NCLEX RN Substance Abuse Nursing
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client admitted for alcohol withdrawal is tremulous, anxious, and
diaphoretic. Which assessment finding requires the nurse’s immediate
attention?
A. Mild nausea
B. Insomnia
C. Blood pressure of 148/88 mm Hg
D. Visual hallucinations
Answer: Visual hallucinations
Rationale: Visual hallucinations can indicate severe alcohol withdrawal and
progression toward delirium tremens, which can become life-threatening.
2. Which medication is commonly prescribed to reduce the symptoms of
acute alcohol withdrawal?
A. Naloxone
B. Lorazepam
C. Disulfiram
D. Naltrexone
Answer: Lorazepam
Rationale: Benzodiazepines such as lorazepam are first-line medications for
managing acute alcohol withdrawal and preventing withdrawal seizures and
delirium tremens.
, 3. A client with a history of chronic alcohol use is admitted with confusion
and an unsteady gait. Which medication should the nurse anticipate
administering?
A. Thiamine
B. Acetaminophen
C. Haloperidol
D. Methadone
Answer: Thiamine
Rationale: Chronic alcohol use can cause thiamine deficiency, leading to
Wernicke encephalopathy. Thiamine administration helps prevent or treat
this neurologic complication.
4. Which finding is most characteristic of opioid overdose?
A. Hypertension and tachycardia
B. Dilated pupils and hyperactivity
C. Respiratory depression and pinpoint pupils
D. Severe diarrhea and abdominal cramping
Answer: Respiratory depression and pinpoint pupils
Rationale: Opioid overdose commonly causes central nervous system
depression, respiratory depression, and pinpoint pupils.
5. Which medication is used to reverse opioid-induced respiratory
depression?
A. Flumazenil
B. Naloxone
C. Disulfiram
D. Acamprosate
Answer: Naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-
induced respiratory and central nervous system depression.
6. A nurse is caring for a client receiving naloxone after an opioid overdose.
Which assessment is the priority?
,A. Appetite
B. Respiratory status
C. Skin turgor
D. Bowel sounds
Answer: Respiratory status
Rationale: Respiratory depression is the most immediately life-threatening
effect of opioid overdose, so airway and breathing must be continuously
assessed.
7. Which symptom is commonly associated with opioid withdrawal?
A. Bradycardia
B. Respiratory depression
C. Diarrhea
D. Pinpoint pupils
Answer: Diarrhea
Rationale: Opioid withdrawal commonly causes diarrhea, abdominal
cramping, rhinorrhea, lacrimation, sweating, anxiety, muscle aches, and
dilated pupils.
8. Which medication may be used as part of medication-assisted treatment
for opioid use disorder?
A. Methadone
B. Disulfiram
C. Lorazepam
D. Acetaminophen
Answer: Methadone
Rationale: Methadone is a long-acting opioid agonist used in opioid use
disorder treatment to reduce cravings and withdrawal symptoms.
9. A client taking methadone should be monitored closely for which
adverse effect?
A. Respiratory depression
B. Hyperactivity
, C. Severe hypertension
D. Increased visual acuity
Answer: Respiratory depression
Rationale: Methadone is an opioid and can cause respiratory depression,
particularly during initiation, dose changes, or when combined with other
central nervous system depressants.
10.Which statement by a client taking disulfiram indicates correct
understanding of the medication?
A. “I can drink beer occasionally while taking this medication.”
B. “I should avoid alcohol-containing products.”
C. “This medication immediately eliminates alcohol cravings.”
D. “I should take this medication whenever I feel intoxicated.”
Answer: “I should avoid alcohol-containing products.”
Rationale: Disulfiram can cause a severe unpleasant reaction when alcohol is
consumed. Clients must avoid alcoholic beverages and products containing
alcohol.
11.Which reaction can occur if a client taking disulfiram consumes alcohol?
A. Bradycardia only
B. Flushing, headache, nausea, and hypotension
C. Increased appetite
D. Severe constipation only
Answer: Flushing, headache, nausea, and hypotension
Rationale: Disulfiram inhibits alcohol metabolism and can cause an
unpleasant reaction that includes flushing, headache, nausea, vomiting,
tachycardia, and hypotension.
12.Which substance is classified as a stimulant?
