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When discussing the purpose of beginning methadone therapy for opioid addiction, which statement by the nurse is most appropriate?
- A. It is not addictive for heroin users.
- B. It takes away the desire for narcotics.
- C. There are no withdrawal symptoms.
- D. Less time will be spent in drug-seeking behaviors.
Correct Answer: D
Rationale: The purpose of using methadone in the management of opioid addicts remains controversial. Methadone has a longer half-life and can be given as a once daily dose. Methadone is safer than heroin and allows the client to work, live, and function normally because less time is spent on drug-seeking behaviors and unsafe drug practices. Methadone is a schedule II synthetic opioid analgesic and has dependency and withdrawal capabilities. The use of methadone does not take away desires for narcotics and urine testing should be routinely completed to deter combined use.
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Which of the following is a true statement regarding alcohol use in the older adult population?
- A. Older adults who drink exhibit less impairment.
- B. Older adults have a higher metabolism which leads to alcohol toxicity.
- C. Alcoholism may be difficult to identify in older adults.
- D. Dementia may be associated with high ingestion of alcohol for 10 or more years.
Correct Answer: C
Rationale: Alcoholism may be difficult to identify in older adults because symptoms such as tremors, unsteady gait, or memory loss mimic changes associated with aging. Older adults who drink exhibit more impairment. Older adults have a slower metabolism. Dementia may be associated with heavy ingestion of alcohol for 10 or more years, or with ingestion of other toxic substances, including heavy metals.
A client states, 'My father was an alcoholic so I am destined to be one too.' Which is the best response by the nurse?
- A. Children of alcoholics are more likely to become alcoholic.
- B. There is treatment available to prevent the trait of alcoholism.
- C. This is just a theory and has no basis of proof.
- D. Let's talk about how you can take control of your destiny.
Correct Answer: D
Rationale: Even with a possible genetic link to alcoholism, the individual remains in control of taking the first drink that triggers the metabolism of alcohol to THIQ. Every person is responsible for his or her own destiny and should receive encouragement to exercise that control. Children of alcoholics (COA) do have a greater likelihood of developing alcohol dependency. The only prevention of the trait of alcoholism is abstinence.
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.
The client, who has recently stopped smoking, is irritable and complaining of a feeling hungry. The nurse would interpret this as which of the following?
- A. Addiction
- B. Withdrawal
- C. Dependency
- D. Tolerance
Correct Answer: B
Rationale: Irritability and increased appetite are physical symptoms that occur when a person abruptly stops using an abused substance, such as tobacco. Addiction and dependency are terms that refer to drug-seeking behaviors that interfere with work, relationships, and normal activities. Tolerance refers to the reduction in a drug's effect that follows persistent use.
The client who is experiencing alcohol withdrawal has a temperature of 100.6?°F, pulse of 112 beats/minute, and BP 180/102 mm Hg. What would the nurse anticipate doing first?
- A. Encourage the client to rest.
- B. Administer benzodiazepine as ordered.
- C. Monitor for any further changes.
- D. Provide emotional support.
Correct Answer: B
Rationale: The standardized symptom withdrawal flow sheet, Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar) as well as the Rule of One Hundreds are indicators of escalating withdrawal. The rise in these vital signs suggests the need for sedative medication. Monitoring hourly vital signs and further changes would be appropriate. Rest and emotional support can be helpful.