NUR 355 EXAM 1 MOD 1 & 2 ACTUAL EXAM 100 QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES/GRADE A+ ASSURED
The patient with an SUD diagnosis may demonstrate which symptoms? (Select all that
apply.)
A. Failure to fulfill major role obligations at work, home, or school
B. Recurrent use in situations in which it is physically hazardous C. Continued use despite
having persistent or recurrent social or interpersonal problems caused or exacerbated by
the effects of the substance
D. Withdrawal from the substance when the dose is decreased or stopped E. Successful
attempts to cut down
Answer: A, B, C, and D
Rationale: The individual who has a SUD may not adhere to an expressed plan to cut back on
the amount or frequency of substance use
The nurse recognizes which patient(s) are at risk for developing problems with substance
abuse? (Select all that apply.)
A. The 14-year-old girl whose family has just moved and is smoking and drinking after
school with friends
B. The 17-year-old senior in high school who has untreated ADHD and whose mother has
an AUD
C. The 32-year-old mother of two with a past history of binge drinking in college whose
husband just left her
D. The 52-year-old executive with severe back pain who typically drinks cocktails in the
evenings after work
E. The 64-year-old recently retired man who has an occasional drink in the evening after
work
Answer: A, B, C, and D
Rationale: The 14-year-old girl who is drinking and smoking with friends after school is at risk
because of her young age at initial use and the fact that this is a time of stress and transition for
her with the recent family move, having to go to a new school, and worry about fitting in, etc.
The 17-year-old boy is at increased risk because males are almost twice as likely as females to
, 2
have problems with substance abuse. Additionally, he has comorbid, untreated ADHD along with
family history of alcoholism. The 32-year-old mother with a past history of problematic drinking
in college is at increased risk of developing problems as she goes through the stress and
transition of a divorce. Lastly, the 52-year-old executive is at increased risk because of his pain
issues and his routine drinking in the evening. While a life change such as retirement is a risk
factor, the man in choice E has limited/less risk due to his limited prior drinking history.
Which reaction in the brain results from drugs causing overwhelming surges of dopamine?
A. Produce more of the neurotransmitter
B. Increase the number of receptors that can receive and transmit signals
C. Have increased ability to respond to any pleasure
D. Have decreased ability to respond to pleasure
Answer: D
Rationale: Addictive drugs, directly or indirectly, target the brain's reward system by flooding the
circuit with dopamine. As a person continues hazardous use of drugs or alcohol, the brain starts
to adapt to these chemical changes by producing less dopamine, reducing the substance user's
ability to enjoy drugs and the things that previously brought pleasure.
The nurse working in the pediatric clinic is performing substance abuse screenings on all
children aged 12 to 18 as part of a community effort to identify at-risk teens. The nurse
should consider which teen at greatest risk?
A. The 13-year-old girl who has recently been irritable and moody
B. The 14-year-old boy being treated for diagnosed ADHD with prescription stimulants
C. The 15-year-old who recently entered high school and appears down, reports trouble
sleeping, and has difficulty concentrating
D. The 17-year-old cheerleader who quits the squad, suddenly changes her group of
friends, and has been acting very secretive at home Answer: D
ANSWER: D
, 3
Rationale: While all of the teens may be at risk, the cheerleader who quit the squad, changed her
peer group, and is being secretive at home is displaying several classic behavioral and
psychological signs of a substance use disorder.
The nurse monitors for which clinical manifestations in the patient diagnosed with early
alcohol withdrawal?
A. Anxiety, stomach cramping, and aching muscles
B. Restlessness, diaphoresis, and sensitivity to lights and sounds
C. Autonomic hyperactivity, hallucinations, and global confusion D. Depression, hunger,
and fatigue
Answer: B
Rationale: Anxiety, cramping, and aching muscles are associated with opiate withdrawal.
Autonomic hyperactivity, hallucinations, and global confusion are indicative of delirium
tremens, which is late ETOH withdrawal.
