Chapter 37: Drug Abuse I: Basic Considerations

Chapter 37: Drug Abuse I: Basic Considerations

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A nurse is teaching a group of nursing students about drug abuse. Which statement by a student indicates a need for further teaching?

a.	“Patients who experience physical dependence will show compulsive drug-seeking behavior.”
b.	“People who are addicted to a drug do not necessarily have tolerance to that drug.”
c.	“Physical dependence means that abstinence syndrome will occur if a drug is withdrawn.”
d.	“Physical dependence often contributes to addictive behavior but does not cause it.”

 

 

ANS:  A

Physical dependence occurs with prolonged drug exposure and, through neuroadaptive processes, results in abstinence syndrome if a drug is withdrawn. It does not necessarily result in compulsive drug-seeking behavior. Patients can have drug addiction, which involves compulsive drug seeking without having developed a tolerance to drug effects. Addictive behavior is the result of psychologic dependence with an intense subjective need for a drug. Because abstinence syndrome is uncomfortable, physical dependence can increase subjective feelings for a drug.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 406-407

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

2. A patient is ready for discharge home from a lengthy hospital stay after a motor vehicle accident. The patient suffered multiple fractures and required large doses of morphine for several weeks. The nurse preparing the patient for discharge notes that the patient requests the maximum dose of the oral opioid analgesic at the exact intervals it is prescribed. The nurse is correct to suspect that what has occurred?

a.	Addiction
b.	Compulsive drug seeking
c.	Cross-tolerance
d.	Drug tolerance

 

 

ANS:  D

Patients who use a drug regularly develop tolerance to the drug when a dose produces a smaller response than it did initially. This patient has been on large doses of opioids for several weeks and has developed tolerance to this class of drugs. Addiction is characterized by compulsive drug seeking, which has not occurred. A patient using narcotics for severe pain is not a compulsive drug seeker. Cross-tolerance occurs when tolerance to one drug confers tolerance to another drug. The opioid analgesic for home use is in the same drug classification, so this is not cross-tolerance.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 406-407

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

3. A patient who has been taking a medication with a side effect of drowsiness stops taking the medication after several weeks. The patient reports feeling anxious and jittery. The nurse understands that this response is due to:

a.	addiction.
b.	psychologic dependence.
c.	tolerance.
d.	withdrawal syndrome.

 

 

ANS:  D

Withdrawal syndrome occurs when patients have developed a physical dependence on a drug and then often show symptoms that are the opposite of the drug’s effect when the drug is withdrawn. Addiction is characterized by compulsive drug seeking. Psychologic dependence is an intense subjective need for a drug. Tolerance develops when increased amounts of a drug are needed to achieve the drug’s effects.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 406-407

TOP:   Nursing Process: Evaluation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

4. A nurse is caring for four patients. The nurse would be concerned about which patient developing a substance use disorder?

a.	A college student who reports having experimented with marijuana in the past year
b.	An older adult patient with terminal cancer who requires twice the normal dose of morphine for pain relief
c.	A patient in moderate to severe pain after a total hip replacement who asks for pain medication an hour before the next dose is due
d.	A patient whose history indicates the use of prescription narcotic analgesics for back and headache pain

 

 

ANS:  D

Patients who use narcotics for minor pains are more likely to be compulsive drug seekers. A college student who experiments with an illegal substance is not necessarily going to develop a substance use disorder. An elderly patient with terminal cancer pain has most likely developed physical dependence and tolerance to morphine but is not a substance abuser. Patients with significant pain who ask for more frequent dosing are not showing substance use disorder.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 406-407

TOP:   Nursing Process: Diagnosis

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies