Question 1

The nurse is caring for a client who takes methadone daily to prevent a relapse of heroin addiction and has been admitted for knee surgery. Which of the following actions should the nurse include in the plan of care to promote effective pain control postoperatively?

Accepted Answer

A)  Use a mixed opioid agonist-antagonist drug for pain relief.
B)  Administer opioid analgesics on a regularly scheduled basis.
C)  Avoid use of opioids and use alternatives such as NSAIDs.
D)  Give prescribed doses of opioid pain medication as needed for pain. B

Question 2

The nurse is caring for a young adult client who has inhaled cocaine and has been admitted to the emergency department with palpitations and shortness of breath. Which of the following actions ordered by the health care provider will the nurse implementfirst?

Accepted Answer

A)  Obtain a 12-lead ECG.
B)  Start O2 at 4 L/minute.
C)  Draw blood for drug screening.
D)  Infuse normal saline at 100 mL/hour. B

Question 3

The nurse is caring for a client who smokes a pack of cigarettes daily and has been admitted to the hospital for surgery. In anticipation of nicotine withdrawal, which of the following goals should the nurse include when planning postoperative care?

Accepted Answer

A)  Improve sleep.
B)  Enhance appetite.
C)  Decrease diarrhea.
D)  Prevent sore throat. A

Question 4

The nurse is caring for a young adult who has a cocaine addiction. Which of the following routes of cocaine administration results in the fastest absorption and the highest "rush"?

Accepted Answer

A)  Smoking
B)  Buccal
C)  Oral
D)  Intranasal

Question 5

Aclient who is alcohol-intoxicated must undergo emergency surgery for abdominal trauma. Which of the following should the nurse anticipate when caring for the client in the perioperative period?

Accepted Answer

A)  An increased dose of the general anaesthetic medication.
B)  Frequent monitoring for bleeding and respiratory complications.
C)  Development of withdrawal symptoms within a few hours after surgery.
D)  Stimulation every hour to prevent prolonged postoperative sedation.

Question 6

Aclient who smokes a pack of cigarettes daily develops tachycardia and irritability on the second day after abdominal surgery. Which of the following actions should the nurse implement first?

Accepted Answer

A)  Escort the client outside where smoking is allowed.
B)  Request a prescription for a nicotine replacement agent.
C)  Move the client to a private room and allow smoking.
D)  Tell the client that this is a good time to quit smoking.

Question 7

The nurse is caring for a client who has a history of ongoing opioid use and has been hospitalized for surgery. After a visit by a friend, the nurse assesses that the client is unresponsive with pinpoint pupils. Which of these prescribed medications will thenurse administer immediately?

Accepted Answer

A)  Naloxone
B)  Diazepam
C)  Clonidine
D)  Methadone

Question 8

An agitated individual is brought to the emergency department by friends who state that the client took a hallucinogenic drug at a party and then tried to jump from a second-story window. Which of the following nursing diagnoses is priority?

Accepted Answer

A)  Risk for injury related to altered sensation.
B)  Ineffective health maintenance related to ineffective coping strategies.
C)  Powerlessness related to insufficient knowledge to manage a situation.
D)  Ineffective denial related to insufficient sense of control.

Question 9

A young adult client arrives at the emergency department with severe chest pain and agitation. Which of the following actions should the nurse take first?

Accepted Answer

A)  Give the PRN naloxone IV.
B)  Ask about any use of stimulant drugs.
C)  Assess orientation to person, place, and time.
D)  Check blood pressure, pulse, and respirations.

Question 10

The nurse is assessing a client who has a history of alcohol use. Which of the following assessment data should the nurse expect?

Accepted Answer

A)  Low blood pressure
B)  Decreased heart rate
C)  Elevated temperature
D)  Abdominal tenderness

Question 11

The nurse is caring for a client admitted to the hospital after an automobile accident who has a blood alcohol concentration (BAC) of 48 mmol/L (0.22 mg%). The client is alert and does not appear highly intoxicated. Which of the following nursing actionsshould the nurse implement?

