SUBSTANCE ABUSE AND ABUSE
NCLEX PRACTICE QUIZ: 55
QUESTIONS
1. Question
Nurse Rob has observed a co-worker arriving to work drunk at
least three times in the past month. Which action by Nurse Rob
would best ensure client safety and obtain necessary assistance
for the co-worker?
o A. Ignore the co worker's behavior, and frequently
assess the clients assigned to the co-worker.
o B. Make general statements about safety issues at the
next staff meeting.
o C. Report the coworker's behavior to the
appropriate supervisor.
o D. Warn the co-worker that this practice is unsafe.
Incorrect
Correct Answer: C. Report the coworker’s behavior to the
appropriate supervisor.
The nurse is obligated by ethical considerations of client safety,
as well as by nurse practice acts in many states, to report
substance abuse in health care workers. Most healthcare facilities
have an employee assistance program to help workers with
substance abuse problems. Alcohol and drug abuse by employees
cause many expensive problems for business and industry
ranging from lost productivity, injuries, and an increase in health
insurance claims. The loss to companies in the United States due
to alcohol and drug-related abuse by employees totals $100
billion a year, according to the National Clearinghouse for Alcohol
and Drug Information (NCADI).
Option A: Ignoring the co-worker’s behavior would be
a form of enabling behavior (codependency) on the
staff nurse’s part. Misuse of alcohol and drugs among
U.S. workers create costly medical, social, and other
, problems that affect both employees and employers.
Substance abuse among employees can threaten
public safety, impair job performance and threaten
their own safety.
Option B: Making general statements about safety in
a staff meeting avoids dealing with the problem. When
the issue of workplace substance abuse is addressed
by establishing comprehensive programs, it is a “win-
win” situation for both employers and employees,
according to the U.S. Department of Labor. Companies
and employers, large and small, can adopt a
workplace substance abuse policy that will reduce the
loss of productivity and provide a safer work
environment for all.
Option D: Warning the co-worker is inadequate; it
does not ensure client safety or helps him receive
necessary aid. The culture of the workplace can play a
large role in whether drinking and drug use are
accepted and encouraged or discouraged and
inhibited. Part of this culture can depend on the
gender mix of employees. Research shows that the job
itself can contribute to higher rates of employee
substance abuse. Work that is boring, stressful, or
isolating can contribute to employees drinking.
2. 2. Question
Elsa is being treated in a chemical dependency unit. She tells the
nurse that she only uses drugs when under stress and therefore
does not have a substance problem. Which defense mechanism is
the client using?
A. Compensation
B. Denial
C. Suppression
D. Undoing
Incorrect
Correct Answer: B. Denial
, Individuals who have substance problems often use denial. Denial
is probably one of the best-known defense mechanisms, used
often to describe situations in which people seem unable to face
reality or admit an obvious truth (e.g., “He’s in denial”). Addiction
is one of the best-known examples of denial. People who are
living with a substance use problem will often flat-out deny that
their behavior is problematic. In other cases, they might admit
that they do use drugs or alcohol but will claim that their
substance use is not problematic.
Option A: Compensation is overachieving in one area
to compensate for failures in another. This
psychological strategy allows people to disguise
inadequacies, frustrations, stresses, or urges by
directing energy toward excelling or achieving in other
areas.
Option C: Sometimes we do this consciously by
forcing the unwanted information out of our
awareness, which is known as suppression. In most
cases, however, this removal of anxiety-provoking
memories from our awareness is believed to occur
unconsciously.
Option D: Undoing is trying to make up for what one
feels are inappropriate thoughts, feelings, or behaviors
(e.g., if you hurt someone’s feelings, you might offer
to do something nice for them in order to assuage
your anxiety or guilt).
3. 3. Question
Nurse Tara is teaching a community group about substance
abuse. She explains that a genetic component has been
implicated in which of the following commonly abused
substances?
A. Alcohol
B. Barbiturates
C. Heroin
D. Marijuana
, Incorrect
Correct Answer: A. Alcohol
Several chromosomes (1, 3, and 7) have been implicated in
increased vulnerability to alcohol abuse. Statistics have shown
that risk for alcohol abuse in first-degree relatives of alcohol
abusers is as high as 40% to 60%. Most of the genetic research
has been done related to alcohol. Some of the genes suspected
include GABRG2 and GABRA2, COMT Val 158Met, DRD2 Taq1A,
and KIAA0040. Personality disorders associated with the
development of an alcohol use disorder include disinhibition and
impulsivity-type disorders, as well as depressive and
socialization-related disorders.
Option B: Barbiturate overdose can be intentional or
unintentional. Decreased use of this controlled
substance has led to a decrease in barbiturate-related
fatalities. However, this medication should still be
considered in cases of suspected overdose in patients
with respiratory depression. A study in 2016 described
two cases of intentional barbiturate overdose with
medication purchased over the internet. These
medications also can be obtained in laboratory
settings as they are often used as buffers.
Option C: From 2002 through 2013, heroin overdoses
went from 0.7 deaths per 100,000 to 2.7. In 2013,
roughly 517,000 people reported heroin use in the
past year, 1.5 times the amount in 2007. State and
federal legislation are implementing diverse methods
to curb this epidemic of heroin overdose deaths. The
many infectious and economic effects of heroin
dependence add to the risk of death.
Option D: Definitive data regarding genetic
transmission is not available at this time for
marijuana. Cannabis use varies based on
demographics. Research shows college students, and
young adults most commonly use cannabis to socially
conform (42%), experiment (29%), and for enjoyment
(24%). Twelve percent primarily use the agent to
manage stress or relax consistent with other studies
associating its use for depression, anxiety, social
anxiety, and post-traumatic stress disorder.
