WorksheetsChapter 62: Substance Abuse
Total questions: 77
Worksheet time: 2hrs 56mins
the theory that substance dependence is caused by faulty physiologic processes is the
biologic
denial
addiction
codependent
Mr. White was arrested for public intoxication and was advised by attorney to enroll in an alcohol treatment program. A nurse interviews him when he comes to a mental health center . He tells the nurse that he just had a few too many drinks while celebrating with a friend. This is an example of which defense mechanism
rationalization
denial
intellectualization
projection
what is the chief advantage of using hair analysis to detect drug use?
hair samples can be taken without patient permission
hair samples will reveal drug use a long as 1 year later
it is not possible for a patient to substitutes someone else's
the chain of custody is unnecessary with hair sample
An alcoholic patient was injured in an automobile accident. she said that she had her last drink 2 hours before the accident. About 8 hours after admission, she developed symptoms of early alcohol withdrawal. you should anticipates delirium tremens by blank hours after her last drink
3
8
72
120
Mr. Jones calls the hospital to report that his wife, a dietitian, cannot come to work because she has "flu". In reality, she consumed a large amount of alcohol the previous evening and has a hangover. this has happened several time in the past. Mr. Jones' behavior is an example of the following?
support
enabling
rationalization
comprensation
when a patient who is taking disulfiram ( Antabuse) consumes alcohol expected outcomes include which of the following
SATA
hypotension
tachycardia
confusion
nausea and vomiting
young people should be warned that inhalants can cause which of the following
progressive brain damage
sexual dysfunction
schizophrenia
aggressive behavior
a patient being treated for an overdose of opioids is given Narcan. Narcan is given for which of the following reasons
to stimulate the heart
to raise BP
to treat respiratory depression
to sedate the patient and prevent seizures
which of the following are among the drug most commonly used by older adults with substance use disorder
SATA
cocaine
pain medication
sleeping aids
alcohol
which statement most accurately describe drug use among adolescents
only 1 in 10 adolescents have problems with substance use
adolescent tend to deny any possible negative outcomes of drug use
most adolescents seek treatment for substance use on their own
adolescent should be treated with adults who can model mature behavior
chronic relapsing brain disease characterized by compulsive drug seeking and use, despite harmful consequences
addiction
delirium tremens
codependent
comorbidity and dual diagnosis
self-help support process outlining steps to overcoming dependence on something outside oneself, such as alcohol. part of alcoholics anonymous process
addication
12 - step program
delirium tremens
codependent
situation in which two disorders or illnesses occur in the same person at the same time or when one follows the other
addication
12 step program
comorbidity and dual diagnosis
delirium tremers
unpleasant and sometimes life-threatening physical substance specific syndrome occurring after stopping or reducing the habitual dose or frequency of a used substance
addication
12-step program
comorbidity and dual diagnosis
delirium tremens
occurs when blood and tissue levels of the substance decline after prolonged use
withdrawal
tolerance
codependant
addiction
need for increasing amounts of a substance to achieve the same effect brought about by the original amounts
withdrawal
tolerance
codependent
addiction
behavior is highly structured around managing and adapting to the alcoholic's dysfunctional behavior
withdrawal
tolerance
codependent
addiction
a recent addition to the methods for the detection of used substances; tool used in the diagnosis and follow - up of substance use disorders
Requires sensitive technology and can detect drugs for up to 1 year after use
hair analysis
urine drug screening
blood alcohol study
what does urine drug test screen for what drugs
amphetamine (speed)
barbiturate (depressants); benzodiazepines (depressants)
marijuana
mathdone
the most accurate type of test available to measure the degree of intoxication on initiation of treatment for alcohol use disorder
urine drug screening
hair analysis
blood alcohol study
synthetic opioid analgesic that is sometimes prescribed for chronic severe pain
- used for opioid detoxification
- controversial substance as it constitutes substituting another addictive drug for the one misused by the patient
- side effects include constipation and sweating
methadone
clonidine
naloxone (Narcan)
opioid antagonist
- counteracts respiratory depressant effects of heroin and other opioid
methodone
clonidine
naloxone (Narcan)
non-opiate antihypertensive drug that partially blocks withdrawal symptoms
methadone
clonidine
naloxone (Narcan)
the least likely way to alienate an already defensive patient is to use a manner that is matter-of-fact and:
nonjudgmental
assertive
reassuring
positive
it is believed that the cause of hangover symptoms to the buildup of acetaldehyde and lactic acid in the blood dehydration and
hyperkalemia
hyponatremia
hypoglycemia
hyperthyoridism
