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Ch6 | Test Bank – Nursing Care Of Patients With Problems Of

LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)

Chapter 6 Nursing Care of Patients with Problems of Substance Abuse

1) A patient is concerned about becoming an alcoholic since both parents abuse alcohol. How should the nurse respond to the patient?

1. "There are studies that support a genetic link for developing alcoholism."

2. "Why are you concerned about becoming an alcoholic?"

3. "You will likely become an alcoholic."

4. "Don't worry about that."

Page Ref: 128

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.2. Recognize the relationship of genetics and genomics to health, prevention, screening, diagnostics, prognostics, selection of treatment, and monitoring of treatment effectiveness, using a constructed pedigree from collected family history information as well as standardized symbols and terminology | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Implementation

Learning Outcome: 6.1 Outline the pathophysiology, manifestations, and complications of substance abuse; the risk factors for substance abuse; and characteristics of individuals who abuse substances including nurses.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

2) The mother of a patient admitted with alcohol abuse tells the nurse that alcohol is not consumed at home and the patient is adopted. What should the nurse suspect about the patient?

1. The patient's biological parents might have abused alcohol.

2. The patient spent time drinking with friends.

3. Consuming alcohol is a symptom of stress.

4. Alcoholism is a learned behavior.

Page Ref: 128

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

3) A patient reports having a glass of wine every evening at home after work to "unwind" and cannot continue with the day until the wine is consumed. In which way is this patient using alcohol?

1. Cope with day-to-day problems

2. Deal with difficulty expressing emotions

3. Express a genetic need for alcohol

4. Socialize with others

Page Ref: 129

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

4) While analyzing data collected during an assessment, the nurse realizes that a patient's risk for alcohol abuse is low. What information did the nurse use to come to this conclusion?

1. The patient is Asian American.

2. The patient is diagnosed with type 2 diabetes.

3. The patient has two children.

4. The patient is employed as an accountant.

Page Ref: 129-130

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Reduction of Risk Potential

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

5) The nurse is concerned about potential substance abuse by a coworker. What behavior should be further investigated?

1. The coworker frequently wastes medications.

2. The coworker frequently requests the largest patient care assignment for the shift.

3. The coworker prefers not to be the "medication nurse" on the shift.

4. The coworker declines to take scheduled breaks.

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: II.B.6. Initiate requests for help when appropriate to situation | AACN Essentials Competencies: VIII.12. Act to prevent unsafe, illegal or unethical care practices | NLN Competencies: Personal and Professional Development; Practice-Know-How; Apply decision making skills, particularly in the context of uncertainty and ambiguity | Nursing/Integrated Concepts: Nursing Process: Assessment

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

6) A nurse consistently who wears long-sleeved clothing despite the temperature being in the 90s and the air humid becomes defensive and avoids others when asked about the uniform being worn. What does the nurse's behavior suggest?

1. Substance abuse

2. A long-standing illness

3. Introverted behavior

4. Low self-esteem

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

7) The manager is concerned that one staff nurse is demonstrating signs of substance abuse. Which behavior did the manager observe in the staff nurse? Select all that apply.

1. Calling for days off or illness before scheduled days off.

2. Using the bathroom frequently.

3. Excessive use of mouthwash.

4. Volunteering to transfer a patient to the intensive care unit.

5. Following up with nursing assistants on patient care needs.

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

8) The nurse is concerned that a colleague is experiencing depression from substance abuse. What does the nurse observe to make this assumption?

1. The colleague leaves the unit and cannot be located for long periods of time.

2. The colleague uses the visitor bathroom instead of employee bathroom.

3. The colleague often eats lunch away from the hospital.

4. The colleague complains of frequent headaches at work.

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

9) A patient recovering from outpatient surgery reports frustration and excruciating pain and wants stronger pain medication immediately. What should this patient's behavior suggest to the nurse?

1. The patient could have a substance abuse problem.

2. There is a surgical wound problem.

3. The patient was not given strong enough postoperative pain medication.

4. The patient is under stress to return to work.

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Standards: QSEN Competencies: I.A.3. Demonstrate comprehensive understanding of the concepts of pain and suffering, including physiologic models of pain and comfort | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

10) A patient complaining of back pain requests several refills on any prescription since the medication is taken more frequently than prescribed. What should this information suggest to the nurse?