The nurse understands an antagonist agent works by which of the following mechanism to
treat opiate overdose?
A. Binds with the receptor to elicit an effect similar to natural neurotransmitters
B. Partially binds with the receptor to elicit an effect similar to natural neurotransmitters
C. Binds with the receptor but blocks the effect similar to natural neurotransmitters
D. Partially binds with the receptor but blocks the effect similar to natural
neurotransmitters
Answer: C
Rationale: Antagonists bind to the same receptor but do not cause activity. They prevent the
opiate "high" while simultaneously blockading the receptor to other agonists.
The nurse suspects cocaine withdrawal in a patient demonstrating which of the following
symptoms? (Select all that apply.)
A. Euphoria
B. Cravings
C. Irritability
, 4
D. Heightened awareness
E. Anxiety
Answer: B, C, and E
Rationale: Euphoria and heightened awareness are effects of taking the drug.
When using motivational interviewing techniques the nurse employs which of the following
strategies?
A. Gently informing the patient about the correct and appropriate behaviors
B. Quietly maintaining an ongoing conversation to keep the patient engaged
C. Using long periods of silence so the patient can contemplate their issues
D. Using reflection and open-ended questions to encourage discussion
Answer: D
Rationale: The MI approach is to use open-ended questions, affirmations, reflective listening,
and summaries (OARS). Motivational interviewing attempts to meet the individual where they
are rather than where they should be, finding out what is important to the individual and using
that as motivation for change.
The nurse should be on high alert for drug abuse if the teen patient is demonstrating which
of the following behaviors? (Select all that apply.)
A. A change in peer group
B. Secretive behavior
C. Change in sporting activity
D. Poor performance in school
E. Frequent dieting
Answer: A, B, and D
Rationale: Sporting activities even when changed are good. Teenagers frequently diet.
When describing tolerance, which of the following definitions is correct?
A. A pattern of substance use that is problematic
B. When the body naturally adapts to regular exposure to a substance
DETAILED ANSWERS WITH RATIONALES/GRADE A+ ASSURED
The patient with an SUD diagnosis may demonstrate which symptoms? (Select all that
apply.)
A. Failure to fulfill major role obligations at work, home, or school
B. Recurrent use in situations in which it is physically hazardous C. Continued use despite
having persistent or recurrent social or interpersonal problems caused or exacerbated by
the effects of the substance
D. Withdrawal from the substance when the dose is decreased or stopped E. Successful
attempts to cut down
Answer: A, B, C, and D
Rationale: The individual who has a SUD may not adhere to an expressed plan to cut back on
the amount or frequency of substance use
The nurse recognizes which patient(s) are at risk for developing problems with substance
abuse? (Select all that apply.)
A. The 14-year-old girl whose family has just moved and is smoking and drinking after
school with friends
B. The 17-year-old senior in high school who has untreated ADHD and whose mother has
an AUD
C. The 32-year-old mother of two with a past history of binge drinking in college whose
husband just left her
D. The 52-year-old executive with severe back pain who typically drinks cocktails in the
evenings after work
E. The 64-year-old recently retired man who has an occasional drink in the evening after
work
Answer: A, B, C, and D
Rationale: The 14-year-old girl who is drinking and smoking with friends after school is at risk
because of her young age at initial use and the fact that this is a time of stress and transition for
her with the recent family move, having to go to a new school, and worry about fitting in, etc.
The 17-year-old boy is at increased risk because males are almost twice as likely as females to
, 2
have problems with substance abuse. Additionally, he has comorbid, untreated ADHD along with
family history of alcoholism. The 32-year-old mother with a past history of problematic drinking
in college is at increased risk of developing problems as she goes through the stress and
transition of a divorce. Lastly, the 52-year-old executive is at increased risk because of his pain
issues and his routine drinking in the evening. While a life change such as retirement is a risk
factor, the man in choice E has limited/less risk due to his limited prior drinking history.