which defense mechanism is used when people addicted to alcohol shift the blame for their behavior onto their spouse
rationalization
intellectualization
denial
projection
the biggest issue for a patient with a substance use disorder to addressed at the first during rehabilitation is
rationalization
sublimation
denial
comprensation
who was a higher alcohol level of drinks
females
men
dogs
cats
which are behaviors that often leads to relapse for a person with substance use disorder
SATA
over-tiredness
argumentativeness
depression
self-pity
why shouldn't alcoholic should go "cold turkey"
they have heat the turkey
heart attack
because they can go into withdrawal symptoms
amphetamine which make you go faster
older individuals who have substance use disorders an extended period of time many experience significant medical problems as result of decrease ability to
circulate and absorb drugs
utilize and react to drugs
metabolize and eliminate drugs
transport and detoxify drugs
patient taking anti-anxiety or antidepressant agents with alcohol may risk accidental overdose due to
antagonist effect
idiosyncratic effect
stimulant effects
additive effects
program developed for health professionals addicted to a substance to prevent having their licenses revoked called
alcoholics anonymous
peer assistance program
codependent anonymous
al-anon
which are characteristics that people with substance use disorders frequently have
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damaged relationship
erratic and unprovoked mood swings
blackouts
significant problems at work
which finding should be reported to the health care provider because they may indicate the patient is entering physical withdrawal from alcohol abuse
mental status changes
high blood pressure
tachycardia
nausea and vomiting
a patient who has abused alcohol or a benzodiazepine must be monitored for signs of physical withdrawal because the patient may be at risk for
paranoia
seizures
violence
euphoria
which drug is not identified in urine drug screening
methadone
amphetamines
benzodiazepines
cocaine
which supplements may be given to individuals with chronic alcoholism
beta carotene and vitamin C
iron and vitamin C
folate and vitamin B12
calcium and vitamin D
which are symptoms of patients with an overdose of depressants
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over-sedation
respiratory depression
impaired coordination
brain damage
which are stimulants
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amphetamines
cocaine
barbiturates
hypnotics
which are signs and symptoms of chronic inhalation of cocaine
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runny nose
hyperactivity
hypotension
hallucinations
hyperactivity irritability combativeness and paranoia are symptoms of the use of
opioids
depressants
anxiolytics
amphetamines
which are identified by the DSM-V as drugs associated with substance - related disorders
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caffeine
tobacco
steriods
NSAIDs
which is common effect of caffeine and nicotine
euphoria
poor judgement
alters mood
relaxation
which substance produces euphoria
alcohol
caffeine
nicotine
amphetamine
which signs are related to an older patient with alcohol use disorder
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malnutrition
constipation
bone thining
poor memory
which defense mechanism do addicts use when trying to justify the reasons or "make an excuse" for their addiction
rationalization
intellectualization
denial
projection
a few patients may not experience any physical withdrawal symptoms despite a history of prolonged, frequent, and heavy substance abuse. which factors may affect the incidence of withdrawal effects
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weight of the patient
stage of addiction
baseline physical status of the patient
type of drugs being misused
which are physical characteristics of the appearance of the person with substance use disorder
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obese
malnourished
poorly cared for
evidence of physical trauma
which is a correct statement about persons with gambling addiction
prevalence is high in Caucasian
twenty five percent of those with a gambling addiction
incidence of gambling in older adults than younger adults
involves risking something of value in hopes of gaining something of greater value
which are goals of an intervention for an impaired nurse
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assist the impaired nurse to receive treatment
protect the public from an untreated nurse
help the recovering nurse in a planned, safe way
assist in monitoring the continued recovery of the nurse for a period of time
usually there is a 2-year time period after intervention for an impaired nurse to comply with the peer assistance process. which are steps to be accomplished by the impaired nurse in this 2-year period
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the nurse is required to attend AA or NA group regularly
the nurse participates in peer support groups
the nurse meets routinely with an identified support person representing the peer assistance program
the nurse submits random urine drug screen to ensure that no relapse has occurred
which problems of a patient with a substance use disorder may increase the potential for injury
