Wilkes NSG 526 Exam 4 | Clinical
Modalities in Advanced Psych | Questions
& Correct Verified Answers with Rationales
| Latest 2026/2027 Update | Graded A+|
Which assessment findings are likely for an individual who recently injected heroin?
a. Anxiety, restlessness, paranoid delusions
b. Muscle aching, dilated pupils, tachycardia
c. Heightened sexuality, insomnia, euphoria
d. Drowsiness, constricted pupils, slurred speech –
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Correct Answer :ANS: D
Heroin, an opiate, is a central nervous system (CNS) depressant. Blood pressure, pulse, and
respirations will be decreased, and attention will be impaired. The distracters describe
behaviors consistent with amphetamine use, symptoms of narcotic withdrawal, and cocaine
use.
An adult in the emergency department states, "Everything I see appears to be waving. I am
outside my body looking at myself. I think I'm losing my mind." When vital signs are slightly
elevated what should the nurse suspect?
a. a schizophrenic episode.
b. hallucinogen ingestion.
c. opium intoxication.
d. cocaine overdose. –
Correct Answer :ANS: B
The client who is high on a hallucinogen often experiences synesthesia (visions in sound),
depersonalization, and concerns about going "crazy." Synesthesia is not common in
schizophrenia. CNS stimulant overdose more commonly involves elevated vital signs and
assaultive, grandiose behaviors. Phencyclidine (PCP) use commonly causes bizarre or violent
behavior, nystagmus, elevated vital signs, and repetitive jerking movements
A nurse wants to research epidemiology, assessment techniques, and best practices
regarding persons with addictions. Which resource will provide the most comprehensive
information?
a. Substance Abuse and Mental Health Services Administration (SAMHSA)
b. Institute of Medicine (IOM)-National Research Council
c. National Council of State Boards of Nursing (NCSBN)
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, • NSG 526 Exam 09/01/2026
d. American Society of Addictions Medicine –
Correct Answer :ANS: A
The SAMHSA is the official resource for comprehensive information regarding addictions. The
other resources have relevant information, but they are not as comprehensive.
A client is thin, tense, jittery, and has dilated pupils. The client says, "My heart is pounding in
my chest. I need help." The client allows vital signs to be taken but then becomes suspicious
and says, "You could be trying to kill me." The client refuses further examination. Abuse of
which substance is most likely?
a. phencyclidine (PCP)
b. Heroin
c. Barbiturates
d. Amphetamines –
Correct Answer :ANS: D
The physical symptoms are consistent with central nervous system (CNS) stimulation.
Suspicion and paranoid ideation are also present. Amphetamine use is likely. PCP use would
probably result in bizarre, violent behavior. Barbiturates and heroin would result in symptoms
of CNS depression.
What is the priority outcome for a client completing the fourth alcohol detoxification
program in the past year?
a. Prior to discharge, the client will state, "I know I need long-term treatment."
b. Prior to discharge, the client will use denial and rationalization in healthy ways.
c. Prior to discharge, the client will identify constructive outlets for expression of anger.
d. Prior to discharge, the client will develop a trusting relationship with one staff member –
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, • NSG 526 Exam 09/01/2026
Correct Answer :ANS: A
The correct response recognizes the need for ongoing treatment after detoxification and is
the best goal related to controlling relapse. The scenario does not give enough information to
determine whether anger has been identified as a problem. A trusting relationship, while
desirable, should have occurred earlier in treatment
A nurse prepares for an initial interaction with a client with a long history of
methamphetamine abuse. Which is the nurse's best first action?
a. Perform a thorough assessment of the client.
b. Verify that security services are immediately available.
c. Self-assess personal attitude, values, and beliefs about this health problem.
d. Obtain a face shield because oral hygiene is poor in methamphetamine abusers. –
Correct Answer :ANS: C
The nurse should show compassion, care, and helpfulness for all clients, including those with
addictive diseases. It is important to have a clear understanding of one's own perspective.
Negative feelings may occur for the nurse; supervision is an important resource. The activities
identified in the distracters occur after self-assessment
A client undergoing alcohol rehabilitation decides to begin disulfiram therapy. Client
teaching should include the need to (Select all that apply.)
a. avoid aged cheeses.
b. avoid alcohol-based skin products.
c. read labels of all liquid medications.
d. wear sunscreen and avoid bright sunlight.
e. maintain an adequate dietary intake of sodium.
P 4