NCLEX : Alcohol and Drug Abuse

Study concepts, example questions & explanations for NCLEX

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Example Questions

Example Question #1 : Alcohol And Drug Abuse

An emergency room nurse is assessing a 26 year old female patient who frequently uses opium. What symptoms would indicate that she is experiencing withdrawal?

Possible Answers:

Nausea, vomiting, and anxiety

Diaphoresis, seizures, and apathy

Irritability, tremors, and seizures

Fatigue, disorientation, and craving

Correct answer:

Nausea, vomiting, and anxiety

Explanation:

Anxiety, nausea, and vomiting are common symptoms of opium withdrawal.

Example Question #1 : Alcohol And Drug Abuse

A nurse is monitoring an 18 year old who is experiencing heroin withdrawal. What symptoms might the nurse observe?

Possible Answers:

Nausea and fainting

Yawning, cramps, and diarrhea

Seizures, tremors, and tachycardia

Coma and convulsions

Correct answer:

Yawning, cramps, and diarrhea

Explanation:

Yawning, cramps, and diarrhea are common signs of heroin withdrawal.

Example Question #2 : Alcohol And Drug Abuse

Which of the following drugs is considered a central nervous system (CNS) depressant?

Possible Answers:

Atenolol

Marijuana

All of these

Cyclobenzaprine

Correct answer:

All of these

Explanation:

All of the drugs listed are considered to be CNS depressants. While generally classified as a psychedelic, marijuana has multiple central depressant effects such as sedation and muscle relaxation. Also, alcohol is another commonly used depressant. 

Example Question #3 : Alcohol And Drug Abuse

Alcohol abuse-induced thiamine deficiency can cause which of the following?

Possible Answers:

Agnosia

Lewy body dementia

Wernicke-Korsakoff syndrome

Wolf-Hirschhorn syndrome

Correct answer:

Wernicke-Korsakoff syndrome

Explanation:

Wernicke-Korsakoff syndrome is caused by a severe deficiency in thiamine, often seen in severe alcohol dependency. It is characterized by visual disturbances, ataxia, and altered consciousness. Wolf-Hirschhorn syndrome is a genetic disorder causing developmental disability and may involve seizures. Lewy body dementia is associated with Parkinson's disease. Agnosia is a neurological disorder causing impaired ability to process sensory information.

Example Question #2 : Alcohol And Drug Abuse

The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V) criteria for substance abuse includes all of the following except __________.

Possible Answers:

recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home

All of these are part of the DSM V criteria for substance abuse

recurrent substance use in situations in which it is physically hazardous

continued substance use despite having persistent or recurrent social or interpersonal problems caused by or exacerbated by the effects of the substance

Correct answer:

All of these are part of the DSM V criteria for substance abuse

Explanation:

All of the items listed are part of the DSM V criteria for substance abuse. In addition, the individual's symptoms must not qualify for substance dependence and recurrent substance-related legal problems are other DSM V criteria for substance abuse.

Example Question #41 : Patient Specific Care

A 42 year old man presents to the ER for alcohol toxicity. While taking the history, the nurse discovers that he drinks on average one fifth of vodka per night, and often must drink an additional 6-12oz to get "a good buzz." When he doesn't drink, he experiences tremors and feels unwell until he is able to drink again. When asked if he would like to quit drinking he states that he has tried unsuccessfully several times over his life. He knows that he needs to get control over his drinking because it is seriously impairing his relationship with his husband and their 13 year old daughter. 

According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V), this patient can be considered to have which of the following conditions?

Possible Answers:

None of these

Substance dependency

Substance addiction

Substance abuse

Correct answer:

Substance dependency

Explanation:

The symptoms described by this patient put his alcohol use in the category of substance dependency, according to the DSM V, a more severe form of abuse than substance addiction. The criteria for this condition are:

  1. Tolerance 
  2. Withdrawal
  3. Unintentional excesses in consumption
  4. Persistent desire or unsuccessful efforts to reduce or control substance use
  5. A great deal of time is spent to get, use, or recover from the substance
  6. Interference with social life
  7. The substance use is continued despite knowledge problems caused by use

Example Question #3 : Alcohol And Drug Abuse

Prolonged alcohol abuse can result in a severe deficiency in what vitamin?

Possible Answers:

Folate

Vitamin C

Niacin (B3)

Thiamine (B1)

Correct answer:

Thiamine (B1)

Explanation:

Prolonged alcohol abuse can result in a severe deficiency in thiamine, or vitamin B1 by reducing dietary thiamine intake, impairing gastrointestinal absorption of thiamine, and causing impaired thiamine utilization in cells. Note that individuals who partake in prolonged alcohol abuse may have various other dietary deficiencies.

Example Question #3 : Alcohol And Drug Abuse

Which of the following symptoms is most worrisome in a patient undergoing alcohol withdrawal?

Possible Answers:

Tachycardia

Agitation

Delirium tremens

Bradycardia

Correct answer:

Delirium tremens

Explanation:

Delirium tremens (DT) is a rapid onset of confusion seen during alcohol withdrawal. The symptoms of DT include altered mental status, autonomic instability, and even seizures. DT is also characterized by hallucinations such as the sensation of something "crawling" on the patient. DT is the most severe consequence of withdrawal and can be fatal if untreated.

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