Chapter 9: Drugs of Abuse Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 9: Drugs of Abuse

Test Bank

MULTIPLE CHOICE

1. The nurse instructs a client prescribed alprazolam (Xanax) for treatment of short-term anxiety to avoid which herbal preparation?

a.

Chamomile

b.

Ginger

c.

Saw palmetto

d.

Valerian

ANS: D

Valerian interacts with benzodiazepines such as alprazolam (Xanax), causing increased central nervous system (CNS) depression.

DIF: Cognitive Level: Comprehension REF: p. 152

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

2. A client is admitted to the emergency room after overdosing on a benzodiazepine. The nurse anticipates that the healthcare provider will order which antidote?

a.

Caffeine

b.

Epinephrine (Adrenalin)

c.

Flumazenil (Romazicon)

d.

Phentolamine (Regitine)

ANS: C

Flumazenil (Romazicon) is a benzodiazepine antagonist used to reverse the respiratory and sedative effects of benzodiazepines.

DIF: Cognitive Level: Application REF: pp. 150-151

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

3. A client has terminal cancer. She is taking large doses of opiates to control pain. The nurse should:

a.

inform the client to decrease drug dose to avoid drug addiction.

b.

instruct the client to increase drug dose.

c.

discontinue the clients opiates to avoid drug addiction.

d.

allow the prescribed opiate dose unless drug toxicity occurs.

ANS: D

Patients with terminal disease may require large doses of pain medication to manage their pain. The priority in this case is managing the pain, not the potential for addiction.

DIF: Cognitive Level: Application REF: p. 154

TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

4. A client enters the emergency department complaining of acute lower right quadrant abdominal pain. It is determined that the client has appendicitis and is scheduled to go to the operating room immediately. The nurse notes on the database that the client generally drinks 10 to 12 beers a day, although he did not drink in the past 4 days because of the pain. The nurse would expect that the:

a.

clients surgery would be canceled because of the threat of a withdrawal reaction.

b.

clients surgery would proceed with no change in the plan of care.

c.

client would require a greater level of anesthesia as a result of cross-tolerance.

d.

client would need less anesthesia because of the circulating blood alcohol.

ANS: C

Alcohol interacts with many commonly prescribed or over-the-counter medications. Potentiation and cross-tolerance with other CNS depressants also may occur.

DIF: Cognitive Level: Analysis REF: p. 140

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

5. The spouse of a client asks why her husband seems to drink more when he is depressed. What should the nurse say in response?

a.

The body craves alcohol more when someone is sad.

b.

A persons mood does not have any impact on his or her drinking.

c.

Depression is an excuse to drink.

d.

Research indicates that alcohol elevates a persons mood.

ANS: D

Alcohol is a general CNS depressant. Additionally, alcohol binds with receptors in the brain reward system, resulting in the release of dopamine and promoting the addictive process.

DIF: Cognitive Level: Application REF: pp. 148-149

TOP: Nursing Process: Intervention/Communication

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

6. A client expresses the desire to quit smoking. She elects to use Nicorette gum replacement therapy. Which statement by the nurse is true regarding this smoking cessation technique?

a.

You should not eat or drink for 15 minutes before or after chewing the gum.

b.

You may experience a skin rash as a result of this treatment.

c.

Using a nicotine replacement system will decrease the risk of cancer.

d.

The gum will take away the craving to smoke.

ANS: A

The client who uses Nicorette should not eat or drink for 15 minutes before or after chewing the gum in order to achieve the full effect.

DIF: Cognitive Level: Application REF: p. 143

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

7. A client with a history of long-term alcohol abuse is diagnosed with Wernickes encephalopathy. The nurse would plan the clients care with the knowledge that which treatment will be needed first?

a.

Large volumes of intravenous fluids to rehydrate

b.

Bolus of high-concentration glucose solution to treat hypoglycemia

c.

Intravenous thiamine to address nutritional deficiency

d.

Administration of stimulants to counteract depression

ANS: C

The client must receive thiamine first to treat the nutritional deficiency that is the source of the condition.

DIF: Cognitive Level: Analysis REF: p. 149

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

8. A client is admitted to a nursing unit in acute alcoholic withdrawal. Which nursing diagnosis is the highest priority early in this admission?

a.

Risk for injury related to disorientation and seizure activity

b.

Disturbed thought processes due to symptoms of withdrawal

c.

Imbalanced nutrition: less than body requirements due to poor intake

d.

Acute constipation related to effects of poor nutrition and decreased activity

ANS: A

Risk for injury is the priority because of the safety needs of this client.