1. The patient has lost control over the consumption of the pain medication.

2. The patient is impulsive.

3. The patient uses the pain medication to fit in with a peer group.

4. The patient uses the pain medication to overcome low self-esteem.

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

11) A patient receives a gunshot wound while attempting to rob a convenience store. For which health problem should this patient be assessed?

1. Drug and alcohol abuse

2. Cardiovascular disease

3. Respiratory disease

4. Mental health disorder

Page Ref: 130

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

12) A patient reports becoming very angry and abusive to friends and family when unable to obtain an illegal substance. How should the nurse respond to this patient?

1. "Have you considered seeking treatment for this behavior?"

2. "You must not have many friends left."

3. "Are you this argumentative when at work?"

4. "What does your family say about this?"

Page Ref: 130

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

13) A patient with a history of alcohol abuse experiences consistent post-operative pain even when receiving prescribed pain medication. Which should this patient's pain experience indicate to the nurse?

1. The patient is likely cross-tolerant to the prescribed analgesic.

2. The patient has an unreported addiction to the pain medication being prescribed.

3. The patient has a history of using this medication at home.

4. The patient has a dual diagnosis relating to alcohol and drug addiction.

Page Ref: 133

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with substance use disorder.

14) A patient involved in a minor accident reports having used "crank" for the first time an hour ago. What manifestations can the nurse anticipate occurring with this patient?

1. Reports of insomnia and confusion

2. Demonstrates increased strength and cognition

3. Displays paranoia

4. Exhibits hallucinations

Page Ref: 136

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

15) A patient seeks medical attention for possible sexual activity after not remembering what occurred when attending a rave. Which substance might have caused this effect in the patient?

1. Ecstasy

2. Crank

3. Marijuana

4. Alcohol

Page Ref: 137

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

16) A patient admitted with seizures is diagnosed with a perforated nasal septum. Which substance should the nurse suspect this patient has been using?

1. Cocaine

2. Marijuana

3. Alcohol

4. Barbiturates

Page Ref: 135

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

17) An adolescent patient ingested barbiturates with alcohol. For which adverse effect should the nurse assess this patient?

1. Respiratory depression

2. Seizure activity

3. Signs of withdrawal

4. Signs of hallucinations

Page Ref: 135

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with substance use disorder.

18) A patient overdoses on PCP. Which intervention should the nurse anticipate for this patient?

1. Administer haloperidol (Haldol) as prescribed.

2. Induce vomiting.

3. Talk the patient down.

4. Administer naloxone (Narcan) as prescribed.

Page Ref: 139

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with substance use disorder.

19) A patient has dilated pupils, respiratory rate of six per minute, and seizure activity. What should the nurse prepare to administer to this patient?

1. Naloxone (Narcan)

2. Activated charcoal

3. Ammonium chloride

4. Diazepam (Valium)

Page Ref: 139

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with substance use disorder.

20) A patient with a history of chronic alcohol use is underweight and malnourished. What should the nurse expect to be prescribed to manage the patient's nutritional status?

1. Thiamine (vitamin B1)

2. Diazepam (Valium)

3. Methadone

4. Naloxone (Narcan)

Page Ref: 140

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with substance use disorder.

21) A patient has been using amphetamines for the last three years. Which patient statements should the nurse attribute to substance dependence? Select all that apply.

1. "I am so tired and I feel so down about everything that is happening around me."

2. "I really tried to cut down my use, but I fail miserably every time."

3. "The only thing I care about right now is getting my fix."

4. "I have to use a lot more right now to get the same high as I did before."

5. "I have a great job where I work fulltime as a mechanical engineer, so that part of my life is very fulfilling."

Page Ref: 136

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

22) The nurse is preparing material for a staff development presentation on alcohol abuse in families. Which information should the nurse include that increases the risk of alcohol abuse? Select all that apply.

