Chapter 62

45問 • 1年前

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A patient has been diagnosed with alcoholism. A nurse tells him that he has a physical illness with a genetic predisposition to alcoholism, and the only effective treatment is total abstinence from alcohol. This type of approach characterizes which theory?

Biologic

During the taking of a medical history, a patient who is addicted to heroin reports he only uses the drug a few times a week. What is the nurse's best response when trying to disclose more precise information?

"Rate your weekly usage on a scale of 1 to 15."

A patient who has alcoholism with a history of heavy drinking is brought to the inpatient psychiatric unit saying that he does not know where he is or what day it is. What should the nurse suspect he is exhibiting?

Blackout

A nurse is discharging a patient with a pulmonary disorder to return home with her family. She has had a difficult time while in the hospital and has experienced withdrawal from tobacco. When the nurse tells her that community resources are available to help her to stop smoking, she says, "That's OK.I can stop whenever I want to." What does this exemplify?

Denial

A patient with an alcohol addiction says, "My drinking is all my wife's fault. She makes me so crazy I just have to have a drink." What does this exemplify?

Projection

Which information about a patient should lead a nurse to suspect substance abuse?

Abnormal liver function test result and a gastrointestinal (GI)bleed

A urine drug screen is ordered for a patient suspected of a driving while intoxicated (DWI).What drugs are included in this screening?

Lysergic acid diethylamide (LSD), Valium, and Percocet

An alcoholic is brought into the emergency department in an intoxicated state at 2000.The day shift nurse assesses the patient to exhibit tremors, have increased blood pressure, and agitation at 0800 rounds. What do these signs and symptoms indicate?

Early withdrawal

Which syndrome of alcoholism is related to thiamine deficiency?

Wernicke encephalopathy

A wife of a man with long-term alcoholism wants to help her husband quit drinking. The nurse tells her that an initial approach might be for a group of friends and family to confront the patient with his alcoholism. What should this group be prepared to indicate during this confrontation?

They reject his drinking but think he is a valuable person.

A nurse recommends to an alcoholic that he join Alcoholics Anonymous. What is true about this organization?

Based on a 12-step approach with a strong religious base

What should be avoided to prevent the accidental activation of Antabuse?

Mouthwash

A nurse in the admissions unit is informed that a patient is being brought in who has been using "ice." What should the nurse assess?

Violent behavior

An LPN is assisting with the development of a nursing care plan for a patient who has been using cocaine for 5 years. What should the nurse consider will most commonly need to be dealt with in this patient?

Depression

What might the positive effects of marijuana be used to treat?

Chemotherapy-induced nausea and vomiting

A nurse is counseling a pregnant cocaine abuser. What should the nurse inform this patient that she is placing her baby at significant risk for?

Neurologic impairments

What is the rationale for using methadone in the treatment of heroin abuse?

Does not give the "rush" that a person addicted to heroin is looking for.

Narcan has been given to a person with respiratory depression who is addicted to heroin. What should the nurse be alert for indications of?

Acute withdrawal symptoms

Two treatment plans for abusers of alcohol and drugs are similar-90 meetings in 90 days and 12-step programs. What is the major difference in the success of the two types of programs?

Relapse rates for patients using drugs other than alcohol alone are much higher.

Which implementation can be used to help prevent relapse in a patient who has a substance abuse problem?

Stress management

In some cases, patients will use drugs or alcohol to treat the disturbing symptoms of a psychiatric disease. What can occur in this scenario?

An accidental overdose by mixing alcohol with anxiolytic medications, antipsychotic medications, or antidepressants

A nurse indicates that a urine sample is needed for screening in a case of DWI. What actions should be implemented? (Select all that apply.)

Collection and witnessing by a staff member of the same gender, Documented with a chain-of-custody form signed by all who handle the specimen, Keep specimen under secure conditions if temporary storage is necessary

A nurse documents signs of Wernicke encephalopathy in a patient with long-term alcoholism. What do these signs include? (Select all that apply.)

Confabulation, Ataxia, Delirium, Decreasing level of consciousness

What does alcohol abuse in the older adult place him or her at risk for? (Select all that apply.)

Falls, Malnutrition, Bone demineralization, Cirrhosis

What is true regarding hair analysis done on an alcoholic? (Select all that apply.)

Requires sensitive technology, Can assess relapse

What factors make the adolescent extremely vulnerable to substance abuse (Select all that apply.)

Egocentricity, Poor impulse control, Desire for peer identification

Which blood alcohol level would indicate the need for the treatment of alcohol overdose?

0.3%

The nurse questions the patient about the heroin substance abuse. The patient states, "Heroin is the only way to relieve my back pain." This response is which type of defense mechanism?

Rationalization

Fetal alcohol syndrome is caused by the consumption of alcohol during which part of the pregnancy cycle?

Throughout

Once a patient has progressed to Korsakoff's psychosis, any acquired dementia is considered to be in which classification?

Permanent

Which type of questioning would the nurse use to obtain reliable data when interviewing a patient who may have a substance abuse disorder?

Specific

Denial about substance abuse is apparent when the patient makes which statement?

"I have no problem with drug use."

Which blood alcohol level is considered legally intoxicated in most states?

0.05%

Urine drug screening may be useful in identifying particular drugs, including marijuana and which other drug?

Cocaine

A nurse is presenting a community education class on drug abuse prevention. Which drug is the most commonly abused in the United States?

Alcohol

The LPN is reviewing laboratory tests for a patient who has a substance abuse disorder. The nurse needs to determine the degree of intoxication of the patient. Which lab test provides this information?

Blood alcohol study

Which medication increases impulse control and may decrease the chances of relapse in the recovering alcoholic?

Antabuse

Wernicke's encephalopathy, often seen with chronic alcohol use, may be a result of a deficiency in which vitamin?

Thiamine

"Crashing" is a profound depression often experienced by people withdrawing from which medication?

Amphetamines

An Alcoholics Anonymous sponsor is a person to whom the participant can relate and meets which other criteria?

An experienced AA member of the same sex

During a health history interview, the patient states to the nurse, "I had back surgery a couple of years ago, but my back never got fixed. The doctor stopped prescribing me pain medication. So, I found someone who would sell me morphine pills. That's the only thing that will make my pain tolerable." The patient is using which type of defense mechanism?

Rationalization

When taking disulfiram, patients must be instructed to avoid all alcohol, including alcohol found in which items?

cough syrup and mouthwash

Lysergic acid diethylamide's (LSD's) primary site of action is in which body system?

central nervous

Which factors are involved in substance dependence?

psychological and physical

A patient is being treated for alcohol dependency and has been prescribed disulfiram to aid in impulse control. What would the nurse instruct the patient to avoid while on this medication?

Cologne

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