Nokea
Disulfiram is prescribed for a client recovering from alcohol dependency. What is the primary reason for prescribing this drug?
- A. Protects the liver from damage
- B. Prevents client from becoming intoxicated
- C. Makes consuming any type of alcohol unpleasant
- D. Prevents the client from drinking alcohol
Correct Answer: C
Rationale: The ingestion of alcohol while taking disulfiram will result in uncomfortable symptoms. Disulfiram does not protect the liver. Disulfiram deters drinking but does not prevent the ingestion of alcohol.
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A hypertensive client is admitted to the acute care facility that has a tobacco-free policy. Which nursing intervention would be most appropriate for the client who is a smoker?
- A. Allow the client to go outside to smoke.
- B. Anticipate withdrawal symptoms and treat accordingly.
- C. Contact the physician for a nonnicotine medication.
- D. Offer the client nicotine gum.
Correct Answer: C
Rationale: Nonnicotine medications such as Zyban and Chantix are dopamine uptake inhibitors that help suppress nicotine's addicting reinforcement. The order for these medications must be initiated by the physician and should lower the incidence of withdrawal symptoms for the client. Tobacco-free institutions do not permit smoking outdoors, and this activity should not be encouraged by the nurse. Offering nicotine gum without a physician's order is not appropriate. The nurse should anticipate withdrawal symptoms and provide kind supportive encouragement.
What assessment finding(s) is most important in determining the presence of alcohol dependency in a client? Select all that apply.
- A. Patterns of use
- B. Weight loss
- C. Fluctuation in appetite
- D. Absenteeism from work
- E. Blurred vision
- F. Blackouts
Correct Answer: A,D,F
Rationale: People who are dependent on alcohol are driven by the pattern of use and how or when to obtain alcohol. They begin drinking earlier in the day and create opportunities to drink. Loss of work hours, especially on Mondays, becomes a pattern. Blackouts or loss of episodes of time can occur in the early and later stages of the abuse. Weight loss and fluctuation in appetite may be associated with alcohol use disorder but is not a determining factor. Blurred vision is not significant in the assessment of the disorder.
A client is brought to the emergency department with hallucinations, acne, and blackened teeth. During the nursing assessment, a generalized seizure begins. The nurse interprets this as possible toxicity by which substance?
- A. Crack
- B. Cocaine
- C. Opiate
- D. Methamphetamine
Correct Answer: D
Rationale: Methamphetamine users may develop acne, 'meth mouth,' tactile hallucinations, and can develop convulsions, respiratory, and cardiac arrest. Cocaine and opiate dependence do not result in the inclusion of the symptoms presented, but the nurse should understand that poly drug use disorder is common.
Which is the best nursing intervention to prevent a potential depressant action of methadone caused by mixing with another drug?
- A. Urine testing
- B. Provide only liquid form of methadone.
- C. Interview client prior to dosing.
- D. Assess vital signs.
Correct Answer: A
Rationale: The practice of testing the urine before providing methadone is one way of screening and eliminating those who are abusing the system and trying to potentiate the effects of the methadone by combining with another depressant. The methadone should be administered by a professional and supplied in a liquid form to avoid cheeking of the drug. Addictive clients are drug-seeking in nature and cannot be trusted to always be honest with drug use questioning and answers. Vital sign monitoring is not significant in the detection of alternate drug use.
A client has a blood alcohol level that is double the legal limit for driving yet does not exhibit behaviors of intoxication. The nurse knows that this is due to which effect?
- A. Tolerance
- B. Addiction
- C. Alcoholism
- D. Relapse
Correct Answer: A
Rationale: Tolerance occurs when the body develops mechanisms to reduce the effects of a drug through persistent use. This results in the need to increase the amount of a substance to obtain the desired effect. Addiction is a term that refers to drug-seeking behavior that interferes with work, relationships, and normal activities. Alcoholism is a chronic, progressive disease characterized by an inability to control the consumption of alcohol in which tolerance develops. Relapse is a term referring to the return to drug or alcohol use after a period of abstinence.