Chapter 37: Alcohol, Tobacco and Other Drug Problems Nursing School Test Banks

Stanhope: Public Health Nursing, 8th Edition

Chapter 37: Alcohol, Tobacco and Other Drug Problems

Test Bank

MULTIPLE CHOICE

1. Why must nurses examine their attitudes about alcohol, tobacco, and other drug abuse and addiction before working with individuals with this health problem?
a. Working with clients who have addiction problems often puts the nurse at risk for violence.
b. The population of persons with drug and alcohol addiction is found in low-income neighborhoods.
c. To be therapeutic, a nurse must develop a trusting non-judgmental relationship with clients.
d. Nurses are the primary persons who treat addiction problems.
ANS: C
To be therapeutic, the nurse must develop a trusting, non-judgmental relationship with clients. Therefore, nurses must examine their own attitudes ahead of time.

DIF: COG: Understanding REF: 806 OBJ: 1

2. Which health problem causes more deaths, illnesses, and disabilities than any other in the United States?
a. Tobacco addiction
b. Alcohol abuse
c. Substance abuse
d. Caffeine addiction
ANS: C
Substance abuse is the number one national health problem.

DIF: COG: Remembering REF: 805 OBJ: 2

3. The use of any substance that threatens a persons health or impairs his or her social or economic functioning is:
a. Drug dependence
b. Substance abuse
c. Drug addiction
d. Illegal
ANS: B
Substance abuse is the use of any substance that threatens a persons health or impairs his or her social or economic functioning.

DIF: COG: Understanding REF: 807 OBJ: 2

4. Dependence is a term that refers to the:
a. Presence and severity of withdrawal symptoms
b. Necessary use of drugs to prevent withdrawal symptoms
c. Level of intoxication associated with addiction
d. Amount of substance needed to satisfy cravings
ANS: B
Dependence refers to the necessary use of drugs to prevent withdrawal symptoms.

DIF: COG: Understanding REF: 807-808 OBJ: 2

5. What has happened in the United States as a result of prohibition?
a. Substance abuse has declined.
b. Violent crime and corruption has increased.
c. The need for community health nurses has declined.
d. Facilities to treat substance abuse have improved.
ANS: B
Prohibition has led to increased crime and corruption among law officials related to the illicit market.

DIF: COG: Understanding REF: 805 OBJ: 2

6. Which factor has contributed to the problem of substance abuse?
a. Increased knowledge about the use of drugs
b. Social acceptability of certain drugs
c. Recognition of substance abuse as a health problem
d. Control of the content and strength of illegal drugs
ANS: B
Social acceptance of certain drugs contributes to the substance abuse problem.

DIF: COG: Understanding REF: 805 OBJ: 2

7. A client who is experiencing a drug addiction is at risk for having a(n):
a. Infant with a high birth weight
b. Easily cured illness or disease
c. Accident or committing suicide
d. Problem finding employment
ANS: C
Alcohol, tobacco, and other drug (ATOD) abuse and addiction is associated with many problems, including neonates with low birth weights and congenital anomalies; accidents, homicides, and suicides; chronic diseases such as cardiovascular disease, cancer, lung disease, hepatitis, human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS); and mental illness.

DIF: COG: Applying REF: 805 OBJ: 2

8. The oldest and most widely used psychoactive drug in the world is:
a. Marijuana
b. Heroin
c. Alcohol
d. Cocaine
ANS: C
The oldest and most widely used psychoactive drug in the world is alcohol.

DIF: COG: Remembering REF: 809 OBJ: 3

9. How much alcohol can the liver metabolize in an hour?
a. 1 ounce of whiskey
b. 3 ounces of wine
c. 5 ounces of wine
d. 12 ounces of beer
ANS: D
Whiskey is 3/4 oz and wine is 4 oz.

DIF: COG: Remembering REF: 809 OBJ: 3

10. The most widely used illicit drug in the United States is:
a. Alcohol
b. Heroin
c. Cocaine
d. Marijuana
ANS: D
Marijuana is the most widely used illicit drug in the United States.

DIF: COG: Remembering REF: 812 OBJ: 3

11. Which statement about nicotine and smoking is accurate?
a. Cigars contain higher doses of nicotine than cigarettes.
b. Tolerance to nicotine takes days to develop.
c. Sidestream smoke contains more toxic compounds than mainstream smoke.
d. The harsher smoke of pipes and cigars is more hazardous than cigarette smoke.
ANS: C
It is true that sidestream smoke contains greater concentrations of toxic and carcinogenic compounds than mainstream smoke.