Accepted Answer

A)  Maintain the client on NPO status.
B)  Avoid the use of intravenous (IV)  fluids.
C)  Administer acetaminophen for headache.
D)  Monitor frequently for anxiety, hyper-reflexia, and sweating.

Question 12

A client who is disoriented and agitated comes to the emergency department after using methamphetamine. Vital signs are blood pressure 162/98, heart rate 142 and irregular, and respirations 32. Which of the following actions is priority for the nurse toimplement?

Accepted Answer

A)  Reorient the client at frequent intervals.
B)  Monitor the client's ECG and vital signs.
C)  Keep the client in a quiet and darkened room.
D)  Obtain a health history including prior drug use.

Question 13

All the following medications are ordered for a client admitted with a blood alcohol concentration of 0.18 mg%. Which of the following should the nurse administer first?

Accepted Answer

A)  Thiamine 100 mg daily
B)  Lorazepam 1 mg as needed
C)  Folic acid 0.4 mg daily
D)  Dextrose 5% in 0.45 saline over 8 hours

Question 14

An older adult has been taking alprazolam and calls the clinic asking for a refill of the prescription 1 month before it should need to be refilled. Which of the following responses is most appropriate?

Accepted Answer

A)  "The prescription cannot be refilled for another month. What happened to all of your pills?"
B)  "Do you have any muscle cramps or tremors if you don't take the medication frequently?"
C)  "I will ask the doctor to prescribe a few more pills, but you will not be able to get any more for another month."
D)  "I am concerned that you may be overusing the alprazolam. Let's make an appointment for you to see the doctor today."

Question 15

Suicide is an overdose effect of which of the following substances?

Accepted Answer

A)  Alcohol
B)  Inhalants
C)  Opioids
D)  Hallucinogens

Question 16

The nurse is caring for a client admitted to hospital with chest pain who is a pack-a-day smoker and tells the nurse, "I am just not ready to quit smoking yet." Which of the following responses is the most appropriate?

Accepted Answer

A)  "This would be a really good time to quit."
B)  "Your smoking is the cause of your chest pain."
C)  "Do you think that smoking has caused any health problems?"
D)  "Are you familiar with the various nicotine replacement options?"

Question 17

Aclient with a history of heavy alcohol use is seen at the clinic with acute gastritis. Which statement by the client indicates that the client is in the contemplation stage of change?

Accepted Answer

A)  "I am older and wiser now, and I know I can change my drinking behaviour."
B)  "Alcohol has never bothered my stomach. I think it's likely that I have the flu."
C)  "I think my drinking is affecting my stomach, but maybe some drugs will help."
D)  "People say that I drink too much, but I really feel pretty good most of the time."

Question 18

The nurse is caring for a client who is admitted to the hospital for treatment of an abscess on the left thigh and the client tells the nurse that they use fentanyl illegally. Which of the following symptoms should the nurse anticipate assessing?

Accepted Answer

A)  Nausea and diarrhea
B)  Tremors and seizures
C)  Lethargy and disorientation
D)  Delusions and hallucinations

Question 19

The nurse is caring for a client with alcohol dependence who has been admitted to the hospital with chest pain. Twenty-four hours after admission, the client becomes very tremulous and anxious. Which of the following actions should the nurse implement?

Accepted Answer

A)  Insert an IV line and infuse fluids.
B)  Promote oral intake to 3 000 mL/day.
C)  Provide a quiet, well-lit environment.
D)  Administer opioids to provide sedation.

Question 20

During physical assessment of a client who has sinus headaches, the nurse finds nasal sores and necrosis of the nasal septum. Client use of which of the following substances should the nurse include in the assessment?

Accepted Answer

A)  Heroin
B)  Cocaine
C)  Tobacco
D)  Marijuana

Exam 11: Substance Use