Adams4e Tif Ch11

Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 11
Question 1 Type: MCMA The nurse is managing care for a group of substance abusers. The patients have completed group education about the disease of addiction. The nurse determines that learning has occurred when the patients make which statements? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. "A heroin addict can die from heroin withdrawal." 2. "Substance abuse depends on comple variables." 3. "Most addicts became addicted from pain medication in a hospital." 4. "Addiction includes a compulsion to use a mood!altering substance." 5. "There is most likely a genetic component to addiction." Corre t Ans!er: "#$#% "ationa#e 1& Addiction is an overwhelming compulsion that drives someone to repetitive drug!taking behavior# despite serious health and social conse'uences. Substance abuse depends on multiple# comple # interacting variables. Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents. (rescription drugs rarely cause addiction when used according to accepted medical protocols. )hile e tremely unpleasant# withdrawal from opioids is not life threatening. "ationa#e 2& Addiction is an overwhelming compulsion that drives someone to repetitive drug!taking behavior# despite serious health and social conse'uences. Substance abuse depends on multiple# comple # interacting variables. Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents. (rescription drugs rarely cause addiction when used according to accepted medical protocols. )hile e tremely unpleasant# withdrawal from opioids is not life threatening. "ationa#e 3& Addiction is an overwhelming compulsion that drives someone to repetitive drug!taking behavior# despite serious health and social conse'uences. Substance abuse depends on multiple# comple # interacting variables. Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents. (rescription drugs rarely cause addiction when used according to accepted medical protocols. )hile e tremely unpleasant# withdrawal from opioids is not life threatening. "ationa#e 4& Addiction is an overwhelming compulsion that drives someone to repetitive drug!taking behavior# despite serious health and social conse'uences. Substance abuse depends on multiple# comple # interacting variables. Children of alcoholic parents are four times more likely to become alcoholics than children of
Adams, Pharmacology for Nurse: A Pathophysiologic Approach, $*+ Copyright ",-$ by (earson +ducation# .nc.
nonalcoholic parents. (rescription drugs rarely cause addiction when used according to accepted medical protocols. )hile e tremely unpleasant# withdrawal from opioids is not life threatening. "ationa#e 5& Addiction is an overwhelming compulsion that drives someone to repetitive drug!taking behavior# despite serious health and social conse'uences. Substance abuse depends on multiple# comple # interacting variables. Children of alcoholic parents are four times more likely to become alcoholics than children of nonalcoholic parents. (rescription drugs rarely cause addiction when used according to accepted medical protocols. )hile e tremely unpleasant# withdrawal from opioids is not life threatening. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (sychosocial .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& +valuation (earnin& +ut ome: --!Question 2 Type: MCSA The adolescent patient is in a drug rehabilitation program. The mother of this patient says to the nurse# "The doctor said my son has a physical addiction to alcohol. )hat does this mean?" )hat is the best response by the nurse? 1. "0is brain remembers the euphoria he had with alcohol# and he has a craving to return to it." 2. "0e will have an intense craving for alcohol1 this is best managed in group therapy." 3. "0is body is used to alcohol1 he will have specific withdrawal symptoms when it is stopped." 4. "0e will have feelings of depression when stopping alcohol1 we need to monitor him for suicide." Corre t Ans!er: 2 "ationa#e 1& 3ver time# the body4s cells become accustomed to the presence of the unnatural substance. Specific# physical withdrawal symptoms will occur1 the patient needs to be medically withdrawn from the substance. (sychological dependence# or craving# does not involve physical withdrawal symptoms. Alcohol does produce euphoria# but a craving for the substance is not a medical issue. 5epression may accompany physical withdrawal# but physical signs are what re'uire medical management. "ationa#e 2& 3ver time# the body4s cells become accustomed to the presence of the unnatural substance. Specific# physical withdrawal symptoms will occur1 the patient needs to be medically withdrawn from the substance. (sychological dependence# or craving# does not involve physical withdrawal symptoms. Alcohol does produce euphoria# but a craving for the substance is not a medical issue. 5epression may accompany physical withdrawal# but physical signs are what re'uire medical management.
"ationa#e 3& 3ver time# the body4s cells become accustomed to the presence of the unnatural substance. Specific# physical withdrawal symptoms will occur1 the patient needs to be medically withdrawn from the substance. (sychological dependence# or craving# does not involve physical withdrawal symptoms. Alcohol does produce euphoria# but a craving for the substance is not a medical issue. 5epression may accompany physical withdrawal# but physical signs are what re'uire medical management. "ationa#e 4& 3ver time# the body4s cells become accustomed to the presence of the unnatural substance. Specific# physical withdrawal symptoms will occur1 the patient needs to be medically withdrawn from the substance. (sychological dependence# or craving# does not involve physical withdrawal symptoms. Alcohol does produce euphoria# but a craving for the substance is not a medical issue. 5epression may accompany physical withdrawal# but physical signs are what re'uire medical management. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (sychosocial .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!" Question 3 Type: MCSA The patient has an e tensive history of alcoholism. 0e is having coronary bypass surgery. )hile administering anesthesia# the certified nurse anesthetist notes that the patient re'uires higher!than!usual amounts of the drug. The nurse correctly evaluates this response as what phenomenon? 1. The nurse anesthetist most likely did not calculate the correct amount of anesthesia for this patient. 2. The patient has developed a parado ical reaction to the anesthesia# and will re'uire a different drug. 3. The patient has developed a resistance to the anesthesia# so it will not work very well. 4. The patient had developed cross!tolerance to the anesthesia# and will re'uire higher amounts. Corre t Ans!er: $ "ationa#e 1& )ith chronic alcohol use# the liver adapts and metaboli6es alcohol at a faster rate. More of the substance is re'uired to achieve the same effect. This is a phenomenon known as cross!tolerance. This patient has a tolerance to alcohol# so he will re'uire additional anesthesia for surgery since both drugs are C/S depressants. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose. 7esistance refers to the immune system and infections# and should not be used interchangeably with tolerance. (arado ical refers to the opposite response1 in this case# the patient would have become very e citable1 there is no evidence of this. "ationa#e 2& )ith chronic alcohol use# the liver adapts and metaboli6es alcohol at a faster rate. More of the substance is re'uired to achieve the same effect. This is a phenomenon known as cross!tolerance. This patient has
