C HAPTER 22: S UBSTANCE -R ELATED AND
A DDICTIVE D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. Which features should be present in a therapeutic milieu for a client
experiencing a hallucinogen overdose?
a. Simple and safe
b. Active and bright
c. Stimulating and colorful
d. Confrontational and challenging
ANS: A
Because the individual who has ingested a hallu cinogen is probabl y
experiencing feelings of unrealit y and altered sensory perceptions, the
best environment is one that does not add to the stimulation. A simple,
safe environment is a better choice than an environment with any of the
characteristics list ed in the other options. The other options would
contribute to a “bad trip.”
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
,2. When a client first began u sing alcohol, two drinks produced relaxation
and drowsiness. After 1 year, four drinks are needed to achieve the same
response. Why has this change occurred?
a. Tolerance has developed.
b. Antagonistic effects are evident.
c. Metabolism of the alcohol is now delaye d.
d. Pharmacokinetics of the alcohol have changed.
ANS: A
Tolerance refers to needing higher and higher doses of a drug to
produce the desired effect. The potency of the alcohol is stable.
Neither hypomagnesemia nor antagonistic effects account for this
change.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Physiological Integrity
3. At a meeting for famil y members of alcoholics, a spouse says, “I did
everything I could to help. I even request ed sick leave when my partner
was too drunk to go to work.” The nurse assesses these comments as what?
a. codependence.
b. assertiveness.
c. role reversal.
d. homeostasis.
ANS: A
, Codependence refers to participating in behaviors that maintain the
addiction or allow it to continue without holding the user accountable
for his or her actions. The other options are not supported by
information given in the scenario.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
4. In the emergency department, a client’s vital signs are BP 66/40 mm Hg;
pulse 140 beats/minute; respirations 8 breaths/minute and shallow. The
nursing diagnosis is Ineffective breathing pattern related to depression of
respiratory center secondary to opioid intoxication. What is the priorit y
outcome?
a. The client will demonstrate effective coping skills and identify
communit y resources for treatment of substance abuse within 1
week of hospitalization.
b. Within 4 hours, vital sign s will stabilize, with BP above 90/60 mm
Hg, pulse less than 100 beats/minute, and respirations at or above
12 breaths/minute.
c. The client will correctl y describe a plan for home care and
achieving a drug-free state before release from the emergency
department.
d. Within 6 hours, the client’s breath sounds will be clear bilaterall y
and throughout lung fields.
ANS: B
The correct short -term outcome is the only one that relates to the
client’s physical condition. It is expected that vital signs will return to
A DDICTIVE D ISORDERS
Halter: Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: A
Clinical Approach, 9th Edition
MULTIPLE CHOICE
1. Which features should be present in a therapeutic milieu for a client
experiencing a hallucinogen overdose?
a. Simple and safe
b. Active and bright
c. Stimulating and colorful
d. Confrontational and challenging
ANS: A
Because the individual who has ingested a hallu cinogen is probabl y
experiencing feelings of unrealit y and altered sensory perceptions, the
best environment is one that does not add to the stimulation. A simple,
safe environment is a better choice than an environment with any of the
characteristics list ed in the other options. The other options would
contribute to a “bad trip.”
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Implementation MSC: Client
Needs: Safe, Effective Care Environment
,2. When a client first began u sing alcohol, two drinks produced relaxation
and drowsiness. After 1 year, four drinks are needed to achieve the same
response. Why has this change occurred?
a. Tolerance has developed.
b. Antagonistic effects are evident.
c. Metabolism of the alcohol is now delaye d.
d. Pharmacokinetics of the alcohol have changed.
ANS: A
Tolerance refers to needing higher and higher doses of a drug to
produce the desired effect. The potency of the alcohol is stable.
Neither hypomagnesemia nor antagonistic effects account for this
change.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Physiological Integrity
3. At a meeting for famil y members of alcoholics, a spouse says, “I did
everything I could to help. I even request ed sick leave when my partner
was too drunk to go to work.” The nurse assesses these comments as what?
a. codependence.
b. assertiveness.
c. role reversal.
d. homeostasis.
ANS: A
, Codependence refers to participating in behaviors that maintain the
addiction or allow it to continue without holding the user accountable
for his or her actions. The other options are not supported by
information given in the scenario.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
TOP: Nursing Process: Assessment MSC: Client Needs:
Psychosocial Integrity
4. In the emergency department, a client’s vital signs are BP 66/40 mm Hg;
pulse 140 beats/minute; respirations 8 breaths/minute and shallow. The
nursing diagnosis is Ineffective breathing pattern related to depression of
respiratory center secondary to opioid intoxication. What is the priorit y
outcome?
a. The client will demonstrate effective coping skills and identify
communit y resources for treatment of substance abuse within 1
week of hospitalization.
b. Within 4 hours, vital sign s will stabilize, with BP above 90/60 mm
Hg, pulse less than 100 beats/minute, and respirations at or above
12 breaths/minute.
c. The client will correctl y describe a plan for home care and
achieving a drug-free state before release from the emergency
department.
d. Within 6 hours, the client’s breath sounds will be clear bilaterall y
and throughout lung fields.
ANS: B
The correct short -term outcome is the only one that relates to the
client’s physical condition. It is expected that vital signs will return to
