a. “Would you say your mood is often sad?”
b. “Are you having any trouble with your memory?”
c. “Have you noticed an increase in your alcohol use?”
d. “Do you often experience moderate-to-severe pain?”
Answer: A
Question: When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After 1 year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur?
Answer Options:
a. Tolerance develops.
b. The alcohol is less potent.
c. Antagonistic effects occur.
d. Hypomagnesemia develops.
Answer: a. Tolerance develops.
Question: A patient admitted yesterday for injuries sustained in a fall while intoxicated believes snakes are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis?
Answer Options:
a. Disturbed sensory perception
b. Ineffective coping
c. Ineffective denial
d. Risk for injury
Answer: d. Risk for injury
Question: Which assessment findings will the nurse expect in an individual who has injected heroin?
Answer Options:
a. Anxiety, restlessness, paranoid delusions
b. Heightened sexuality, insomnia, euphoria
c. Muscle cramping, dilated pupils, tachycardia
d. Drowsiness, constricted pupils, slurred speech
Answer: d. Drowsiness, constricted pupils, slurred speech
Question: Which assessment findings support a nurse’s suspicion that a patient has been using inhalants?
Answer Options:
a. Pinpoint pupils and respiratory rate of 12 breaths per minute
b. Perforated nasal septum and hypertension
c. Drowsiness, euphoria, and constipation
d. Nosebleed, muscle wasting, and impaired hearing
Answer: d. Nosebleed, muscle wasting, and impaired hearing
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 Options:
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: 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 Options:
a. Cocaine overdose
b. Schizophrenic episode
c. Phencyclidine (PCP) intoxication
d. Lysergic acid diethylamide (LSD) ingestion
Answer: d. Lysergic acid diethylamide (LSD) ingestion
Question: Which assessment findings best correlate to the withdrawal from central nervous system depressants?
Answer Options:
a. Dilated pupils, tachycardia, elevated blood pressure, elation
b. Labile mood, lack of coordination, elevation, drowsiness
c. Nausea, vomiting, diaphoresis, anxiety, tremors
d. Excessive eating, constipation, headache
Answer: c. Nausea, vomiting, diaphoresis, anxiety, tremors
Question: An older adult patient brings a bag of medication to the clinic. The nurse finds one bottle labeled “Ativan” and one labeled “lorazepam,” and both are labeled “Take two times daily.” Bottles of hydrochlorothiazide, Inderal, and rofecoxib, each labeled “Take one daily,” are also included. Which conclusion is accurate?
a. Rofecoxib should not be taken with Ativan.
b. The patient’s blood pressure is likely to be very high.
c. This patient should not self-administer any medication.
d. Lorazepam and Ativan are the same drug; consequently, the dose is excessive.
Answer: D
Question: A 78-year-old nursing home resident diagnosed with hypertension and cardiac disease is usually alert and oriented. This morning, however, the resident says, “My family visited during the night. They stood by the bed and talked to me.” In reality, the patient’s family lives 200 miles away. The nurse should first suspect what as the trigger for the resident’s experience?
a. Side effects associated with medications.
b. Early Alzheimer’s disease associated with advanced age.
c. A transient ischemic attack and developed sensory perceptual alterations.
d. Previously unidentified alcohol abuse and is beginning alcohol withdrawal delirium.
Answer: A
Question: A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe?
Answer Options:
a. Monoamine oxidase inhibitor, such as phenelzine
b. Phenothiazine, such as thioridazine
c. Benzodiazepine, such as lorazepam
d. Narcotic analgesic, such as morphine
Answer: c. Benzodiazepine, such as lorazepam
Question: Which medication is the nurse most likely to see prescribed as part of the treatment plan for both a patient in an alcoholism treatment program and a patient in a program for the treatment of opioid addiction?
Answer Options:
a. Methadone
b. Bromocriptine
c. Disulfiram
d. Naltrexone
Answer: d. Naltrexone
Question: (Multiple Response):
An older patient reports drinking a six-pack of beer daily. The patient tells the community health nurse, “I’ve been having trouble with my arthritis lately, so I take acetaminophen four times a day for pain.” What are the nurse’s priority interventions? (Select all that apply.)
a. Assess for potential alcohol withdrawal.
b. Teach the patient about the risks of combining acetaminophen with alcohol.
c. Refer the patient to a substance abuse program.
d. Advise the patient to stop drinking alcohol immediately.
e. Arrange for a liver function test.
Answer: s:
A, B, C, E
Question: When assessing a patient who has ingested flunitrazepam, what should the nurse expect?
Answer Options:
a. Acrophobia
b. Hypothermia
c. Hallucinations
d. Anterograde amnesia
Answer: d. Anterograde amnesia
Question: A patient undergoing alcohol rehabilitation decides to accept disulfiram therapy to avoid impulsively responding to drinking cues. Which information should be included in the discharge teaching for this patient? (Select all that apply.)
Answer Options:
a. Avoid aged cheeses.
b. Read labels of all liquid medications.
c. Wear sunscreen and avoid bright sunlight.
d. Maintain an adequate dietary intake of sodium.
e. Avoid breathing fumes of paints, stains, and stripping compounds.
Answer: b. Read labels of all liquid medications.
e. Avoid breathing fumes of paints, stains, and stripping compounds.
Question: A patient comes to an outpatient appointment obviously intoxicated. The nurse should implement what intervention?
Answer Options:
a. Exploring the patient’s reasons for drinking today
b. Arranging admission to an inpatient psychiatric unit
c. Coordinating emergency admission to a detoxification unit
d. Telling the patient, “We cannot see you today because you’ve been drinking”
Answer: d. Telling the patient, “We cannot see you today because you’ve been drinking”
Question: A newly hospitalized patient has not used heroin for 24 hours. 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 Options:
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: Select the most appropriate outcome for a patient completing the fourth alcohol detoxification program in 1 year. Before discharge, what will the patient do?
Answer Options:
a. Use rationalization in healthy ways.
b. State, “I see the need for ongoing treatment.”
c. Identify constructive outlets for expression of anger.
d. Develop a trusting relationship with one staff member.
Answer: b. State, “I see the need for ongoing treatment.”