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Chapter 48: Substance Abuse
Test Bank
MULTIPLE CHOICE
1. A 16-year-old male has been referred to the community mental health center following legal
charges of driving under the influence. Which screening tests would be appropriate to use
on this patient?
a. Drug Abuse Screening Test (DAST)
b. Adolescent Alcohol Involvement Scale (AAIS)
c. Adolescent Drug Abuse Diagnosis (ADAD)
d. Minnesota Multiphasic Personality Inventory (MMPI 2)
ANS: B
The adolescent patient has legal problems associated with alcohol use. The AAIS screening
instrument would be appropriate to use. DAST is a comprehensive screening and assessment
instrument. ADAD is an adolescent drug abuse diagnosis instrument. MMPI is a personality
inventory.
DIF: Cognitive Level: ComprehensionREF: p. 834 OBJ: N/A
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
2. A patient admitted 48 hours ago has a diagnosis of gastrointestinal (GI) bleeding and is
receiving IV hydration and transfusions. When making rounds, the nurse observes the
patient to be having a tonic clonic seizure. What may be the cause of the seizure?
a. Low blood counts as a result of bleeding
b. Alcohol withdrawal
c. Alkalosis
d. Inadequate nutrition
ANS: B
Alcohol withdrawal symptoms can begin within a few hours of discontinuation of drinking
and may continue for 3 to 10 days. Withdrawal symptoms may be severe and include visual
and auditory hallucinations and tonic clonic seizures. The patient’s admitting diagnosis, GI
bleeding, may be associated with alcohol abuse. Denial is a common symptom associated
with alcoholism, and the patient may not have been honest about alcohol intake when the
health care provider took the history on admission. History may be obtained from the
patient’s family or significant other. It is unlikely that the blood loss is significant enough to
induce seizures. Alkalosis is not likely the cause of seizures in this case; the patient is more
likely to be acidotic from the combined dehydration and withdrawal. Common causes in the
setting of alcohol withdrawal include alcoholic ketoacidosis and ingestion of alcohols or
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medications that result in metabolic acidosis (e.g., methanol, ethylene glycol, salicylate).
Inadequate nutrition is not likely to cause seizures in this patient.
DIF: Cognitive Level: Application REF: p. 837 OBJ: 5
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
3. Which theory views addiction as a maladaptive habit that can be examined and changed the
same way as other habits?
a. Psychoanalytic theory
b. Behavior theory
c. Cognitive theory
d. Family system theory
ANS: B
Behavior or learning theories view addictive behaviors as overlearned maladaptive habits
that can be examined and changed in the same way as other habits. Psychoanalytic theory
bases substance abuse on fixation with oral issues. Cognitive theories suggest that addiction
is based on a distorted way of thinking about substance use. Family system theory
emphasizes the pattern of relationships among family members through the generations as
an explanation of substance abuse.
DIF: Cognitive Level: ComprehensionREF: p. 829 OBJ: 2
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
4. A nurse working the night shift suspects that a colleague is abusing alcohol. Which action by
the nurse is most important?
a. “Good faith” reporting is unfaithful to a colleague.
b. Reporting will result in loss of the colleague’s license.
c. It is not of concern, and the nurse won’t be penalized for refusing to get involved.
d. State guidelines may mandate to report substance abuse.
ANS: D
In some states, when substance abuse of a colleague is suspected, reporting is mandatory.
Professionals must be loyal to their patients and protect them from harm. “Good faith”
reporting should not be viewed as disloyalty to a colleague. Licenses are often not revoked
when a colleague self reports or is reported for substance abuse. Health professionals may
be named in a civil lawsuit if they fail to report suspected impairment of another
professional.
DIF: Cognitive Level: Analysis REF: pp. 834-835 OBJ: 3
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
5. What does a urinalysis that is positive for the drug tested indicate?
a. It indicates illegal drug use.
