1. A male client with a history of cocaine addiction is admitted to the coronary care unit for evaluation of substernal chest pain. The electrocardiogram (ECG) shows a 1-mm ST-segment elevation the anteroseptal leads and T-wave inversion in leads V3 to V5. Considering the client’s history of drug abuse, nurse Greg expects the physician to prescribe:
a. lidocaine (Xylocaine).
b. procainamide (Pronestyl).
c. nitroglycerin (Nitro-Bid IV).
2. A 14-year-old client is brought to the clinic by her mother. Her mother expresses concern about her daughter’s weight loss and constant dieting. Nurse Kris conducts a health history interview. Which of the following comments indicates that the client may be suffering from anorexia nervosa?
a. "I like the way I look. I just need to keep my weight down because I’m a cheerleader."
b. "I don’t like the food my mother cooks. I eat plenty of fast food when I’m out with my friends."
c. "I just can’t seem to get down to the weight I want to be. I’m so fat compared to other girls."
d. "I do diet around my periods; otherwise, I just get so bloated."
3. Nurse Fey is aware that the drug of choice for treating Tourette syndrome?
a. fluoxetine (Prozac)
b. fluvoxamine (Luvox)
c. haloperidol (Haldol)
d. paroxetine (Paxil)
4. A male client tells the nurse he was involved in a car accident while he was intoxicated. What would be the most therapeutic response from nurse Julia?
a. "Why didn’t you get someone else to drive you?"
b. "Tell me how you feel about the accident."
c. "You should know better than to drink and drive."
d. "I recommend that you attend an Alcoholics Anonymous meeting."
5. A male adult client voluntarily admits himself to the substance abuse unit. He confesses that he drinks 1 qt or more of vodka each day and uses cocaine occasionally. Later that afternoon, he begins to show signs of alcohol withdrawal. What are some early signs of this condition?
a. Vomiting, diarrhea, and bradycardia
b. Dehydration, temperature above 101° F (38.3° C), and pruritus
c. Hypertension, diaphoresis, and seizures
d. Diaphoresis, tremors, and nervousness
6. When monitoring a female client recently admitted for treatment of cocaine addiction, nurse Aaron notes sudden increases in the arterial blood pressure and heart rate. To correct these problems, the nurse expects the physician to prescribe:
a. norepinephrine (Levophed) and lidocaine (Xylocaine)
b. nifedipine (Procardia) and lidocaine.
c. nitroglycerin (Nitro-Bid IV) and esmolol (Brevibloc)
d. nifedipine and esmolol
7. A 25 –year old client experiencing alcohol withdrawal is upset about going through detoxification. Which of the following goals is a priority?
a. The client will commit to a drug-free lifestyle
b. The client will work with the nurse to remain safe
c. The client will drink plenty of fluids daily
d. The client will make a personal inventory of strength
8. A male client is admitted to a psychiatric facility by court order for evaluation for antisocial personality disorder. This client has a long history of initiating fights and abusing animals and recently was arrested for setting a neighbor’s dog on fire. When evaluating this client for the potential for violence, nurse Perry should assess for which behavioral clues?
a. A rigid posture, restlessness, and glaring
b. Depression and physical withdrawal
c. Silence and noncompliance
d. Hypervigilance and talk of past violent acts
9. A male client is brought to the psychiatric clinic by family members, who tell the admitting nurse that the client repeatedly drives while intoxicated despite their pleas to stop. During an interview with the nurse Linda, which statement by the client most strongly supports a diagnosis of psychoactive substance abuse?
a. "I’m not addicted to alcohol. In fact, I can drink more than I used to without being affected."
b. "I only spend half of my paycheck at the bar."
c. "I just drink to relax after work."
d. "I know I’ve been arrested three times for drinking and driving, but the police are just trying to hassle me."
10. A female client with borderline personality disorder is admitted to the psychiatric unit. Initial nursing assessment reveals that the client’s wrists are scratched from a recent suicide attempt. Based on this finding, the nurse Lenny should formulate a nursing diagnosis of:
a. Ineffective individual coping related to feelings of guilt.
b. Situational low self-esteem related to feelings of loss of control
c. Risk for violence: Self-directed related to impulsive mutilating acts
d. Risk for violence: Directed toward others related to verbal threats
11. A male client recently admitted to the hospital with sharp, substernal chest pain suddenly complains of palpitations. Nurse Ryan notes a rise in the client’s arterial blood pressure and a heart rate of 144 beats/minute. On further questioning, the client admits to having used cocaine recently after previously denying use of the drug. The nurse concludes that the client is at high risk for which complication of cocaine use?