1. An alcoholic parent is depressed or has another psychological problem.

2. Both parents abuse alcohol and other drugs.

3. The parents' alcohol abuse is severe.

4. Family conflicts lead to aggression and violence.

5. Children of alcoholics will avoid the substance because of family exposure.

Page Ref: 129

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

23) A patient is being treated for withdrawal symptoms. Which patient statement indicates that additional teaching about prescribed medication is required? Select all that apply.

1. "Naltrexone is an antidepressant."

2. "The Antabuse will help me with my cravings for heroin."

3. "The chlordiazepoxide is also called Librium and it can help with my anxiety."

4. "The phenobarbital will help prevent me from having another seizure."

5. "I need folic acid and other vitamin supplements because I haven't eaten well for so long."

Page Ref: 140

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Relationship-Centered Care; Practice-Know-How; Communicate information effectively | Nursing/Integrated Concepts: Nursing Process: Evaluation/Teaching/Learning

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with substance use disorder.

24) A nurse is concerned that a newly hired colleague is exhibiting signs of a substance abuse problem. What did the nurse observe to come to this conclusion? Select all that apply.

1. The new nurse is always sucking on mints and has applied strong-smelling cologne.

2. The new nurse completes documentation and is prepared to give report at the end of the shift.

3. The new nurse has volunteered to give medications to patients.

4. The new nurse has displayed difficulty juggling his patient assignment and seems to be highly unorganized.

5. The narcotic count at the end of the shift is off; two doses of morphine sulfate are missing.

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

25) The patient is exhibiting addictive behaviors and has admitted to using illegal drugs. Which patient statement is consistent with addictive behaviors? Select all that apply.

1. "I think even as a child I was much more anxious than my friends."

2. "When I was in the hospital for appendicitis, they told me they had to give me more pain medications than normal because I was still in pain."

3. "Sometimes I steal things from stores just to see if I can get away with it."

4. "I like to play it safe. When my friends were bungee jumping off the bridge, I just watched."

5. "I have always been very slow to anger."

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

26) The patient states, "I think I am actually addicted to nicotine." Which assessment findings are consistent with this type of addiction? Select all that apply.

1. The blood pressure is 182/86 mmHg.

2. The patient states, "Sometimes, I feel so nauseated after I smoke cigarettes."

3. The patient states, "I have never been able to stop smoking for more than two weeks at a time because the cravings get so bad."

4. An apical heart rate is 72 beats per minute.

5. A respiratory rate is 14 breaths per minute.

Page Ref: 133-134

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

27) The nurse reviews the long-term effects of alcohol use with a patient who has experienced chronic alcoholism for 25 years. Which patient statements indicate that additional teaching is required? Select all that apply.

1. "My yellow skin is really just caused by the thiamine deficiency."

2. "My problems with COPD weren't because I smoke; it's because I was drinking so much."

3. "I was surprised to learn that my coronary artery disease may have been worsened by my drinking."

4. "I think I would've stopped drinking a long time ago if I had known that it may have caused my impotence."

5. "My mom was an alcoholic and died from breast cancer and it may have been the result of her drinking."

Page Ref: 132

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

28) A patient has been brought to the emergency department with a blood alcohol level of 0.51%. Which finding is consistent with this information? Select all that apply.

1. A sternal rub was performed with no response elicited.

2. The patient's respiratory rate is eight breaths per minute.

3. The patient's radial and pedal pulses are bounding.

4. The patient states, "I sleep for a long time, but I never feel rested when I wake up."

5. The patient states, "I really think I can drive myself home. I am fine!"

Page Ref: 133

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

29) A patient with injuries from a motor vehicle crash frequently smokes ice and had smoked some as recently as two hours prior to the accident. Which assessment finding is consistent with this information? Select all that apply.

1. Apical heart rate is 112 beats per minute.

2. Supraventricular contractions are noted during electrocardiogram.

3. The patient weighs 92 pounds and is 5′5″ tall.

4. The patient is complaining of chest pain.

5. Blood pressure is 96/72 mmHg.

Page Ref: 135-136

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

30) The nurse suspects that a patient has a substance dependency. What observation did the nurse use to come to this conclusion? Select all that apply.

