C HAPTER 22: S UBSTANCE R ELATED AND
A DDICTIVE D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which features should be present in a therapeutic milieu for a patient with
a hallucinogen overdose?
a. Simple and safe
b. Active and bright
c. Stimulating and colorful
d. Confrontational and challenging
ANS: A
Because the individual who has ingeste d a hallucinogen is probabl y
experiencing feelings of unrealit y and altered sensory perceptions, the
best environment is one that does not add to the stimulation. A simple,
safe environment is a better choice than an environment with any of the
characteristics listed in the other options. The other options would
contribute to a bad trip.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 408 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
,2. When a patient first began using alcohol, two drinks produced relaxation
and drowsiness. After 1 year, four drinks are needed to achieve the same
response. Why has this change occurred?
a. Tolerance has developed.
b. Antagonistic effects are evident.
c. Metabolism of the alcoh ol is now delayed.
d. Pharmacokinetics of the alcohol have changed.
ANS: A
Tolerance refers to needing higher and higher doses of a drug to
produce the desired effect. The potency of the alcohol is stable.
Neither hypomagnesemia nor antagonistic effects acc ount for this
change.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 408 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
3. At a meeting for famil y members of alcoholics, a spouse says, I did
everything I could to help. I even requested sick leave when my partner
was too drunk to go to work. The nurse assesses these comments as:
a. codependence.
b. assertiveness.
c. role reversal.
d. homeostasis.
ANS: A
, Codependence refers to participating in behaviors that maintain the
addiction or allow it to continue without holding the user accountable
for his or her actions. The other options are not supported by
information given in the scenario. See relationship to audience
response question.
PTS: 1 DIF: Cognitive Level: Understa nd (Comprehension)
REF: 415 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
4. In the emergency department, a patients vital signs are BP 66/40 mm Hg;
pulse 140 beats/min; respirations 8 breaths/min and shallow. The nursing
diagnosis is Ineffective breathing pattern related to depression of
respiratory center secondary to narcotic intoxication. Select the priorit y
outcome.
a. The patient will demonstrate effective coping skills and identify
communit y resources for treatment of subst ance abuse within 1
week of hospitalization.
b. Within 4 hours, vital signs will stabilize, with BP above 90/60 mm
Hg, pulse less than 100 beats/min, and respirations at or above 12
breaths/min.
c. The patient will correctl y describe a plan for home care and
achieving a drug-free state before release from the emergency
department.
d. Within 6 hours, the patients breath sounds will be clear bilaterall y
and throughout lung fields.
ANS: B
The correct short -term outcome is the only one that relates to the
patients physical condition. It is expected that vital signs will return to
A DDICTIVE D ISORDERS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. Which features should be present in a therapeutic milieu for a patient with
a hallucinogen overdose?
a. Simple and safe
b. Active and bright
c. Stimulating and colorful
d. Confrontational and challenging
ANS: A
Because the individual who has ingeste d a hallucinogen is probabl y
experiencing feelings of unrealit y and altered sensory perceptions, the
best environment is one that does not add to the stimulation. A simple,
safe environment is a better choice than an environment with any of the
characteristics listed in the other options. The other options would
contribute to a bad trip.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 408 TOP: Nursing Process: Implementation
MSC: Client Needs: Safe, Effective Care Environment
,2. When a patient first began using alcohol, two drinks produced relaxation
and drowsiness. After 1 year, four drinks are needed to achieve the same
response. Why has this change occurred?
a. Tolerance has developed.
b. Antagonistic effects are evident.
c. Metabolism of the alcoh ol is now delayed.
d. Pharmacokinetics of the alcohol have changed.
ANS: A
Tolerance refers to needing higher and higher doses of a drug to
produce the desired effect. The potency of the alcohol is stable.
Neither hypomagnesemia nor antagonistic effects acc ount for this
change.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 408 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
3. At a meeting for famil y members of alcoholics, a spouse says, I did
everything I could to help. I even requested sick leave when my partner
was too drunk to go to work. The nurse assesses these comments as:
a. codependence.
b. assertiveness.
c. role reversal.
d. homeostasis.
ANS: A
, Codependence refers to participating in behaviors that maintain the
addiction or allow it to continue without holding the user accountable
for his or her actions. The other options are not supported by
information given in the scenario. See relationship to audience
response question.
PTS: 1 DIF: Cognitive Level: Understa nd (Comprehension)
REF: 415 TOP: Nursing Process: Assessment MSC:
Client Needs: Psychosocial Integrit y
4. In the emergency department, a patients vital signs are BP 66/40 mm Hg;
pulse 140 beats/min; respirations 8 breaths/min and shallow. The nursing
diagnosis is Ineffective breathing pattern related to depression of
respiratory center secondary to narcotic intoxication. Select the priorit y
outcome.
a. The patient will demonstrate effective coping skills and identify
communit y resources for treatment of subst ance abuse within 1
week of hospitalization.
b. Within 4 hours, vital signs will stabilize, with BP above 90/60 mm
Hg, pulse less than 100 beats/min, and respirations at or above 12
breaths/min.
c. The patient will correctl y describe a plan for home care and
achieving a drug-free state before release from the emergency
department.
d. Within 6 hours, the patients breath sounds will be clear bilaterall y
and throughout lung fields.
ANS: B
The correct short -term outcome is the only one that relates to the
patients physical condition. It is expected that vital signs will return to
