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The nurse is caring for a patient who takes methadone daily to prevent a relapse of heroin addiction and has been admitted for knee surgery. Which of the following actions should the nurse include in the plan of care to promote effective pain control postoperatively?
- A. Use a mixed opioid agonist-antagonist drug for pain relief.
- B. Administer opioid analgesics on a regularly scheduled basis.
- C. Avoid use of opioids and use alternatives such as NSAIDs.
- D. Give prescribed doses of opioid pain medication as needed for pain.
Correct Answer: B
Rationale: A patient addicted to opioids should receive them on an around-the-clock basis to prevent withdrawal. Normal opioid doses given on a PRN basis will not effectively relieve pain in a patient who has developed tolerance. NSAIDs may be used as adjuncts, but they should not be the primary analgesic used. Mixed opioid agonist-antagonist drugs can precipitate withdrawal in patients who have tolerance to opioids.
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The nurse is caring for a patient who smokes a pack of cigarettes daily and has been admitted to the hospital for surgery. In anticipation of nicotine withdrawal, which of the following goals should the nurse include when planning postoperative care?
- A. Improve sleep.
- B. Enhance appetite.
- C. Decrease diarrhea.
- D. Prevent sore throat.
Correct Answer: A
Rationale: Insomnia is a characteristic of nicotine withdrawal. Diarrhea, sore throat, and anorexia are not symptoms associated with nicotine withdrawal.
Suicide is an overdose effect of which of the following substances?
- A. Alcohol
- B. Inhalants
- C. Opioids
- D. Hallucinogens
Correct Answer: B
Rationale: Suicide is an overdose effect of the use of inhalants. Suicide has not been identified as an overdose effect of alcohol, opioids, or hallucinogens.
A patient with a history of heavy alcohol use is seen at the clinic with acute gastritis. Which statement by the patient indicates that the patient is in the contemplation stage of change?
- A. I am older and wiser now, and I know I can change my drinking behaviour.
- B. Alcohol has never bothered my stomach. I think it's likely that I have the flu.
- C. I think my drinking is affecting my stomach, but maybe some drugs will help.
- D. People say that I drink too much, but I really feel pretty good most of the time.
Correct Answer: C
Rationale: This statement indicates that the patient recognizes that alcohol use is the reason for the gastritis but is not yet willing to make a change. The statement 'I am older and wiser now, and I know I can change my drinking behaviour' indicates a patient at the preparation stage. The remaining two statements are typical of the precontemplation stage.
The nurse is assessing a patient who has a history of alcohol use. Which of the following assessment data should the nurse expect?
- A. Low blood pressure
- B. Decreased heart rate
- C. Elevated temperature
- D. Abdominal tenderness
Correct Answer: D
Rationale: Abdominal pain associated with gastrointestinal tract and liver dysfunction is common in patients with persistent alcohol use. The other problems are not typically associated with alcohol use.
The nurse is caring for an adult patient who is experiencing acute intoxication. Which of the following time frames should the nurse anticipate for the resolution of acute intoxication responses?
- A. 4 hours
- B. 12 hours
- C. 24 hours
- D. 48 hours
Correct Answer: C
Rationale: Intoxication responses usually last less than 24 hours and are directly related to the ingestion of psychoactive substances.