Which reaction in the brain results from drugs causing overwhelming surges of dopamine?
A. Produce more of the neurotransmitter
B. Increase the number of receptors that can receive and transmit signals
C. Have increased ability to respond to any pleasure
D. Have decreased ability to respond to pleasure
Answer: D
Rationale: Addictive drugs, directly or indirectly, target the brain's reward system by flooding the
circuit with dopamine. As a person continues hazardous use of drugs or alcohol, the brain starts
to adapt to these chemical changes by producing less dopamine, reducing the substance user's
ability to enjoy drugs and the things that previously brought pleasure.
The nurse working in the pediatric clinic is performing substance abuse screenings on all
children aged 12 to 18 as part of a community effort to identify at-risk teens. The nurse
should consider which teen at greatest risk?
A. The 13-year-old girl who has recently been irritable and moody
B. The 14-year-old boy being treated for diagnosed ADHD with prescription stimulants
C. The 15-year-old who recently entered high school and appears down, reports trouble
sleeping, and has difficulty concentrating
D. The 17-year-old cheerleader who quits the squad, suddenly changes her group of
friends, and has been acting very secretive at home Answer: D
ANSWER: D
, 3
Rationale: While all of the teens may be at risk, the cheerleader who quit the squad, changed her
peer group, and is being secretive at home is displaying several classic behavioral and
psychological signs of a substance use disorder.
The nurse monitors for which clinical manifestations in the patient diagnosed with early
alcohol withdrawal?
A. Anxiety, stomach cramping, and aching muscles
B. Restlessness, diaphoresis, and sensitivity to lights and sounds
C. Autonomic hyperactivity, hallucinations, and global confusion D. Depression, hunger,
and fatigue
Answer: B
Rationale: Anxiety, cramping, and aching muscles are associated with opiate withdrawal.
Autonomic hyperactivity, hallucinations, and global confusion are indicative of delirium
tremens, which is late ETOH withdrawal.
The nurse understands an antagonist agent works by which of the following mechanism to
treat opiate overdose?
A. Binds with the receptor to elicit an effect similar to natural neurotransmitters
B. Partially binds with the receptor to elicit an effect similar to natural neurotransmitters
C. Binds with the receptor but blocks the effect similar to natural neurotransmitters
D. Partially binds with the receptor but blocks the effect similar to natural
neurotransmitters
Answer: C
Rationale: Antagonists bind to the same receptor but do not cause activity. They prevent the
opiate "high" while simultaneously blockading the receptor to other agonists.
The nurse suspects cocaine withdrawal in a patient demonstrating which of the following
symptoms? (Select all that apply.)
A. Euphoria
B. Cravings
C. Irritability
, 4
D. Heightened awareness
E. Anxiety
Answer: B, C, and E
Rationale: Euphoria and heightened awareness are effects of taking the drug.
When using motivational interviewing techniques the nurse employs which of the following
strategies?
A. Gently informing the patient about the correct and appropriate behaviors
B. Quietly maintaining an ongoing conversation to keep the patient engaged
C. Using long periods of silence so the patient can contemplate their issues
D. Using reflection and open-ended questions to encourage discussion
Answer: D
Rationale: The MI approach is to use open-ended questions, affirmations, reflective listening,
and summaries (OARS). Motivational interviewing attempts to meet the individual where they
are rather than where they should be, finding out what is important to the individual and using
that as motivation for change.
The nurse should be on high alert for drug abuse if the teen patient is demonstrating which
of the following behaviors? (Select all that apply.)
A. A change in peer group
B. Secretive behavior
C. Change in sporting activity
D. Poor performance in school
E. Frequent dieting
Answer: A, B, and D
Rationale: Sporting activities even when changed are good. Teenagers frequently diet.
When describing tolerance, which of the following definitions is correct?
A. A pattern of substance use that is problematic
B. When the body naturally adapts to regular exposure to a substance
