Nokea
A 20-year-old man arrives at the emergency department by ambulance. He is unconscious, with slow respirations and pinpoint pupils. There are tracks visible on his arms. The friend who came with him reports that the client had just shot up heroin when he became unconscious. Which medication would the nurse most likely expect to administer?
- A. Naloxone
- B. Naltrexone
- C. Bupropion
- D. Varenicline
Correct Answer: A
Rationale: Naloxone (A) is an opioid antagonist used to reverse heroin overdose, counteracting respiratory depression and unconsciousness. Naltrexone (B) is for maintenance, bupropion (C) is for depression/smoking cessation, and varenicline (D) is for smoking cessation.
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A client with a history of opioid abuse is exhibiting manifestations of moderate withdrawal. Which of the following would the nurse expect to assess?
- A. Rhinorrhea
- B. Lacrimation
- C. Dilated pupils
- D. Dysphoria
Correct Answer: A,B,C,D
Rationale: Moderate opioid withdrawal includes rhinorrhea (A), lacrimation (B), dilated pupils (C), and dysphoria (D) due to autonomic and psychological distress. All are characteristic symptoms.
A nurse is talking with a 57-year-old client who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit. It is 5:00 AM, and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that basically describes how her nursing supervisor came to visit and gave it to her to wear so she?d remember to get well. The nurse suspects that the client may be experiencing which of the following?
- A. Wernicke?s syndrome
- B. Delirium tremens
- C. Korsakoff?s psychosis
- D. Malignant hyperthermia
Correct Answer: C
Rationale: The client?s confabulation (fabricated story about the stethoscope) and insomnia suggest Korsakoff?s psychosis (C), a chronic condition from alcohol-related thiamine deficiency causing memory deficits. Wernicke?s syndrome (A) involves ataxia and confusion, delirium tremens (B) includes severe autonomic symptoms, and malignant hyperthermia (D) is unrelated to alcohol.
A client is receiving methadone maintenance therapy. After teaching the client about this treatment, the nurse determines that the teaching was successful when the client states which of the following?
- A. I can have a glass of wine with dinner if I choose.
- B. I should eat small frequent meals if I get nauseated.
- C. I should take the drug on an empty stomach.
- D. I might experience diarrhea with this drug.
Correct Answer: B
Rationale: Methadone can cause nausea, and eating small, frequent meals (B) helps manage this side effect. Alcohol (A) should be avoided, methadone is taken without regard to food (C), and constipation, not diarrhea (D), is a common side effect.
A nurse is obtaining a history from a client who drinks about 6 cups of coffee and several diet cola drinks per day. The client states, I just cut down my coffee and soda intake to one per day. Which of the following would the nurse most likely expect to assess? Select all that apply.
- A. Headache
- B. Fatigue
- C. Yawning
- D. Flushing
- E. Diuresis
Correct Answer: A,B,C
Rationale: Abrupt reduction in caffeine intake can cause withdrawal symptoms like headache (A), fatigue (B), and yawning (C) due to CNS and adenosine receptor changes. Flushing (D) and diuresis (E) are not typical caffeine withdrawal symptoms.
A client has been prescribed naltrexone (Trexan) for treatment of alcohol dependence. The nurse has explained the drug?s purpose to the client. The nurse determines that the client has understood the instructions when the client identifies which of the following about the drug?
- A. Causes itching if alcohol is consumed
- B. Produces the euphoria of alcohol
- C. Reduces the appeal of alcohol
- D. Improves appetite and nutritional status
Correct Answer: C
Rationale: Naltrexone (C) reduces the appeal of alcohol by blocking opioid receptors, decreasing the rewarding effects of drinking. It does not cause itching (A), produce euphoria (B), or directly improve appetite/nutrition (D).