Mental Health Nursing Chapter 22 – Substance-Related and
Addictive Disorders COMPLETE EXAM LATEST VERSION 2026-
2027 QUESTIONS AND ANSWERS
Which substance abuse would the nurse inquire about with a patient diagnosed with mouth cancer?
A. Opium
B. Alcohol
C Cocaine
D. Tobacco
Answer D
Rationale Substance use disorders arise from cravings for drugs or other substances and eventually turn
to physical addictions. Oral and injection are the common routes of administration. Addiction to
tobacco causes disorders like hypertension, chronic lung disorders, and mouth cancer. These symptoms
are not seen in cases of opium, alcohol, and cocaine addictions. Addiction to opium may result in
constipation, hepatitis, and endocarditis. Addiction to alcohol may result in loss of consciousness, visual
distortions, sexual dysfunction, and liver and heart disorders. Addiction to cocaine may result in
hypertension.
Which chemical in tobacco causes addiction?
A. Opium
B. Nicotine
C. Cocaine
D Cannabinoids
Answer B
Nicotine is found in tobacco and causes an addictive disorder. This chemical overpowers the reward
pathway circuit and releases the neurotransmitter dopamine, which gradually becomes more important
than the reward of pleasure. The increased saliency of the addictive process cancels the inhibitory
,function of the frontal cortex, leading to craving. Opium and cocaine are other substances that cause
addiction. These are not found in tobacco. Cannabinoids are the chemicals found in marijuana.
Which nursing diagnosis is the most appropriate for a patient who exhibits impulsiveness and
experiences a loss of relationships and occupation because of a focus on alcohol use?
A. Risk for injury
B. Hopelessness
C. Risk for suicide
D. Ineffective coping
Answer C
Rationale The nursing diagnosis that is most appropriate for a patient who exhibits impulsiveness and
experiences a loss of relationships and occupation because of a focus on alcohol use is risk for suicide.
The impulsive behavior is the key component that may result in the patient harming themselves. A
patient at risk for injury exhibits signs that include impairment, overdose, withdrawal from substances,
and hallucinations. A patient who displays hopelessness presents with a lack of initiative, is passive, and
reports seeing no alternatives or personal control. Signs and symptoms of a patient with ineffective
coping include the decreased use of social support, destructive behavior toward themselves and others,
inadequate problem solving, poor concentration, and a reported inability to cope.
Which abuse-related outcome exists when a patient hospitalized after a heroin overdose shares, "I've
been using more heroin lately to get my usual high"?
A. Tolerance
B. Addiction
C. Intoxication
D. Withdrawal
Answer A
Rationale Tolerance is described as needing increasingly greater amounts of a substance to become
intoxicated or finding that using the same amount over time results in a much-diminished effect.
Addiction is loss of behavioral control with craving and inability to abstain, loss of emotional regulation,
and loss of the ability to identify problematic behaviors and relationships. Intoxication is the effect of
the drug. Withdrawal is a set of symptoms patients experience when they stop taking the drug.
, Which need has the highest priority when caring for a patient who is intoxicated from alcohol?
A. Self-esteem needs
B. Safety and security
C. Physiological stability
D. Cultural preferences
Rationale The plan should address safety needs, severity and range of symptoms, motivation or
readiness to change, skills and strengths, availability of a support system, and cultural needs. Safety is
the highest priority because of the patient's imminent risks for injury while intoxicated. Physiological
stability has the second highest priority. Self-esteem needs and cultural preferences do not hold the
highest priority for care.
Which drug would the nurse suspect the patient is abusing when multiple injection marks are observed
on the arm?
A. Opium
B. Cocaine
C. Hashish
D. Marijuana
Answer B
Rationale Cocaine is a stimulant and is administered by snorting, smoking, or injecting. Opium is an
opioid that is swallowed or smoked. Hashish is a cannabinoid that is smoked or swallowed. Marijuana is
a cannabinoid that is smoked or swallowed.
Which information is important for the nurse to understand when initiating the use of naltrexone
prescribed for alcohol relapse prevention?
