Exam (elaborations)
Chapter 23. Substance-Related and Addictive Disorders
- Course
- Psychology
- Institution
- Forest Institute Of Professional Psychology
Chapter 23. Substance-Related and Addictive Disorders
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TownsendPMHN, 10e
Chapter 23 - ETB
abirb.com/test
Chapter 23. Substance-Related and Addictive Disorders
MULTIPLE CHOICE
1. Which is the priority nursing diagnosis for a client experiencing alcohol withdrawal?
1. Risk for injury related to (R/T) central nervous system (CNS) asbtirmb.cuolma/tteiostn
2. Disturbed thought processes R/T tactile hallucinations
3. Ineffective coping R/T powerlessness over alcohol use
4. Ineffective denial R/T continued alcohol use despite negative consequences
ANS: 1
Chapter: Chapter 23, Substance-Related and Addictive Disorders
Objective: Identify nursing diagnoses common to clients with suabbsirtba.ncocme/-
tersetlated and addictive disorders and select appropriate nursing interventions for
each.
Page: 387
Heading: The Dynamics of Substance-Related Disorders > Alcohol Use Disorder >
Effects on the Body; Case Study and Sample Care Plan
Integrated Processes: Nursing Process: Analysis
Client Need: Physiological Integrity: Reduction of Risk Potential
Cognitive Level: Analysis [Analyzing]
Concept: Addiction and Behaviors
Difficulty: Moderate
Feedback
1. This is correct. The priority nursing diagnosis for a client experiencing alcohol
withdrawal is “Risk for injury R/T CNS.” Alcohol withdrawal may include the
following symptoms: course tremors of hands, tongue, or eaybierbli.cdosm;/tseestizures;
nausea or vomiting; malaise or weakness; tachycardia; sweating; elevated blood
pressure; anxiety; depressed mood; hallucinations; headache; and insomnia. Safety
is always a
2. priority.
This is incorrect. Disturbed thought processes is not a priority nursing diagnosis.
abirb.com/test
Keeping the client safe is the priority, which is not addressed in this diagnosis.
3. This is incorrect. Ineffective coping is not a priority nursing diagnosis. Keeping the
client safe is the priority, which is not addressed in this diaagbnirbo.scoism./test
4. This is incorrect. Ineffective denial is not a NANDA International nursing diagnosis
and does not represent the priority of keeping the client safe.
CON: Addiction and Behaviors
,Townsend
PMHN, 10e
Chapter 23 - ETB
abirb.com/test
2. The nurse evaluates a client’s patient-controlled analgesia (PCA) pump and notices
100 attempts within a 30-minute period. Which is the best rationale for assessing this
client for substance use disorder?
1. Narcotic pain medication is contraindicated for all clients withabaicrbt.icvome /steusbt
stance use problems.
2. Clients who are regularly using alcohol or benzodiazepines may have developed
cross-tolerance to analgesics and require increased doses to
achieavbierbe.cfofme/ctetsitve pain control.
3. There is no need to assess the client for substance use disorder. There is an obvious
PCA malfunction.
4. The client is experiencing symptoms of withdrawal and needs to be accurately
assessed for lorazepam (Ativan) dosage.
ANS: 2
Chapter: Chapter 23, Substance-Related and Addictive Disorders
Objective: Identify symptomatology and use the information in assessment of
clients with various substance-related and addictive disorders.
Page: 392
Heading: Sedative, Hypnotic, or Anxiolytic Use Disorder > 4. Cross-Tolerance and
Cross-Dependence May Exist Between Various CNS Depressants
Integrated Processes: Nursing Process: Assessment
Client Need: Physiological Integrity: Physiological Adaptation
Cognitive Level: Comprehension [Understanding]
Concept: Addiction and Behaviors
Difficulty: Moderate
Feedback
1. This is incorrect. Narcotic pain medication may be used whabeirnb.ncoeme/dteestd for
clients
with active substance abuse problems; however, the client must be monitored
2. carefully
This and the
is correct. dosing adjusted
Cross-tolerance appropriately.
occurs when one drug
lesseabnirsb.acnomi/ntedstividual’s
response to another drug. Clients who are regularly using alcohol or benzodiazepines
have developed cross-tolerance to analgesics and require increased doses to achieve
3. effective
This pain control.
is incorrect. Clients who are regularly using alcohol oarbbirbe.cnozmo/dteisat
zepines have
developed cross-tolerance to analgesics and require increased doses to achieve
effective pain control. This client is demonstrating behaviors that suggest possible
4. substance
This abuse due
is incorrect. Thetoscenarios
the numerous attempts
does not to symptoms
suggest receive pabof
inirb.coemd/tiecsarather,
withdrawal; t tion.
the client demonstrates behaviors that demonstrate possible cross-tolerance.
