Nokea
Clinical manifestations of methamphetamine use include which of the following?
- A. Weight gain
- B. Moist mucous membranes
- C. Acne
- D. Vasodilation of blood vessels
Correct Answer: C
Rationale: Methamphetamine users may develop acne and be covered with multiple scratched areas because they believe that insects are crawling under their skin. The client will have dry mucous membranes, weight loss, and vasoconstriction of blood vessels.
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Which of the following instructions should a nurse give to clients with opiate dependency who take methadone?
- A. Avoid driving for 3 hours after medication.
- B. Take vitamin substitutes.
- C. Maintain bed rest for 1 hour after medication.
- D. Wear a MedicAlert tag.
Correct Answer: D
Rationale: The nurse should instruct the client who takes methadone to tell healthcare providers or wear a MedicAlert tag in case the client needs a narcotic, tranquilizer, or barbiturate. Because methadone is a narcotic, lower dosages of other sedative drugs are necessary because the combination may potentiate their depressant action. It is not essential for client to avoid driving or to maintain bed rest after medication. Vitamin substitutes may not be required.
Which of the following is a true statement regarding alcohol use in the older adult population?
- A. Older adults who drink exhibit less impairment.
- B. Older adults have a higher metabolism which leads to alcohol toxicity.
- C. Alcoholism may be difficult to identify in older adults.
- D. Dementia may be associated with high ingestion of alcohol for 10 or more years.
Correct Answer: C
Rationale: Alcoholism may be difficult to identify in older adults because symptoms such as tremors, unsteady gait, or memory loss mimic changes associated with aging. Older adults who drink exhibit more impairment. Older adults have a slower metabolism. Dementia may be associated with heavy ingestion of alcohol for 10 or more years, or with ingestion of other toxic substances, including heavy metals.
Upon admission of a client to the detox unit, the nurse administers lorazepam (Ativan). The client asks, 'How long will I get these drugs?' Which is the best understanding by the nurse?
- A. The drugs will be given routinely until detox is completed.
- B. Because Ativan has potential addictive qualities, it will be stopped after 24 hours.
- C. High doses may be required initially but then will be tapered and stopped.
- D. The physician will decide the dosage and reorder every third day.
Correct Answer: C
Rationale: Ativan is used to control withdrawal symptoms. Initially, the medication may need to be administered frequently and in high doses to compensate for the client's cross-tolerance and then tapered and discontinued. Ativan is a controlled substance and should not be prescribed for long-term use. The physician establishes the order for the administration of all medications during the detoxification of clients.
Which blood alcohol level (BAL) is associated with coma?
- A. 200 mg/dL
- B. 300 mg/dL
- C. 400 mg/dL
- D. 500 mg/dL
Correct Answer: C
Rationale: A BAL of 400 mg/dL is associated with coma. A BAL of 200 mg/dL is associated with staggering and poor control of emotions. A BAL of 300 mg/dL is associated with mental confusion and stupor. A BAL of 500 mg/dL is associated with respiratory depression and death.
The client who reports drinking half a case of beer each day is admitted for detoxification. Which answer explains the onset of withdrawal symptoms 4 hours after last reported drink?
- A. The client will progress through detox faster than expected.
- B. Early onset of withdrawal symptoms indicates incorrect reporting of the time of last use.
- C. Three hours is the normal onset for withdrawal symptoms to begin.
- D. The withdrawal process will take about 24 hours from time of onset.
Correct Answer: B
Rationale: Alcohol withdrawal usually begins 6 hours after last drink. This client has incorrectly reported the time of last use. The withdrawal process from alcohol usually takes about 48 hours or more.