1. Presence of tolerance

2. Substance taken longer than intended

3. Spends more time in private using the substance

4. Desire to control substance use

5. Discontinues use while experiencing intrapersonal problems

Page Ref: 127

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

31) The nurse is caring for a patient who uses marijuana. Which observations suggest that the amount of marijuana that the patient is using is dose-related? Select all that apply.

1. Fetal CNS disturbances

2. Tachycardia

3. Asthma with long-term use

4. Diuresis

5. Hypertension

Page Ref: 135

Cognitive Level: Analyzing

Client Need & Sub: Physiological Integrity: Physiological Adaptation

Learning Outcome: 6.2 Differentiate the effects of selected addictive substances on physiologic, cognitive, psychologic, and social well-being.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with substance use disorder.

32) The nurse is caring for a patient with chronic alcoholism. Which vitamin should the nurse expect this patient to be prescribed? Select all that apply.

1. Thiamine (vitamin B1)

2. Folic acid

3. Cyanocobalamin (vitamin B12)

4. Vitamin E

5. Potassium chloride

Page Ref: 140

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Pharmacological and Parenteral Therapies

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.3. Implement holistic, patient-centered care that reflects an understanding of human growth and development, pathophysiology, pharmacology, medical management and nursing management across the health-illness continuum, across lifespan, and in all healthcare settings | NLN Competencies: Context and Environment; Knowledge; chronic disease management | Nursing/Integrated Concepts: Nursing Process: Planning

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 2. Consider intraprofessional care for patients with substance use disorder.

33) The nurse is assessing a patient with substance abuse. What question should the nurse use to obtain the most information during this assessment? Select all that apply.

1. On average, how many days a week do you drink or use drugs?

2. How often and how much do you usually use?

3. What is the greatest number of drinks you have had at any one time in the past month?

4. Do you drink beer or whiskey?

5. Did you drink beer before coming to the hospital?

Page Ref: 141

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Standards: QSEN Competencies: I.A.1. Integrate understanding of multiple dimensions of patient-centered care | AACN Essentials Competencies: IX.1. Conduct comprehensive and focused physical, behavioral, psychological, spiritual, socioeconomic, and environmental assessments of health and illness parameters in patients, using developmentally and culturally appropriate approaches | NLN Competencies: Context and Environment; Knowledge; transcultural approaches to health | Nursing/Integrated Concepts: Nursing Process: Assessment

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with substance use disorder.

34) A nurse has been convicted of driving while under the influence. What regulatory body will determine the status of the nurse's license?

1. State board of nursing

2. Employee assistance program

3. State court system

4. American Nurses Association

Page Ref: 130

Cognitive Level: Applying

Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

35) The manager suspects that a nurse is experiencing role strain and is at risk for developing substance abuse. What did the manager observe to come to this conclusion about the nurse? Select all that apply.

1. Frequently late to work

2. Incomplete charting

3. Errors in patient care judgment

4. Erratic behavior

5. Mood swings

Page Ref: 130

Cognitive Level: Analyzing

Client Need & Sub: Safe and Effective Care Environment: Safety and Infection Control

Standards: QSEN Competencies: II.B.6. Initiate requests for help when appropriate to situation | AACN Essentials Competencies: VIII.12. Act to prevent unsafe, illegal or unethical care practices | NLN Competencies: Personal and Professional Development; Ethics Comportment Practice-Know-How; Apply decision making skills, particularly in the context of uncertainty and ambiguity | Nursing/Integrated Concepts: Nursing Process: Assessment

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

36) The nurse identifies the problem of imbalanced nutrition due to insufficient intake for a patient hospitalized for substance abuse. What intervention should the nurse identify as appropriate for this patient? Select all that apply.

1. Monitor the CBC and liver enzymes.

2. Collaborate with the dietician.

3. Administer vitamins and diet supplements.

4. Provide high fat, high carbohydrate diet.

5. Restrict fluid intake to 1500 mL per day.

Page Ref: 144

Cognitive Level: Applying

Client Need & Sub: Physiological Integrity: Basic Care and Comfort

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 4. Determine appropriate nursing interventions for patients with substance use disorder.

