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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.
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A patient is being treated for ethanol alcohol abuse in a rehabilitation center. The nurse will include which information when teaching him about disulfiram therapy?
- A. He should not smoke cigarettes while on this drug.
- B. He needs to know about the common over-the-counter substances that contain alcohol.
- C. This drug will cause the same effects as the alcohol did, without the euphoric effects.
- D. Mouthwashes and cough medicines that contain alcohol are safe because they are used in small amounts.
Correct Answer: B
Rationale: Disulfiram causes severe adverse reactions when combined with alcohol, including from over-the-counter products like mouthwashes or cough medicines, as even small amounts (e.g., 7 mL) can trigger symptoms. Smoking is not contraindicated, and disulfiram does not mimic alcohol's 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.
The nurse is conducting a smoking-cessation program. Which statement regarding drugs used in cigarette-smoking-cessation programs is true?
- A. Rapid chewing of the nicotine gum releases an immediate dose of nicotine.
- B. Quick relief from withdrawal symptoms is most easily achieved by using a transdermal patch.
- C. Compliance with treatment is higher with use of the gum rather than the transdermal patch.
- D. The nicotine gum can be used only up to six times per day.
Correct Answer: A
Rationale: Rapid chewing of nicotine gum releases an immediate dose of nicotine, providing quick relief from withdrawal symptoms. Transdermal patches provide steady release, not rapid relief, and compliance is higher with patches due to ease of use. Gum use is not limited to six times per day.
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.
When admitting a patient with a suspected diagnosis of chronic alcohol use, the nurse will keep in mind that chronic use of alcohol might result in which condition?
- A. Renal failure
- B. Cerebrovascular accident
- C. Korsakoff's psychosis
- D. Alzheimer's disease
Correct Answer: C
Rationale: Chronic alcohol use is associated with Korsakoff's psychosis, a neurologic disorder caused by thiamine deficiency, often linked to alcoholism. Renal failure, cerebrovascular accidents, and Alzheimer's disease are not directly caused by chronic alcohol use.