RNSG 2213 MH Module 8 Chemical
Dependency Review Questions and
Answers
What are some assessment strategies that can be used by a nurse when assessing
chemical dependency? ✅Inquire about amount/type of alcohol and other drugs (AOD)
used by pt/family, included prescribed meds; ask about medical problems associated w/
AOD used. Blood/urine screen may be required to provide objective information. Denial
complicates assessment. Can use screening tools (MAST, CAGE)
alcoholism screening tool; can help unconvinced pt gain insight into possibility of a
problem if questions are answered honestly; can also aid clinician in diagnostic
assessment and modified to fit other drug problems. ✅Michigan Alcoholism Screening
Test (MAST)
alcoholism screening tool; easy to administer and perceived as less accusatory.
Comprised of four questions—1)have you ever felt you should Cut down on your
drinking? 2) have people Annoyed you by criticizing your drinking? 3) have you ever felt
bad or Guilty about your drinking? 4) have you ever had an Eye-opener in the morning
to steady your nerves or get rid of a hangover? Two positive responses are suggestive
of alcoholism; three or four positives are diagnostic. ✅CAGE questionnaire
What are the two umbrella treatment philosophies of addiction? ✅Behavioral model
and disease model
treatment philosophy of addiction; defines addiction as a habit that interferes with daily
life, and a habit that the addicted individual believes he/she cannot change. One
approach is moderation management (learning to drink in moderation). ✅Behavioral
model
treatment philosophy of addiction; points to physiologic effects and explanations. Goal is
total abstinence. Use of counseling groups, 12 step programs. ✅Disease model
Regarding the nurse-pt relationship, what is the benchmark for working with chemically
independent clients? ✅Establishing a trusting therapeutic relationship in which the
rules are consistently applied
What are the goals of detoxification? ✅To maintain safety and dignity; absence of
discomfort may not be a realistic outcome. Goal is not absolute comfort. To assess
objective measures of withdrawal (vital signs, observable findings, withdrawal rating
, scores)—very useful for monitoring the course of withdrawal and supplementing the
subjective data from the client
What are some nursing and milieu interventions when caring for a client in
detox/recovery treatment? ✅Examine own attitudes about substance use &
dependence. Provide a safe environment, empathy and acceptance, hope for recovery,
offer groups (support, 12 step, etc), and offer treatment for comorbid mental illnesses.
Limit setting.
Describe the biological theory of the etiology of addiction. ✅When a drug is used, it
targets specific receptors; replaces endogenous brain chemical at receptor site,
stimulates brain's "reward" pathway. Frequent use of the drug leads to creation of extra
receptors and brain's perception that drug's stimuli are necessary for survival (cravings
when drug not available). Eventually, there is inactivation of endogenous chemical.
There are also heritable risk factors for addiction
Describe the biology + learning theory regarding the etiology of addiction. ✅Drug
dependence results from interaction of the physiological effects of substances on brain
areas associated with motivation and emotion, combined with ''learning'' about the
relationship between substances and substance-related cues. This theory gives support
to why relapse may occur even after long period of abstinence (i.e. smell of cigarette
can cause an ex-smoker to light up)
What are some sociocultural factors regarding the etiology of addiction? ✅Social and
economic adversity. Advertising and the media. Cultural and religious values. Sex
differences—males abuse alcohol and opioids more. Females abuse prescription drugs.
Availability, cost
Describe the psychological/psychodynamic theory of the etiology of addiction.
✅Fundamentally negative view of self. Substances used to escape from anxiety or
emotional pain. Personality traits associated with risk for substance dependence include
denial, inability to express emotions, high anxiety in interpersonal relations, emotional
immaturity, Ambivalence towards authority; rule breaker, Low frustration tolerance;
wants instant gratification, Low self-esteem , Feelings of isolation,
Overdependence/lack of autonomy, Perfectionism and compulsiveness, Anger, Sex role
confusion
What are some signs and symptoms of suspected substance-related disorder?
✅Absenteeism, frequent accidents/injuries, drowsiness, slurred speech, inattention to
appearance, increasing isolation, frequent secretive disappearances, tremors, flushed
face, water/reddened eyes, appearing spaced out, odor of alcohol/strong mouthwash,
high number of physical complaints, disappearing prescriptions
Occurs when the dependent person does not recognize destructive nature of AOD use,
although blatantly obvious to others. ✅Denial