a tolerance to alcohol# so he will re'uire additional anesthesia for surgery since both drugs are C/S depressants. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose. 7esistance refers to the immune system and infections# and should not be used interchangeably with tolerance. (arado ical refers to the opposite response1 in this case# the patient would have become very e citable1 there is no evidence of this. "ationa#e 3& )ith chronic alcohol use# the liver adapts and metaboli6es alcohol at a faster rate. More of the substance is re'uired to achieve the same effect. This is a phenomenon known as cross!tolerance. This patient has a tolerance to alcohol# so he will re'uire additional anesthesia for surgery since both drugs are C/S depressants. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose. 7esistance refers to the immune system and infections# and should not be used interchangeably with tolerance. (arado ical refers to the opposite response1 in this case# the patient would have become very e citable1 there is no evidence of this. "ationa#e 4& )ith chronic alcohol use# the liver adapts and metaboli6es alcohol at a faster rate. More of the substance is re'uired to achieve the same effect. This is a phenomenon known as cross!tolerance. This patient has a tolerance to alcohol# so he will re'uire additional anesthesia for surgery since both drugs are C/S depressants. There is no evidence to support that the nurse anesthetist incorrectly calculated the anesthesia dose. 7esistance refers to the immune system and infections# and should not be used interchangeably with tolerance. (arado ical refers to the opposite response1 in this case# the patient would have become very e citable1 there is no evidence of this. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy6ing C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& +valuation (earnin& +ut ome: --!$ Question 4 Type: MCSA The patient comes to the emergency department and tells the nurse# ". have been off my drugs for 2 days." The nurse assesses the patient for withdrawal symptoms associated with the category of drug used. )ithdrawal from which drug# if taken by the patient# should cause the nurse the most concern? 1. 0eroin 2. Alpra6olam 89ana : 3. Cocaine 4. Mari;uana Corre t Ans!er: "
"ationa#e 1& Alpra6olam 89ana : is a ben6odia6epine. This drug# which is a central nervous system 8C/S: depressant# will likely lead to the most life!threatening withdrawal symptoms in a patient who has stopped taking it. )ithdrawal from heroin is very unpleasant# but it is not life threatening. )ithdrawal from cocaine is uncomfortable# but it is not life threatening. There is virtually no withdrawal from mari;uana. "ationa#e 2& Alpra6olam 89ana : is a ben6odia6epine. This drug# which is a central nervous system 8C/S: depressant# will likely lead to the most life!threatening withdrawal symptoms in a patient who has stopped taking it. )ithdrawal from heroin is very unpleasant# but it is not life threatening. )ithdrawal from cocaine is uncomfortable# but it is not life threatening. There is virtually no withdrawal from mari;uana. "ationa#e 3& Alpra6olam 89ana : is a ben6odia6epine. This drug# which is a central nervous system 8C/S: depressant# will likely lead to the most life!threatening withdrawal symptoms in a patient who has stopped taking it. )ithdrawal from heroin is very unpleasant# but it is not life threatening. )ithdrawal from cocaine is uncomfortable# but it is not life threatening. There is virtually no withdrawal from mari;uana. "ationa#e 4& Alpra6olam 89ana : is a ben6odia6epine. This drug# which is a central nervous system 8C/S: depressant# will likely lead to the most life!threatening withdrawal symptoms in a patient who has stopped taking it. )ithdrawal from heroin is very unpleasant# but it is not life threatening. )ithdrawal from cocaine is uncomfortable# but it is not life threatening. There is virtually no withdrawal from mari;uana. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (sychosocial .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!2 Question 5 Type: MCSA The mother of an adolescent patient says to the nurse# ". think my son is staying up too late studying# and . see him using <isine eye drops all the time for his red eyes. Should . have his vision checked?" )hat is the best response by the nurse? 1. "0e might be depressed1 insomnia is common with depression." 2. "Sounds like he is smoking mari;uana# and . would talk to him." 3. "Sounds like he is using cocaine1 . have seen this before." 4. "=es# that is a great idea# he may need some glasses." Corre t Ans!er: " "ationa#e 1& 3ne hallmark symptom of mari;uana use is red or bloodshot eyes# caused by dilation of blood vessels. <isine constricts the blood vessels of the eyes# reducing the redness. .t is important for the parent to
discuss this with the adolescent. 0aving the adolescent4s eyes checked may indicate that the mother is in denial# and that the nurse needs to be more alert to the signs and symptoms of drug abuse. 5epression in this patient is possible# but depressed patients do not always have red eyes# and do not commonly use <isine eye drops. 7ed or bloodshot eyes are not commonly seen with cocaine abuse# but are always seen with mari;uana use. "ationa#e 2& 3ne hallmark symptom of mari;uana use is red or bloodshot eyes# caused by dilation of blood vessels. <isine constricts the blood vessels of the eyes# reducing the redness. .t is important for the parent to discuss this with the adolescent. 0aving the adolescent4s eyes checked may indicate that the mother is in denial# and that the nurse needs to be more alert to the signs and symptoms of drug abuse. 5epression in this patient is possible# but depressed patients do not always have red eyes# and do not commonly use <isine eye drops. 7ed or bloodshot eyes are not commonly seen with cocaine abuse# but are always seen with mari;uana use. "ationa#e 3& 3ne hallmark symptom of mari;uana use is red or bloodshot eyes# caused by dilation of blood vessels. <isine constricts the blood vessels of the eyes# reducing the redness. .t is important for the parent to discuss this with the adolescent. 0aving the adolescent4s eyes checked may indicate that the mother is in denial# and that the nurse needs to be more alert to the signs and symptoms of drug abuse. 5epression in this patient is possible# but depressed patients do not always have red eyes# and do not commonly use <isine eye drops. 7ed or bloodshot eyes are not commonly seen with cocaine abuse# but are always seen with mari;uana use. "ationa#e 4& 3ne hallmark symptom of mari;uana use is red or bloodshot eyes# caused by dilation of blood vessels. <isine constricts the blood vessels of the eyes# reducing the redness. .t is important for the parent to discuss this with the adolescent. 0aving the adolescent4s eyes checked may indicate that the mother is in denial# and that the nurse needs to be more alert to the signs and symptoms of drug abuse. 5epression in this patient is possible# but depressed patients do not always have red eyes# and do not commonly use <isine eye drops. 7ed or bloodshot eyes are not commonly seen with cocaine abuse# but are always seen with mari;uana use. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (sychosocial .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!% Question , Type: MCSA The patient has been abusing alcohol for several years and tells the nurse# ". used to drink a pint of whiskey every day. /ow . get sick and pass out after ;ust two drinks." )hat does the nurse correctly recogni6e about this patient? 1. The patient4s symptoms are related to hyperglycemia1 he may have pancreatic damage. 2. The patient may have liver damage# resulting in an inability to metaboli6e large amounts of alcohol. 3. The patient is in denial and is most likely minimi6ing the amount of alcohol he consumes. 4. The patient has brain damage from the alcohol and cannot remember how much he consumes.