37) The nurse is determining a patient's degree of dependence on a substance. Which screening tool should the nurse use to help with this assessment? Select all that apply.

1. Michigan Alcohol Screening Test

2. CAGE questionnaire

3. Brief Drug Abuse Screening Test

4. Clinical Institute Withdrawal Assessment of Alcohol-Revised

5. Clinical Opiate Withdrawal Scale

Page Ref: 142

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with substance use disorder.

38) The nurse is assessing a patient for alcohol abuse. On which mental health problems should the nurse focus during this assessment? Select all that apply.

1. Psychosis

2. Depression

3. Malnutrition

4. Alzheimer disease

5. Cerebrovascular accident

Page Ref: 128

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

39) During an assessment a patient with multiple substance addictions asks why the need for drugs and alcohol is so great. What should the nurse include when responding to this patient? Select all that apply.

1. "Substance abuse is a sign of weakness and boredom with life."

2. "It becomes a habit of self-medication, used to cope with daily problems."

3. "There is a human tendency to seek pleasure and avoid stress and pain."

4. "It really depends upon genetic makeup and if your parents used drugs."

5. "One substance in the brain, dopamine, is responsible for drug-seeking behavior."

Page Ref: 127, 129

Cognitive Level: Applying

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

MNL Learning Outcome: 1. Examine the pathophysiology, incidence, risk factors, and clinical manifestations for patients with substance use disorder.

40) The nurse uses the CAGE questionnaire and B-DAST screening tool to assess an adolescent experiencing panic and agitation. Which substance is the nurse most likely planning to assess in this patient? Select all that apply.

1. PCP

2. LSD

3. Crack

4. Heroin

5. Alcohol

Page Ref: 139

Cognitive Level: Analyzing

Client Need & Sub: Psychosocial Integrity: Chemical and Other Dependencies/Substance Use Disorder

Learning Outcome: 6.3 Describe the interprofessional care, nursing care, and transitions of care for patients who abuse substances.

MNL Learning Outcome: 3. Analyze assessment data to determine a plan of care for patients with substance use disorder.

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Created Date:

Aug 21, 2025

Chapter Name:

Chapter 6 Nursing Care Of Patients With Problems Of Substance Abuse

Author:

LeMone, Burke, Gerene Bauldoff

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Ch6 | Test Bank – Nursing Care Of Patients With Problems Of

LeMone & Burke's Medical-Surgical Nursing, 7e (Bauldoff/Gubrud/Carno)

Chapter 6 Nursing Care of Patients with Problems of Substance Abuse

1) A patient is concerned about becoming an alcoholic since both parents abuse alcohol. How should the nurse respond to the patient?

2) The mother of a patient admitted with alcohol abuse tells the nurse that alcohol is not consumed at home and the patient is adopted. What should the nurse suspect about the patient?

3) A patient reports having a glass of wine every evening at home after work to "unwind" and cannot continue with the day until the wine is consumed. In which way is this patient using alcohol?

4) While analyzing data collected during an assessment, the nurse realizes that a patient's risk for alcohol abuse is low. What information did the nurse use to come to this conclusion?

5) The nurse is concerned about potential substance abuse by a coworker. What behavior should be further investigated?

6) A nurse consistently who wears long-sleeved clothing despite the temperature being in the 90s and the air humid becomes defensive and avoids others when asked about the uniform being worn. What does the nurse's behavior suggest?

7) The manager is concerned that one staff nurse is demonstrating signs of substance abuse. Which behavior did the manager observe in the staff nurse? Select all that apply.

8) The nurse is concerned that a colleague is experiencing depression from substance abuse. What does the nurse observe to make this assumption?

9) A patient recovering from outpatient surgery reports frustration and excruciating pain and wants stronger pain medication immediately. What should this patient's behavior suggest to the nurse?

10) A patient complaining of back pain requests several refills on any prescription since the medication is taken more frequently than prescribed. What should this information suggest to the nurse?

11) A patient receives a gunshot wound while attempting to rob a convenience store. For which health problem should this patient be assessed?

