Substance Use and Addiction Disorders Practice Questions
20 free Substance Use and Addiction Disorders practice questions for the NCLEX Exam. Tap an option to answer — you get instant feedback, the correct answer, and a detailed explanation for every question.
What is the definition of tolerance in substance use disorders?
- A Immediately experiencing withdrawal symptoms whenever the substance is stopped
- B Needing larger amounts of the substance to achieve the same effect
- C Experiencing a single one-time overdose after using the substance once
- D Permanently refusing to ever use the substance again under any circumstance
Correct answer: Needing larger amounts of the substance to achieve the same effect
Tolerance refers to needing larger amounts of the substance over time to achieve the same effect, which is a key criterion in substance use disorders.
During a group session for clients with alcohol use disorder, what does feeling shaky when not having a drink indicate?
- A Tolerance
- B Withdrawal
- C Dependence
- D Relapse
Correct answer: Withdrawal
Feeling shaky when not drinking suggests withdrawal symptoms, which occur when the body reacts to the absence of a substance after habitual use.
What group intervention is most appropriate when observing members using substances to cope with stress?
- A Immediately confront the members and ask them to leave the group
- B Educate the group on healthier coping strategies and facilitate peer discussion
- C Ignore the discussion since substance use is expected within the group
- D Punish the members by assigning them extra written homework
Correct answer: Educate the group on healthier coping strategies and facilitate peer discussion
Providing psychoeducation and discussing alternative coping strategies helps group members replace maladaptive behaviors with healthier ones—a suitable group mental-health intervention.
Which screening model is commonly used in early detection of substance-use disorders in community or group settings?
- A Cognitive Behavioral Therapy (CBT) for restructuring thoughts
- B Screening, Brief Intervention and Referral to Treatment (SBIRT)
- C Electroconvulsive Therapy (ECT) for treatment-resistant cases
- D Motivational Interviewing used as a standalone screening tool
Correct answer: Screening, Brief Intervention and Referral to Treatment (SBIRT)
SBIRT is an evidence-based approach to screen, intervene briefly, and refer individuals with risky substance use for treatment.
What is an essential ground rule in group therapy for addiction to ensure safety and trust among members?
- A Members must share only when the facilitator says so
- B Confidentiality of what is discussed in the group
- C The group must remain silent throughout the session
- D Always encourage full-detailed disclosure of substance use
Correct answer: Confidentiality of what is discussed in the group
Confidentiality helps create a safe and trusting environment for members to share, which is critical in group treatment for substance use and addiction disorders.
What is the best nursing response to a client in a substance-use recovery group stating, 'I can stop anytime; it’s no big deal'?
- A 'If that is true, then you really do not need this group.'
- B 'It sounds like you feel in control. What brought you here today?'
- C 'You are lying to yourself; everyone here knows they are addicted.'
- D 'Let us skip that topic for now and move on to someone else.'
Correct answer: 'It sounds like you feel in control. What brought you here today?'
The response validates the client’s belief and opens a discussion about readiness for change—a motivational group technique appropriate for addiction recovery.
What is a key nursing priority when a client arrives for a group session after recent intoxication?
- A Ask them to lead the group so the activity keeps them awake
- B Assess for safety, withdrawal symptoms, and readiness to participate
- C Ignore the intoxication because group work alone is sufficient
- D Encourage them to keep drinking in order to avoid withdrawal
Correct answer: Assess for safety, withdrawal symptoms, and readiness to participate
Nursing care must assess for acute intoxication/withdrawal, medical stability, and ability to engage in the group session safely.
What does 'relapse' mean in the context of addiction in groups?
- A A complete failure of treatment requiring it to be stopped
- B A return to substance use after a period of abstinence
- C A state of never again experiencing any cravings or urges
- D Consistently staying abstinent without any setbacks at all
Correct answer: A return to substance use after a period of abstinence
Relapse is generally defined as a return to substance use following a period of recovery or abstinence and is a recognized part of the addiction process.
Which comorbid condition is commonly associated with substance-use disorders and is important to address in group treatment?
- A Seasonal allergies and intermittent hay fever
- B Major depressive disorder or anxiety disorders
- C Acute appendicitis requiring urgent surgery
- D A chronic non-healing skin ulcer on the leg
Correct answer: Major depressive disorder or anxiety disorders
Substance-use disorders frequently co-occur with mood and anxiety disorders, and addressing these conditions in group settings improves outcomes.
What is 'urge surfing' when taught as a coping technique in addiction recovery?
- A A way to ride out cravings without acting on them
- B Encouraging immediate use to reduce stress
- C Denying the urge until it vanishes
- D Replacing the substance with caffeine
Correct answer: A way to ride out cravings without acting on them
'Urge surfing' is a mindfulness-based coping technique where the individual observes and allows the craving to rise and fall without acting, aiding relapse prevention.
When a group member expresses shame about almost overdosing, what is the therapeutic group response from the nurse?
