportive.

Explanation

Enabling behaviors that inadvertently promote continued use of a substance by the person abusing substances is known as codependency.Option A: The sister’s behavior is not an example of caretaking or support. She is taking responsibility for the client’s behavior and allowing her to avoid the consequences of his abuse problem.Options C and D: The behavior is unhelpful and unsupportive.

3. Nurse Wilma is teaching a client about disulfiram (Antabuse).which the client is taking to deter his use of alcohol. She explains that using alcohol when taking this medication can result in:

Abdominal cramps and diarrhea.

Drowsiness and decreased respiration.

Flushing.vomiting.and dizziness.

Increased pulse and blood pressure.

Disulfiram (Antabuse) prevents complete alcohol metabolism in the body. Therefore when alcohol is consumed.the client has a hypersensitivity reaction. Flushing.vomiting.and dizziness are associated with the incomplete breakdown of alcohol metabolites.Options A.B.and D: Other choices are not associated with the use of disulfiram along with alcohol.

Explanation

Disulfiram (Antabuse) prevents complete alcohol metabolism in the body. Therefore when alcohol is consumed.the client has a hypersensitivity reaction. Flushing.vomiting.and dizziness are associated with the incomplete breakdown of alcohol metabolites.Options A.B.and D: Other choices are not associated with the use of disulfiram along with alcohol.

4. Nurse Christine is teaching an adolescent health class about the dangers of inhalant abuse; the nurse warns about the possibility of:

Contracting an infectious disease.such as hepatitis or AIDS

Recurrent flashback events

Psychological dependence after initial use

Sudden death from cardiac or respiratory depression

Inhalants are CNS depressants; if taken in an excess amount.they can cause cardiac and respiratory depressions. It is impossible to control the inhalant dosage; therefore.death can occur.Options A.B.and C: Contracting an infectious disease.recurrent flashback events.and psychological dependence after initial use are not associated with inhalant abuse.

Explanation

Inhalants are CNS depressants; if taken in an excess amount.they can cause cardiac and respiratory depressions. It is impossible to control the inhalant dosage; therefore.death can occur.Options A.B.and C: Contracting an infectious disease.recurrent flashback events.and psychological dependence after initial use are not associated with inhalant abuse.

5. Which medication is commonly used in treatment programs for heroin abusers to produce a non-euphoric state and to replace heroin use?

Diazepam

Carbamazepine

Clonidine

Methadone

Methadone maintenance programs are used to provide a heroin-depleted individual with a medically controlled dose of methadone to produce a noneuphoric state that will prevent withdrawal symptoms. This method of treatment is advocated to help heroin abusers avoid criminal activities associated with obtaining heroin; it also prevents diseases associated with I.V. use of heroin.Options A and B: Diazepam and carbamazepine may be used for withdrawal from alcohol.barbiturates.and benzodiazepines.Option C: Clonidine can be used in acute withdrawal from heroin to avoid norepinephrine rebound when opiates are stopped.

Explanation

Methadone maintenance programs are used to provide a heroin-depleted individual with a medically controlled dose of methadone to produce a noneuphoric state that will prevent withdrawal symptoms. This method of treatment is advocated to help heroin abusers avoid criminal activities associated with obtaining heroin; it also prevents diseases associated with I.V. use of heroin.Options A and B: Diazepam and carbamazepine may be used for withdrawal from alcohol.barbiturates.and benzodiazepines.Option C: Clonidine can be used in acute withdrawal from heroin to avoid norepinephrine rebound when opiates are stopped.

6. The newly hired nurse at Nurseslabs Medical Center is assessing a client who abuses barbiturates and benzodiazepine. The nurse would observe for evidence of which withdrawal symptoms?

Anxiety.tremors.and tachycardia

Respiratory depression.stupor.and bradycardia

Muscle aches.cramps.and lacrimation

Paranoia.depression.and agitation

Barbiturates and benzodiazepine are CNS depressants; therefore.withdrawal symptoms are related to CNS stimulation caused by the rebounding of neurotransmitters (norepinephrine). Symptoms include increased anxiety.tremors.and vital sign changes (such as tachycardia and hypertension).Option B: Respiratory depression.stupor.and bradycardia are typically associated with an overdose—not withdrawal—of barbiturates or benzodiazepine.Option C: Muscle aches.cramps.and lacrimation are most commonly associated with withdrawal from opiates.Option D: Paranoia.depression.and agitation are usually associated with withdrawal from CNS stimulants.such as amphetamines or cocaine.

