Nokea
A 38-year-old male patient stopped smoking 6 months ago. He tells the nurse that he still feels strong cigarette cravings and wonders if he is ever going to feel 'normal' again. Which statement by the nurse is correct?
- A. It's possible that these cravings will never stop.
- B. These cravings may persist for several months.
- C. The cravings tell us that you are still using nicotine.
- D. The cravings show that you are about to experience nicotine withdrawal.
Correct Answer: B
Rationale: Cigarette cravings can persist for months or even years after quitting due to nicotine's addictive nature, but they typically lessen over time. The other options are incorrect: cravings do not indicate ongoing nicotine use or impending withdrawal, and while cravings may persist, they are not necessarily permanent.
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The nurse is presenting a substance-abuse lecture for teenagers and is asked about 'ecstasy.' The nurse recognizes that this is the slang term for which substance?
- A. Cocaine
- B. Flunitrazepam
- C. Methamphetamine
- D. Methylenedioxymethamphetamine (MDMA)
Correct Answer: D
Rationale: Ecstasy is a common slang term for methylenedioxymethamphetamine (MDMA), a synthetic amphetamine derivative with stimulant and hallucinogenic properties. The other substances listed have different slang names and effects.
A patient has been taking disulfiram as part of his rehabilitation therapy. However, this evening, he attended a party and drank half a beer. As a result, he became ill and his friends took him to the emergency department. The nurse will look for which adverse effects associated with acetaldehyde syndrome? (Select all that apply.)
- A. Euphoria
- B. Severe vomiting
- C. Diarrhea
- D. Pulsating headache
- E. Difficulty breathing
- F. Sweating
Correct Answer: B,D,E,F
Rationale: Acetaldehyde syndrome, triggered by alcohol consumption while on disulfiram, causes severe vomiting, pulsating headache, difficulty breathing, and sweating due to acetaldehyde buildup. Euphoria and diarrhea are not associated with this syndrome.
A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?
- A. Diazepam
- B. Methadone
- C. Disulfiram
- D. Bupropion
Correct Answer: B
Rationale: Methadone is commonly used to manage opioid withdrawal symptoms by reducing cravings and withdrawal effects due to its long-acting opioid properties. Diazepam and disulfiram are used for alcohol dependence, and bupropion is used for smoking cessation.
A patient has been taking naltrexone as part of the treatment for addiction to heroin. The nurse expects that the naltrexone will have which therapeutic effect for this patient?
- A. Naltrexone prevents the cravings for opioid drugs.
- B. Naltrexone works as a safer substitute for the heroin until the patient completes withdrawal.
- C. The patient will experience flushing, sweating, and severe nausea if he takes heroin while on naltrexone.
- D. If opioid drugs are used while taking naltrexone, euphoria is not produced; thus, the opioid's desired effects are lost.
Correct Answer: D
Rationale: Naltrexone blocks opioid receptors, preventing the euphoria associated with heroin use, thus reducing the reinforcing effects of the drug. It does not directly prevent cravings, act as a substitute, or cause severe nausea like disulfiram does with alcohol.
A nurse is providing teaching for a patient who will be taking varenicline as part of a smoking-cessation program. Which teaching points are appropriate for a patient taking this medication? (Select all that apply.)
- A. This drug is available as a chewing gum that can be taken to reduce cravings.
- B. Use caution when driving because drowsiness may be a problem.
- C. There have been very few adverse effects reported for this drug.
- D. Notify the prescriber immediately if feelings of sadness or thoughts of suicide occur.
- E. Avoid caffeine while on this drug.
Correct Answer: B,D
Rationale: Varenicline, an oral tablet, can cause drowsiness, requiring caution during activities like driving, and is associated with psychiatric risks like depression or suicidality, necessitating immediate reporting. It is not a gum, has common side effects like nausea and insomnia, and has no specific caffeine restrictions.