DIF: Cognitive Level: Analysis REF: p. 149

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

9. A nurse in the emergency department receives a call that a client is being transported to the hospital by paramedics. The client is a known heroin addict and is showing signs of potential overdose. The nurse would expect which symptoms?

a.

Anxiety, blurred vision, agitation

b.

Clammy skin, constricted pupils, decreased level of consciousness

c.

Fatigue, paranoia, hallucinations

d.

Panic behaviors, tachycardia, hypertension

ANS: B

Clammy skin, constricted pupils, and decreased level of consciousness are behaviors characteristic of opioid overdose. All the other options indicate an increased level of agitation, characteristic of psychedelic drugs.

DIF: Cognitive Level: Application REF: p. 151

TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

10. A postoperative client received morphine in the recovery room. On assessment, the nurse notes that the clients respiratory rate is 6 breaths per minute and that the client has a decreased level of consciousness. The anesthesiologist orders naloxone (Narcan). The nurse administers this medication with the knowledge that this drug is a(n):

a.

respiratory stimulant.

b.

opioid antagonist.

c.

bronchodilator.

d.

anticonvulsant.

ANS: B

Naloxone is a short-acting opioid antagonist given with suspected opioid overmedication.

DIF: Cognitive Level: Comprehension REF: pp. 151-152

TOP: Nursing Process: Intervention/Implementation

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

11. A client with congestive heart failure receives digoxin (Lanoxin) to slow and strengthen ventricular contraction. He tells a nurse during his health history that he frequently uses amphetamines to deal with all the stress. Which assessments and diagnostics would be a priority for this client?

a.

Urinalysis and creatinine clearance

b.

Digoxin levels and palpation for edema

c.

Blood pressure and BUN

d.

Auscultation of heart rhythm and an ECG

ANS: D

Amphetamines may cause ventricular dysrhythmias. Digoxin may accentuate these rhythm changes, which need to be monitored through auscultation and a rhythm strip.

DIF: Cognitive Level: Analysis REF: p. 146

TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

12. Which client statement demonstrates the greatest readiness for smoking or alcohol cessation?

a.

I will cut down my smoking and drinking, but I wont stop completely.

b.

I dont know why everyone thinks my smoking and drinking are a problem.

c.

I need help in dealing with my addiction to smoking and drinking.

d.

I will quit when my smoking and drinking really affect my life.

ANS: C

The correct option indicates the greatest readiness. The other options show a reluctance to recognize the problems imposed by the addiction.

DIF: Cognitive Level: Analysis REF: p. 140

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

13. The nurse is caring for a client with opioid addiction. The client requires the reversal of respiratory depression and coma. The nurse anticipates that she will be treated with which medication?

a.

Methadone (Dolophine)

b.

Buprenorphine (Subutex)

c.

Naltrexone (ReVia, Depade)

d.

Naloxone (Narcan)

ANS: D

Naloxone (Narcan) is the only choice that can be used to reverse the symptoms of respiratory depression and coma resulting from opioid addiction.

DIF: Cognitive Level: Application REF: p. 149

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

14. The nurse is caring for a client who is detoxifying after an opioid overdose. The nurse anticipates that which drug will be given to substitute for the opioid?

a.

Nalmefene (Revex)

b.

Naltrexone (ReVia, Depade)

c.

Phenytoin (Dilantin)

d.

Buprenorphine (Subutex)

ANS: D

Buprenorphine (Subutex) is the only choice that can be used to substitute for the opioid.

DIF: Cognitive Level: Application REF: p. 149

TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

15. The client is receiving nicotine replacement therapy in the form of the Commit lozenge. The client tells the nurse that she has been experiencing extreme nausea and indigestion. The nurse recognizes that the client is probably making which mistake?

a.

Taking too many of the lozenges per day

b.

Letting the lozenge dissolve over a long time period

c.

Chewing and swallowing the lozenge

d.

Taking too few of the lozenges per day

ANS: C

Chewing and swallowing the lozenge will intensify the gastrointestinal side effects.

DIF: Cognitive Level: Application REF: p. 143

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

MULTIPLE RESPONSE

1. The nurse is aware that some drugs of abuse may cause significant withdrawal effects. The nurse anticipates withdrawal syndromes with which medications? (Select all that apply.)

a.

Cannabinoids

b.

Opioids

c.

Alcohol

d.

Amphetamines

e.

Barbiturates

f.

Anxiolytics

ANS: B, C, D, F

Based on the physiological response to the agents, cannabis and barbiturates do not lead to withdrawal symptoms.

DIF: Cognitive Level: Analysis REF: pp. 141-142

TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Psychosocial Integrity: Dependency

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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