Corre t Ans!er: " "ationa#e 1& Alcoholism is a common cause of cirrhosis# a debilitating# and often fatal# failure of the liver to perform its vital functions# such as metabolism of alcohol. )hile patients with alcoholism are fre'uently in denial# and tend to minimi6e the amount of alcohol they consume# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have pancreatic damage# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have brain damage# this patient is describing the results of liver damage. "ationa#e 2& Alcoholism is a common cause of cirrhosis# a debilitating# and often fatal# failure of the liver to perform its vital functions# such as metabolism of alcohol. )hile patients with alcoholism are fre'uently in denial# and tend to minimi6e the amount of alcohol they consume# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have pancreatic damage# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have brain damage# this patient is describing the results of liver damage. "ationa#e 3& Alcoholism is a common cause of cirrhosis# a debilitating# and often fatal# failure of the liver to perform its vital functions# such as metabolism of alcohol. )hile patients with alcoholism are fre'uently in denial# and tend to minimi6e the amount of alcohol they consume# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have pancreatic damage# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have brain damage# this patient is describing the results of liver damage. "ationa#e 4& Alcoholism is a common cause of cirrhosis# a debilitating# and often fatal# failure of the liver to perform its vital functions# such as metabolism of alcohol. )hile patients with alcoholism are fre'uently in denial# and tend to minimi6e the amount of alcohol they consume# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have pancreatic damage# this patient is describing the results of liver damage. )hile patients with alcoholism fre'uently have brain damage# this patient is describing the results of liver damage. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy6ing C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!% Question Type: MCMA The patient is withdrawing from opioids. )hich symptom best describe8s: the results of the nurse4s assessment? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Abdominal cramping and pain
2. 0ypotension 3. (inpoint pupils 4. 5ilated pupils 5. 5iaphoresis Corre t Ans!er: -#$#% "ationa#e 1& Signs of opioid withdrawal include diaphoresis# restlessness# dilated pupils# hypertension# and abdominal cramps and pain. The pupils will be dilated during opioid withdrawal# but will appear as pinpoints when the patient is using opioids. The blood pressure will be elevated during opioid withdrawal# but will be decreased when the patient is using opioids. "ationa#e 2& Signs of opioid withdrawal include diaphoresis# restlessness# dilated pupils# hypertension# and abdominal cramps and pain. The pupils will be dilated during opioid withdrawal# but will appear as pinpointswhen the patient is using opioids. The blood pressure will be elevated during opioid withdrawal# but will be decreased when the patient is using opioids. "ationa#e 3& Signs of opioid withdrawal include diaphoresis# restlessness# dilated pupils# hypertension# and abdominal cramps and pain. The pupils will be dilated during opioid withdrawal# but will appear as pinpoints when the patient is using opioids. The blood pressure will be elevated during opioid withdrawal# but will be decreased when the patient is using opioids. "ationa#e 4& Signs of opioid withdrawal include diaphoresis# restlessness# dilated pupils# hypertension# and abdominal cramps and pain. The pupils will be dilated during opioid withdrawal# but will appear as pinpoints when the patient is using opioids. The blood pressure will be elevated during opioid withdrawal# but will be decreased when the patient is using opioids. "ationa#e 5& Signs of opioid withdrawal include diaphoresis# restlessness# dilated pupils# hypertension# and abdominal cramps and pain. The pupils will be dilated during opioid withdrawal# but will appear as pinpoints when the patient is using opioids. The blood pressure will be elevated during opioid withdrawal# but will be decreased when the patient is using opioids. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (sychosocial .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!2 Question . Type: MCSA )hat is a priority outcome for the patient who has chronic alcoholism with liver damage?
