NCLEX-PN › 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?
Fatigue, disorientation, and craving
Irritability, tremors, and seizures
Nausea, vomiting, and anxiety
Diaphoresis, seizures, and apathy
Anxiety, nausea, and vomiting are common symptoms of opium withdrawal.
The Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM V) criteria for substance abuse includes all of the following except __________.
All of these are part of the DSM V criteria for substance abuse
recurrent substance use resulting in a failure to fulfill major role obligations at work, school, or home
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
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.
A nurse is monitoring an 18 year old who is experiencing heroin withdrawal. What symptoms might the nurse observe?
Yawning, cramps, and diarrhea
Seizures, tremors, and tachycardia
Coma and convulsions
Nausea and fainting
Yawning, cramps, and diarrhea are common signs of heroin withdrawal.
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?
Substance dependency
Substance abuse
Substance addiction
None of these
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:
Which of the following symptoms is most worrisome in a patient undergoing alcohol withdrawal?
Delirium tremens
Tachycardia
Bradycardia
Agitation
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.
Alcohol abuse-induced thiamine deficiency can cause which of the following?
Wernicke-Korsakoff syndrome
Lewy body dementia
Wolf-Hirschhorn syndrome
Agnosia
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.
Prolonged alcohol abuse can result in a severe deficiency in what vitamin?
Thiamine (B1)
Folate
Niacin (B3)
Vitamin C
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.
Which of the following drugs is considered a central nervous system (CNS) depressant?
All of these
Marijuana
Cyclobenzaprine
Atenolol
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.