C HAPTER 48: S UBSTANCE A BUSE
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which prescription must be administered before glucose infusions for a
patient in al cohol withdrawal to prevent Wernicke‘s encephalopathy?
a. Chlordiazepoxide (Librium)
b. Thiamine
c. Diazepam (Valium)
d. Bromocriptine (Parlodel)
ANS: B
Thiamine and multiple vitamins should be administered routinel y to patients
in alcohol withdrawal. Intr avenous fluid therapy for rehydration may be
necessary, but thiamine must be administered before glucose infusion to
prevent Wernicke‘s encephalopathy. Benzodiazepines are given for treatment
of anxiet y and seizures associated with alcohol withdrawal. Brom ocriptine is
not used to prevent Wernicke‘s encephalopathy.
DIF: Cognitive Level: Comprehension REF: p. 826 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Ad diction | Safet y
2. Which effect will occur if a patient being treated with naltrexone (ReVia)
for substance abuse ingests opioids or alcohol?
a. Increased euphoria
, b. Nausea, vomiting, and diarrhea
c. Deep sedation
d. An absence of the “high” associated with drugs
ANS: D
Naltrexone is an opioid antagonist prescribed to block the pharmacologic
effects of the “high” associated with opioids and alcohol. Studies report less
alcohol craving and fewer drinking days, especiall y when naltrexone is
combined with psychosocial treatment. Naltrexone prevents the euphoria
associated with taking drugs like opioids and alcohol. These are symptoms of
taking alcohol in combination with disulfiram (Antabuse). Naltrexone is not
sedating.
DIF: Cognitive Level: Comprehension REF: p. 821 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integri t y
TOP: Nursing Process Step: Evaluation
CON: Clinical Judgment | Addiction
3. A patient is admitted into a substance abuse treatment centre and is
withdrawing from alcohol. Which statement made by the patient‘s famil y
member shows a need for further education?
a. “Withdrawal symptoms can begin within a few hours of
discontinuation of drinking. ”
b. “Withdrawal symptoms will improve within 24 hours. ”
c. “Less than 1% of patients develop delirium tremens. ”
d. “Benzodiazepines are commonl y used for detoxification. ”
ANS: B
Withdrawal symptoms may continue for 3 to 10 days. Withdrawal symptoms
can begin within a few hours of discontinuation of drinking. Less than 1% of
Willihnganz: Clayton’s Basic Pharmacology for Nurses, 19th Edition
MULTIPLE CHOICE
1. Which prescription must be administered before glucose infusions for a
patient in al cohol withdrawal to prevent Wernicke‘s encephalopathy?
a. Chlordiazepoxide (Librium)
b. Thiamine
c. Diazepam (Valium)
d. Bromocriptine (Parlodel)
ANS: B
Thiamine and multiple vitamins should be administered routinel y to patients
in alcohol withdrawal. Intr avenous fluid therapy for rehydration may be
necessary, but thiamine must be administered before glucose infusion to
prevent Wernicke‘s encephalopathy. Benzodiazepines are given for treatment
of anxiet y and seizures associated with alcohol withdrawal. Brom ocriptine is
not used to prevent Wernicke‘s encephalopathy.
DIF: Cognitive Level: Comprehension REF: p. 826 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integrit y
TOP: Nursing Process Step: Implementation
CON: Clinical Judgment | Ad diction | Safet y
2. Which effect will occur if a patient being treated with naltrexone (ReVia)
for substance abuse ingests opioids or alcohol?
a. Increased euphoria
, b. Nausea, vomiting, and diarrhea
c. Deep sedation
d. An absence of the “high” associated with drugs
ANS: D
Naltrexone is an opioid antagonist prescribed to block the pharmacologic
effects of the “high” associated with opioids and alcohol. Studies report less
alcohol craving and fewer drinking days, especiall y when naltrexone is
combined with psychosocial treatment. Naltrexone prevents the euphoria
associated with taking drugs like opioids and alcohol. These are symptoms of
taking alcohol in combination with disulfiram (Antabuse). Naltrexone is not
sedating.
DIF: Cognitive Level: Comprehension REF: p. 821 OBJ: 4
NAT: NCLEX Client Needs Category: Physiological Integri t y
TOP: Nursing Process Step: Evaluation
CON: Clinical Judgment | Addiction
3. A patient is admitted into a substance abuse treatment centre and is
withdrawing from alcohol. Which statement made by the patient‘s famil y
member shows a need for further education?
a. “Withdrawal symptoms can begin within a few hours of
discontinuation of drinking. ”
b. “Withdrawal symptoms will improve within 24 hours. ”
c. “Less than 1% of patients develop delirium tremens. ”
d. “Benzodiazepines are commonl y used for detoxification. ”
ANS: B
Withdrawal symptoms may continue for 3 to 10 days. Withdrawal symptoms
can begin within a few hours of discontinuation of drinking. Less than 1% of
