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Which assessment finding is most important in determining nursing care of a client withdrawing from cocaine?
- A. Suicide precautions
- B. Nutritional support
- C. Facial burns
- D. Perforated septum
Correct Answer: A
Rationale: Depression and dysphoria are of concern during recovery from cocaine addiction. Monitoring the client for suicidal ideation and administering medications that provide support during withdrawal are essential nursing interventions. Weight loss and nutritional deficits are common among cocaine addiction but not the primary concern. Facial burns (fire, debasing) and perforated septum (from snorting) are common problems associated with cocaine addiction.
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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.
Many healthcare providers are screening applicants for tobacco use. Which is the primary reasoning for this new employment practice?
- A. Clients should not be exposed to the odor of tobacco.
- B. Nurses should be a role model to the clients served.
- C. Shooters take more breaks during the work day.
- D. Nicotine contributes to fatal illnesses.
Correct Answer: D
Rationale: According to the CDC (2020), smoking is responsible for 80% to 90% of deaths from lung cancer.
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.
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.