1. The patient will switch to a safer drug# like a ben6odia6epine. 2. The patient will become involved in Alcoholics Anonymous 8AA:. 3. The patient will keep all appointments with the doctor treating his liver damage. 4. The patient will learn to drink more responsibly. Corre t Ans!er: " "ationa#e 1& >ong!term management for alcohol abuse includes behavioral counseling and self!help groups like Alcoholics Anonymous 8AA:. The priority outcome# and a principle of Alcoholics Anonymous 8AA:# is complete abstinence from mood!altering substances so the patient should not use ben6odia6epines. 5rinking more responsibly is not appropriate1 the patient must abstain from all alcohol. ?eeping all medical appointments is a good outcome# but does not address the problem of the patient4s continued use of alcohol. "ationa#e 2& >ong!term management for alcohol abuse includes behavioral counseling and self!help groups like Alcoholics Anonymous 8AA:. The priority outcome# and a principle of Alcoholics Anonymous 8AA:# is complete abstinence from mood!altering substances so the patient should not use ben6odia6epines. 5rinking more responsibly is not appropriate1 the patient must abstain from all alcohol. ?eeping all medical appointments is a good outcome# but does not address the problem of the patient4s continued use of alcohol. "ationa#e 3& >ong!term management for alcohol abuse includes behavioral counseling and self!help groups like Alcoholics Anonymous 8AA:. The priority outcome# and a principle of Alcoholics Anonymous 8AA:# is complete abstinence from mood!altering substances so the patient should not use ben6odia6epines. 5rinking more responsibly is not appropriate1 the patient must abstain from all alcohol. ?eeping all medical appointments is a good outcome# but does not address the problem of the patient4s continued use of alcohol. "ationa#e 4& >ong!term management for alcohol abuse includes behavioral counseling and self!help groups like Alcoholics Anonymous 8AA:. The priority outcome# and a principle of Alcoholics Anonymous 8AA:# is complete abstinence from mood!altering substances so the patient should not use ben6odia6epines. 5rinking more responsibly is not appropriate1 the patient must abstain from all alcohol. ?eeping all medical appointments is a good outcome# but does not address the problem of the patient4s continued use of alcohol. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy6ing C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& (lanning (earnin& +ut ome: --!@ Question / Type: MCSA The patient is admitted to the in!patient substance abuse unit. She tells the nurse she has been buying "yellow ;ackets" 8pentobarbital# A/embutalB: on the street# but hasn4t had any for a few days. )hat is the best plan by the nurse at this time?
1. (repare to manage the depression and suicidal thoughts the patient will have. 2. (repare to do fre'uent room searches# as the patient4s friends will most likely bring drugs in for her. 3. (repare to manage a withdrawal that could be life threatening. 4. (repare to manage a withdrawal that will likely be minimal. Corre t Ans!er: 2 "ationa#e 1& Carbiturates are central nervous depressant 8C/S: drugs. )ithdrawal symptoms resemble those of alcohol withdrawal# and may be life threatening. )ithdrawal from barbiturates will more likely be life threatening# not minimal. (hysical needs have priority over psychological needs# such as depression# in this case. 5oing room searches is a good idea# but preparing for withdrawal is a higher priority. "ationa#e 2& Carbiturates are central nervous depressant 8C/S: drugs. )ithdrawal symptoms resemble those of alcohol withdrawal# and may be life threatening. )ithdrawal from barbiturates will more likely be life threatening# not minimal. (hysical needs have priority over psychological needs# such as depression# in this case. 5oing room searches is a good idea# but preparing for withdrawal is a higher priority. "ationa#e 3& Carbiturates are central nervous depressant 8C/S: drugs. )ithdrawal symptoms resemble those of alcohol withdrawal# and may be life threatening. )ithdrawal from barbiturates will more likely be life threatening# not minimal. (hysical needs have priority over psychological needs# such as depression# in this case. 5oing room searches is a good idea# but preparing for withdrawal is a higher priority. "ationa#e 4& Carbiturates are central nervous depressant 8C/S: drugs. )ithdrawal symptoms resemble those of alcohol withdrawal# and may be life threatening. )ithdrawal from barbiturates will more likely be life threatening# not minimal. (hysical needs have priority over psychological needs# such as depression# in this case. 5oing room searches is a good idea# but preparing for withdrawal is a higher priority. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& (lanning (earnin& +ut ome: --!% Question 10 Type: MCSA The patient had been abusing cocaine for several years. 7ecently# the patient snorted cocaine that was much purer than was thought# resulting in an overdose. The patient died in the emergency department. )hat does the nurse recogni6e as the most likely cause of death? 1. Cardiac arrest
2. 7habdomyolysis 3. .mpurities in the cocaine 4. Cowel ischemia Corre t Ans!er: "ationa#e 1& 3verdose of cocaine can result in dysrhythmias# convulsions# stroke# or death due to cardiac and respiratory arrest. .mpurities in the cocaine would not have resulted in the death of the patient. Cowel ischemia would not occur with a cocaine overdose. 7habdomyolysis would not occur with a cocaine overdose. "ationa#e 2& 3verdose of cocaine can result in dysrhythmias# convulsions# stroke# or death due to cardiac and respiratory arrest. .mpurities in the cocaine would not have resulted in the death of the patient. Cowel ischemia would not occur with a cocaine overdose. 7habdomyolysis would not occur with a cocaine overdose. "ationa#e 3& 3verdose of cocaine can result in dysrhythmias# convulsions# stroke# or death due to cardiac and respiratory arrest. .mpurities in the cocaine would not have resulted in the death of the patient. Cowel ischemia would not occur with a cocaine overdose. 7habdomyolysis would not occur with a cocaine overdose. "ationa#e 4& 3verdose of cocaine can result in dysrhythmias# convulsions# stroke# or death due to cardiac and respiratory arrest. .mpurities in the cocaine would not have resulted in the death of the patient. Cowel ischemia would not occur with a cocaine overdose. 7habdomyolysis would not occur with a cocaine overdose. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& +valuation (earnin& +ut ome: --!% Question 11 Type: MCSA The patient has smoked a pack of cigarettes per day for ", years. The patient also takes oral contraceptives. .n implementing a teaching plan# what is the most important information for the nurse to include? 1. D=ou are at a higher risk for a heart attack than nonsmokers.E 2. DThe nicotine will decrease the effectiveness of your birth control pills.E 3. D=ou are at a higher risk for developing diabetes than smokers who do not use birth control pills.E 4. D=ou are at a higher risk for emphysema than nonsmokers.E Corre t Ans!er: Adams, Pharmacology for Nurse: A Pathophysiologic Approach, $*+ Copyright ",-$ by (earson +ducation# .nc.
