Nokea
While caring for a patient with a methamphetamine overdose, which tasks are the priorities of care?
- A. Administration of naloxone (Narcan)
- B. Vitamin B12 and folate supplements
- C. Restoring nutritional integrity
- D. Prevention of seizures
- E. Reduction of fever
Correct Answer: D,E
Rationale: Hyperpyrexia and convulsions are life-threatening in methamphetamine overdose, making these priorities.
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Which medication is the nurse most likely to see prescribed as part of the treatment plan for both a patient in an alcoholism treatment program and a patient in a program for the treatment of opioid addiction?
- A. Methadone
- B. Bromocriptine
- C. Disulfiram
- D. Naltrexone
Correct Answer: D
Rationale: Naltrexone blocks opioid action and reduces alcohol craving, useful for both addictions.
A woman in the last trimester of pregnancy drinks 8 to 12 ounces of alcohol daily. The nurse plans for the delivery of an infant who presents with what related characteristic?
- A. Jaundice
- B. Dependent on alcohol
- C. Healthy but underweight
- D. Facial abnormalities and cognitive impairment
Correct Answer: D
Rationale: Fetal alcohol syndrome is the result of alcohol's inhibiting fetal development in the first trimester. The fetus of a woman who drinks that much alcohol will probably have this disorder.
A patient admitted yesterday for injuries sustained while intoxicated believes the window blinds are snakes trying to get into the room. The patient is anxious, agitated, and diaphoretic. Which medication can the nurse anticipate the health care provider will prescribe?
- A. Monoamine oxidase inhibitor, such as phenelzine
- B. Phenothiazine, such as thioridazine
- C. Benzodiazepine, such as lorazepam
- D. Narcotic analgesic, such as morphine
Correct Answer: C
Rationale: Benzodiazepines are the drugs of choice for alcohol withdrawal delirium due to their high therapeutic safety index and anticonvulsant properties.
In the emergency department, a patient's vital signs are: blood pressure (BP), 66/40 mm Hg; pulse (P), 140 beats/min (bpm); and respirations (R), 8 breaths per minute and shallow. The patient overdosed on illegally obtained hydromorphone. What is the priority outcome for this patient?
- A. Within 8 hours, vital signs will stabilize as evidenced by BP greater than 90/60 mm Hg, P less than 100 bpm, and respirations at or above 12 breaths per minute.
- B. The patient will be able to describe a plan for home care and achieve a drug-free state before being released from the emergency department.
- C. The patient will attend daily meetings of Narcotics Anonymous within 1 week of beginning treatment.
- D. The patient will identify two community resources for the treatment of substance abuse by discharge.
Correct Answer: A
Rationale: Stabilizing vital signs is the priority for an opiate overdose.
An adult in the emergency department states, 'I feel restless. Everything I look is wavy. Sometimes I'm outside my body looking at myself. I hear colors. I think I'm losing my mind.' Vital signs are slightly elevated. The nurse should suspect what triggered these reports?
- A. Cocaine overdose
- B. Schizophrenic episode
- C. Phencyclidine (PCP) intoxication
- D. Lysergic acid diethylamide (LSD) ingestion
Correct Answer: D
Rationale: LSD ingestion causes synesthesia, depersonalization, and concerns about losing sanity.