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 Options:
Answer: b. The patient has a high tolerance to alcohol.
Question: A patient admitted to an alcoholism rehabilitation program says, “I’m just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and several drinks during the evening.” The patient is using which defense mechanism?
Answer Options:
Answer: d. Denial
Question: A new patient in an alcoholism rehabilitation program says, “I’m just a social drinker. I usually have a drink or two at brunch, a few cocktails in the afternoon, wine at dinner, and a few drinks in the evening.” Which response by the nurse will help the patient view the drinking more honestly?
Answer Options:
Answer: d. “You describe drinking steadily throughout the day and evening. Am I correct?”
Question: During the third week of treatment, the spouse of a patient in an alcoholism rehabilitation program says, “After discharge, I think everything will be just fine.” Which remark by the nurse will be most helpful to the spouse?
Answer Options:
Answer: b. “Although sobriety solves some problems, new ones may emerge as one adjusts to living without alcohol.”
Question: A patient diagnosed with schizophrenia and also diagnosed with alcoholism asks, “Shouldn’t I just stop drinking and then worry about the schizophrenia?” Which response by the nurse reflects current clinical practice guidelines?
Answer Options:
Answer: d. Treat the schizophrenia first, and then establish the goals for the treatment of substance abuse.
Question: When working with a patient beginning treatment for alcohol abuse, what is the nurse’s most therapeutic approach?
Answer Options:
Answer: a. Empathetic, supportive
Question: A patient comes to an outpatient appointment obviously intoxicated. The nurse should implement what intervention?
Answer Options:
Answer: d. Telling the patient, “We cannot see you today because you’ve been drinking”
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:
Answer: a. Tolerance develops.
Question: Which statement most accurately describes substance addiction?
Answer Options:
Answer: a. A chronic, relapsing brain disease associated with craving and a lack of control over use of a substance.
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 Options:
Answer: c. Symptoms of opiate withdrawal are present.
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 Options:
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 Options:
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 Options:
Answer: b. Seeking to be assigned as a medication nurse
Question: A nurse overhears a nurse say, “I can handle the drinking. I just have to cut back. Work after attending to a relative’s needs is a strain. I need a few drinks at the local liquor store when a nurse visits.” Which nursing diagnosis applies?
Answer Options:
Answer: b. Denial
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 Options:
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 Options:
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 Options:
Answer: d. Observe for depression and suicidal ideation.