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The nurse is discussing the effects of secondhand smoking with a group of new mothers. What information is most important for the nurse to include?
- A. Higher risk for fractures as they age
- B. Severe asthma attacks in children of smokers
- C. Greater risk for lung cancer
- D. Increased rate for coronary heart disease
Correct Answer: B
Rationale: Children with asthma have a greater frequency and more severe attacks when exposed to secondhand smoke. New mothers who smoked during pregnancy need to know their infants are at increased risk of sudden infant death syndrome. Higher incidence of lung cancer, fractures, and coronary heart disease are all consequences of smoking but not specific to new mothers or their infants.
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Which of the following assessment findings is observed in a client with opiate use?
- A. Diarrhea
- B. Pinpoint-sized pupils
- C. Weight gain
- D. Bulimia
Correct Answer: B
Rationale: The assessment findings in a client with opiate use are pinpoint-sized pupils, constipation, weight loss, and anorexia. Diarrhea, weight gain, and bulimia are not the assessment findings observed in a client with opiate dependency.
Which of the following refers to the reduction in a drug's effect that follows persistent use?
- A. Addiction
- B. Tolerance
- C. Withdrawal
- D. Dependence
Correct Answer: B
Rationale: Tolerance refers to the reduction in a drug's effect that follows persistent use. Addiction is drug-seeking behaviors that interfere with work, relationships, and normal activities. Withdrawal refers to the physical symptoms and craving for a drug that occur when a person abruptly stops using an abused substance. Dependence means that a person must take a drug to avoid withdrawal symptoms.
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.
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.
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.