Chapter 19: Addictions and Compulsions

Essentials of Psychiatric Mental Health Nursing ,2nd Edition by Elizabeth M. Varcarolis

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Chapter 19: Addictions and Compulsions

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. An alcohol-dependent patient was hospitalized at 0200 today. When would the nurse expect withdrawal symptoms to peak?
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)

 

 

ANS:  B

Alcohol withdrawal usually begins 6 to 8 hours after cessation or significant reduction of alcohol intake. It peaks between 24 and 48 hours, then resolves or progresses to delirium.

 

DIF:    Cognitive Level: Application           REF:   Pages: 336-367

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

 

  1. 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 who is:
a. jaundiced
b. dependent on alcohol
c. healthy but underweight
d. microcephalic and cognitively impaired

 

 

ANS:  D

Fetal alcohol syndrome is the result of alcohol’s inhibiting fetal development in the first trimester. The fetus of a woman who drinks that much alcohol will probably have this disorder. Alcohol use during pregnancy is not likely to produce the findings listed in the distracters.

 

DIF:    Cognitive Level: Application           REF:   Page: 363

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

 

  1. A patient was admitted last night with a hip fracture sustained in a fall while intoxicated. The patient points to the Buck traction and screams, “Somebody tied me up with ropes.” The patient is experiencing:
a. illusion
b. delusion
c. hallucinations
d. hypnagogic phenomenon

 

 

ANS:  A

The patient is misinterpreting a sensory perception when seeing a noose instead of traction. Illusions are common in early withdrawal from alcohol. A delusion is a fixed, false belief. Hallucinations are sensory perceptions occurring in the absence of a stimulus. Hypnagogic phenomena are sensory disturbances that occur between waking and sleeping.

 

DIF:    Cognitive Level: Comprehension     REF:   Page: 367

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

 

  1. 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 per minute. The patient shouts, “Bugs are crawling on my bed. I’ve got to get out of here.” What is the most accurate assessment of the situation? The patient:
a. is attempting to obtain attention by manipulating staff.
b. may have sustained a head injury before admission.
c. has symptoms of alcohol withdrawal delirium.
d. is having a recurrence of an acute psychosis.

 

 

ANS:  C

Symptoms of agitation, elevated pulse, and perceptual distortions point to alcohol withdrawal delirium, a medical emergency. The findings are inconsistent with manipulative attempts, head injury, or functional psychosis.

 

DIF:    Cognitive Level: Application           REF:   Pages: 366-368

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

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