NR 443 CHAPTER 57: SUBSTANCE-
RELATED AND ADDICTIVE DISORDERS
Chapter 57: Substance-Related and Addictive Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A patient has been diagnosed with alcoholism. A nurse tells him that he has a physical
illness with a genetic predisposition to alcoholism, and the only effective treatment is total
abstinence from alcohol. This type of approach characterizes which theory?
a. Biologic
b. Behavioral
c. Sociocultural
d. Intrapersonal
ANS: A
The biologic approach is based on the theory that there is a faulty physiologic process that
causes a predisposition to an addiction. This theory includes the belief that such an addition
is incurable and only total abstinence will be effective.
DIF: Cognitive Level: Comprehension REF: p. 1306 OBJ: 1
TOP: Etiology and Risk Factors KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
2. A nurse explains that according to the intrapersonal theory, addiction is caused by early
childhood rejection. These substance abusers are thought to have common characteristics.
What do these characteristics include?
a. Open-boundary approach to life that likes to party frequently
b. Attention seeking, need for control, and self-centeredness
c. Shyness and anxiety
d. Stress and eagerness to be a part of the in-group
ANS: B
The intrapersonal theory identifies the common personality traits of self-centeredness, need
for control, and attention seeking as parts of the addictive personality.
DIF: Cognitive Level: Comprehension REF: p. 1307 OBJ: 1
TOP: Etiology and Risk Factors KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. During the taking of a medical history, a patient who is addicted to heroin reports he only
uses the drug a few times a week. What is the nurse’s best response when trying to
disclose more precise information?
a. “OK. You only use heroin two times a week?”
b. “What do you mean when you say ‘a few?’”
c. “Are you saying that in a week’s time would you use heroin only two times?”
, d. “Rate your weekly usage on a scale of 1 to 15.”
ANS: D
When trying to get a health history on a patient with a substance abuse problem, the best
method is an open discussion of the drug use. The discussion should be open and
nonjudgmental. By requesting a scale, the patient’s response will be more informative.
DIF: Cognitive Level: Application REF: p. 1309 OBJ: 6
TOP: Nursing Assessment of the Substance Abuser
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A patient who is has alcoholism with a history of heavy drinking is brought to the inpatient
psychiatric unit saying that he does not know where he is or what day it is. What should the
nurse suspect he is exhibiting?
a. Delirium
b. Alcoholic dementia
c. Blackout
d. Amnesia
ANS: C
Blackouts are common with heavy drinking over time. The patient data support that the
memory loss is associated with the alcohol use and that blackouts would be an expected
outcome.
DIF: Cognitive Level: Comprehension REF: p. 1309 OBJ: 3
TOP: Patterns and Consequences of Abuse
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. A nurse is discharging a patient with a pulmonary disorder to return home with her family.
She has had a difficult time while in the hospital and has experienced withdrawal from
tobacco. When the nurse tells her that community resources are available to help her to
stop smoking, she says, “That’s OK. I can stop whenever I want to.” What does this
exemplify?
a. Rationalization
b. Denial
c. Intellectualization
d. Projection
ANS: B
Denial is a common defense mechanism used by substance abusers.
DIF: Cognitive Level: Application REF: p. 1309 OBJ: 3
TOP: Defense Mechanisms KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
6. A patient with an alcohol addiction says, “My drinking is all my wife’s fault. She makes me
so crazy I just have to have a drink.” What does this exemplify?
a. Rationalization
b. Denial
RELATED AND ADDICTIVE DISORDERS
Chapter 57: Substance-Related and Addictive Disorders
Linton: Introduction to Medical-Surgical Nursing, 6th Edition
MULTIPLE CHOICE
1. A patient has been diagnosed with alcoholism. A nurse tells him that he has a physical
illness with a genetic predisposition to alcoholism, and the only effective treatment is total
abstinence from alcohol. This type of approach characterizes which theory?
a. Biologic
b. Behavioral
c. Sociocultural
d. Intrapersonal
ANS: A
The biologic approach is based on the theory that there is a faulty physiologic process that
causes a predisposition to an addiction. This theory includes the belief that such an addition
is incurable and only total abstinence will be effective.
DIF: Cognitive Level: Comprehension REF: p. 1306 OBJ: 1
TOP: Etiology and Risk Factors KEY: Nursing Process Step: Implementation
MSC: NCLEX: Health Promotion and Maintenance: Prevention and Early Detection of
Disease
2. A nurse explains that according to the intrapersonal theory, addiction is caused by early
childhood rejection. These substance abusers are thought to have common characteristics.
What do these characteristics include?
a. Open-boundary approach to life that likes to party frequently
b. Attention seeking, need for control, and self-centeredness
c. Shyness and anxiety
d. Stress and eagerness to be a part of the in-group
ANS: B
The intrapersonal theory identifies the common personality traits of self-centeredness, need
for control, and attention seeking as parts of the addictive personality.
DIF: Cognitive Level: Comprehension REF: p. 1307 OBJ: 1
TOP: Etiology and Risk Factors KEY: Nursing Process Step: Implementation
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
3. During the taking of a medical history, a patient who is addicted to heroin reports he only
uses the drug a few times a week. What is the nurse’s best response when trying to
disclose more precise information?
a. “OK. You only use heroin two times a week?”
b. “What do you mean when you say ‘a few?’”
c. “Are you saying that in a week’s time would you use heroin only two times?”
, d. “Rate your weekly usage on a scale of 1 to 15.”
ANS: D
When trying to get a health history on a patient with a substance abuse problem, the best
method is an open discussion of the drug use. The discussion should be open and
nonjudgmental. By requesting a scale, the patient’s response will be more informative.
DIF: Cognitive Level: Application REF: p. 1309 OBJ: 6
TOP: Nursing Assessment of the Substance Abuser
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
4. A patient who is has alcoholism with a history of heavy drinking is brought to the inpatient
psychiatric unit saying that he does not know where he is or what day it is. What should the
nurse suspect he is exhibiting?
a. Delirium
b. Alcoholic dementia
c. Blackout
d. Amnesia
ANS: C
Blackouts are common with heavy drinking over time. The patient data support that the
memory loss is associated with the alcohol use and that blackouts would be an expected
outcome.
DIF: Cognitive Level: Comprehension REF: p. 1309 OBJ: 3
TOP: Patterns and Consequences of Abuse
KEY: Nursing Process Step: Assessment
MSC: NCLEX: Physiological Integrity: Physiological Adaptation
5. A nurse is discharging a patient with a pulmonary disorder to return home with her family.
She has had a difficult time while in the hospital and has experienced withdrawal from
tobacco. When the nurse tells her that community resources are available to help her to
stop smoking, she says, “That’s OK. I can stop whenever I want to.” What does this
exemplify?
a. Rationalization
b. Denial
c. Intellectualization
d. Projection
ANS: B
Denial is a common defense mechanism used by substance abusers.
DIF: Cognitive Level: Application REF: p. 1309 OBJ: 3
TOP: Defense Mechanisms KEY: Nursing Process Step: Assessment
MSC: NCLEX: Psychosocial Integrity: Coping and Adaptation
6. A patient with an alcohol addiction says, “My drinking is all my wife’s fault. She makes me
so crazy I just have to have a drink.” What does this exemplify?
a. Rationalization
b. Denial
