Nokea
Which stage of tobacco dependence occurs when a person uses tobacco sporadically?
- A. Contemplation
- B. Experimentation
- C. Initiation
- D. Precontemplation
Correct Answer: B
Rationale: The experimentation stage occurs when the client uses tobacco sporadically. The contemplation stage entertains the possibility of using a tobacco product. During the initiation stage, the client uses tobacco for the first time. During the precontemplation stage, the client lacks ideas about personally using tobacco.
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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.
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.
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 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.
A client has a blood alcohol level that is double the legal limit for driving yet does not exhibit behaviors of intoxication. The nurse knows that this is due to which effect?
- A. Tolerance
- B. Addiction
- C. Alcoholism
- D. Relapse
Correct Answer: A
Rationale: Tolerance occurs when the body develops mechanisms to reduce the effects of a drug through persistent use. This results in the need to increase the amount of a substance to obtain the desired effect. Addiction is a term that refers to drug-seeking behavior that interferes with work, relationships, and normal activities. Alcoholism is a chronic, progressive disease characterized by an inability to control the consumption of alcohol in which tolerance develops. Relapse is a term referring to the return to drug or alcohol use after a period of abstinence.