Nursing A Concept Based Approach to Learning Volume II 2nd Ed

Nursing A Concept Based Approach to Learning Volume II 2nd Ed

Nursing: A Concept-Based Approach to Learning, 2e (Pearson)

Module 22 Addiction

The Concept of Addiction

1) While practicing at an outpatient addiction clinic, the nurse is summarizing a diagram in the orientation handbook for a new associate she is precepting. Which statement most closely aligns with the meaning of this diagram?

1. A) Addiction involves an alteration in the amount of available neurotransmitters.
2. B) Actions at the neurotransmitter level affecting addiction are not genetic.
3. C) High self-esteem as a basis for pleasure seeking lowers neurotransmitter levels.
4. D) An addictive personality is identified by differences in the processing of neurotransmitters.

Answer: A

Explanation: A) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.

1. B) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
2. C) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
3. D) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.

Page Ref: 1520

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Client Need Sub: Physiological Adaptation

Nursing Process: Assessment

Learning Outcome: 1. Summarize the physiological and psychological processes that contribute to addiction.

2) During a class for college seniors, a participant admits to frequently using alcohol. What is the priority action of the nurse?

1. A) Initiate a community assessment of the campus.
2. B) Contact the campus nurse and refer the student.
3. C) Notify campus security to watch for driving under the influence.
4. D) Complete a crisis assessment.

Answer: D

Explanation: A) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student’s permission. There is no evidence that the student is driving under the influence.

1. B) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student’s permission. There is no evidence that the student is driving under the influence.
2. C) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student’s permission. There is no evidence that the student is driving under the influence.
3. D) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the student’s permission. There is no evidence that the student is driving under the influence.

Page Ref: 1527

Cognitive Level: Applying

Client Need: Health Promotion and Maintenance

Nursing Process: Implementation

Learning Outcome: 4. Differentiate assessments of addictions across the life span.

3) A nursing instructor is teaching her students about the comprehensive theory of addiction by George Engel. Which statement or statements indicate that the student understands the theory?

Select all that apply.

1. A) “Addiction occurs due to a lack of emotional attachment.”
2. B) “There is a biological factor involved in the development of addiction.”
3. C) “There are social factors that contribute to the development of addiction.”
4. D) “There is a moral factor involved in the development of addiction.”
5. E) “There is a psychological factor involved in the development of addiction.”

Answer: B, C, E

Explanation: A) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.

1. B) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
2. C) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
3. D) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
4. E) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.

Page Ref: 1520

Cognitive Level: Analyzing

Client Need: Psychosocial Integrity

Nursing Process: Implementation

Learning Outcome: 1. Summarize the physiological and psychological processes that contribute to addiction.

4) During visitation on the unit, the nurse is observing the family dynamics of an adolescent client who has an addiction problem and recognizes that the family is experiencing behaviors consistent with codependence. Which problems might the nurse expect this family to manifest on an ongoing basis?

1. A) Frustration intolerance
2. B) Enabling
3. C) Argumentative behaviors
4. D) Impatience

Answer: B

Explanation: A) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.

1. B) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
2. C) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
3. D) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.

Page Ref: 1526

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Nursing Process: Implementation

Learning Outcome: 2. Examine the relationship between addiction and other concepts/systems.

5) A new nurse orienting to the unit is preparing to assist with obtaining data for a screening tool to determine whether a client is addicted to alcohol. Which tool or tools will be used to assess the client?

Select all that apply.

1. A) OOWS
2. B) MAST
3. C) CAGE questionnaire
4. D) B-DAST
5. E) CIWA-ar

Answer: B, C, E

Explanation: A) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.

1. B) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.
2. C) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.
3. D) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.
4. E) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.

Page Ref: 1540

Cognitive Level: Understanding

Client Need: Psychosocial Integrity

Nursing Process: Assessment

Learning Outcome: 3. Illustrate the nursing process in providing culturally competent care across the life span for individuals who abuse alcohol.

6) The client enters the Emergency Department with signs of drug use. The client reports having ingested Percocet. Which medications will be indicated to manage a potential overdose?

1. A) Diazepam
2. B) Haldol
3. C) Vitamin B12
4. D) Narcan

Answer: D

Explanation: A) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.

1. B) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.
2. C) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.
3. D) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.

Page Ref: 1540

Cognitive Level: Analyzing

Client Need: Physiological Integrity

Nursing Process: Implementation

Learning Outcome: 6. Explain prevention and management of addictions.

7) At a neighborhood clinic, the nurse is planning addiction treatment groups. What knowledge of addictions and related therapies will facilitate implementation of the groups?

1. A) Relapse is a common feature of substance abuse.
2. B) Hereditary, as well as complex environmental influences, predisposes one to substance dependence.
3. C) Clients with a substance dependence cannot be held accountable for their actions.
4. D) Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are accepted treatment approaches.

Answer: B

Explanation: A) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

1. B) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
2. C) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
3. D) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Page Ref: 1521

Cognitive Level: Applying

Client Need: Psychosocial Integrity

Nursing Process: Implementation

Learning Outcome: 3. Identify commonly occurring addictions and their related therapies.

8) The nurse is called to an injury accident of an employee who has a history of addiction and is currently enrolled in a 12-step recovery program. In accordance with company policy, which test will the nurse perform?

1. A) Liver enzymes
2. B) Stool guaiac
3. C) Urine specific gravity
4. D) Hair testing

Answer: D

Explanation: A) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.

1. B) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.
2. C) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.
3. D) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.

Page Ref: 1528

Cognitive Level: Understanding

Client Need: Health Promotion and Maintenance

Nursing Process: Assessment

Learning Outcome: 5. Describe diagnostic and laboratory tests to determine an individual’s addiction status.