Chapter 9- Lifestyle- Substance Abuse
1. A nurse is caring for a patient who abuses marijuana. The treatment for marijuana abuse consists mainly
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A) nonpharmacologic interventions combined with an exercise program.
B) drug therapy with bromocriptine (Parlodel).
C) aggressive respiratory assistance
D) no nursing action unless the patient experiences a “bad trip.” Ans: A
Feedback:
Treatment for marijuana abuse consists mainly of nonpharmacologic interventions combined with an exercise program to help deal with withdrawal symptoms and cravings for the drug. Treatment of LSD and PCP use is necessary only when the user experiences a “bad trip.” Parlodel is given for cocaine addiction. Patients with acute inhalant intoxication may need respirator assistance.
2. A nurse is working in the emergency department and is assigned to a patient brought in by family members. The family thinks that the patient is on methamphetamine. Which of the following will the nurse assess for?
A) Increased appetite
B) Hypertension
C) Bradycardia
D) Stupor
Ans: B
Feedback:
Methamphetamine is a CNS stimulant that initially increases heart rate and blood pressure. This drug usually decreases appetite, energizes muscles, and causes some degree of mental and physical alertness.
3. A patient comes to the clinic asking for help to quit drinking alcohol. She has a 21-year history of heavy drinking and is worried about developing cirrhosis of the liver. The patient agrees to take disulfiram (Antabuse). The nurse will teach the patient that the combination of alcohol and Antabuse will cause which of the following?
A) Bradycardia
B) Diarrhea
C) Nausea
D) Slight headache
Ans: C
Feedback:
The effectiveness of Antabuse relies on a drug interaction between ethanol and disulfiram to produce unpleasant and undesirable symptoms as a deterrent to alcohol ingestion. Symptoms include facial flushing, throbbing headache, hyperventilation, tachycardia, palpitations, nausea and copious vomiting, hypotension, shortness of breath, vertigo, syncope, confusion, and profuse diaphoresis.
4. A patient has been admitted to the hospital with acute cocaine intoxication. Family members are present and are observing prolonged seizure activity. The family is upset and asks the nurse how long the patient will experience the seizures. An appropriate response by the nurse would be
A) “Not long, he should be fine in a few minutes.”
B) “It's very hard to tell, but the seizure activity might not end right away.”
C) “It is possible that the seizure activity could last a week or more.”
D) “Once a person has had a seizure there is always a possibility of other seizures.” Ans: B
Feedback:
Acute intoxication of cocaine can cause severe and prolonged seizure activity. Withdrawal symptoms occur with 24 hours of the last ingestion and can last as long as 1 week. Once the withdrawal symptoms occur, the patient will begin to experience nausea, sleep disorders, craving, depression, irritability, agitation, and fatigue. It is true that once a person experiences a seizure, that person is considered high risk for another seizure. However, with this particular patient, the more appropriate response would be that once the withdrawal of the drug begins, the seizure activity should stop.
5. A Native-American man is admitted to the emergency department exhibiting a reddened face and an increased heart rate. He reports that he does not normally drink alcohol but at a party had punch that contained vodka. The nurse recognizes that this reaction may be related to the ethanol exposure and caused by
A) retarded absorption from the small intestine.
B) immediate distribution at the rate proportional to blood flow and water content.
C) metabolism using the enzyme alcohol dehydrogenase.
D) deficiency in the enzyme aldehyde dehydrogenase. Ans: D
Feedback:
East Asians and Native Americans exhibit an unusual response of facial flushing, vasodilation, and tachycardia after consuming ethanol. They have a genetic deficiency in the enzyme aldehyde dehydrogenase, which leads to an accumulation of acetaldehyde after consuming even relatively small amounts of ethanol. Retarded absorption, immediate distribution, or metabolism using the enzyme alcohol dehydrogenase does not explain this type of reaction. [Show Less]