12) A patient reports becoming very angry and abusive to friends and family when unable to obtain an illegal substance. How should the nurse respond to this patient?

13) A patient with a history of alcohol abuse experiences consistent post-operative pain even when receiving prescribed pain medication. Which should this patient's pain experience indicate to the nurse?

14) A patient involved in a minor accident reports having used "crank" for the first time an hour ago. What manifestations can the nurse anticipate occurring with this patient?

15) A patient seeks medical attention for possible sexual activity after not remembering what occurred when attending a rave. Which substance might have caused this effect in the patient?

16) A patient admitted with seizures is diagnosed with a perforated nasal septum. Which substance should the nurse suspect this patient has been using?

17) An adolescent patient ingested barbiturates with alcohol. For which adverse effect should the nurse assess this patient?

18) A patient overdoses on PCP. Which intervention should the nurse anticipate for this patient?

19) A patient has dilated pupils, respiratory rate of six per minute, and seizure activity. What should the nurse prepare to administer to this patient?

20) A patient with a history of chronic alcohol use is underweight and malnourished. What should the nurse expect to be prescribed to manage the patient's nutritional status?

21) A patient has been using amphetamines for the last three years. Which patient statements should the nurse attribute to substance dependence? Select all that apply.

22) The nurse is preparing material for a staff development presentation on alcohol abuse in families. Which information should the nurse include that increases the risk of alcohol abuse? Select all that apply.

23) A patient is being treated for withdrawal symptoms. Which patient statement indicates that additional teaching about prescribed medication is required? Select all that apply.

24) A nurse is concerned that a newly hired colleague is exhibiting signs of a substance abuse problem. What did the nurse observe to come to this conclusion? Select all that apply.

25) The patient is exhibiting addictive behaviors and has admitted to using illegal drugs. Which patient statement is consistent with addictive behaviors? Select all that apply.

26) The patient states, "I think I am actually addicted to nicotine." Which assessment findings are consistent with this type of addiction? Select all that apply.

27) The nurse reviews the long-term effects of alcohol use with a patient who has experienced chronic alcoholism for 25 years. Which patient statements indicate that additional teaching is required? Select all that apply.

28) A patient has been brought to the emergency department with a blood alcohol level of 0.51%. Which finding is consistent with this information? Select all that apply.

29) A patient with injuries from a motor vehicle crash frequently smokes ice and had smoked some as recently as two hours prior to the accident. Which assessment finding is consistent with this information? Select all that apply.

30) The nurse suspects that a patient has a substance dependency. What observation did the nurse use to come to this conclusion? Select all that apply.

31) The nurse is caring for a patient who uses marijuana. Which observations suggest that the amount of marijuana that the patient is using is dose-related? Select all that apply.

32) The nurse is caring for a patient with chronic alcoholism. Which vitamin should the nurse expect this patient to be prescribed? Select all that apply.

33) The nurse is assessing a patient with substance abuse. What question should the nurse use to obtain the most information during this assessment? Select all that apply.

34) A nurse has been convicted of driving while under the influence. What regulatory body will determine the status of the nurse's license?

35) The manager suspects that a nurse is experiencing role strain and is at risk for developing substance abuse. What did the manager observe to come to this conclusion about the nurse? Select all that apply.

36) The nurse identifies the problem of imbalanced nutrition due to insufficient intake for a patient hospitalized for substance abuse. What intervention should the nurse identify as appropriate for this patient? Select all that apply.

37) The nurse is determining a patient's degree of dependence on a substance. Which screening tool should the nurse use to help with this assessment? Select all that apply.

38) The nurse is assessing a patient for alcohol abuse. On which mental health problems should the nurse focus during this assessment? Select all that apply.

39) During an assessment a patient with multiple substance addictions asks why the need for drugs and alcohol is so great. What should the nurse include when responding to this patient? Select all that apply.

40) The nurse uses the CAGE questionnaire and B-DAST screening tool to assess an adolescent experiencing panic and agitation. Which substance is the nurse most likely planning to assess in this patient? Select all that apply.

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