DIF: COG: Understanding REF: 811 OBJ: 3

12. The nurse is interviewing a client who reports that he drinks alcohol when snorting cocaine. This client is experiencing:
a. Drug addiction
b. Polysubstance use
c. Drug and alcohol abuse
d. Indiscriminate drug use
ANS: B
A client who drinks alcohol when snorting cocaine is suffering from polysubstance abuse.

DIF: COG: Applying REF: 813 OBJ: 3

13. Which physical effect is the nurse most likely to be concerned about when caring for a client who has had long-term marijuana use?
a. Constipation
b. Cardiac dysrhythmia
c. Abdominal pain
d. Respiratory tract damage
ANS: D
Respiratory tract damage occurs from smoking the drug and is the greatest physical concern among chronic users.

DIF: COG: Analyzing REF: 812 OBJ: 3

14. A nurse is providing education to a parent-teacher organization about substance use and abuse among children. Which information would the nurse most likely include in this presentation?
a. Inhalants are among the first drugs that young children use.
b. Implementing the DARE program is the most effective way to prevent drug-use.
c. Underage drinking is not a problem in most communities.
d. Early experimentation with substances decreases the likelihood of future abuse.
ANS: A
Inhalants are among the first drugs that young children use.

DIF: COG: Analyzing REF: 808 OBJ: 3

15. Which individual would mostly likely have the lowest blood alcohol concentration?
a. An individual who consumes a drink with a high concentration of alcohol
b. An individual who drinks without consuming food
c. An individual of the female gender
d. An individual with a high body weight
ANS: D
An individual with a high body weight would likely have the lowest blood alcohol concentration. Increased alcohol concentration, drinking without consuming food, and being a female are all factors which increase blood alcohol concentration.

DIF: COG: Evaluating REF: 809 OBJ: 3

16. The leading cause of birth defects in the United States is:
a. Cigarette smoking
b. Fetal alcohol syndrome
c. Marijuana use
d. HIV from sharing needles
ANS: B
The leading preventable cause of birth defects in the United States is fetal alcohol syndrome, causing mental and behavioral impairment.

DIF: COG: Remembering REF: 818 OBJ: 4

17. A nurse is providing care for a family in which a non-addict is experiencing a stress-induced preoccupation with an addicts life leading to extreme dependence on the addict. This describes:
a. Obsession
b. Codependency
c. Enabling
d. Addiction
ANS: B
Codependency occurs when a person in a close relationship with an addict develops unhealthy coping mechanisms to continue the relationship.

DIF: COG: Applying REF: 819 OBJ: 4

18. Which stage of change is a client experiencing when a commitment to take action has not yet been made?
a. Precontemplation
b. Contemplation
c. Preparation
d. Action
ANS: B
During contemplation, the individual is aware that a problem exists and is seriously thinking about overcoming it but has not yet made a commitment to take action. The nurse can encourage the individual to weigh the pros and cons of the problem and the solution to the problem.

DIF: COG: Applying REF: 824 OBJ: 4

19. A nurse is working with a client during a smoking cessation program. The client has developed an action plan for smoking cessation, but has not yet implemented it. Which stage of change is the client experiencing?
a. Precontemplation
b. Contemplation
c. Preparation
d. Action
ANS: C
During preparation, the individual is prepared for action and may reduce the problem behavior but has not taken effective action yet.

DIF: COG: Applying REF: 824 OBJ: 4

20. Drug education programs in the school, such as Project DARE, are an example of which level of prevention?
a. Primary level of prevention
b. Secondary level of prevention
c. Tertiary level of prevention
d. Primary health care prevention
ANS: A
Primary prevention includes education about drugs and guidelines for their use. DARE is a drug use prevention program.

DIF: COG: Applying REF: 813|825 OBJ: 4

21. When assessing for addiction, the nurse should be aware that a primary symptom of addiction is:
a. Anger
b. Apathy
c. Denial
d. Violence
ANS: C
In assessing for addiction, the nurse should be aware that a primary symptom of addiction is denial.

DIF: COG: Applying REF: 815 OBJ: 4

22. Which action would the nurse take when giving advice using the acronym FRAMES?
a. Offer a menu of options or choices.
b. Provide clear guidance to change risky behavior.
c. Support the clients ability to change the behavior.
d. Emphasize the clients responsibility for change.
ANS: B
Providing clear guidance to change risky behavior is one of the elements of the FRAMES method of intervention.

DIF: COG: Analyzing REF: 824 OBJ: 4

23. A nurse caring for adolescents who have experienced substance abuse recognizes that they are most influenced by:
a. Family-related factors
b. Positive media messages
c. Socioeconomic level
d. Peer pressure
ANS: A
Substance abuse among adolescents is influenced most by family-related factors, such as genetics, family stress, and parenting styles.

