Chapter 10: Substance Use Disorders

Chapter 10: Substance Use Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. Which assessment finding would alert the nurse to ask the patient about alcohol use?

a.	Low blood pressure	c.	Elevated temperature
b.	Decreased heart rate	d.	Abdominal tenderness

 

 

ANS:  D

Abdominal pain associated with gastrointestinal tract and liver dysfunction is common in patients with chronic alcohol use. The other problems are not associated with alcohol use.

 

DIF:    Cognitive Level: Apply (application)           REF:               151

TOP:   Nursing Process: Assessment           MSC:  NCLEX: Psychosocial Integrity

 

2. The nurse plans postoperative care for a patient who smokes two packs of cigarettes daily. Which goal should the nurse include in the plan of care for this patient?

a.	Improve sleep	c.	Decrease diarrhea
b.	Enhance appetite	d.	Prevent sore throat

 

 

ANS:  A

Insomnia is a characteristic of nicotine withdrawal. Diarrhea, sore throat, and anorexia are not symptoms associated with nicotine withdrawal.

 

DIF:    Cognitive Level: Apply (application)           REF:               150

TOP:   Nursing Process: Planning               MSC:  NCLEX: Psychosocial Integrity

 

3. A young adult patient scheduled for an annual physical examination arrives in the clinic smelling of cigarette smoke and carrying a pack of cigarettes. Which action will the nurse plan to take?

a.	Urge the patient to quit smoking as soon as possible.
b.	Avoid confronting the patient about smoking at this time.
c.	Wait for the patient to start a discussion about quitting smoking.
d.	Explain that the “cold turkey” method is most effective in stopping smoking.

 

 

ANS:  A

Current national guidelines indicate that health care professionals should urge patients who smoke to quit smoking at every encounter. The other actions will not help decrease the patient’s health risks related to smoking.

 

DIF:    Cognitive Level: Apply (application)           REF:               146

TOP:   Nursing Process: Planning               MSC:  NCLEX: Health Promotion and Maintenance

 

4. A patient admitted to the hospital after an automobile accident is alert and does not appear to be highly intoxicated. The blood alcohol concentration (BAC) is 110 mg/dL (0.11 mg%). Which action by the nurse is appropriate?

a.	Restrict oral and IV fluids.
b.	Maintain the patient on NPO status.
c.	Administer acetaminophen for headache.
d.	Monitor for hyperreflexia and diaphoresis.

 

 

ANS:  D

The patient’s assessment data indicate probable physiologic dependence on alcohol, and the patient is likely to develop acute withdrawal such as anxiety, hyperreflexia, and sweating, which could be life threatening. Acetaminophen is not recommended because it is metabolized by the liver. Alcohol has a dehydrating effect so fluids should not be restricted and there is no indication that the patient should be NPO.

 

DIF:    Cognitive Level: Apply (application)           REF:               155

TOP:   Nursing Process: Implementation     MSC:  NCLEX: Psychosocial Integrity

 

5. An alcohol-intoxicated patient with a penetrating wound to the abdomen is undergoing emergency surgery. What will the nurse expect the patient to need during the perioperative period?

a.	An increased dose of the general anesthetic medication
b.	Interventions to prevent withdrawal symptoms within 2 hours
c.	Frequent monitoring for bleeding and respiratory complications
d.	Stimulation every hour to prevent prolonged postoperative sedation

 

 

ANS:  C

Patients who are intoxicated at the time of surgery are at increased risk for problems with bleeding and respiratory complications such as aspiration. In an intoxicated patient, a lower dose of anesthesia is used because of the synergistic effect of the alcohol. Withdrawal is likely to occur later in the postoperative course because the medications used for anesthesia, sedation, and pain will delay withdrawal symptoms. The patient should be monitored frequently for oversedation but does not need to be stimulated.

 

DIF:    Cognitive Level: Apply (application)           REF:               149

TOP:   Nursing Process: Planning               MSC:  NCLEX: Psychosocial Integrity