Substance Abuse and Abuse NCLEX Practice Quiz: 55 Questions

Substance Abuse and Abuse NCLEX Practice Quiz: 55 Questions 1. 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.