Chapter 14 Substance Use and Addictive Disorders

Chapter 14  Substance Use and Addictive Disorders

Complete Chapter Questions And Answers
 

Sample Questions

____ 1. What should be the priority nursing diagnosis for a client experiencing alcohol withdrawal?
1.
Risk for injury R/T central nervous system stimulation
2.
Disturbed thought processes R/T tactile hallucinations
3.
Ineffective coping R/T powerlessness over alcohol use
4.
Ineffective denial R/T continued alcohol use despite negative consequences

____ 2. A nurse evaluates a client’s patient-controlled analgesia (PCA) pump and notices 100 attempts within a 30-minute period. Which is the best rationale for assessing this client for substance addiction?
1.
Narcotic pain medication is contraindicated for all clients with active substance use disorders.
2.
Clients who are addicted to alcohol or benzodiazepines may develop cross-tolerance to analgesics and require increased doses to achieve effective pain control.
3.
There is no need to assess the client for substance addiction. There is an obvious PCA malfunction, because these clients have a higher pain tolerance.
4.
The client is experiencing alcohol withdrawal symptoms and needs accurate assessment.

____ 3. On the first day of a client’s alcohol detoxification, which nursing intervention should take priority?
1.
Strongly encourage the client to attend 90 Alcoholics Anonymous (AA) meetings in 90 days.
2.
Educate the client about the biopsychosocial consequences of alcohol abuse.
3.
Administer ordered chlordiazepoxide (Librium) in a dosage according to protocol.
4.
Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.

____ 4. Which client statement indicates a knowledge deficit related to a substance use disorder?
1.
“Although it’s legal, alcohol is one of the most widely abused drugs in our society.”
2.
“Tolerance to heroin develops quickly.”
3.
“Flashbacks from lysergic acid diethylamide (LSD) use may reoccur spontaneously.”
4.
“Marijuana is like smoking cigarettes. Everyone does it. It’s essentially harmless.”

Answer Section

MULTIPLE CHOICE

1. ANS: 1
Chapter: Chapter 14, Substance Use and Addictive Disorders
Objective: Identify nursing diagnoses common to clients with substance-related and addictive disorders, and select appropriate nursing interventions for each.
Page: 284
Heading: Substance Use Disorder, Defined > Substance Withdrawal
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Analysis [Analyzing]
Concept: Addiction and Behaviors
Difficulty: Moderate

Feedback
1
The priority nursing diagnosis for a client experiencing alcohol withdrawal should be risk for injury R/T central nervous system stimulation. Alcohol withdrawal may include the following symptoms: course tremors of hands, tongue, or eyelids; nausea or vomiting; malaise or weakness; tachycardia; sweating; elevated blood pressure; anxiety; depressed mood; hallucinations; headache; and insomnia.
2
Disturbed thought processes R/T tactile hallucinations is important, but is not the priority nursing diagnosis.
3
Ineffective coping R/T powerlessness over alcohol use is important, but is not the priority nursing diagnosis.
4
Ineffective denial R/T continued alcohol use despite negative consequences is important, but is not the priority nursing diagnosis.

PTS: 1 CON: Addiction and Behaviors

2. ANS: 2
Chapter: Chapter 14, Substance Use and Addictive Disorders
Objective: Identify nursing diagnoses common to clients with substance-related and addictive disorders, and select appropriate nursing interventions for each.
Page: 287
Heading: Alcohol Use Disorder > Patterns of Use
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Moderate

Feedback
1
Narcotic pain medication should never be held because a client has a substance abuse disorder.
2
The nurse should assess the client for substance addiction, because clients who are addicted to alcohol or benzodiazepines may have developed cross-tolerance to analgesics and require increased doses to achieve effective pain control. Cross-tolerance is exhibited when one drug results in a lessened response to another drug.
3
The client should be assessed for a substance abuse disorder as needed, so that proper follow up can be arranged for the client.
4
In this scenario, the client is not exhibiting signs of substance abuse withdrawal.

PTS: 1 CON: Addiction and Behaviors

3. ANS: 3
Chapter: Chapter 14, Substance Use and Addictive Disorders
Objective: Identify nursing diagnoses common to clients with substance-related and addictive disorders, and select appropriate nursing interventions for each.
Page: 284
Heading: Substance Use Disorder, Defined > Substance Withdrawal
Integrated Processes: Nursing Process
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Moderate

Feedback
1
Encouraging AA meetings is important, but the administration of medication to prevent alcohol withdrawal takes priority due to client safety.
2
Education is important, but the administration of medication to prevent alcohol withdrawal takes priority due to client safety.
3
The priority nursing intervention for this client should be to administer ordered chlordiazepoxide in a dosage according to protocol. Chlordiazepoxide is a benzodiazepine and is often used for substitution therapy in alcohol withdrawal to reduce life-threatening complications.
4
Vitamin B1 administration is important, but the administration of medication to prevent alcohol withdrawal takes priority due to client safety.

PTS: 1 CON: Addiction and Behaviors

4. ANS: 4
Chapter: Chapter 14, Substance Use and Addictive Disorders
Objective: Identify topics for client and family teaching relevant to substance-related and addictive disorders.
Page: 307
Heading: Cannabis Intoxication
Integrated Processes: Teaching and Learning
Client Need: Safe and Effective Care Environment: Management of Care
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Moderate

Feedback
1
Cannabis is the second most widely abused drug in the United States.
2
This statement does not indicate a knowledge deficit.
3
This statement is true regarding LSD.
4
The nurse should determine that the client has a knowledge deficit related to substance use disorders when the client compares marijuana to smoking cigarettes and claims it to be harmless.

PTS: 1 CON: Addiction and Behaviors