Questions and Answers
An adult in the emergency department states, 'Everything I see appears to be waving. I am outside my body looking at myself. I think I'm losing my mind.' Vital signs are slightly elevated. The nurse should suspect:
A nurse wants to research epidemiology, assessment techniques, and best practices regarding persons with addictions. Which resource will provide the most comprehensive information?
A patient is thin, tense, jittery, and has dilated pupils. The patient says, 'My heart is pounding in my chest. I need help.' The patient allows vital signs to be taken but then becomes suspicious and says, 'You could be trying to kill me.' Abuse of which substance is most likely?
Select the priority outcome for a patient completing the fourth alcohol-detoxification program in the past year. Prior to discharge, the patient will:
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A nurse prepares for an initial interaction with a patient with a long history of methamphetamine abuse. Which is the nurse's best first action?
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A patient undergoing alcohol rehabilitation decides to begin disulfiram (Antabuse) therapy. Patient teaching should include the need to: (Select all that apply)
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The nurse can assist a patient to prevent substance abuse relapse by: (Select all that apply)
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A patient took a large quantity of bath salts. Priority nursing and medical measures include: (Select all that apply)
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A new patient beginning an alcoholism rehabilitation program says, 'I'm just a social drinker. I usually have one drink at lunch, two in the afternoon, wine at dinner, and a few drinks during the evening.' Select the nurse's most therapeutic responses. (Select all that apply)
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A patient diagnosed with alcoholism asks, 'How will Alcoholics Anonymous (AA) help me?' Select the nurse's best response.
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A nurse reviews vital signs for a patient admitted with an injury sustained while intoxicated. What is the nurse's priority action?
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A nurse cares for a patient diagnosed with an opioid overdose. Which focused assessment has the highest priority?
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A patient admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The patient shows symptoms consistent with alcohol withdrawal delirium. What is the most accurate assessment?
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What is the priority nursing diagnosis for a patient who is anxious, agitated, and has perceptual distortions?
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What medication is the health care provider likely to prescribe for a patient with alcohol abuse disorder experiencing acute agitation?
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A patient diagnosed with an alcohol abuse disorder says, 'Drinking helps me cope with being a single parent.' Which response by the nurse would help the patient conceptualize drinking objectively?
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What is Alcoholics Anonymous (AA)?
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What conclusion can be drawn about a patient with a blood alcohol level of 500 mg% who demonstrates ataxia and slurred speech?
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A patient in a rehabilitation program states, 'I'm just a social drinker.' Which defense mechanism is the patient using?
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Which medication would likely be prescribed for maintaining abstinence in patients with addiction to alcohol or opioids?
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What comment by the nurse will be most helpful to the spouse of a patient in a rehabilitation program?
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What should the treatment team consider for a patient diagnosed with schizophrenia and cannabis abuse who is having hallucinations?
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Which therapeutic manner should a nurse adopt when working with a patient beginning treatment for alcohol addiction?
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What features should be present in a therapeutic milieu for a patient with a hallucinogen overdose?
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What does it mean when a patient requires more alcohol to achieve the same effect over time?
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What assessment findings are likely for an individual who recently injected heroin?
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During the third week of treatment, the spouse of a patient in a rehabilitation program says, 'After this treatment program, I think everything will be all right.' How should the nurse respond?
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Which priority nursing intervention should be performed for a patient after an overdose of amphetamines?
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What symptoms of withdrawal from opioids should the nurse assess for?
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What scenario describes a patient experiencing addiction when trying to reduce smoking?
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What is the nursing diagnosis for a patient with respiratory depression due to narcotic intoxication?
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What should family members understand about relapses in alcoholism treatment?
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Study Notes
Alcoholics Anonymous (AA)
- AA supports individuals seeking abstinence from alcohol through a peer-based approach.
- Members focus on recovery one day at a time rather than learning controlled drinking.
Vital Signs in Intoxicated Patients
- Monitoring vital signs is crucial; elevated blood pressure and pulse can indicate alcohol withdrawal.
- Medical intervention should be sought if concerning trends are observed.
Opioid Overdose
- Respiratory assessment is the priority due to risk of respiratory depression leading to death in opioid overdose cases.
Alcohol Withdrawal Symptoms
- Symptoms include agitation, elevated pulse, hallucinations, and anxiety.
