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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.
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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 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).
A client is brought to the emergency department after having overdosed on cocaine. When assessing the client, which of the following would the nurse expect to find? Select all that apply.
- A. Euphoria
- B. Seizures
- C. Cardiac arrhythmia
- D. Paranoia
- E. Dilated pupils
Correct Answer: B,C,D,E
Rationale: Cocaine overdose can cause seizures (B), cardiac arrhythmia (C), paranoia (D), and dilated pupils (E) due to excessive CNS and sympathetic stimulation. Euphoria (A) is more typical of use, not overdose.
A client is brought into the emergency department because he was involved in an automobile accident. His blood alcohol level (BAL) is 0.10 mg %. Based on this finding, the nurse would expect to assess which of the following?
- A. Difficulty with coordination
- B. Stupor
- C. Emotional lability
- D. Ataxia
Correct Answer: A
Rationale: A BAL of 0.10 mg % (0.10 g/dL) typically causes difficulty with coordination (A), such as impaired motor skills. Stupor (B) occurs at higher levels (e.g., >0.30), emotional lability (C) is less specific, and ataxia (D) is more severe and less common at this level.
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.