Nokea
A nurse is exploring treatment options with a client addicted to heroin. Which information regarding the use of methadone is important for the nurse to include?
- A. Unlike heroin, methadone is nonaddicting.
- B. Methadone will meet the physical need for opiates without producing cravings for more.
- C. Methadone will produce a high similar to heroin.
- D. People taking methadone run the same risks associated with IV drug use as those taking heroin.
Correct Answer: B
Rationale: Methadone satisfies opiate needs without increasing cravings, unlike heroin, but is still addictive, does not produce a high, and avoids IV drug risks.
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A client with a history of heavy alcohol use, whose last drink was 24 hours ago, is seen in the emergency department. The client is oriented but is tremulous, weak, and sweaty and has some gastrointestinal (GI) symptoms. Which of the following is typical of these symptoms?
- A. Alcohol withdrawal syndrome
- B. Continuing intoxication
- C. Delirium tremens
- D. Wernicke-Korsakoff syndrome
Correct Answer: A
Rationale: Symptoms like tremors, weakness, and sweating 24 hours after the last drink indicate alcohol withdrawal, not intoxication, delirium tremens, or Wernicke-Korsakoff syndrome.
A client with alcohol dependence is admitted to the hospital with pancreatitis. Which intervention should be included in the client's plan of care?
- A. Fluid restriction of 1000 ml per 24 hours
- B. Glucometer checks b.i.d.
- C. High-protein diet
- D. Protective isolation precautions
Correct Answer: B
Rationale: Pancreatitis from alcohol dependence can elevate glucose levels, necessitating glucometer checks, unlike fluid restriction, high-protein diets, or isolation.
The nurse is assessing a client's risk factors for developing a substance abuse disorder. Which family characteristics would the nurse identify as a significant risk factor?
- A. One parent who is an alcoholic
- B. Parents who practiced strict discipline
- C. Overprotective parents
- D. Being raised in an urban area
Correct Answer: A
Rationale: Children of alcoholics are four times more likely to develop alcoholism, a stronger risk factor than strict discipline, overprotection, or urban environments.
The nurse is working in an intensive care unit and observes that some clients do not respond to injections of diazepam (Valium) when the injections are given by a particular nurse. This nurse returns from lunch exhibiting slurred speech and euphoria. Which is the best action for the nurse to take?
- A. Ask other nurses if they have noticed anything unusual.
- B. Call the manager and report the observations.
- C. Observe the nurse as injections are prepared and administered.
- D. Tell the nurse, 'I know you've been stealing Valium.'
Correct Answer: B
Rationale: Reporting to the manager addresses suspected diversion and ensures client safety, unlike asking others, observing further, or confronting directly.
Which of the following neurochemical influences is a probable cause of substance abuse?
- A. Imbalances of serotonin and norepinephrine in the brain
- B. Inhibition of GABA in the brain
- C. Excessive serotonin activity in the CNS
- D. Stimulation of dopamine pathways in the brain
Correct Answer: D
Rationale: Stimulating dopamine pathways in the limbic system produces reinforcing pleasurable effects, driving substance abuse, unlike serotonin, norepinephrine, or GABA imbalances.