"ationa#e 1& Cardiovascular effects can be particularly serious in patients taking oral contraceptives if they also smoke. The risk of a fatal heart attack is five times greater in smokers who also use oral contraceptives than in nonsmokers. There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives. Smokers are at higher risk for emphysema# but this has nothing do with the patient4s use of oral contraceptives. There is no evidence to support a correlation between diabetes# smoking# and oral contraceptives. "ationa#e 2& Cardiovascular effects can be particularly serious in patients taking oral contraceptives if they also smoke. The risk of a fatal heart attack is five times greater in smokers who also use oral contraceptives than in nonsmokers. There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives. Smokers are at higher risk for emphysema# but this has nothing do with the patient4s use of oral contraceptives. There is no evidence to support a correlation between diabetes# smoking# and oral contraceptives. "ationa#e 3& Cardiovascular effects can be particularly serious in patients taking oral contraceptives if they also smoke. The risk of a fatal heart attack is five times greater in smokers who also use oral contraceptives than in nonsmokers. There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives. Smokers are at higher risk for emphysema# but this has nothing do with the patient4s use of oral contraceptives. There is no evidence to support a correlation between diabetes# smoking# and oral contraceptives. "ationa#e 4& Cardiovascular effects can be particularly serious in patients taking oral contraceptives if they also smoke. The risk of a fatal heart attack is five times greater in smokers who also use oral contraceptives than in nonsmokers. There is no evidence to support that nicotine decreases the effectiveness of oral contraceptives. Smokers are at higher risk for emphysema# but this has nothing do with the patient4s use of oral contraceptives. There is no evidence to support a correlation between diabetes# smoking# and oral contraceptives. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!% Question 12 Type: MCSA The patient has been prescribed disulfiram 8Antabuse: to discourage a return to drinking alcohol. The patient tells the nurse that after stopping disulfiram 8Antabuse: for a week# he returned to drinking alcohol. )hat will the nurse most likely assess in the patient? 1. 0eadache# nausea# and vomiting 2. Confusion and fine tremors 3. An absence of symptoms# as the drug was discontinued 4. Severe hyperglycemia and dry skin Corre t Ans!er: Adams, Pharmacology for Nurse: A Pathophysiologic Approach, $*+ Copyright ",-$ by (earson +ducation# .nc.
"ationa#e 1& .f alcohol is consumed while taking disulfiram 8Antabuse:# the patient becomes violently ill within % to -, minutes. Symptoms include headache# shortness of breath# nausea# and vomiting. Alcohol sensitivity continues for up to " weeks after disulfiram 8Antabuse: has been discontinued. Severe hypoglycemia and dry skin are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. Confusion and fine tremors are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. "ationa#e 2& .f alcohol is consumed while taking disulfiram 8Antabuse:# the patient becomes violently ill within % to -, minutes. Symptoms include headache# shortness of breath# nausea# and vomiting. Alcohol sensitivity continues for up to " weeks after disulfiram 8Antabuse: has been discontinued. Severe hypoglycemia and dry skin are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. Confusion and fine tremors are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. "ationa#e 3& .f alcohol is consumed while taking disulfiram 8Antabuse:# the patient becomes violently ill within % to -, minutes. Symptoms include headache# shortness of breath# nausea# and vomiting. Alcohol sensitivity continues for up to " weeks after disulfiram 8Antabuse: has been discontinued. Severe hypoglycemia and dry skin are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. Confusion and fine tremors are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. "ationa#e 4& .f alcohol is consumed while taking disulfiram 8Antabuse:# the patient becomes violently ill within % to -, minutes. Symptoms include headache# shortness of breath# nausea# and vomiting. Alcohol sensitivity continues for up to " weeks after disulfiram 8Antabuse: has been discontinued. Severe hypoglycemia and dry skin are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. Confusion and fine tremors are not side effects of the combined use of alcohol and disulfiram 8Antabuse:. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!@ Question 13 Type: MCSA The patient tells the nurse that her -"!year!old child asks to use her nail polish remover several times a day. )hen her friends come to visit# this seems to occur more fre'uently. )hat is the best response by the nurse? 1. "=our daughter may be 4huffing41 that is really scary." 2. "=our daughter may be 4huffing4 or inhaling the remover." 3. "=our daughter may be 4huffing4 or drinking small amounts of the remover." 4. "=our daughter may be 4huffing4 or rubbing the remover on her skin." Corre t Ans!er: "
"ationa#e 1& .nhaling volatile chemicals# known as "huffing" is most prevalent in the -,!to!-"!year!old group. <irtually any organic compound can be huffed# including nail polish remover# spray paint# household glue# and gasoline. 0uffing involves inhaling volatile chemicals# not rubbing them on the skin. 0uffing involves inhaling volatile chemicals# not drinking them. Telling the mother that "huffing" is scary does not give her much information# and is an inappropriate response. "ationa#e 2& .nhaling volatile chemicals# known as "huffing" is most prevalent in the -,!to!-"!year!old group. <irtually any organic compound can be huffed# including nail polish remover# spray paint# household glue# and gasoline. 0uffing involves inhaling volatile chemicals# not rubbing them on the skin. 0uffing involves inhaling volatile chemicals# not drinking them. Telling the mother that "huffing" is scary does not give her much information# and is an inappropriate response. "ationa#e 3& .nhaling volatile chemicals# known as "huffing" is most prevalent in the -,!to!-"!year!old group. <irtually any organic compound can be huffed# including nail polish remover# spray paint# household glue# and gasoline. 0uffing involves inhaling volatile chemicals# not rubbing them on the skin. 0uffing involves inhaling volatile chemicals# not drinking them. Telling the mother that "huffing" is scary does not give her much information# and is an inappropriate response. "ationa#e 4& .nhaling volatile chemicals# known as "huffing" is most prevalent in the -,!to!-"!year!old group. <irtually any organic compound can be huffed# including nail polish remover# spray paint# household glue# and gasoline. 0uffing involves inhaling volatile chemicals# not rubbing them on the skin. 0uffing involves inhaling volatile chemicals# not drinking them. Telling the mother that "huffing" is scary does not give her much information# and is an inappropriate response. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (sychosocial .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!% Question 14 Type: MCSA The patient is a -,!year!old child admitted to the emergency department after "huffing" gasoline. The physician suspects mild brain damage. )hat signs will the nurse teach the parents to observe for after they take the child home? 1. Slurred speech# memory loss# and personality changes 2. 5epression# cold e tremities# and dyspnea 3. /ausea# vomiting# and di66iness 4. .rregular pulse# fainting# and anger Corre t Ans!er: Adams, Pharmacology for Nurse: A Pathophysiologic Approach, $*+ Copyright ",-$ by (earson +ducation# .nc.
