Nokea
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.
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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.
A patient who is alcohol-intoxicated must undergo emergency surgery for abdominal trauma. Which of the following should the nurse anticipate when caring for the patient in the perioperative period?
- A. An increased dose of the general anaesthetic medication
- B. Frequent monitoring for bleeding and respiratory complications
- C. Development of withdrawal symptoms within a few hours after surgery
- D. Stimulation every hour to prevent prolonged postoperative sedation
Correct Answer: B
Rationale: Patients who are intoxicated at the time of surgery are at increased risk for problems with bleeding and respiratory complications such as aspiration. In an intoxicated patient, a lower dose of anesthesia is used because of the synergistic effect of the alcohol. Withdrawal is likely to occur later in the postoperative course because the medications used for anesthesia, sedation, and pain will delay withdrawal symptoms. The patient should be monitored frequently for oversedation but does not need to be stimulated.
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.
An agitated individual is brought to the emergency department by friends who state that the patient took a hallucinogenic drug at a party and then tried to jump from a second-story window. Which of the following nursing diagnoses is priority?
- A. Risk for injury related to altered sensation.
- B. Ineffective health maintenance related to ineffective coping strategies.
- C. Powerlessness related to insufficient knowledge to manage a situation.
- D. Ineffective denial related to insufficient sense of control.
Correct Answer: A
Rationale: Although all the diagnoses may be appropriate for the patient, the highest priority is to address the patient's immediate risk for injury.
During physical assessment of a patient who has sinus headaches, the nurse finds nasal sores and necrosis of the nasal septum. Patient use of which of the following substances should the nurse include in the assessment?
- A. Heroin
- B. Cocaine
- C. Tobacco
- D. Marijuana
Correct Answer: B
Rationale: When cocaine is inhaled, it causes ischemia of the nasal septum, leading to nasal sores and necrosis. These symptoms are not associated with the use of heroin, tobacco, or marijuana.