DIF: COG: Analyzing REF: 816 OBJ: 4

24. When implementing the harm reduction model, the nurse focuses on using which approach?
a. Education
b. Law enforcement
c. Scare tactics
d. Rehabilitation
ANS: A
The harm reduction model accepts the reality that psychoactive drug use is endemic, and it focuses on pragmatic interventions, especially education, to reduce the adverse consequences of drug abuse and get treatment for addicts.

DIF: COG: Analyzing REF: 807 OBJ: 4

25. A nurse recommends to a school board that other methods besides the just say no approach be considered when providing drug use prevention education to the elementary students. The rationale for this recommendation is:
a. Children do not like to hear the word no, and the approach is too negative.
b. Project DARE is more effective and has decreased drug use.
c. Children are naturally curious and may experiment with drugs.
d. Just say no to drugs does not include smoking and alcohol abuse.
ANS: C
The just say no approach does not help young people because children are naturally curious and drug experimentation is often part of normal development, children from dysfunctional homes often use drugs to get attention and escape intolerable environments, and it does not address the powerful component of peer pressure.

DIF: COG: Analyzing REF: 814 OBJ: 4

26. When providing comprehensive education about HIV transmission for an injection drug user (IDU), the most important information to include is:
a. How and where to acquire needles
b. Proper needle usage and possible injection sites
c. Spreading of the virus via homosexual activities
d. Using bleach between needle uses
ANS: D
IDUs represent the most rapidly growing source of new cases of acquired immunodeficiency syndrome (AIDS), and they are the greatest risk for spread of the virus in the heterosexual community. Emphasis is being placed on reduction of the transmission of this disease through contaminated needles. Nurses should provide education on cleaning needles with bleach between uses and on needle exchange programs to decrease the spread of the virus.

DIF: COG: Analyzing REF: 817 OBJ: 4

27. The nurse collects a urine specimen knowing that urinalysis for drug testing can be used to determine:
a. Whether a certain drug has been used in the recent past
b. The degree of intoxication
c. The extent of performance impairment
d. How much alcohol was consumed
ANS: A
The nurse collects a urine specimen with the rationale that urinalysis for drug testing can be used to determine whether a certain drug has been used in the recent past.

DIF: COG: Analyzing REF: 816 OBJ: 4

28. What would a nurse look for when investigating the setting of a particular drug experience?
a. A back alley or abandoned building where people are using crack
b. An area at the local high school where students are known to smoke cigarettes
c. The individuals using the drug, including that individuals expectations
d. The physical, social, and cultural environment within which the use occurs
ANS: D
Setting is the influence of the physical, social, and cultural environmental within which the use occurs. The other answers are too specific; the last option covers the entire scope of the setting.

DIF: COG: Analyzing REF: 812 OBJ: 4

29. When assessing drug use patterns of a client, which question is most appropriate for the nurse ask?
a. Where was the drug acquired?
b. Who gave the drug to you?
c. What drug was taken?
d. How often do you use the drug?
ANS: D
During an assessment, all relevant drug-use history is collected and aids in the assessment of drug-use patterns. The nurse should note any changes in drug-use patterns over time. Thus, the most appropriate question is the nurse asking how often a client uses drugs.

DIF: COG: Evaluating REF: 815 OBJ: 4

30. A nurse refers a client to Alcoholics Anonymous (AA). Who will play the most important role in the treatment of alcoholism at this support group?
a. Self
b. Spouses
c. Children
d. Peers
ANS: D
Alcoholics Anonymous began a strong movement of peer support to treat a chronic illness. The fellowship, support, and encouragement among AA members provide a vital social network for the person recovering from an addiction.

DIF: COG: Evaluating REF: 822 OBJ: 4

31. A nurse partners with multiple agencies in the community to create a support group for those suffering from addiction in the community. Which level of prevention is being implemented?
a. Primary
b. Secondary
c. Tertiary
d. Health promotion
ANS: C
When using tertiary prevention, the nurse helps the addict and the addicts family.

DIF: COG: Applying REF: 815 OBJ: 5

32. A nurse lobbies with legislators for the passage of legislation to prohibit smoking of tobacco products in public places. Which level of prevention is being implemented?
a. Primary
b. Secondary
c. Tertiary
d. Health promotion
ANS: A
When using primary prevention, the focus is on health promotion and disease prevention.

DIF: COG: Applying REF: 813 OBJ: 5

MULTIPLE RESPONSE

1. Which medical problems would a client with chronic alcohol abuse most likely experience? Select all that apply.
a. Gastrointestinal disturbances
b. Cardiac dysrhythmias
c. Depression
d. Organic brain syndrome
ANS: A, B, C, D
Gastrointestinal disturbances, cardiac dysrhythmias, depression, and organic brain syndrome are some effects of chronic alcohol abuse.

DIF: COG: Analyzing REF: 809 OBJ: 2

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