"ationa#e 1& Children can die after a single episode of "huffing" a volatile chemical# or they may suffer brain damage. Crain damage may be manifested as slurred or slow speech# memory loss# or personality changes. .rregular pulse# fainting# and anger are not signs of brain damage. 5epression# cold e tremities# and dyspnea are not signs of brain damage. /ausea# vomiting# and di66iness are not signs of brain damage. "ationa#e 2& Children can die after a single episode of "huffing" a volatile chemical# or they may suffer brain damage. Crain damage may be manifested as slurred or slow speech# memory loss# or personality changes. .rregular pulse# fainting# and anger are not signs of brain damage. 5epression# cold e tremities# and dyspnea are not signs of brain damage. /ausea# vomiting# and di66iness are not signs of brain damage. "ationa#e 3& Children can die after a single episode of "huffing" a volatile chemical# or they may suffer brain damage. Crain damage may be manifested as slurred or slow speech# memory loss# or personality changes. .rregular pulse# fainting# and anger are not signs of brain damage. 5epression# cold e tremities# and dyspnea are not signs of brain damage. /ausea# vomiting# and di66iness are not signs of brain damage. "ationa#e 4& Children can die after a single episode of "huffing" a volatile chemical# or they may suffer brain damage. Crain damage may be manifested as slurred or slow speech# memory loss# or personality changes. .rregular pulse# fainting# and anger are not signs of brain damage. 5epression# cold e tremities# and dyspnea are not signs of brain damage. /ausea# vomiting# and di66iness are not signs of brain damage. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!@ Question 15 Type: MCSA )hich of the following profiles would have the greatest risk for developing a drug addiction? 1. A 2,!year!old female who is pregnant and lives in an apartment in a small town 8lower middle class: 2. A $%!year!old female with diabetes who lives in a house in the country 8middle class: 3. A "-!year!old male with insomnia who lives in a college dormitory 8wealthy: 4. A F,!year!old retired male with congestive heart failure who lives in his house in a large city 8fi ed income: Corre t Ans!er: 2 "ationa#e 1& The "-!year!old male has the most risk factors. 0e lives in a college dormitory# where peer pressure and drug availability are more likely. 0e also suffers from insomnia# which would likely encourage scheduled drug use. Ginally# he is wealthy# enabling him to purchase drugs. The F,!year!old male has congestive heart failure# which generally does not re'uire highly addictive drugs. Additionally# he is on a fi ed income# which would make it more difficult to support a drug addiction. The 2,!year!old female is also in a lower financial class#
making it more difficult to support a drug addiction. Additionally# she is pregnant# and social norms generally are not supportive of drug use during pregnancy. The $%!year!old female might have the financial means to support a drug addiction but suffers from diabetes# which does not generally re'uire addictive drug therapy. "ationa#e 2& The "-!year!old male has the most risk factors. 0e lives in a college dormitory# where peer pressure and drug availability are more likely. 0e also suffers from insomnia# which would likely encourage scheduled drug use. Ginally# he is wealthy# enabling him to purchase drugs. The F,!year!old male has congestive heart failure# which generally does not re'uire highly addictive drugs. Additionally# he is on a fi ed income# which would make it more difficult to support a drug addiction. The 2,!year!old female is also in a lower financial class# making it more difficult to support a drug addiction. Additionally# she is pregnant# and social norms generally are not supportive of drug use during pregnancy. The $%!year!old female might have the financial means to support a drug addiction but suffers from diabetes# which does not generally re'uire addictive drug therapy "ationa#e 3& The "-!year!old male has the most risk factors. 0e lives in a college dormitory# where peer pressure and drug availability are more likely. 0e also suffers from insomnia# which would likely encourage scheduled drug use. Ginally# he is wealthy# enabling him to purchase drugs. The F,!year!old male has congestive heart failure# which generally does not re'uire highly addictive drugs. Additionally# he is on a fi ed income# which would make it more difficult to support a drug addiction. The 2,!year!old female is also in a lower financial class# making it more difficult to support a drug addiction. Additionally# she is pregnant# and social norms generally are not supportive of drug use during pregnancy. The $%!year!old female might have the financial means to support a drug addiction but suffers from diabetes# which does not generally re'uire addictive drug therapy. "ationa#e 4& The "-!year!old male has the most risk factors. 0e lives in a college dormitory# where peer pressure and drug availability are more likely. 0e also suffers from insomnia# which would likely encourage scheduled drug use. Ginally# he is wealthy# enabling him to purchase drugs. The F,!year!old male has congestive heart failure# which generally does not re'uire highly addictive drugs. Additionally# he is on a fi ed income# which would make it more difficult to support a drug addiction. The 2,!year!old female is also in a lower financial class# making it more difficult to support a drug addiction. Additionally# she is pregnant# and social norms generally are not supportive of drug use during pregnancy. The $%!year!old female might have the financial means to support a drug addiction but suffers from diabetes# which does not generally re'uire addictive drug therapy. $#o%a# "ationa#e: Co&niti'e (e'e#: Hnderstanding C#ient )eed: 0ealth (romotion and Maintenance C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!Question 1, Type: MCSA )hen an individual wants to stop using a drug but canIt# she would be suffering from 1. psychological dependence. 2. substance dependence.
