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A graduate nurse worked at a hospital for several months, resigned, and then took a position at another hospital. In the new position, the nurse often volunteers to be the medication nurse. After several serious medication errors, an investigation reveals that the nurse was diverting patient narcotics for self-use. What early indicator of the nurse's drug use was evident?
- A. Changing employment after only several months
- B. Seeking to be assigned as a medication nurse
- C. Frequent socializes with unit staff after work
- D. Recent graduate
Correct Answer: B
Rationale: Seeking access to medications is a drug-seeking behavior.
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Select the nursing intervention necessary after administering naloxone to a patient experiencing an opiate overdose.
- A. Monitor the airway and vital signs every 15 minutes.
- B. Insert a nasogastric tube and test gastric pH.
- C. Treat hyperpyrexia with cooling measures.
- D. Insert an indwelling urinary catheter.
Correct Answer: A
Rationale: Naloxone reverses CNS depression, but monitoring is needed as narcotics outlast the antagonist.
A patient has smoked two packs of cigarettes daily for many years. When the patient does not smoke or tries to cut back, anxiety, craving, poor concentration, and headache result. What does this scenario describe?
- A. Substance abuse
- B. Substance addiction
- C. Substance intoxication
- D. Recreational use of a social drug
Correct Answer: B
Rationale: Nicotine addiction is indicated by compulsive use, craving, tolerance, and withdrawal symptoms.
In what significant ways is the therapeutic environment different for a patient who has ingested lysergic acid diethylamide (LSD) than for a patient who has ingested phencyclidine (PCP)?
- A. For LSD ingestion, one person stays with the patient and provides verbal support. For PCP ingestion, a regimen of limited contact with staff members is maintained, and continual visual monitoring is provided.
- B. For PCP ingestion, the patient is placed on one-on-one intensive supervision. For LSD ingestion, a regimen of limited interaction and minimal verbal stimulation is maintained.
- C. For LSD ingestion, continual moderate sensory stimulation is provided. For PCP ingestion, continual high-level stimulation is provided.
- D. For LSD ingestion, the patient is placed in restraints. For PCP ingestion, seizure precautions are implemented.
Correct Answer: A
Rationale: LSD patients benefit from verbal support, while PCP patients require minimal stimulation due to violent tendencies.
Which assessment findings best correlate to the withdrawal from central nervous system depressants?
- A. Dilated pupils, tachycardia, elevated blood pressure, elation
- B. Labile mood, lack of coordination, fever, drowsiness
- C. Nausea, vomiting, diaphoresis, anxiety, tremors
- D. Excessive eating, constipation, headache
Correct Answer: C
Rationale: CNS depressant withdrawal symptoms resemble a flulike state with seizures possible.
When a person first begins drinking alcohol, two drinks produce relaxation and drowsiness. After 1 year of drinking, four drinks are needed to achieve the same relaxed, drowsy state. Why does this change occur?
- A. Tolerance develops.
- B. The alcohol is less potent.
- C. Antagonistic effects occur.
- D. Hypomagnesemia develops.
Correct Answer: A
Rationale: Tolerance means needing higher doses to achieve the same effect.