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inadequate problem-solving and series of self -perpetuating
excessive use of the drug and risk for relapse
driving while under the influence
returning to places where one used drugs
when patients abusing alcohol state that they can quit easily and that they do not have a problem, they may be experiencing
inadequate coping
denial
potential injury
inability to communicate effectively
a person with a substance use disorder who has driven under the influence of drugs and who engages in excessive drug use is increasing the potential for
infection
injury
aspiration
inadequate self-care
which are significant neurologic signs that may be associated with nutritional deficits in the patient with a substance use disorder
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confusion
memory loss
tremors
lack of coordination
which are typical stressors of aging that may cause older adults to use alcohol or. experience alcohol use disorder for the first time
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retirement
losses of significant, loss of self-worth
family conflict
health problems, social isolation
comorbidity
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two diagnosis or illnesses exist
mental illness and drug addiction often are diagnosed together
one may cause the other vice versa
creates an even greatest challenge in treatment
Cause and risk factors
biologic
genetics
gender
ethnicity
mental disorder
cause and risk factor
environment
dysfunctional home
abuse
(physical and verbal)
parents use and attitude
peers
treatment
no single treatment for everyone
needs to be readily available
focus on multiple needs of patient
must remain in treatment adequate amount of time
- days, weeks, months, years, lifetime
health history
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gather information from individual and family friends
must be nonjudgmental
ask for specifics
"do u have two beers a week"
assess for problems or consequences by addiction
- job loss, finances, family relationships, health, etc
physical exam
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appearance (dress hygiene)
jaundice protuberant abdomen (ascites)
change in mental status
neurological changes
needle tracks - may be in places not readily obvious
delirium tremens (DTs)- may lead to seizures
nutritional considerations
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may replace food with drugs or alcohol
decrease appetite
impairs absorption
chronic alcoholism - may need folate and vitamin B6 supplements
diagnostic test
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liver function tests (LFTs)
abnormal, electrolytes, screens for disease ( HIV, Hepatitis, STDs)
blood alcohol level
urine drug screening
hair analysis
common mood altering chemical
alcohol
caffiene
inhalants
cannabis
opioid
hallucinogens
alcohol and alcoholism
chronic daily use of large amounts of alcohol
binge drinking, drinking heavily only on weekends with periods of abstinence
withdrawal when alcohol not in system-
early: 6-12 h
major: 3 days
changes in vitals, mental status, hallucinations, blackouts (may not know where they are at, what day it is, or be able to recall events of what happen or certain behaviors
complications of alocholism
cirrhosis
werincke encephalopathy
korsakoff psychosis
fetal alcohol syndrome
treatment of alcoholism
AA- based on 12 step program approach with strong religious base
antabuse (disulfiram)
flagyl
naltrexone
medications
methadone
clonidine (Catapres)
naloxone (Narcan)
trexan
methadone maintenance is used for patient who have experienced multiple relapse into heroin use after standard treatment and rehabilitation efforts
t/f
true
false
methadone is a synthetic opioid analgesic that may be used in the detoxification of heroin-related opioid addiction
t/f
true
false
disulfiram (Antabuse) is sometimes used to assist a recovering alcoholic who is highly motivated to remain sober but who recognizes that poor impulse control may increase the odds of relapse
t/f
true
false
naltrexone ( Revia Depade) does not cure alcoholism but may help to decrease the desire to drink thereby extending the length of time an individual maintain sobriety. patient wait 7 to 10 days after discontinuing opioids before starting this medication and may not use opioid of any kind while on naltrexone
t/f
true
false
to avoid a disulfiram-alcohol reaction, pt who are taking disulfiram ( Antabuse) must be instructed to avoid alcohol in food (sauces, candies) topical preparations (alcohol cologne aftershave) mouthwashes and medications (OTC cold preparations cough syrup)
t/f
true
false
do not use alcohol to cleanse injection if the patient is taking disulfiram ( Antabuse)
t/f
true
false
the american society of addiction medicine defines alcohol as a drug because it has addictive qualities similar to those associated with other drug-related disorders. simple intoxication from alcohol usually later less than 12 h and is about 4 to 6 h after the last drink. typical symptoms include headache upset stomach vomiting sweating thirst fatigue and blurred vision or "seeing stars". the cause of these symptoms has not been pinpointed however it is believed to be result of hypoglycemia, dehydration and the buildup of acetaldehyde and lactic acid in blood.
t/f
true
false
