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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.
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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.
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 presenting a substance-abuse lecture for teenagers and is asked about 'ecstasy.' The nurse recognizes that this is the slang term for which substance?
- A. Cocaine
- B. Flunitrazepam
- C. Methamphetamine
- D. Methylenedioxymethamphetamine (MDMA)
Correct Answer: D
Rationale: Ecstasy is a common slang term for methylenedioxymethamphetamine (MDMA), a synthetic amphetamine derivative with stimulant and hallucinogenic properties. The other substances listed have different slang names and effects.
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.