Explanation

Barbiturates and benzodiazepine are CNS depressants; therefore.withdrawal symptoms are related to CNS stimulation caused by the rebounding of neurotransmitters (norepinephrine). Symptoms include increased anxiety.tremors.and vital sign changes (such as tachycardia and hypertension).Option B: Respiratory depression.stupor.and bradycardia are typically associated with an overdose—not withdrawal—of barbiturates or benzodiazepine.Option C: Muscle aches.cramps.and lacrimation are most commonly associated with withdrawal from opiates.Option D: Paranoia.depression.and agitation are usually associated with withdrawal from CNS stimulants.such as amphetamines or cocaine.

7. Johnette is reviewing her lessons in Pharmacology. She is aware that the general classification of drugs belonging to the opioid category is analgesic and:

Depressant.

Hallucinogenic.

Stimulant.

Tranquilizing.

Opiates are both analgesics and CNS depressants because they decrease the effect of neurotransmitters that are excitatory or stimulating.Options B and C: Hallucinogenic and stimulant are categories that do not apply to opiates.Option D: Although an opiate can provide a tranquilizing effect; the general category would be that of a depressant.

Explanation

Opiates are both analgesics and CNS depressants because they decrease the effect of neurotransmitters that are excitatory or stimulating.Options B and C: Hallucinogenic and stimulant are categories that do not apply to opiates.Option D: Although an opiate can provide a tranquilizing effect; the general category would be that of a depressant.

8. During an initial assessment of a client admitted to a substance abuse unit for detoxification and treatment.the nurse asks questions to determine patterns of use of substances. Which of the following questions are most appropriate at this time? Select all that apply.

How long have you used substances?

How often do you use substances?

How do you get substances into your body?

Do you feel bad or guilty about your use of substances?

These questions will elicit information about the client’s pattern of use of substances. Options D and F are questions related to CAGE.a tool for screening suspected substance abusers.

Explanation

These questions will elicit information about the client’s pattern of use of substances. Options D and F are questions related to CAGE.a tool for screening suspected substance abusers.

9. The nurse administers bromocriptine (Parlodel) to Bryan who is undergoing detoxification for amphetamine abuse. The rationale for this medication is to:

Aid in GABA inhibition.

Prevent norepinephrine excess.

Restore depleted dopamine levels.

Treat psychotic symptoms.

Amphetamine abuse depletes the neurotransmitter dopamine. When withdrawing from amphetamines.dopamine depletion causes depression.insomnia.and intense craving for the drug. Bromocriptine (Parlodel) is a dopamine agonist that will help restore this neurotransmitter. GABA inhibition.prevention of norepinephrine excess.and treatment of psychotic symptoms are incorrect rationales for the use of this medication.Options A.B.and D: GABA inhibition.prevention of norepinephrine excess.and treatment of psychotic symptoms are incorrect rationales for the use of this medication.

Explanation

Amphetamine abuse depletes the neurotransmitter dopamine. When withdrawing from amphetamines.dopamine depletion causes depression.insomnia.and intense craving for the drug. Bromocriptine (Parlodel) is a dopamine agonist that will help restore this neurotransmitter. GABA inhibition.prevention of norepinephrine excess.and treatment of psychotic symptoms are incorrect rationales for the use of this medication.Options A.B.and D: GABA inhibition.prevention of norepinephrine excess.and treatment of psychotic symptoms are incorrect rationales for the use of this medication.

10. When a client abuses a CNS depressant.withdrawal symptoms will be caused by which of the following?

Acetylcholine excess

Dopamine depletion

Serotonin inhibition

Norepinephrine rebound

CNS depressants.when abused.cause depletion of stimulating neurotransmitters. When the CNS depressant is stopped.the result is a rebound of excitatory or stimulating neurotransmitters.such as norepinephrine.Options A.B.and C: Acetylcholine.dopamine.and serotonin are not significant factors in the symptoms of withdrawal from a CNS depressant.

Explanation

CNS depressants.when abused.cause depletion of stimulating neurotransmitters. When the CNS depressant is stopped.the result is a rebound of excitatory or stimulating neurotransmitters.such as norepinephrine.Options A.B.and C: Acetylcholine.dopamine.and serotonin are not significant factors in the symptoms of withdrawal from a CNS depressant.