Question: In the emergency department, a patient’s vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats/min (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone. What is the priority outcome for this patient?
Answer Choices: a. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute. b. The patient will be able to describe a plan for home care and achieve a drug-free state before being released from the emergency department. c. Within 3 days, the patient will demonstrate readiness to participate in a substance abuse program. d. The patient will verbalize understanding of the relationship between substance abuse and overdose.
Answer: a. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
Question: Select the nursing intervention necessary after administering naloxone to a patient experiencing an opiate overdose.
Answer Choices: a. Monitor the airway and vital signs every 15 minutes. b. Insert a nasogastric tube and test gastric pH. c. Treat hyperpyrexia with cooling measures. d. Insert an indwelling urinary catheter.
Answer: a. Monitor the airway and vital signs every 15 minutes.
Question: A graduate nurse worked at a hospital for several months, resigned, and then took a position at another hospital. In the new position, the nurse often volunteers to be the medication nurse. After several serious medication errors, an investigation reveals that the nurse was diverting patient narcotics for self-use. What early indicator of the nurse’s drug use was evident?
Answer Choices: a. Changing employment after only several months b. Seeking to be assigned as a medication nurse c. Frequent socializes with unit staff after work d. Recent graduate
Answer: b. Seeking to be assigned as a medication nurse
Question: A nurse with a history of narcotic abuse is found unconscious in the hospital locker room after a break. The nurse’s friend attempts to divert attention from substance abuse until fit for care. Which response by the nurse’s friend demonstrates an enabling?
Answer Choices: a. Conveying understanding that pressures associated with nursing practice underlie substance abuse b. Pointing out that work problems are the result, but not the cause, of substance abuse c. Conveying empathy when the nurse discusses fears of disciplinary action by the state board of nursing d. Providing health teaching about stress management
Answer: a. Conveying understanding that pressures associated with nursing practice underlie substance abuse
Question: Which treatment approach is most appropriate for a patient with poor social skills who has been treated several times for substance addiction but has relapsed?
Answer Choices: a. 1-week detoxification program b. Long-term outpatient therapy c. 12-step self-help program d. Residential program
Answer: d. Residential program
Question: Which nursing diagnosis would likely apply both to a patient diagnosed with schizophrenia as well as a patient diagnosed with amphetamine-induced psychosis?
Answer Choices: a. Powerlessness b. Disturbed thought processes c. Ineffective thermoregulation d. Impaired oral mucous membrane
Answer: b. Disturbed thought processes
Question: Which is an important nursing intervention when giving care to a patient withdrawing from a central nervous system (CNS) stimulant?
Answer Choices: a. Observe for increased motor activity and agitation. b. Provide a calm atmosphere and reassure the patient that the symptoms are temporary. c. Avoid manipulation by denying the patient’s requests. d. Observe for depression and suicidal ideation.
Answer: d. Observe for depression and suicidal ideation.
Question: Which assessment findings best correlate to the withdrawal from central nervous system depressants?
Answer Choices: a. Dilated pupils, tachycardia, elevated blood pressure, elation b. Labile mood, lack of coordination, fever, drowsiness c. Nausea, vomiting, diaphoresis, anxiety, tremors d. Excessive eating, constipation, headache
Answer: c. Nausea, vomiting, diaphoresis, anxiety, tremors
Question: A patient has smoked two packs of cigarettes daily for many years. When the patient does not smoke or tries to cut back, anxiety, craving, poor concentration, and headache result. What does this scenario describe?
Answer Choices: a. Substance abuse b. Substance addiction c. Substance intoxication d. Recreational use of a social drug
Answer: b. Substance addiction
Question: Which assessment findings will the nurse expect in an individual who has just injected heroin?
Answer Choices: a. Anxiety, restlessness, paranoid delusions b. Heightened sexuality, insomnia, euphoria c. Muscle aching, dilated pupils, tachycardia d. Drowsiness, constricted pupils, slurred speech
Answer: d. Drowsiness, constricted pupils, slurred speech
Question: A newly hospitalized patient has needle tracks on both arms. A friend states that the patient uses heroin daily but has not used in the past 24 hours. The nurse should assess the patient for which withdrawal symptoms?
Answer Choices: a. Slurred speech, excessive drowsiness, and bradycardia b. Paranoid delusions, tactile hallucinations, and panic c. Runny nose, yawning, insomnia, and chills d. Anxiety, agitation, and aggression
Answer: c. Runny nose, yawning, insomnia, and chills
Question: A nurse is called to the home of a neighbor and finds an unconscious person still holding a medication bottle labeled “lorazepam.” What is the nurse’s first action?
Answer Choices: a. Test reflexes. b. Check pupils. c. Initiate vomiting. d. Establish a patent airway.
Answer: d. Establish a patent airway.
Question: An adult in the emergency department states, “I feel restless. Everything I look is wavy. Sometimes I’m outside my body looking at myself. I hear colors. I think I’m losing my mind.” Vital signs are slightly elevated. The nurse should suspect what triggered these reports?
Answer Choices: a. Cocaine overdose b. Schizophrenic episode c. Phencyclidine (PCP) intoxication d. Lysergic acid diethylamide (LSD) ingestion
Answer: d. Lysergic acid diethylamide (LSD) ingestion
Question: In what significant ways is the therapeutic environment different for a patient who has ingested lysergic acid diethylamide (LSD) than for a patient who has ingested phencyclidine (PCP)?
Answer Choices: a. For LSD ingestion, one person stays with the patient and provides verbal support. For PCP ingestion, a regimen of limited contact with staff members is maintained, and continual visual monitoring is provided. b. For PCP ingestion, the patient is placed on one-on-one intensive supervision. For LSD ingestion, a regimen of limited interaction and minimal verbal stimulation is maintained. c. For LSD ingestion, continual moderate sensory stimulation is provided. For PCP ingestion, continual high-level stimulation is provided. d. For LSD ingestion, the patient is placed in restraints. For PCP ingestion, seizure precautions are implemented.
Answer: a. For LSD ingestion, one person stays with the patient and provides verbal support. For PCP ingestion, a regimen of limited contact with staff members is maintained, and continual visual monitoring is provided.
Question: When assessing a patient who has ingested flunitrazepam, what should the nurse expect?
Answer Choices: a. Acrophobia b. Hypothermia c. Hallucinations d. Anterograde amnesia
Answer: d. Anterograde amnesia
Question: A patient is admitted in a comatose state after ingesting five capsules of lorazepam. A friend of the patient says, “Often my friend drinks, along with taking more of the drug than is prescribed.” What is the effect of the use of alcohol with this drug?
Answer Choices: a. The drug’s metabolism is stimulated. b. The drug’s effect is diminished. c. The drug’s effect is potentiated. d. There is no effect.
Answer: c. The drug’s effect is potentiated.