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A client who has attempted to quit smoking and failed two times before is reluctant to make another attempt. Which response by the nurse is most appropriate?
- A. You will know when the time is right.
- B. Most people who have tried and failed ultimately do succeed.
- C. Tell me what you have tried before and we can make changes to your plan.
- D. I know you can do it this time.
Correct Answer: B
Rationale: Attempts to quit are a predictor of eventual success, and many of those who have tried and failed do ultimately succeed. Providing the client with this encouragement supports the desire to quit. Waiting until the time is right may postpone the urge to quit. The nurse does not 'know' for certainty that a client is going to achieve a goal but can be a supporter during the process. Although having a plan to follow is important, the support and encouragement to take the first step is the springboard.
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A client has overdosed on opiates. Which drug would the nurse anticipate being ordered for this client?
- A. Dolphine
- B. Naltrexone
- C. Naloxone
- D. Hydromorphone
Correct Answer: C
Rationale: Opiate overdose leads to respiratory depression, unconsciousness, and death. Naloxone is administered to reverse the effects of opiates and assists in restoring respiration. Naltrexone is an opiate antagonist that is used for rapid opiate detoxification while the client is under anesthesia. Dolphine and hydromorphone are opiate drugs and would increase the effects of respiratory depression.
A client is brought to the emergency department with hallucinations, acne, and blackened teeth. During the nursing assessment, a generalized seizure begins. The nurse interprets this as possible toxicity by which substance?
- A. Crack
- B. Cocaine
- C. Opiate
- D. Methamphetamine
Correct Answer: D
Rationale: Methamphetamine users may develop acne, 'meth mouth,' tactile hallucinations, and can develop convulsions, respiratory, and cardiac arrest. Cocaine and opiate dependence do not result in the inclusion of the symptoms presented, but the nurse should understand that poly drug use disorder is common.
The client who reports drinking half a case of beer each day is admitted for detoxification. Which answer explains the onset of withdrawal symptoms 4 hours after last reported drink?
- A. The client will progress through detox faster than expected.
- B. Early onset of withdrawal symptoms indicates incorrect reporting of the time of last use.
- C. Three hours is the normal onset for withdrawal symptoms to begin.
- D. The withdrawal process will take about 24 hours from time of onset.
Correct Answer: B
Rationale: Alcohol withdrawal usually begins 6 hours after last drink. This client has incorrectly reported the time of last use. The withdrawal process from alcohol usually takes about 48 hours or more.
Which of the following instructions should a nurse give to clients with opiate dependency who take methadone?
- A. Avoid driving for 3 hours after medication.
- B. Take vitamin substitutes.
- C. Maintain bed rest for 1 hour after medication.
- D. Wear a MedicAlert tag.
Correct Answer: D
Rationale: The nurse should instruct the client who takes methadone to tell healthcare providers or wear a MedicAlert tag in case the client needs a narcotic, tranquilizer, or barbiturate. Because methadone is a narcotic, lower dosages of other sedative drugs are necessary because the combination may potentiate their depressant action. It is not essential for client to avoid driving or to maintain bed rest after medication. Vitamin substitutes may not be required.
A client states, 'My father was an alcoholic so I am destined to be one too.' Which is the best response by the nurse?
- A. Children of alcoholics are more likely to become alcoholic.
- B. There is treatment available to prevent the trait of alcoholism.
- C. This is just a theory and has no basis of proof.
- D. Let's talk about how you can take control of your destiny.
Correct Answer: D
Rationale: Even with a possible genetic link to alcoholism, the individual remains in control of taking the first drink that triggers the metabolism of alcohol to THIQ. Every person is responsible for his or her own destiny and should receive encouragement to exercise that control. Children of alcoholics (COA) do have a greater likelihood of developing alcohol dependency. The only prevention of the trait of alcoholism is abstinence.