Chapter 06: Substance Use Assessment
Physical Examination and Health Assessment, 8th Edition by
Carolyn Jarvis
MULTIPLE CHOICE
1. A woman has come to the clinic to seek help with a substance abuse problem. She admits
to using cocaine just before arriving. Which of these assessment findings would the nurse
expect to find when examining this woman?
a. Dilated pupils, pacing, and psychomotor agitation
b. Dilated pupils, unsteady gait, and aggressiveness
c. Pupil constriction, lethargy, apathy, and dysphoria
d. Constricted pupils, euphoria, and decreased temperature
ANS: A
A cocaine users appearance includes pupillary dilation, tachycardia or
bradycardia, elevated or lowered blood pressure, sweating, chills, nausea,
vomiting, and weight loss. The persons behavior includes euphoria, talkativeness,
hypervigilance, pacing, psychomotor agitation, impaired social or occupational
functioning, fighting, grandiosity, and visual or tactile hallucinations.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
2. The nurse is assessing a patient who has been admitted for cirrhosis of the liver,
secondary to chronic alcohol use. During the physical assessment, the nurse looks for
cardiac problems that are associated with chronic use of alcohol, such as:
a. Hypertension.
b. Ventricular fibrillation.
c. Bradycardia.
d. Mitral valve prolapse.
ANS: A
Even moderate drinking leads to hypertension and cardiomyopathy, with an
increase in left ventricular mass, dilation of ventricles, and wall thinning.
Ventricular fibrillation, bradycardia, and mitral valve prolapse are not associated
with chronic heavy use of alcohol.
DIF: Cognitive Level: Applying (Application)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
, 3. The nurse is conducting a class on alcohol and the effects of alcohol on the body. How
many standard drinks (each containing 14 grams of alcohol) per day in men are associated
with increased deaths from cirrhosis, cancers of the mouth, esophagus, and injuries?
a. 2
b. 4
c. 6
d. 8
ANS: B
In men, alcohol consumption of at least four standard drinks per day is associated
with increased deaths from liver cirrhosis, cancers of the mouth, esophagus and
other areas, and deaths from injuries and other external causes.
DIF: Cognitive Level: Understanding (Comprehension)
MSC: Client Needs: Physiologic Integrity: Reduction of Risk Potential
4. During a session on substance abuse, the nurse is reviewing statistics with the class. For
persons aged 12 years and older, which illicit substance was most commonly used?
a. Crack cocaine
b. Heroin
c. Marijuana
d. Hallucinogens
ANS: C
In persons age 12 years and older who reported using during the past month,
marijuana (hashish) was the most commonly used illicit drug reported.
DIF: Cognitive Level: Remembering (Knowledge)
MSC: Client Needs: Physiologic Integrity: Physiologic Adaptation
5. A woman who has just discovered that she is pregnant is in the clinic for her first
obstetric visit. She asks the nurse, How many drinks a day is safe for my baby? The
nurses best response is:
a. You should limit your drinking to once or twice a week.
b. Its okay to have up to two glasses of wine a day.
c. As long as you avoid getting drunk, you should be safe.
d. No amount of alcohol has been determined to be safe during pregnancy.
ANS: D
No amount of alcohol has been determined to be safe for pregnant women. The
potential adverse effects of alcohol use on the fetus are well known; women who
are pregnant should be screened for alcohol use, and abstinence should be
recommended.
DIF: Cognitive Level: Analyzing (Analysis)
MSC: Client Needs: Safe and Effective Care Environment: Safety and Infection
Control