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Chapter 48: Substance Abuse
Test Bank
MULTIPLE CHOICE
1. A 16-year-old male has been referred to the community mental health center following legal
charges of driving under the influence. Which screening tests would be appropriate to use
on this patient?
a. Drug Abuse Screening Test (DAST)
b. Adolescent Alcohol Involvement Scale (AAIS)
c. Adolescent Drug Abuse Diagnosis (ADAD)
d. Minnesota Multiphasic Personality Inventory (MMPI 2)
ANS: B
The adolescent patient has legal problems associated with alcohol use. The AAIS screening
instrument would be appropriate to use. DAST is a comprehensive screening and assessment
instrument. ADAD is an adolescent drug abuse diagnosis instrument. MMPI is a personality
inventory.
DIF: Cognitive Level: ComprehensionREF: p. 834 OBJ: N/A
TOP: Nursing Process Step: Assessment
MSC: NCLEX Client Needs Category: Psychosocial Integrity
2. A patient admitted 48 hours ago has a diagnosis of gastrointestinal (GI) bleeding and is
receiving IV hydration and transfusions. When making rounds, the nurse observes the
patient to be having a tonic clonic seizure. What may be the cause of the seizure?
a. Low blood counts as a result of bleeding
b. Alcohol withdrawal
c. Alkalosis
d. Inadequate nutrition
ANS: B
Alcohol withdrawal symptoms can begin within a few hours of discontinuation of drinking
and may continue for 3 to 10 days. Withdrawal symptoms may be severe and include visual
and auditory hallucinations and tonic clonic seizures. The patient’s admitting diagnosis, GI
bleeding, may be associated with alcohol abuse. Denial is a common symptom associated
with alcoholism, and the patient may not have been honest about alcohol intake when the
health care provider took the history on admission. History may be obtained from the
patient’s family or significant other. It is unlikely that the blood loss is significant enough to
induce seizures. Alkalosis is not likely the cause of seizures in this case; the patient is more
likely to be acidotic from the combined dehydration and withdrawal. Common causes in the
setting of alcohol withdrawal include alcoholic ketoacidosis and ingestion of alcohols or
This study source was downloaded by 100000761823232 from CourseHero.com on 04-12-2021 14:56:25 GMT -05:00
https://www.coursehero.com/file/18846269/c49/
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medications that result in metabolic acidosis (e.g., methanol, ethylene glycol, salicylate).
Inadequate nutrition is not likely to cause seizures in this patient.
DIF: Cognitive Level: Application REF: p. 837 OBJ: 5
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
3. Which theory views addiction as a maladaptive habit that can be examined and changed the
same way as other habits?
a. Psychoanalytic theory
b. Behavior theory
c. Cognitive theory
d. Family system theory
ANS: B
Behavior or learning theories view addictive behaviors as overlearned maladaptive habits
that can be examined and changed in the same way as other habits. Psychoanalytic theory
bases substance abuse on fixation with oral issues. Cognitive theories suggest that addiction
is based on a distorted way of thinking about substance use. Family system theory
emphasizes the pattern of relationships among family members through the generations as
an explanation of substance abuse.
DIF: Cognitive Level: ComprehensionREF: p. 829 OBJ: 2
TOP: Nursing Process Step: Evaluation
MSC: NCLEX Client Needs Category: Psychosocial Integrity
4. A nurse working the night shift suspects that a colleague is abusing alcohol. Which action by
the nurse is most important?
a. “Good faith” reporting is unfaithful to a colleague.
b. Reporting will result in loss of the colleague’s license.
c. It is not of concern, and the nurse won’t be penalized for refusing to get involved.
d. State guidelines may mandate to report substance abuse.
ANS: D
In some states, when substance abuse of a colleague is suspected, reporting is mandatory.
Professionals must be loyal to their patients and protect them from harm. “Good faith”
reporting should not be viewed as disloyalty to a colleague. Licenses are often not revoked
when a colleague self reports or is reported for substance abuse. Health professionals may
be named in a civil lawsuit if they fail to report suspected impairment of another
professional.
DIF: Cognitive Level: Analysis REF: pp. 834-835 OBJ: 3
TOP: Nursing Process Step: Planning
MSC: NCLEX Client Needs Category: Safe, Effective Care Environment
5. What does a urinalysis that is positive for the drug tested indicate?
a. It indicates illegal drug use.
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