Substance Use, Withdrawal, And Overdose Care - NCLEX-PN
Card 1 of 25
Which finding most strongly suggests stimulant (cocaine/amphetamine) intoxication?
Which finding most strongly suggests stimulant (cocaine/amphetamine) intoxication?
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Agitation with tachycardia, hypertension, hyperthermia, dilated pupils. Stimulants enhance catecholamine release, producing sympathetic activation and these characteristic adrenergic signs.
Agitation with tachycardia, hypertension, hyperthermia, dilated pupils. Stimulants enhance catecholamine release, producing sympathetic activation and these characteristic adrenergic signs.
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What is the priority nursing action during an active generalized tonic-clonic seizure?
What is the priority nursing action during an active generalized tonic-clonic seizure?
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Protect airway; turn to side; do not restrain or place objects in mouth. These measures prevent aspiration and injury while avoiding actions that could cause harm during uncontrolled movements.
Protect airway; turn to side; do not restrain or place objects in mouth. These measures prevent aspiration and injury while avoiding actions that could cause harm during uncontrolled movements.
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What vitamin should be given before glucose in a patient at risk for Wernicke encephalopathy?
What vitamin should be given before glucose in a patient at risk for Wernicke encephalopathy?
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Thiamine (vitamin B1). Chronic alcohol use depletes thiamine, and glucose without prior supplementation can precipitate acute encephalopathy.
Thiamine (vitamin B1). Chronic alcohol use depletes thiamine, and glucose without prior supplementation can precipitate acute encephalopathy.
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Which medication class is first-line for acute alcohol withdrawal symptom control?
Which medication class is first-line for acute alcohol withdrawal symptom control?
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Benzodiazepines. These agents enhance GABA activity to mitigate withdrawal-induced hyperexcitability and prevent complications like seizures.
Benzodiazepines. These agents enhance GABA activity to mitigate withdrawal-induced hyperexcitability and prevent complications like seizures.
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What is the priority intervention for severe hyperthermia from stimulant intoxication?
What is the priority intervention for severe hyperthermia from stimulant intoxication?
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Rapid cooling and supportive care. Stimulant-induced hyperthermia risks organ failure, so prompt cooling and support are critical to restore homeostasis.
Rapid cooling and supportive care. Stimulant-induced hyperthermia risks organ failure, so prompt cooling and support are critical to restore homeostasis.
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What is the nursing priority intervention for suspected opioid overdose with apnea?
What is the nursing priority intervention for suspected opioid overdose with apnea?
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Support airway and breathing; provide bag-valve-mask ventilation. Opioids suppress respiratory drive, making immediate airway support and ventilation essential to prevent hypoxia and cardiac arrest.
Support airway and breathing; provide bag-valve-mask ventilation. Opioids suppress respiratory drive, making immediate airway support and ventilation essential to prevent hypoxia and cardiac arrest.
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What is the most serious complication of severe alcohol withdrawal (delirium tremens)?
What is the most serious complication of severe alcohol withdrawal (delirium tremens)?
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Seizures and autonomic instability (can be fatal). Delirium tremens involves extreme autonomic dysregulation and neuronal hyperexcitability, leading to potentially lethal outcomes.
Seizures and autonomic instability (can be fatal). Delirium tremens involves extreme autonomic dysregulation and neuronal hyperexcitability, leading to potentially lethal outcomes.
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Which assessment finding most strongly suggests alcohol withdrawal rather than intoxication?
Which assessment finding most strongly suggests alcohol withdrawal rather than intoxication?
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Tremors with tachycardia and hypertension. Withdrawal triggers sympathetic hyperactivity, producing these signs in contrast to the depressant effects of intoxication.
Tremors with tachycardia and hypertension. Withdrawal triggers sympathetic hyperactivity, producing these signs in contrast to the depressant effects of intoxication.
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Identify the key safety risk after naloxone is given to an opioid-dependent patient.
Identify the key safety risk after naloxone is given to an opioid-dependent patient.
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Acute withdrawal with agitation and recurrent respiratory depression. In dependent patients, naloxone precipitates abrupt withdrawal, and its short half-life allows opioid effects to potentially recur.
Acute withdrawal with agitation and recurrent respiratory depression. In dependent patients, naloxone precipitates abrupt withdrawal, and its short half-life allows opioid effects to potentially recur.
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What classic triad is most associated with opioid overdose?
What classic triad is most associated with opioid overdose?
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CNS depression, respiratory depression, pinpoint pupils. Opioid receptor activation causes profound sedation, slowed breathing, and miosis as hallmark physiological responses.
CNS depression, respiratory depression, pinpoint pupils. Opioid receptor activation causes profound sedation, slowed breathing, and miosis as hallmark physiological responses.
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What medication is the antidote for opioid overdose?
What medication is the antidote for opioid overdose?
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Naloxone. As a competitive opioid antagonist, it rapidly displaces opioids from mu receptors to reverse life-threatening effects.
Naloxone. As a competitive opioid antagonist, it rapidly displaces opioids from mu receptors to reverse life-threatening effects.
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Which withdrawal syndrome is most associated with life-threatening seizures: alcohol or opioids?
Which withdrawal syndrome is most associated with life-threatening seizures: alcohol or opioids?
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Alcohol withdrawal. Abrupt alcohol cessation causes neuronal hyperexcitability, heightening seizure risk unlike the flu-like symptoms of opioid withdrawal.
Alcohol withdrawal. Abrupt alcohol cessation causes neuronal hyperexcitability, heightening seizure risk unlike the flu-like symptoms of opioid withdrawal.
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Which medication class is often used first to treat severe agitation from stimulant intoxication?
