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.
Option C: From 2002 through 2013, heroin overdoses went from
0.7 deaths per 100,000 to 2.7. In 2013, roughly 517,000 people
reported heroin use in the past year, 1.5 times the amount in
2007. State and federal legislation are implementing diverse
methods to curb this epidemic of heroin overdose deaths. The
many infectious and economic effects of heroin dependence add
to the risk of death.
Option D: Definitive data regarding genetic transmission is not
available at this time for marijuana. Cannabis use varies based on
demographics. Research shows college students, and young
adults most commonly use cannabis to socially conform (42%),
experiment (29%), and for enjoyment (24%). Twelve percent
primarily use the agent to manage stress or relax consistent with
other studies associating its use for depression, anxiety, social
anxiety, and post-traumatic stress disorder.
4. 4. Question
Nurse Julie recommends that the family of a client with substance-
related disorder attend a support group, such as Al-Anon and Alateen.
The purpose of these groups is to help family members understand the
problem and to:
A. Change the problem behaviors of the abuser.
B. Learn how to assist the abuser in getting help.
C. Maintain focus on changing their own behaviors.
D. Prevent substance problems in vulnerable family members.
Incorrect
Correct Answer: C. Maintain focus on changing their own
behaviors.
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.
Option C: From 2002 through 2013, heroin overdoses went from
0.7 deaths per 100,000 to 2.7. In 2013, roughly 517,000 people
reported heroin use in the past year, 1.5 times the amount in
2007. State and federal legislation are implementing diverse
methods to curb this epidemic of heroin overdose deaths. The
many infectious and economic effects of heroin dependence add
to the risk of death.
Option D: Definitive data regarding genetic transmission is not
available at this time for marijuana. Cannabis use varies based on
demographics. Research shows college students, and young
adults most commonly use cannabis to socially conform (42%),
experiment (29%), and for enjoyment (24%). Twelve percent
primarily use the agent to manage stress or relax consistent with
other studies associating its use for depression, anxiety, social
anxiety, and post-traumatic stress disorder.
4. 4. Question
Nurse Julie recommends that the family of a client with substance-
related disorder attend a support group, such as Al-Anon and Alateen.
The purpose of these groups is to help family members understand the
problem and to:
A. Change the problem behaviors of the abuser.
B. Learn how to assist the abuser in getting help.
C. Maintain focus on changing their own behaviors.
D. Prevent substance problems in vulnerable family members.
Incorrect
Correct Answer: C. Maintain focus on changing their own
behaviors.