A. Heroin
B. Cocaine
C. Alcohol
D. Diazepam
Practice Exam 100 Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026
1. A client admitted for alcohol withdrawal is tremulous, anxious, and
diaphoretic. Which assessment finding requires the nurse’s immediate
attention?
A. Mild nausea
B. Insomnia
C. Blood pressure of 148/88 mm Hg
D. Visual hallucinations
Answer: Visual hallucinations
Rationale: Visual hallucinations can indicate severe alcohol withdrawal and
progression toward delirium tremens, which can become life-threatening.
2. Which medication is commonly prescribed to reduce the symptoms of
acute alcohol withdrawal?
A. Naloxone
B. Lorazepam
C. Disulfiram
D. Naltrexone
Answer: Lorazepam
Rationale: Benzodiazepines such as lorazepam are first-line medications for
managing acute alcohol withdrawal and preventing withdrawal seizures and
delirium tremens.
, 3. A client with a history of chronic alcohol use is admitted with confusion
and an unsteady gait. Which medication should the nurse anticipate
administering?
A. Thiamine
B. Acetaminophen
C. Haloperidol
D. Methadone
Answer: Thiamine
Rationale: Chronic alcohol use can cause thiamine deficiency, leading to
Wernicke encephalopathy. Thiamine administration helps prevent or treat
this neurologic complication.
4. Which finding is most characteristic of opioid overdose?
A. Hypertension and tachycardia
B. Dilated pupils and hyperactivity
C. Respiratory depression and pinpoint pupils
D. Severe diarrhea and abdominal cramping
Answer: Respiratory depression and pinpoint pupils
Rationale: Opioid overdose commonly causes central nervous system
depression, respiratory depression, and pinpoint pupils.
5. Which medication is used to reverse opioid-induced respiratory
depression?
A. Flumazenil
B. Naloxone
C. Disulfiram
D. Acamprosate
Answer: Naloxone
Rationale: Naloxone is an opioid antagonist that rapidly reverses opioid-
induced respiratory and central nervous system depression.
6. A nurse is caring for a client receiving naloxone after an opioid overdose.
Which assessment is the priority?
,A. Appetite
B. Respiratory status
C. Skin turgor
D. Bowel sounds
Answer: Respiratory status
Rationale: Respiratory depression is the most immediately life-threatening
effect of opioid overdose, so airway and breathing must be continuously
assessed.
7. Which symptom is commonly associated with opioid withdrawal?
A. Bradycardia
B. Respiratory depression
C. Diarrhea
D. Pinpoint pupils
Answer: Diarrhea
Rationale: Opioid withdrawal commonly causes diarrhea, abdominal
cramping, rhinorrhea, lacrimation, sweating, anxiety, muscle aches, and
dilated pupils.
8. Which medication may be used as part of medication-assisted treatment
for opioid use disorder?
A. Methadone
B. Disulfiram
C. Lorazepam
D. Acetaminophen
Answer: Methadone
Rationale: Methadone is a long-acting opioid agonist used in opioid use
disorder treatment to reduce cravings and withdrawal symptoms.
9. A client taking methadone should be monitored closely for which
adverse effect?
A. Respiratory depression
B. Hyperactivity
, C. Severe hypertension
D. Increased visual acuity
Answer: Respiratory depression
Rationale: Methadone is an opioid and can cause respiratory depression,
particularly during initiation, dose changes, or when combined with other
central nervous system depressants.
10.Which statement by a client taking disulfiram indicates correct
understanding of the medication?
A. “I can drink beer occasionally while taking this medication.”
B. “I should avoid alcohol-containing products.”
C. “This medication immediately eliminates alcohol cravings.”
D. “I should take this medication whenever I feel intoxicated.”
Answer: “I should avoid alcohol-containing products.”
Rationale: Disulfiram can cause a severe unpleasant reaction when alcohol is
consumed. Clients must avoid alcoholic beverages and products containing
alcohol.
11.Which reaction can occur if a client taking disulfiram consumes alcohol?
A. Bradycardia only
B. Flushing, headache, nausea, and hypotension
C. Increased appetite
D. Severe constipation only
Answer: Flushing, headache, nausea, and hypotension
Rationale: Disulfiram inhibits alcohol metabolism and can cause an
unpleasant reaction that includes flushing, headache, nausea, vomiting,
tachycardia, and hypotension.
12.Which substance is classified as a stimulant?
A. Heroin
B. Cocaine
C. Alcohol
D. Diazepam