Which medication class is often used first to treat severe agitation from stimulant intoxication?
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Benzodiazepines. These agents provide GABA-mediated sedation to counteract the excessive sympathetic stimulation from stimulants.
Benzodiazepines. These agents provide GABA-mediated sedation to counteract the excessive sympathetic stimulation from stimulants.
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Which teaching point is essential after naloxone is used in the community for opioid overdose?
Which teaching point is essential after naloxone is used in the community for opioid overdose?
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Call emergency services; naloxone can wear off and relapse can occur. Naloxone's shorter duration compared to many opioids risks symptom recurrence, necessitating professional medical follow-up.
Call emergency services; naloxone can wear off and relapse can occur. Naloxone's shorter duration compared to many opioids risks symptom recurrence, necessitating professional medical follow-up.
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What is the priority environmental intervention for a patient in alcohol withdrawal with confusion?
What is the priority environmental intervention for a patient in alcohol withdrawal with confusion?
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Provide a quiet, well-lit room with frequent reorientation and safety precautions. This setup reduces sensory overload and disorientation while promoting safety in confused, agitated patients.
Provide a quiet, well-lit room with frequent reorientation and safety precautions. This setup reduces sensory overload and disorientation while promoting safety in confused, agitated patients.
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Which lab/monitoring is most important to obtain early in suspected overdose with altered mental status?
Which lab/monitoring is most important to obtain early in suspected overdose with altered mental status?
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Point-of-care blood glucose. Hypoglycemia can mimic overdose symptoms and is a reversible cause of altered consciousness requiring prompt detection.
Point-of-care blood glucose. Hypoglycemia can mimic overdose symptoms and is a reversible cause of altered consciousness requiring prompt detection.
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Identify the best initial nursing action for a patient with suspected overdose of unknown substance.
Identify the best initial nursing action for a patient with suspected overdose of unknown substance.
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Assess ABCs and obtain vital signs; initiate emergency response as needed. Initial focus on airway, breathing, circulation, and vitals ensures rapid identification of life-threatening issues.
Assess ABCs and obtain vital signs; initiate emergency response as needed. Initial focus on airway, breathing, circulation, and vitals ensures rapid identification of life-threatening issues.
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Which assessment finding suggests opioid overdose rather than opioid withdrawal?
Which assessment finding suggests opioid overdose rather than opioid withdrawal?
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Respiratory depression with pinpoint pupils. Overdose involves mu receptor-mediated suppression, contrasting with the dilated pupils and agitation of withdrawal.
Respiratory depression with pinpoint pupils. Overdose involves mu receptor-mediated suppression, contrasting with the dilated pupils and agitation of withdrawal.
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Which finding is most consistent with hallucinogen (LSD) intoxication?
Which finding is most consistent with hallucinogen (LSD) intoxication?
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Perceptual disturbances with anxiety and dilated pupils. Hallucinogens like LSD alter serotonin transmission, inducing sensory distortions and sympathetic arousal.
Perceptual disturbances with anxiety and dilated pupils. Hallucinogens like LSD alter serotonin transmission, inducing sensory distortions and sympathetic arousal.
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What assessment finding is most consistent with cannabis intoxication?
What assessment finding is most consistent with cannabis intoxication?
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Conjunctival injection with impaired coordination. Cannabinoid receptor activation causes ocular vasodilation and motor impairment as common acute effects.
Conjunctival injection with impaired coordination. Cannabinoid receptor activation causes ocular vasodilation and motor impairment as common acute effects.
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Which antidote may reverse benzodiazepine effects but is used cautiously due to seizure risk?
Which antidote may reverse benzodiazepine effects but is used cautiously due to seizure risk?
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Flumazenil. As a GABA receptor antagonist, it reverses sedation but may provoke seizures in dependent patients or mixed overdoses.
Flumazenil. As a GABA receptor antagonist, it reverses sedation but may provoke seizures in dependent patients or mixed overdoses.
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What is the priority assessment for a patient with suspected benzodiazepine overdose?
What is the priority assessment for a patient with suspected benzodiazepine overdose?
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Airway and respiratory status. Benzodiazepines enhance GABA inhibition, potentially causing profound respiratory depression requiring priority monitoring.
Airway and respiratory status. Benzodiazepines enhance GABA inhibition, potentially causing profound respiratory depression requiring priority monitoring.
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Which medication can precipitate withdrawal if given to a patient currently using opioids?
Which medication can precipitate withdrawal if given to a patient currently using opioids?
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Naltrexone. This opioid antagonist displaces active opioids from receptors, triggering immediate and severe withdrawal symptoms.
Naltrexone. This opioid antagonist displaces active opioids from receptors, triggering immediate and severe withdrawal symptoms.
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Which medication is commonly used for opioid use disorder maintenance to reduce cravings and withdrawal?
Which medication is commonly used for opioid use disorder maintenance to reduce cravings and withdrawal?
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Methadone. As a long-acting opioid agonist, it stabilizes patients by suppressing withdrawal and cravings without euphoria.
Methadone. As a long-acting opioid agonist, it stabilizes patients by suppressing withdrawal and cravings without euphoria.
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What symptom cluster is most consistent with opioid withdrawal?
What symptom cluster is most consistent with opioid withdrawal?
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Rhinorrhea, lacrimation, yawning, piloerection, diarrhea, mydriasis. These autonomic rebound symptoms occur due to sudden cessation of opioid suppression in dependent individuals.
Rhinorrhea, lacrimation, yawning, piloerection, diarrhea, mydriasis. These autonomic rebound symptoms occur due to sudden cessation of opioid suppression in dependent individuals.
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