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Which is the best nursing intervention to prevent a potential depressant action of methadone caused by mixing with another drug?
- A. Urine testing
- B. Provide only liquid form of methadone.
- C. Interview client prior to dosing.
- D. Assess vital signs.
Correct Answer: A
Rationale: The practice of testing the urine before providing methadone is one way of screening and eliminating those who are abusing the system and trying to potentiate the effects of the methadone by combining with another depressant. The methadone should be administered by a professional and supplied in a liquid form to avoid cheeking of the drug. Addictive clients are drug-seeking in nature and cannot be trusted to always be honest with drug use questioning and answers. Vital sign monitoring is not significant in the detection of alternate drug use.
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Which blood alcohol level (BAL) is associated with coma?
- A. 200 mg/dL
- B. 300 mg/dL
- C. 400 mg/dL
- D. 500 mg/dL
Correct Answer: C
Rationale: A BAL of 400 mg/dL is associated with coma. A BAL of 200 mg/dL is associated with staggering and poor control of emotions. A BAL of 300 mg/dL is associated with mental confusion and stupor. A BAL of 500 mg/dL is associated with respiratory depression and death.
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.
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.
A client who has attempted to quit smoking and failed two times before is reluctant to make another attempt. Which response by the nurse is most appropriate?
- A. You will know when the time is right.
- B. Most people who have tried and failed ultimately do succeed.
- C. Tell me what you have tried before and we can make changes to your plan.
- D. I know you can do it this time.
Correct Answer: B
Rationale: Attempts to quit are a predictor of eventual success, and many of those who have tried and failed do ultimately succeed. Providing the client with this encouragement supports the desire to quit. Waiting until the time is right may postpone the urge to quit. The nurse does not 'know' for certainty that a client is going to achieve a goal but can be a supporter during the process. Although having a plan to follow is important, the support and encouragement to take the first step is the springboard.
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.