3. physical dependence. 4. withdrawal syndrome. Corre t Ans!er: " "ationa#e 1& The 'uestion does not indicate the presence or lack of symptoms. Therefore# the more general term substance dependence is the best choice. "ationa#e 2& The 'uestion does not indicate the presence or lack of symptoms. Therefore# the more general term substance dependence is the best choice. "ationa#e 3& The 'uestion does not indicate the presence or lack of symptoms. Therefore# the more general term substance dependence is the best choice. "ationa#e 4& The 'uestion does not indicate the presence or lack of symptoms. Therefore# the more general term substance dependence is the best choice. $#o%a# "ationa#e: Co&niti'e (e'e#: 7emembering C#ient )eed: 0ealth (romotion and Maintenance C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!" Question 1Type: MCSA The nurse would e pect to see which of the following withdrawal symptoms from an alcoholic patient? 1. >ethargy# constipation# light sensitivity# and weight loss 2. An iety# sei6ures# hearing loss# and alopecia 3. Tremors# an iety# confusion# and delirium 4. Abdominal pain# chills# pupil dilation# and lethargy Corre t Ans!er: 2 "ationa#e 1& Common withdrawal symptoms associated with alcohol include tremors# fatigue# an iety# abdominal cramping# hallucinations# confusion# sei6ures# and delirium. "ationa#e 2& Common withdrawal symptoms associated with alcohol include tremors# fatigue# an iety# abdominal cramping# hallucinations# confusion# sei6ures# and delirium.
"ationa#e 3& Common withdrawal symptoms associated with alcohol include tremors# fatigue# an iety# abdominal cramping# hallucinations# confusion# sei6ures# and delirium. "ationa#e 4& Common withdrawal symptoms associated with alcohol include tremors# fatigue# an iety# abdominal cramping# hallucinations# confusion# sei6ures# and delirium. $#o%a# "ationa#e: Co&niti'e (e'e#: 7emembering C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!2 Question 1. Type: MCSA A hospice patient has been receiving oral pain medication for several weeks. The patient started with $ mg of the drug# and each week has had to increase the amount by "J2 mg to obtain ade'uate pain relief. The nurse recogni6es that the patient 1. has developed immunity to the drug. 2. has developed a tolerance to the drug. 3. has developed a physiologic addiction to the drug. 4. has developed a psychological addiction to the drug. Corre t Ans!er: 2 "ationa#e 1& 5rug tolerance occurs when the body adapts to a substance after repeated administration. Although addictions are possible# the situation presented best describes drug tolerance# not addiction. 5rug immunity is a term that is often confused with drug tolerance. 5rug immunity is more appropriately used when discussing the immune system. "ationa#e 2& 5rug tolerance occurs when the body adapts to a substance after repeated administration. Although addictions are possible# the situation presented best describes drug tolerance# not addiction. 5rug immunity is a term that is often confused with drug tolerance. 5rug immunity is more appropriately used when discussing the immune system. "ationa#e 3& 5rug tolerance occurs when the body adapts to a substance after repeated administration. Although addictions are possible# the situation presented best describes drug tolerance# not addiction. 5rug immunity is a term that is often confused with drug tolerance. 5rug immunity is more appropriately used when discussing the immune system.
"ationa#e 4& 5rug tolerance occurs when the body adapts to a substance after repeated administration. Although addictions are possible# the situation presented best describes drug tolerance# not addiction. 5rug immunity is a term that is often confused with drug tolerance. 5rug immunity is more appropriately used when discussing the immune system. $#o%a# "ationa#e: Co&niti'e (e'e#: Hnderstanding C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!$ Question 1/ Type: MCSA )hich of the following drugs is least likely to produce physical dependence or tolerance? 1. Mari;uana 2. Morphine 3. /icotine 4. +thyl alcohol Corre t Ans!er: "ationa#e 1& Although psychological dependence is very high with mari;uana# it has minor!to!no withdrawal symptoms. "ationa#e 2& Although psychological dependence is very high with mari;uana# it has minor!to!no withdrawal symptoms. "ationa#e 3& Although psychological dependence is very high with mari;uana# it has minor!to!no withdrawal symptoms. "ationa#e 4& Although psychological dependence is very high with mari;uana# it has minor!to!no withdrawal symptoms. $#o%a# "ationa#e: Co&niti'e (e'e#: 7emembering C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!%
Question 20 Type: MCSA 5uring a health history# the nurse should use therapeutic communication when asking about substance abuse. )hich of the following is essential to establish a trusting nurseJpatient relationship? 1. .nforming the patient that substance abuse is a sin 2. Avoiding communicating disapproval of indicated substance abuse 3. +nsuring that the patient4s mother and father are at the bedside 4. Avoiding shocked facial e pressions Corre t Ans!er: $ "ationa#e 1& The nurse should be non;udgmental# but should firmly communicate disapproval of any indicated substance abuse. .nforming the patient that substance abuse is a sin is being ;udgmental. (atients might be less likely to inform the nurse of a hidden substance abuse problem in the presence of family members. "ationa#e 2& The nurse should be non;udgmental# but should firmly communicate disapproval of any indicated substance abuse. .nforming the patient that substance abuse is a sin is being ;udgmental. (atients might be less likely to inform the nurse of a hidden substance abuse problem in the presence of family members. "ationa#e 3& The nurse should be non;udgmental# but should firmly communicate disapproval of any indicated substance abuse. .nforming the patient that substance abuse is a sin is being ;udgmental. (atients might be less likely to inform the nurse of a hidden substance abuse problem in the presence of family members. "ationa#e 4& The nurse should be non;udgmental# but should firmly communicate disapproval of any indicated substance abuse. .nforming the patient that substance abuse is a sin is being ;udgmental. (atients might be less likely to inform the nurse of a hidden substance abuse problem in the presence of family members. $#o%a# "ationa#e: Co&niti'e (e'e#: Hnderstanding C#ient )eed: Safe +ffective Care +nvironment C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!@ Question 21 Type: MCSA A patient suffering from tachycardia and palpitations would most likely be e periencing the signs of drug to icity from which of the following?