CON: Addiction and Behaviors
,Townsend
PMHN, 10e
Chapter 23 - ETB
abirb.com/test
3. On the first day of a client’s alcohol detoxification, which nursing intervention is the
priority?
1. Encourage the client to attend 90 Alcoholics Anonymous (AA) meetings in 90 days.
2. Educate the client about the biopsychosocial consequences of ablicrbo.chooml/taesbtuse.
3. Administer ordered chlordiazepoxide (Librium) in a dosage per protocol.
4. Administer vitamin B1 to prevent Wernicke-Korsakoff syndrome.
ANS: 3
Chapter: Chapter 23, Substance-Related and Addictive Disorders
Objective: Identify symptomatology and use the information in assessment of clients
with various substance-related and addictive disorders.
Page: 429
Heading: Pharmacotherapy>Medication-Assisted Treatment> Alcohol Withdrawal
Integrated Processes: Nursing Process: Implementation Client Need:
Physiological Integrity: Pharmacological and Parenteral Therapies Cognitive
Level: Analysis [Analyzing]
Concept: Addiction and Behaviors
Difficulty: Moderate
Feedback
1. This is incorrect. Encouraging the client to attend 90 AA mabeierbt.icnogms/teisnt 90
days occurs
after is
2. This successful
incorrect.alcohol detoxification.
Educating the client about the biopsychosocial consequences of
alcohol abuse will occur after successful alcohol detoxificaatbiiorbn.c.om/test
3. This is correct. The priority nursing intervention is to administer chlordiazepoxide
(Librium) per protocol. The benzodiazepine chlordiazepoxide (Librium) is often
used for substitution therapy in alcohol withdrawal. Substitution therapy is used to
reduce life-threatening effects of the rebound stimulation oafbitrhb.ecoCm/NtesSt that
occurs during alcohol withdrawal.
4. This is incorrect. The acute possibility of CNS symptoms related to withdrawal is
the priority over chronic Wernicke-Korsakoff syndrome. Tahbirabm.coimn/etestht
erapy will be started as soon as possible.
CON: Addiction and Behaviors
4. Which client statement indicates a knowledge deficit related toabsirubb.csotma/ntecste use?
1. “Although it’s legal, alcohol is one of the most widely abused drugs in our society.”
2. “Tolerance to heroin develops quickly.”
3. “Flashbacks from lysergic acid diethylamide (LSD) use may reoccur suddenly.”
4. “Everyone smokes marijuana. It’s harmless.”
ANS: 4
Chapter: Chapter 23, Substance-Related and Addictive Disorders
Objective: Identify nursing diagnoses common to clients with substance-related and
, Townsend
PMHN, 10e
Chapter 23 - ETB
abirb.com/test
addictive disorders, and select appropriate nursing interventions for each.
Page: 419
Heading: Cannabis Use Disorder > Effects on the Body; Table 23–9, Assigning Nursing
Diagnoses to Behaviors Commonly Associated With Substance Uabsireb.cDomis/otersdt ers
Integrated Processes: Nursing Process: Assessment
Client Need: Health Promotion and Maintenance
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Moderate
Feedback
1. This is incorrect. This client statement is correct, indicating that alcohol is one of the
most widely abused drugs.
2. This is incorrect. This client statement is correct. Toleranceabtirob.choemr/oteisnt
develops
3. quickly.
This is incorrect. This client statement is correct. Flashbacks from LSD can occur
suddenly. abirb.com/test
4. This is correct. The client has a knowledge deficit related to substances, indicated by
stating that smoking marijuana is harmless. Marijuana is known to have serious
effects on the cardiovascular and respiratory systems.
CON: Addiction and Behaviors
5. A lonely, depressed, divorced person has been self-medicating with cocaine for the
past year. Which term should the nurse use to best describe the client’s situation?
1. Psychological addiction
2. Physical addiction
3. Substance addiction
4. Social addiction
ANS: 1
Chapter: Chapter 23, Substance-Related and Addictive Disorders
Objective: Identify symptomatology and use the information in
aasbsirebs.csomm/etenstt of clients with various substance-related and addictive
disorders.
Page: 395
Heading: Stimulant Use Disorder > Historical Aspects
Integrated Processes: Nursing Process: Assessment
Client Need: Psychosocial Integrity
Cognitive Level: Application [Applying]
Concept: Addiction and Behaviors
Difficulty: Moderate
Feedback
1. This is correct. The term psychological addiction best describes the client’s
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