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A patient has been taking naltrexone as part of the treatment for addiction to heroin. The nurse expects that the naltrexone will have which therapeutic effect for this patient?
- A. Naltrexone prevents the cravings for opioid drugs.
- B. Naltrexone works as a safer substitute for the heroin until the patient completes withdrawal.
- C. The patient will experience flushing, sweating, and severe nausea if he takes heroin while on naltrexone.
- D. If opioid drugs are used while taking naltrexone, euphoria is not produced; thus, the opioid's desired effects are lost.
Correct Answer: D
Rationale: Naltrexone blocks opioid receptors, preventing the euphoria associated with heroin use, thus reducing the reinforcing effects of the drug. It does not directly prevent cravings, act as a substitute, or cause severe nausea like disulfiram does with alcohol.
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A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?
- A. Diazepam
- B. Methadone
- C. Disulfiram
- D. Bupropion
Correct Answer: B
Rationale: Methadone is commonly used to manage opioid withdrawal symptoms by reducing cravings and withdrawal effects due to its long-acting opioid properties. Diazepam and disulfiram are used for alcohol dependence, and bupropion is used for smoking cessation.
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 monitoring a patient who is experiencing severe ethanol withdrawal. Which are signs and symptoms of severe ethanol withdrawal? (Select all that apply.)
- A. Agitation
- B. Drowsiness
- C. Tremors
- D. Systolic blood pressure higher than 160 mm Hg
- E. Temperature over 100?°F
- F. Pulse over 100 beats/min
Correct Answer: A,C,D,F
Rationale: Severe ethanol withdrawal (delirium tremens) is characterized by agitation, tremors, systolic blood pressure over 160 mm Hg, and pulse over 100 beats/min. Drowsiness is not typical, and while fever may occur, a specific threshold like 100?°F is not universally diagnostic.
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.