1. /icotine 2. Alcohol 3. Cen6odia6epines 4. Mari;uana Corre t Ans!er: "ationa#e 1& Signs of nicotine to icity include heart palpitations# tachydysrhythmias# confusion# depression# and sei6ures. "ationa#e 2& Signs of nicotine to icity include heart palpitations# tachydysrhythmias# confusion# depression# and sei6ures. "ationa#e 3& Signs of nicotine to icity include heart palpitations# tachydysrhythmias# confusion# depression# and sei6ures. "ationa#e 4& Signs of nicotine to icity include heart palpitations# tachydysrhythmias# confusion# depression# and sei6ures. $#o%a# "ationa#e: Co&niti'e (e'e#: 7emembering C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!% Question 22 Type: MCMA A patient is admitted with complications of long!term abuse of anabolic steroids. )hich of the following patient histories should not surprise the nurse? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. A "2!year!old personal trainer 2. A -F!year!old senior high school baseball player 3. A 2%!year!old weightlifter 4. A 2"!year!old professional football player
5. A "-!year!old downhill skier preparing for the 3lympics Corre t Ans!er: -#"#2 "ationa#e 1& Some abusers use anabolic steroids to enhance their appearance. .t should not be surprising to find steroid abuse in this patient. "ationa#e 2& 0igh school students are not tested for anabolic steroid use# so it would not be surprising to find steroid abuse in this patient. "ationa#e 3& .f this weightlifter is not competing in a professional organi6ation# it would not be surprising to find that this patient is abusing anabolic steroids. "ationa#e 4& Since most sports organi6ations# including professional football# test for steroid use# it would be surprising to find that this patient is abusing anabolic steroids. "ationa#e 5& Since most sports organi6ations# including the 3lympics# test for steroid use# it would be surprising to find that this patient is abusing anabolic steroids. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy6ing C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: (harmacological and (arenteral Therapies )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!Question 23 Type: MCMA A nurse is preparing to admit a patient suspected of overdose. The nurse knows to suspect which drugs as being the most commonly abused? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. Methylphenidate 87italin: 2. /icotine 3. Mari;uana 4. Amobarbital 8Amytal: 5. Secobarbital 8Seconal:
Corre t Ans!er: -#"#2 "ationa#e 1& >egal prescriptions such as methylphenidate 87italin: have become fre'uent drugs of abuse. "ationa#e 2& /icotine is one of the most commonly abused drugs. "ationa#e 3& Mari;uana is the most fre'uently abused illegal drug. "ationa#e 4& The medical use of barbiturates has declined# decreasing illicit abuse. "ationa#e 5& The medical use of barbiturates has declined# decreasing illicit abuse. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: (harmacological and (arenteral Therapies )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!Question 24 Type: MCMA The nurse is reinforcing factors that contribute to addiction to a group of patients recovering from addiction and their family members. )hich statement made by a patient or family member would indicate the need for additional teaching? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. ".4m not likely to have any more problems with addiction since neither of my parents had a problem with addiction." 2. ". can still see my friends as long as . stay away from alcohol." 3. ". don4t want to become addicted like my husband did. .4m never going to take any kind of drug unless . absolutely have to." 4. ". reali6e now that . was ;ust looking for ways to help me feel good about myself." 5. "After a while# it ;ust seemed even though . was not in pain# . would still want to take the pain pills." Corre t Ans!er: -#"#2 "ationa#e 1& Addiction depends on multiple and comple variables. Kenetics plays a part but many other factors also contribute to addiction.
"ationa#e 2& Counselors encourage users to stop associating with social contacts who shared the substance abuse to lessen the possibility for relapse. "ationa#e 3& The therapeutic use of drugs rarely causes addiction when used according to accepted medical protocols. "ationa#e 4& The drug e perience may bring feelings of pleasure or well!being. The patient may find achieving this feeling to be worth repeating# leading to addiction. "ationa#e 5& This patient recogni6es that taking pain medication even when in not pain leaves one vulnerable for addiction. The therapeutic use of drugs rarely causes addiction when used according to accepted medical protocols. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy6ing C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: (harmacological and (arenteral Therapies )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!$ Question 25 Type: MCMA A patient has been abusing an antian iety medication. )hich assessment by the nurse would confirm this is psychological dependence instead of physical dependence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. The patient4s history reveals the long!term use of high doses of an antian iety medication. 2. The patient describes the "need" to use the antian iety medication despite not feeling an ious. 3. The patient describes feeling nauseous with abdominal cramping. 4. The patient tells you her family has "disowned" her because of her need for the antian iety medication. 5. The patient complains she has not slept in days# feels an ious# and tired. Corre t Ans!er: -#"#$ "ationa#e 1& (sychological dependence usually re'uires the use of relatively high doses of antian iety medication over a prolonged period of time.
"ationa#e 2& (sychological dependence is the "need" or desire to continue taking a drug when there is a lack of physical symptoms. .n this case# the patient does not feel an ious but still has the desire to take the antian iety medication. "ationa#e 3& (hysical dependence produces physical signs of discomfort when the agent is discontinued. This is not true of psychological dependence. "ationa#e 4& To continue the use of the antian iety drug at the risk of ;eopardi6ing relationships is indicative of psychological dependence. "ationa#e 5& (hysical dependence produces physical signs of discomfort when the agent is discontinued. This is not true of psychological dependence. $#o%a# "ationa#e: Co&niti'e (e'e#: Analy6ing C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: (harmacological and (arenteral Therapies )ursin&/*nte&rated Con epts: /ursing (rocess& Assessment (earnin& +ut ome: --!% Question 2, Type: MCMA The nurse is preparing care for a patient diagnosed with substance abuse of a Schedule . drug. )hich drugs are Schedule . drugs? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Standard Text: Select all that apply. 1. 0eroin 2. Mari;uana 3. >S5 4. Cocaine 5. 5ia6epam 8<alium: Corre t Ans!er: -#"#2 "ationa#e 1& 0eroin is a Schedule . drug. "ationa#e 2& Mari;uana is a Schedule . drug.
"ationa#e 3& >S5 is a Schedule . drug. "ationa#e 4& Cocaine is a Schedule .. drug. "ationa#e 5& 5ia6epam 8<alium: is a ben6odia6epine. Cen6odia6epines are Schedule .< drugs. $#o%a# "ationa#e: Co&niti'e (e'e#: Applying C#ient )eed: (hysiological .ntegrity C#ient )eed Su%: (harmacological and (arenteral Therapies )ursin&/*nte&rated Con epts: /ursing (rocess& .mplementation (earnin& +ut ome: --!"

Adams4e Tif Ch11

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Adams, Pharmacology for Nurse: A Pathophysiologic Approach, 4/E Chapter 11

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