A. The tablets will be taken three times a day.
B. Medication can begin on the fifth day of abstinence from alcohol.
Addictive Disorders COMPLETE EXAM LATEST VERSION 2026-
2027 QUESTIONS AND ANSWERS
Which substance abuse would the nurse inquire about with a patient diagnosed with mouth cancer?
A. Opium
B. Alcohol
C Cocaine
D. Tobacco
Answer D
Rationale Substance use disorders arise from cravings for drugs or other substances and eventually turn
to physical addictions. Oral and injection are the common routes of administration. Addiction to
tobacco causes disorders like hypertension, chronic lung disorders, and mouth cancer. These symptoms
are not seen in cases of opium, alcohol, and cocaine addictions. Addiction to opium may result in
constipation, hepatitis, and endocarditis. Addiction to alcohol may result in loss of consciousness, visual
distortions, sexual dysfunction, and liver and heart disorders. Addiction to cocaine may result in
hypertension.
Which chemical in tobacco causes addiction?
A. Opium
B. Nicotine
C. Cocaine
D Cannabinoids
Answer B
Nicotine is found in tobacco and causes an addictive disorder. This chemical overpowers the reward
pathway circuit and releases the neurotransmitter dopamine, which gradually becomes more important
than the reward of pleasure. The increased saliency of the addictive process cancels the inhibitory
,function of the frontal cortex, leading to craving. Opium and cocaine are other substances that cause
addiction. These are not found in tobacco. Cannabinoids are the chemicals found in marijuana.
Which nursing diagnosis is the most appropriate for a patient who exhibits impulsiveness and
experiences a loss of relationships and occupation because of a focus on alcohol use?
A. Risk for injury
B. Hopelessness
C. Risk for suicide
D. Ineffective coping
Answer C
Rationale The nursing diagnosis that is most appropriate for a patient who exhibits impulsiveness and
experiences a loss of relationships and occupation because of a focus on alcohol use is risk for suicide.
The impulsive behavior is the key component that may result in the patient harming themselves. A
patient at risk for injury exhibits signs that include impairment, overdose, withdrawal from substances,
and hallucinations. A patient who displays hopelessness presents with a lack of initiative, is passive, and
reports seeing no alternatives or personal control. Signs and symptoms of a patient with ineffective
coping include the decreased use of social support, destructive behavior toward themselves and others,
inadequate problem solving, poor concentration, and a reported inability to cope.
Which abuse-related outcome exists when a patient hospitalized after a heroin overdose shares, "I've
been using more heroin lately to get my usual high"?
A. Tolerance
B. Addiction
C. Intoxication
D. Withdrawal
Answer A
Rationale Tolerance is described as needing increasingly greater amounts of a substance to become
intoxicated or finding that using the same amount over time results in a much-diminished effect.
Addiction is loss of behavioral control with craving and inability to abstain, loss of emotional regulation,
and loss of the ability to identify problematic behaviors and relationships. Intoxication is the effect of
the drug. Withdrawal is a set of symptoms patients experience when they stop taking the drug.
, Which need has the highest priority when caring for a patient who is intoxicated from alcohol?
A. Self-esteem needs
B. Safety and security
C. Physiological stability
D. Cultural preferences
Rationale The plan should address safety needs, severity and range of symptoms, motivation or
readiness to change, skills and strengths, availability of a support system, and cultural needs. Safety is
the highest priority because of the patient's imminent risks for injury while intoxicated. Physiological
stability has the second highest priority. Self-esteem needs and cultural preferences do not hold the
highest priority for care.
Which drug would the nurse suspect the patient is abusing when multiple injection marks are observed
on the arm?
A. Opium
B. Cocaine
C. Hashish
D. Marijuana
Answer B
Rationale Cocaine is a stimulant and is administered by snorting, smoking, or injecting. Opium is an
opioid that is swallowed or smoked. Hashish is a cannabinoid that is smoked or swallowed. Marijuana is
a cannabinoid that is smoked or swallowed.
Which information is important for the nurse to understand when initiating the use of naltrexone
prescribed for alcohol relapse prevention?
A. The tablets will be taken three times a day.
B. Medication can begin on the fifth day of abstinence from alcohol.
