Nokea
The client has successfully completed detox and is ready for discharge home. What is the primary reason the nurse refers the client to Alcoholics Anonymous (AA)?
- A. To teach how to manage alcohol use
- B. To provide support for a lifelong addiction
- C. To help the client meet other people who have been successful in treatment
- D. To prevent relapse from occurring
Correct Answer: B
Rationale: Alcoholism is a lifelong addiction that must be managed on an hourly/daily/weekly basis because the client is powerless over alcohol. AA emphasizes personal accountability while providing support from those who have walked in the same shoes as the client. Relapse is a common setback among recovering individuals, and AA provides encouragement to work the program of success that is alcohol and drug free.
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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.
Which stage of tobacco dependence occurs when a person uses tobacco sporadically?
- A. Contemplation
- B. Experimentation
- C. Initiation
- D. Precontemplation
Correct Answer: B
Rationale: The experimentation stage occurs when the client uses tobacco sporadically. The contemplation stage entertains the possibility of using a tobacco product. During the initiation stage, the client uses tobacco for the first time. During the precontemplation stage, the client lacks ideas about personally using tobacco.
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 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.
A client has overdosed on opiates. Which drug would the nurse anticipate being ordered for this client?
- A. Dolphine
- B. Naltrexone
- C. Naloxone
- D. Hydromorphone
Correct Answer: C
Rationale: Opiate overdose leads to respiratory depression, unconsciousness, and death. Naloxone is administered to reverse the effects of opiates and assists in restoring respiration. Naltrexone is an opiate antagonist that is used for rapid opiate detoxification while the client is under anesthesia. Dolphine and hydromorphone are opiate drugs and would increase the effects of respiratory depression.