Answer Choices:
A. Powerlessness
B. Disturbed thought processes
C. Ineffective thermoregulation
D. Impaired oral mucous membrane
Answer:
B
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 Choices:
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:
A, B
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
Question: A patient admitted for a heroin overdose received naloxone. The patient’s breathing pattern improved. Two hours later, the patient reports muscle aches, abdominal cramps, gooseflesh and says, “I feel terrible.” Which analysis is correct?
Answer Choices:
A. The patient is exhibiting a prodromal symptom of seizures.
B. An idiosyncratic reaction to naloxone is occurring.
C. Symptoms of opiate withdrawal are present.
D. The patient is experiencing a relapse.
Answer:
C
Question: A woman in the last trimester of pregnancy drinks 8 to 12 ounces of alcohol daily. The nurse plans for the delivery of an infant with presents with what related characteristic?
Answer Choices:
A. Jaundice
B. Dependence
C. Healthy but underweight
D. Facial abnormalities and growth retardation
Answer:
D
Question: Which question has the highest priority when assessing a newly admitted patient with a history of alcohol abuse?
Answer Choices:
A. “Have you ever had blackouts?”
B. “When did you have your last drink?”
C. “Has drinking caused you any problems?”
D. “When do you decide to seek treatment?”
Answer:
B
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 Choices:
A. Disturbed sensory perception
B. Ineffective coping
C. Ineffective denial
D. Risk for injury
Answer:
D
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
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
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
Question: A patient with a history of daily alcohol use says, “Drinking helps me cope with being a single parent.” Which response by the nurse would help the individual conceptualize the drinking more objectively?
Answer Choices:
A. “Sooner or later, alcohol will kill you. Then what will happen to your children?”
B. “I hear a lot of defensiveness in your voice. Do you really believe this?”
C. “If you were coping so well, why were you hospitalized again?”
D. “Tell me what happened the last time you drank.”
Answer:
D
Question: Police bring a patient to the emergency department after an automobile accident. The patient is ataxic with slurred speech and mild confusion. The blood alcohol level is 400 mg/dL. Considering the relationship between behavior and blood alcohol level, which conclusion can the nurse draw?
Answer Choices:
A. The patient rarely drinks alcohol.
B. The patient has a high tolerance to alcohol.
C. The patient has been treated with disulfiram.
D. The patient has recently ingested both alcohol and sedative drugs.
Answer:
B
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 Choices:
A. Tolerance develops.
B. The alcohol is less potent.
C. Antagonistic effects occur.
D. Hypomagnesemia develops.
Answer:
A
Question: A patient was admitted 48 hours ago for injuries sustained while intoxicated. The patient is shaky, irritable, anxious, and diaphoretic. The pulse rate is 130 beats/min. The patient shouts, “Snakes are crawling on my bed. I’ve got to get out of here.” What is the most accurate assessment of the situation?
Answer Choices:
A. The patient is attempting to obtain attention by manipulating staff.
B. The patient may have sustained a head injury before admission.
C. The patient has symptoms of alcohol withdrawal delirium.
D. The patient is having a recurrence of an acute psychosis.
Answer:
C
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 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
Question: A hospitalized patient, injured in a fall while intoxicated, believes spiders are spinning entrapping webs in the room. The patient is anxious, agitated, and diaphoretic. Which nursing intervention has priority?
Answer Choices:
A. Check the patient every 15 minutes.
B. Rigorously encourage fluid intake.
C. Provide one-on-one supervision.
D. Keep the room dimly lit.
Answer:
C
Question: A patient with a history of daily alcohol abuse was hospitalized at 0200 today. When would the nurse expect withdrawal symptoms to peak?
Answer Choices:
A. Between 0800 and 1000 today (6 to 8 hours after drinking stopped)
B. Between 0200 tomorrow and hospital day 2 (24 to 48 hours after drinking stopped)
C. About 0200 on hospital day 3 (72 hours after drinking stopped)
D. About 0200 on hospital day 4 (96 hours after drinking stopped)
Answer:
B
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
Question: Which assessment findings will the nurse expect in an individual who has injected heroin?
Answer Choices:
A. Anxiety, restlessness, paranoid delusions
B. Heightened sexuality, insomnia, euphoria
C. Muscle cramping, dilated pupils, tachycardia
D. Drowsiness, constricted pupils, slurred speech
Answer:
D