- A 'You are a failure, and that is exactly why you ended up here.'
- B 'You were brave to share that. What helped you survive, and what support do you need?'
- C 'Please do not bring that up again; let us move on to another topic.'
- D 'Stop feeling ashamed about it, because plenty of others have it far worse.'
Correct answer: 'You were brave to share that. What helped you survive, and what support do you need?'
This response affirms the courage to share, promotes reflection on survival, and invites consideration of supports—appropriate for a group mental-health setting.
What is one purpose of group therapy for substance use disorders?
- A Treat each member only in isolation, apart from the group
- B Offer social support, model recovery, and reduce isolation
- C Replace prescribed medication entirely with group sessions
- D Enforce strict punishment whenever a member has a relapse
Correct answer: Offer social support, model recovery, and reduce isolation
Group therapy offers a supportive peer environment, promotes modeling of recovery behaviors, and decreases the isolation that often accompanies addiction.
In a group session for clients undergoing alcohol withdrawal, what sign should the nurse watch for as a medical emergency?
- A Mild hand tremors and ordinary situational anxiety
- B Elevated blood pressure, tachycardia, and confusion (possible delirium tremens)
- C Slight nausea without any other accompanying symptoms
- D Occasional yawning and brief periods of drowsiness
Correct answer: Elevated blood pressure, tachycardia, and confusion (possible delirium tremens)
Delirium tremens (DTs) is a potentially life-threatening condition in alcohol withdrawal marked by autonomic instability and confusion, requiring immediate medical intervention.
Which medication is used in maintenance therapy for opioid-use disorder and should be discussed in group education?
- A Aspirin
- B Methadone or buprenorphine
- C Ibuprofen
- D Lorazepam
Correct answer: Methadone or buprenorphine
Methadone and buprenorphine are FDA-approved medications for opioid-use disorder maintenance treatment, and group education should cover their role and benefits.
In a group discussion about stimulant-use disorder, what neurochemical change is often implicated in intense cravings and mood swings?
- A Aspirin taken daily for pain relief
- B Methadone or buprenorphine maintenance
- C Ibuprofen used as needed for aches
- D Lorazepam taken nightly for sleep
Correct answer: Methadone or buprenorphine maintenance
Substance-use disorders often involve disruption of the brain’s dopamine reward pathways, which underlie cravings and mood dysregulation.
What role does setting and reviewing 'personal change goals' serve in group therapy for addiction?
- A It serves mainly to punish the member for their past behavior
- B It provides structure, promotes accountability, and measures progress
- C It conveniently replaces the need for any peer interaction
- D It ensures that every member works toward the exact same goal
Correct answer: It provides structure, promotes accountability, and measures progress
Personal change goals help group members stay focused, track their recovery progress, and increase accountability, which are key for sustained improvement in substance use disorders.
What is the difference between substance dependence (now called substance-use disorder) and simple substance use?
- A Excess serotonin activity acting alone in the brain
- B Dopamine pathway dysregulation in reward circuitry
- C No measurable change occurs in brain chemistry at all
- D Excess hemoglobin circulating throughout the bloodstream
Correct answer: Dopamine pathway dysregulation in reward circuitry
Substance-use disorder is identified by a cluster of behaviors including impaired control over use, continuing despite consequences, tolerance, withdrawal, and significant impairment in functioning.
What effective relapse prevention strategy is mentioned in group treatment for addiction?
- A Avoid identifying high-risk situations and triggers in advance
- B Assume that once abstinent, any return to use is impossible
- C Identify triggers, develop alternate responses, and plan coping
- D Skip preparation altogether because relapse is genuinely rare
Correct answer: Identify triggers, develop alternate responses, and plan coping
Effective relapse prevention involves recognizing triggers, planning responses, and having coping tools ready, essential content for group sessions in addiction recovery.
When discussing 'harm reduction' in a substance-use group, which example illustrates this concept?
- A Insisting that every member stop immediately without any support
- B Teaching safe-injection sites, clean-needle programs, and reduced use
- C Telling the group that harm reduction is never an acceptable goal
- D Avoiding the harm-reduction topic altogether during the session
Correct answer: Teaching safe-injection sites, clean-needle programs, and reduced use
Harm reduction acknowledges that while abstinence is the ideal, reducing negative consequences of use is still a meaningful goal in substance-use treatment.
What is the most appropriate therapeutic group-facilitator approach when a member expresses shame and guilt about their addiction?
- A Teach that guilt is pointless and should simply be ignored
- B Normalize the feelings, encourage expression, and guide toward self-compassion
- C Tell the member their shame is justified and will never go away
- D Change the subject quickly to avoid any group discomfort
Correct answer: Normalize the feelings, encourage expression, and guide toward self-compassion
Facilitators should allow emotional expression, normalize the experience, and guide towards self-compassion and recovery—important in group mental-health settings.