a. Coronary artery spasm
c. Neurobehavioral deficits
d. Panic disorder
12. A male client is being admitted to the substance abuse unit for alcohol detoxification. As part of the intake interview, the nurse asks him when he had his last alcoholic drink. He says that he had his last drink 6 hours before admission. Based on this response, nurse Lorena should expect early withdrawal symptoms to:
a. begin after 7 days
b. not occur at all because the time period for their occurrence has passed
c. begin anytime within the next 1 to 2 days
d. begin within 2 to 7 days
13. Nurse Helen is assigned to care for a client with anorexia nervosa. Initially, which nursing intervention is most appropriate for this client?
a. Providing one-on-one supervision during meals and for 1 hour afterward
b. Letting the client eat with other clients to create a normal mealtime atmosphere
c. Trying to persuade the client to eat and thus restore nutritional balance
d. Giving the client as much time to eat as desired
14. A female client begins to experience alcoholic hallucinosis. Nurse Joy is aware that the best nursing intervention at this time?
a. Keeping the client restrained in bed
b. Checking the client’s blood pressure every 15 minutes and offering juices
c. Providing a quiet environment and administering medication as needed and prescribed
d. Restraining the client and measuring blood pressure every 30 minutes
15. Nurse Bella is aware that assessment finding is most consistent with early alcohol withdrawal?
a. Heart rate of 120 to 140 beats/minute
b. Heart rate of 50 to 60 beats/minute
c. Blood pressure of 100/70 mm Hg
d. Blood pressure of 140/80 mm Hg
16. Nurse Amy is aware that the client is at highest risk for suicide?
a. One who appears depressed, frequently thinks of dying, and gives away all personal possessions
b. One who plans a violent death and has the means readily available
c. One who tells others that he or she might do something if life doesn’t get better soon
d. One who talks about wanting to die
17. Nurse Penny is aware that the following medical conditions is commonly found in clients with bulimia nervosa?
c. Diabetes mellitus
d. Hepatitis A
18. Ken, a high school student is referred to the school nurse for suspected substance abuse. Following the nurse’s assessment and interventions, what would be the most desirable outcome?
a. The student discusses conflicts over drug use
b. The student accepts a referral to a substance abuse counselor
c. The student agrees to inform his parents of the problem
d. The student reports increased comfort with making choice
19. A male client who reportedly consumes 1 qt of vodka daily is admitted for alcohol detoxification. To try to prevent alcohol withdrawal symptoms, Dr. Smith is most likely to prescribe which drug?
a. clozapine (Clozaril)
b. thiothixene (Navane)
c. lorazepam (Ativan)
d. lithium carbonate (Eskalith)
20. A male client is being treated for alcoholism. After a family meeting, the client’s spouse asks the nurse about ways to help the family deal with the effects of alcoholism. Nurse Lily should suggest that the family join which organization?
b. Make Today Count
c. Emotions Anonymous
d. Alcoholics Anonymous
21. A female client is admitted to the psychiatric clinic for treatment of anorexia nervosa. To promote the client’s physical health, nurse Tair should plan to:
a. severely restrict the client’s physical activities
b. weigh the client daily, after the evening meal
c. monitor vital signs, serum electrolyte levels, and acid-base balance
d. instruct the client to keep an accurate record of food and fluid intake
22. Kevin is remanded by the courts for psychiatric treatment. His police record, which dates to his early teenage years, includes delinquency, running away, auto theft, and vandalism. He dropped out of school at age 16 and has been living on his own since then. His history suggests maladaptive coping, which is associated with:
a. antisocial personality disorder
b. borderline personality disorder
c. obsessive-compulsive personality disorder
d. narcissistic personality disorder
23. Mark and May seek emergency crisis intervention because he slapped her repeatedly the night before. The husband indicates that his childhood was marred by an abusive relationship with his father. When intervening with this couple, nurse Gerry knows they are at risk for repeated violence because the husband:
a. has only moderate impulse control
b. denies feelings of jealousy or possessiveness
c. has learned violence as an acceptable behavior
d. feels secure in his relationship with his wife
24. A client whose husband just left her has a recurrence of anorexia nervosa. Nurse Vic caring for her realizes that this exacerbation of anorexia nervosa results from the client’s effort to:
a. manipulate her husband
b. gain control of one part of her life
c. commit suicide
d. live up to her mother’s expectations
25. A male client has approached the nurse asking for advice on how to deal with his alcohol addiction. Nurse Sally should tell the client that the only effective treatment for alcoholism is:
b. total abstinence
c. Alcoholics Anonymous (AA)
d. aversion therapy
Answers and Rationale will be posted soon…
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