Which assessment findings would the nurse evaluate as indicating substance dependence? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply
1. The patient is exhibiting tolerance.
2. The patient spends significant amounts of time trying to obtain the substance.
3. The patient continues to use the substance after acknowledging it is not good for his health.
4. The patient describes several attempts to control substance use.
5. The patient continues to use the substance in spite of serious relationship problems.
1,2,3,4
Rationale 1: Substance dependence is demonstrated by tolerance to the drug.
Rationale 2: A patient who is dependent on a substance spends a significant amount of time trying to obtain it.
Rationale 3: Substance dependence is demonstrated by continuing to use the substance despite recognition of the associated problems and difficulties.
Rationale 4: The patient has made unsuccessful attempts to cut down or control use of the substance.
Rationale 5: Substance abuse, not dependence, is characterized by continued use despite social and relationship problems.
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