Chapter 22: Substance Related and Addictive Disorders

Chapter 22: Substance Related and Addictive Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient diagnosed with alcoholism asks, “How will Alcoholics Anonymous (AA) help me?”  Select the nurse’s best response.

a.	“The goal of AA is for members to learn controlled drinking with the support of a higher power.”
b.	“An individual is supported by peers while striving for abstinence one day at a time.”
c.	“You must make a commitment to permanently abstain from alcohol and other drugs.”
d.	“You will be assigned a sponsor who will plan your treatment program.”

 

 

ANS:  B

Admitting to being an alcoholic, making an attempt to remain alcohol-free for a day at a time, and receiving support from peers are basic aspects of AA. The other options are incorrect.

 

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 422 | Page 424-425                  TOP:   Nursing Process: Implementation

MSC:  Client Needs: Psychosocial Integrity

 

2. A nurse reviews vital signs for a patient admitted with an injury sustained while intoxicated. The medical record shows these blood pressure and pulse readings at the times listed:

0200:  118/78 mm Hg and 72 beats/min

0400:  126/80 mm Hg and 76 beats/min

0600:  128/82 mm Hg and 72 beats/min

0800:  132/88 mm Hg and 80 beats/min

1000:  148/94 mm Hg and 96 beats/min

What is the nurse’s priority action?

a.	Force fluids.
b.	Consult the health care provider.
c.	Obtain a clean-catch urine sample.
d.	Place the patient in a vest-type restraint.

 

 

ANS:  B

Elevated pulse and blood pressure may indicate impending alcohol withdrawal and the need for medical intervention. No indication is present that the patient may have a urinary tract infection or is presently in need of restraint. Hydration will not resolve the problem.

 

PTS:   1                    DIF:    Cognitive Level: Analyze (Analysis)

REF:   Page 421 (Table 22-5)                     TOP:   Nursing Process: Implementation

MSC:  Client Needs: Physiological Integrity

 

3. A nurse cares for a patient diagnosed with an opioid overdose. Which focused assessment has the highest priority?

a.	Cardiovascular	c.	Neurologic
b.	Respiratory	d.	Hepatic

 

 

ANS:  B

Opioid overdose causes respiratory depression. Respiratory depression is the primary cause of death among opioid abusers. The assessment of the other body systems is relevant but not the priority. See relationship to audience response question.

 

PTS:   1                    DIF:    Cognitive Level: Analyze (Analysis)

REF:   Page 413 (Table 22-1)                     TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity

 

4. A patient admitted for injuries sustained while intoxicated has been hospitalized for 48 hours. The patient is now shaky, irritable, anxious, diaphoretic, and reports nightmares. The pulse rate is 130 beats/min. The patient shouts, “Bugs are crawling on my bed. I’ve got to get out of here.” Select the most accurate assessment of this 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 an acute psychosis.

 

 

ANS:  C

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

 

PTS:   1                    DIF:    Cognitive Level: Understand (Comprehension)

REF:   Page 421 (Table 22-5)                     TOP:   Nursing Process: Assessment

MSC:  Client Needs: Physiological Integrity

 

5. A patient admitted yesterday for injuries sustained while intoxicated believes bugs are crawling on the bed. The patient is anxious, agitated, and diaphoretic. What is the priority nursing diagnosis?

a.	Disturbed sensory perception	c.	Ineffective denial
b.	Ineffective coping	d.	Risk for injury

 

 

ANS:  D

The patient’s clouded sensorium, sensory perceptual distortions, and poor judgment predispose a risk for injury. Safety is the nurse’s priority. The other diagnoses may apply but are not the priorities of care.

 

PTS:   1                    DIF:    Cognitive Level: Analyze (Analysis)

REF:   Page 421 (Table 22-5) | Page 423 (Table 22-8)

TOP:   Nursing Process: Diagnosis/Analysis

MSC:  Client Needs: Safe, Effective Care Environment