Chapter 23: Chemically Mediated Responses and Substance-Related Disorders

Principles And Practice of Psychiatric Nursing,10th Edition by Gail Wiscarz Stuart

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Chapter 23: Chemically Mediated Responses and Substance-Related Disorders

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

  1. An individual who is admitted to an alcohol detoxification unit has had no alcohol intake for 3 days. On admission the patient is noted to have tremors, anxiety, insomnia, and disorientation accompanied by tachycardia and diaphoresis. These signs and symptoms are characteristic of the syndrome known as:
a. alcoholic hallucinosis.
b. alcohol-induced psychosis.
c. alcoholic seizure disorder.
d. alcohol withdrawal delirium.

 

 

ANS:  D

The signs and symptoms listed are consistent with alcohol withdrawal delirium. It usually has its onset 3 to 5 days after the last drink and lasts 2 to 3 days. It is considered a medical emergency.

 

DIF:    Cognitive Level: Comprehension     REF:   Text Page: 454

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

 

  1. The nursing intervention of highest priority relative to alcohol withdrawal delirium is:
a. application of restraints.
b. reorientation of the patient to reality.
c. identification of existing social supports.
d. maintenance of fluid and electrolyte balance.

 

 

ANS:  D

Maintaining physiological stability is of highest priority. Withdrawal delirium is often accompanied by loss of fluid and electrolytes through vomiting, diarrhea, and diaphoresis.

 

DIF:    Cognitive Level: Analysis                REF:   Text Page: 454

TOP:   Nursing Process: Planning

MSC:  NCLEX: Physiological Integrity: Physiological Adaptation

 

  1. A patient asks a nurse, “What is the primary aim of self-help groups for alcohol abusers?” The nurse should reply, “The goal is first to:
a. always be available to help others with an addiction.”
b. commit to always strive for total abstinence.”
c. find and rely on the help of the member’s sponsor.”
d. admit powerlessness over the addiction.”

 

 

ANS:  B

Although all the options are expectations in the program, admitting to having alcoholism and staying alcohol-free are the aims of the Alcoholics Anonymous (AA) program.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 461

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

 

  1. The spouse of a patient with alcoholism asks, “How do I respond in a helpful way even though this abuse is so harmful to my family?” The nurse’s best response would be:
a. “Search the house regularly for hidden alcohol.”
b. “Include your spouse in family activities whether or not drinking has occurred.”
c. “Make your spouse responsible for the consequences of the disruptive behavior.”
d. “Refuse to be supportive when your spouse is under the influence of alcohol.”

 

 

ANS:  C

Dysfunctional families often try to protect the patient, avoid confrontation, and blame themselves. These are called enabling behaviors. Making the patient responsible for the consequences of drinking is difficult and usually requires professional support and/or involvement in Alcoholics Anonymous (AA).

 

DIF:    Cognitive Level: Application           REF:   Text Page: 466

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

 

  1. When designing a teaching plan for a patient taking disulfiram (Antabuse), a nurse should include an explanation on the importance of avoiding certain over-the-counter substances. With the appropriate instruction, which substance could the patient identify as being safe to use?
a. Antacids
b. Mouthwash
c. Cough syrups
d. Cold medications

 

 

ANS:  A

Substances that may potentially contain alcohol must be avoided. The use of antacids would be safe.

 

DIF:    Cognitive Level: Application           REF:   Text Page: 462

TOP:   Nursing Process: Implementation

MSC:  NCLEX: Physiological Integrity: Pharmacological and Parenteral Therapies

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