Nokea
Which of the following instructions should a nurse give to clients with opiate dependency who take methadone?
- A. Avoid driving for 3 hours after medication.
- B. Take vitamin substitutes.
- C. Maintain bed rest for 1 hour after medication.
- D. Wear a MedicAlert tag.
Correct Answer: D
Rationale: The nurse should instruct the client who takes methadone to tell healthcare providers or wear a MedicAlert tag in case the client needs a narcotic, tranquilizer, or barbiturate. Because methadone is a narcotic, lower dosages of other sedative drugs are necessary because the combination may potentiate their depressant action. It is not essential for client to avoid driving or to maintain bed rest after medication. Vitamin substitutes may not be required.
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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.
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.
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.
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.
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.