Chapter 06: Substance Use Assessment
Jarvis: Physical Examination and Health Assessment, 8th Edition
MULTIPLE CHOICE
1. A woman has come to the clinic to seek help with a substance-abuse problem. She admits to
using cocaine just before arriving. Which of these assessment findings would the nurse expect
to find when examining this woman?
a.
Dilated pupils, pacing, and psychomotor agitation
b.
Dilated pupils, unsteady gait, and aggressiveness
c.
Pupil constriction, lethargy, apathy, and dysphoria
d.
Constricted pupils, euphoria, and decreased temperature
2. The nurse is assessing a patient who has been admitted for cirrhosis of the liver, secondary to
chronic alcohol use. Which assessment finding should the nurse expect?
a.
Hypertension
b.
Ventricular fibrillation
c.
Bradycardia
d.
Mitral valve prolapse
3. The nurse is conducting a class on alcohol and the effects of alcohol on the body. What
information about the number of standard drinks (each containing 14 grams of alcohol)
associated with a 32% increase in breast cancer should the nurse include in the class?
a.
2.1/day
b.
4.2/day
c.
8/week
d.
15/week
4. During a session on substance abuse, the nurse is reviewing statistics with the class. For
people aged 12 years and older, which illicit substance was most commonly used?
a.
Heroin
b.
Marijuana
c.
Crack cocaine
d.
Hallucinogens
5. A woman who has just discovered that she is pregnant is in the clinic for her first obstetric
visit. She asks the nurse, “How many drinks a day is safe for my baby?” What is the best
response by the nurse?
a.
“You should limit your drinking to once or twice a week.”
b.
“It’s okay to have up to two glasses of wine a day.”
c.
“As long as you avoid getting drunk, you should be safe.”
d.
“No amount of alcohol has been determined to be safe during pregnancy.”
6. During an assessment, the nurse asks a female patient, “How many alcoholic drinks do you
have a week?” Which answer by the patient would indicate at-risk drinking?
a.
“I may have one or two drinks a week.”
b.
“I usually have three or four drinks a week.”
c.
“I’ll have a glass or two of wine every now and then.”
d.
“I have eight to ten drinks a week, but I never get drunk.”
7. The nurse is asking an adolescent about illicit substance abuse. The adolescent answers, “Yes,
I’ve used marijuana at parties with my friends.” What is the next question the nurse should
ask?
a.
“Who are these friends?”
b.
“Is this a regular habit?”
c.
“Do your parents know about this?”
d.
“When was the last time you used marijuana?”
8. The nurse has completed an assessment on a patient who came to the clinic for a leg injury.
As a result of the assessment, the nurse has determined that the patient has at-risk alcohol use.
Which action by the nurse is most appropriate at this time?
a.
Record the results of the assessment, and notify the physician on call.
b.
State, “You are drinking more than is medically safe. I strongly recommend that
you quit drinking, and I’m willing to help you.”
c.
State, “It appears that you may have a drinking problem. Here is the telephone
number of our local Alcoholics Anonymous chapter.”
d.
Give the patient information about a local rehabilitation clinic.
9. A patient is brought to the emergency department. He is restless, has dilated pupils, is
sweating, has a runny nose and tearing eyes, and complains of muscle and joint pains. His
girlfriend thought he had influenza, but she became concerned when his temperature went up
to 39.4 C. She admits that he has been a heavy drug user, but he has been trying to stop on
his own. The nurse suspects that the patient is experiencing withdrawal symptoms from which
substance?
a.
Alcohol
b.
Heroin
c.
Cocaine
d.
Sedatives
10. The nurse is reviewing aspects of substance abuse in preparation for a seminar. Which of
these statements illustrates the concept of tolerance to an illicit substance?
a.
A physiologic dependence on a substance.
b.
A person requires an increased amount of the substance to produce the same effect.
c.
A person requires daily use of the substance to function and is unable to stop using
it.
d.
A person experiences a syndrome of physiologic symptoms if the substance is not
used.
11. The nurse is admitting a patient with an addiction to alcohol to a treatment center. Which
screening tool should the nurse use to assess for symptoms of alcohol withdrawal?
a.
TWEAK
b.
AUDIT
c.
SMAST-G
d.
CIWA-Ar
12. The nurse is conducting an interview with an adult male patient. Which statement made by the
patient indicates an alcohol use disorder?
a.
“I crave alcohol but have successfully cut down on my alcohol consumption.”
b.
“I’ve been late to work a few times so now I limit myself to 2 drinks/day and stick
to it.”
c.
“I usually stay out longer and drink more than I intended but I still make it into
work on time.”
d.
“I have a strong urge to drink and I’ve tried to stop drinking several times but it
doesn’t last long.’
MULTIPLE RESPONSE
1. When reviewing the use of alcohol by older adults, the nurse notes that older adults have
several characteristics that can increase the risk for alcohol use. Which would increase the
bioavailability of alcohol in the blood for longer periods in the older adult? (Select all that
apply.)
a.
Increased muscle mass
b.
Decreased blood pressure
c.
Increased cardiac output
d.
Decreased liver metabolism
e.
Decreased kidney functioning
2. A patient with a known history of heavy alcohol use has been admitted to the ICU after he
was found unconscious outside a bar. The nurse closely monitors him for symptoms of
withdrawal. Which of these symptoms may occur during this time? (Select all that apply.)
a.
Bradycardia
b.
Coarse tremor of the hands
c.
Transient hallucinations
d.
Somnolence
e.
Sweating
3. A patient visits the clinic to ask about smoking cessation. He has smoked heavily for 30 years
and wants to stop “cold turkey.” He asks the nurse, “What symptoms can I expect if I do
this?” Which of these symptoms should the nurse share with the patient as possible symptoms
of nicotine withdrawal? (Select all that apply.)
a.
Headaches
b.
Hunger
c.
Sleepiness
d.
Restlessness
e.
Nervousness
f.
Sweating