4. 4. Question
NCLEX PRACTICE QUIZ: 55
QUESTIONS
1. Question
Nurse Rob has observed a co-worker arriving to work drunk at
least three times in the past month. Which action by Nurse Rob
would best ensure client safety and obtain necessary assistance
for the co-worker?
o A. Ignore the co worker's behavior, and frequently
assess the clients assigned to the co-worker.
o B. Make general statements about safety issues at the
next staff meeting.
o C. Report the coworker's behavior to the
appropriate supervisor.
o D. Warn the co-worker that this practice is unsafe.
Incorrect
Correct Answer: C. Report the coworker’s behavior to the
appropriate supervisor.
The nurse is obligated by ethical considerations of client safety,
as well as by nurse practice acts in many states, to report
substance abuse in health care workers. Most healthcare facilities
have an employee assistance program to help workers with
substance abuse problems. Alcohol and drug abuse by employees
cause many expensive problems for business and industry
ranging from lost productivity, injuries, and an increase in health
insurance claims. The loss to companies in the United States due
to alcohol and drug-related abuse by employees totals $100
billion a year, according to the National Clearinghouse for Alcohol
and Drug Information (NCADI).
Option A: Ignoring the co-worker’s behavior would be
a form of enabling behavior (codependency) on the
staff nurse’s part. Misuse of alcohol and drugs among
U.S. workers create costly medical, social, and other
, problems that affect both employees and employers.
Substance abuse among employees can threaten
public safety, impair job performance and threaten
their own safety.
Option B: Making general statements about safety in
a staff meeting avoids dealing with the problem. When
the issue of workplace substance abuse is addressed
by establishing comprehensive programs, it is a “win-
win” situation for both employers and employees,
according to the U.S. Department of Labor. Companies
and employers, large and small, can adopt a
workplace substance abuse policy that will reduce the
loss of productivity and provide a safer work
environment for all.
Option D: Warning the co-worker is inadequate; it
does not ensure client safety or helps him receive
necessary aid. The culture of the workplace can play a
large role in whether drinking and drug use are
accepted and encouraged or discouraged and
inhibited. Part of this culture can depend on the
gender mix of employees. Research shows that the job
itself can contribute to higher rates of employee
substance abuse. Work that is boring, stressful, or
isolating can contribute to employees drinking.
2. 2. Question
Elsa is being treated in a chemical dependency unit. She tells the
nurse that she only uses drugs when under stress and therefore
does not have a substance problem. Which defense mechanism is
the client using?
A. Compensation
B. Denial
C. Suppression
D. Undoing
Incorrect
Correct Answer: B. Denial
, Individuals who have substance problems often use denial. Denial
is probably one of the best-known defense mechanisms, used
often to describe situations in which people seem unable to face
reality or admit an obvious truth (e.g., “He’s in denial”). Addiction
is one of the best-known examples of denial. People who are
living with a substance use problem will often flat-out deny that
their behavior is problematic. In other cases, they might admit
that they do use drugs or alcohol but will claim that their
substance use is not problematic.
Option A: Compensation is overachieving in one area
to compensate for failures in another. This
psychological strategy allows people to disguise
inadequacies, frustrations, stresses, or urges by
directing energy toward excelling or achieving in other
areas.
Option C: Sometimes we do this consciously by
forcing the unwanted information out of our
awareness, which is known as suppression. In most
cases, however, this removal of anxiety-provoking
memories from our awareness is believed to occur
unconsciously.
Option D: Undoing is trying to make up for what one
feels are inappropriate thoughts, feelings, or behaviors
(e.g., if you hurt someone’s feelings, you might offer
to do something nice for them in order to assuage
your anxiety or guilt).
3. 3. Question
Nurse Tara is teaching a community group about substance
abuse. She explains that a genetic component has been
implicated in which of the following commonly abused
substances?
A. Alcohol
B. Barbiturates
C. Heroin
D. Marijuana
, Incorrect
Correct Answer: A. Alcohol
Several chromosomes (1, 3, and 7) have been implicated in
increased vulnerability to alcohol abuse. Statistics have shown
that risk for alcohol abuse in first-degree relatives of alcohol
abusers is as high as 40% to 60%. Most of the genetic research
has been done related to alcohol. Some of the genes suspected
include GABRG2 and GABRA2, COMT Val 158Met, DRD2 Taq1A,
and KIAA0040. Personality disorders associated with the
development of an alcohol use disorder include disinhibition and
impulsivity-type disorders, as well as depressive and
socialization-related disorders.
Option B: Barbiturate overdose can be intentional or
unintentional. Decreased use of this controlled
substance has led to a decrease in barbiturate-related
fatalities. However, this medication should still be
considered in cases of suspected overdose in patients
with respiratory depression. A study in 2016 described
two cases of intentional barbiturate overdose with
medication purchased over the internet. These
medications also can be obtained in laboratory
settings as they are often used as buffers.
Option C: From 2002 through 2013, heroin overdoses
went from 0.7 deaths per 100,000 to 2.7. In 2013,
roughly 517,000 people reported heroin use in the
past year, 1.5 times the amount in 2007. State and
federal legislation are implementing diverse methods
to curb this epidemic of heroin overdose deaths. The
many infectious and economic effects of heroin
dependence add to the risk of death.
Option D: Definitive data regarding genetic
transmission is not available at this time for
marijuana. Cannabis use varies based on
demographics. Research shows college students, and
young adults most commonly use cannabis to socially
conform (42%), experiment (29%), and for enjoyment
(24%). Twelve percent primarily use the agent to
manage stress or relax consistent with other studies
associating its use for depression, anxiety, social
anxiety, and post-traumatic stress disorder.
4. 4. Question