- Alcohol withdrawal delirium can occur, characterized by severe agitation and perceptual disturbances.
Nursing Diagnosis in Intoxication
- Patients with impaired judgment and sensory distortions pose a risk for injury; safety is the top priority in nursing care.
Medication Use in Withdrawal
- Benzodiazepines like lorazepam or chlordiazepoxide are preferred for sedation during alcohol withdrawal.
Therapeutic Interventions
- One-on-one supervision is recommended for anxious and agitated patients undergoing withdrawal to ensure safety.
- Engaging patients in discussions about previous drinking habits can initiate self-reflection and responsibility.
Alcoholics Anonymous Overview
- AA is a self-help group aimed at achieving sobriety through mutual support, not professional guidance.
Understanding Patient Behavior and Tolerance
- High blood alcohol levels correlating with functional behavior suggest developed tolerance.
- Denial is a common defense mechanism among individuals with substance use issues.
Treatment Options for Addiction
- Naltrexone is effective for both opioid and alcohol addiction, blocking reinforcing effects and cravings.
Family Support in Recovery
- Families should encourage accountability by allowing addicted individuals to face the consequences of their actions.
Goals for Alcohol Treatment
- Achieving physiologic stability is essential before addressing psychological and social recovery strategies.
Addressing Co-occurring Disorders
- Individuals with both substance use disorders and mental health disorders should receive simultaneous treatment for effective recovery.
Nursing Approach in Treatment
- An empathetic and supportive demeanor fosters a safe environment for patients beginning treatment.
Withdrawal Symptoms for Various Substances
- Opioid withdrawal includes nausea, vomiting, and anxiety, reminiscent of alcohol withdrawal symptoms.
Signs of Heroin Use
- Heroin intoxication presents with drowsiness, constricted pupils, and slurred speech, indicative of CNS depression.
Recognition of Hallucinogen Effects
- Symptoms such as altered perceptions and feelings of depersonalization are typical of hallucinogen ingestion.
Researching Addiction Resources
- The Substance Abuse and Mental Health Services Administration (SAMHSA) is the leading source for comprehensive addiction-related information.
Substance Abuse Indicators
- Jitteriness, dilated pupils, and paranoia are suggestive of amphetamine abuse, highlighting the importance of recognizing physical and psychological signs of addiction.### Substance Use and Behavioral Effects
- PCP use can lead to bizarre and violent behavior.
- Barbiturates and heroin are associated with central nervous system (CNS) depression symptoms.
Alcohol Detoxification Outcome
- Priority for a patient completing multiple alcohol detox programs: recognizing the need for long-term treatment.
- Discharge goals should focus on preventing relapse and understanding the ongoing nature of treatment.
Initial Nurse-Patient Interaction in Methamphetamine Abuse
- Best first action for a nurse is self-assessment of personal attitudes and beliefs regarding addiction.
- Understanding personal biases is crucial for providing compassionate care.
Disulfiram (Antabuse) Patient Teaching
- Patients on disulfiram must avoid:
- Alcohol-based skin products.
- Liquid medications that may contain alcohol.
- Fumes from paints or solvents that may trigger reactions.
- Awareness of hidden sources of alcohol is essential for preventing adverse reactions.
Preventing Substance Abuse Relapse
- Strategies to assist patients in preventing relapse:
- Rehearse coping techniques for anticipated stress.
- Identify necessary life skills for effective coping.
- Provide information on expected physiological changes without substances.
- Isolating from significant others is not advised; support systems are critical for sobriety.
Bath Salts Overdose Management
- Priority nursing measures include:
- Management of heart rate due to tachycardia risks.
- Ensuring environmental safety for patients exhibiting bizarre behavior.
- Nutrition and vitamin supplementation are not immediate priorities during an overdose.
Therapeutic Responses in Alcoholism Rehabilitation
- Effective nursing responses can include:
- Clarifying the patient's reported drinking patterns without confrontational statements.
- Providing information that contradicts the patient’s perspective on their drinking behaviors.
- Avoiding strong confrontations early in treatment facilitates healthier coping strategy development.
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Description
This quiz covers essential concepts related to alcohol and opioid dependency, including Alcoholics Anonymous support, vital signs in intoxicated patients, symptoms of alcohol withdrawal, and nursing diagnoses. Test your knowledge on the management and assessment of patients with substance use issues.
