Question 1

A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?&#10;A) Diazepam (Valium)&#10;B) Methadone&#10;C) Disulfiram (Antabuse)&#10;D) Bupropion (Zyban)

Accepted Answer

Opioid withdrawal can be managed with either methadone or clonidine (Catapres). See Box 17-3. Diazepam and disulfiram are used for treatment of alcoholism, and bupropion is used to assist with smoking cessation.

Question 2

A patient has been taking naltrexone (ReVia) as part of the treatment for addiction to heroin. The nurse expects that the naltrexone will have which therapeutic effect for this patient?&#10;A) Naltrexone prevents the cravings for opioid drugs.&#10;B) Naltrexone works as a safer substitute for the heroin until the patient completes withdrawal.&#10;C) The patient will experience flushing, sweating, and severe nausea if he takes heroin while on naltrexone.&#10;D) If opioid drugs are used while taking naltrexone, euphoria is not produced; thus, the opioid's desired effects are lost.

Accepted Answer

Naltrexone works to eliminate the euphoria that occurs with opioid drug use; therefore, the reinforcing effect of the drug is lost.

Question 3

A patient has been taking disulfiram (Antabuse) as part of his rehabilitation therapy. However, this evening, he attended a party and drank half a beer. As a result, he became ill and his friends took him to the emergency department. The nurse will look for which adverse effects associated with acetaldehyde syndrome?

A) Euphoria
B) Severe vomiting
C) Diarrhea
D) Pulsating headache
E) Difficulty breathing
F) Sweating

Severe vomiting
Pulsating headache
Difficulty breathing
Sweating

Accepted Answer

Disulfiram (Antabuse) inhibits the enzyme acetaldehyde dehydrogenase, which is involved in metabolizing ethanol. When alcohol is consumed, it leads to an accumulation of acetaldehyde, causing symptoms such as severe vomiting, pulsating headache, difficulty breathing, and sweating, which are associated with acetaldehyde syndrome.

Question 4

A 38-year-old male patient stopped smoking 6 months ago. He tells the nurse that he still feels strong cigarette cravings and wonders if he is ever going to feel "normal" again. Which statement by the nurse is correct?

A) "It's possible that these cravings will never stop."
B) "These cravings may persist for several months."
C) "The cravings tell us that you are still using nicotine."
D) "The cravings show that you are about to experience nicotine withdrawal."

Accepted Answer

Cigarette cravings may persist for months, or even years, after nicotine withdrawal. The other statements are false.

Question 5

A nurse is providing teaching for a patient who will be taking varenicline (Chantix) as part of a smoking-cessation program. Which teaching points are appropriate for a patient taking this medication?&#10;A) This drug is available as a chewing gum that can be taken to reduce cravings.&#10;B) Use caution when driving because drowsiness may be a problem.&#10;C) There have been very few adverse effects reported for this drug.&#10;D) Notify the prescriber immediately if feelings of sadness or thoughts of suicide occur.&#10;E) Avoid caffeine while on this drug.

Accepted Answer

Patients taking varenicline have reported drowsiness, which has prompted the U.S. Food and Drug Administration (FDA) to recommend caution when driving and engaging in other potentially hazardous activities until the patient can determine how the drug affects his or her mental status. In addition, the FDA has warned about psychiatric symptoms including agitation, depression, and suicidality. Varenicline is an oral tablet, and common adverse effects include nausea, vomiting, headache, and insomnia. There are no cautions about taking caffeine while on this drug.

Question 6

The nurse is monitoring a patient who is experiencing severe ethanol withdrawal. Which are signs and symptoms of severe ethanol withdrawal?&#10;A) Agitation&#10;B) Drowsiness&#10;C) Tremors&#10;D) Systolic blood pressure higher than 200 mm Hg&#10;E) Temperature over 100&#176; F (37.7&#176; C)&#10;F) Pulse rate 150 beats/min

Accepted Answer

Signs and symptoms of severe ethanol withdrawal (delirium tremens) include systolic blood pressure higher than 200 mm Hg, diastolic blood pressure higher than 140 mm Hg, pulse rate higher than 140 beats/min, temperature above 101° F (38.3° C), tremors, insomnia, and agitation. See Box 17-6 for all signs and symptoms of ethanol withdrawal.

Question 7

A patient is being treated for ethanol alcohol abuse in a rehabilitation center. The nurse will include which information when teaching him about disulfiram (Antabuse) therapy?&#10;A) He should not smoke cigarettes while on this drug.&#10;B) He needs to know about the common over-the-counter substances that contain alcohol.&#10;C) This drug will cause the same effects as the alcohol did, without the euphoric effects.&#10;D) Mouthwashes and cough medicines that contain alcohol are safe because they are used in small amounts.

Accepted Answer

The use of disulfiram (Antabuse) with alcohol-containing over-the-counter products will elicit severe adverse reactions. As little as 7 mL of alcohol may cause symptoms in a sensitive person. Cigarette smoking does not cause problems when taking disulfiram. Disulfiram does not have the same effects as alcohol.

Question 8

A 29-year-old patient is admitted to the intensive care unit with the following symptoms: restlessness, hyperactive reflexes, talkativeness, confusion and periods of panic, and tachycardia. The nurse suspects that he may be experiencing the effects of taking which substance?

A) Opioids
B) Alcohol
C) Stimulants
D) Depressants

Accepted Answer

The adverse effects listed may occur with use of stimulants and are commonly an extension of their therapeutic effects. Opioids, alcohol, and depressants do not have these effects.

Question 9

The nurse is presenting a substance-abuse lecture for teenage girls and is asked about &#34;roofies.&#34; The nurse recognizes that this is the slang term for which substance?&#10;A) Cocaine&#10;B) Flunitrazepam&#10;C) Secobarbital&#10;D) Methamphetamine

Accepted Answer

Flunitrazepam is a benzodiazepine that has gained popularity as a recreational drug and is commonly called roofies (the "date-rape" drug). The other drugs are not known as roofies.

Question 10

When admitting a patient with a suspected diagnosis of chronic alcohol use, the nurse will keep in mind that chronic use of alcohol might result in which condition?&#10;A) Renal failure&#10;B) Cerebrovascular accident&#10;C) Korsakoff's psychosis&#10;D) Alzheimer's disease

Accepted Answer

A variety of serious neurologic and mental disorders, such as Korsakoff's psychosis and Wernicke's encephalopathy, as well as cirrhosis of the liver, may occur with chronic use of alcohol. Renal failure, cerebrovascular accident, and Alzheimer's disease are not associated directly with chronic use of alcohol.

Question 11

The nurse is conducting a smoking-cessation program. Which statement regarding drugs used in cigarette-smoking-cessation programs is true?&#10;A) Rapid chewing of the nicotine gum releases an immediate dose of nicotine.&#10;B) Quick relief from withdrawal symptoms is most easily achieved by using a transdermal patch.&#10;C) Compliance with treatment is higher with use of the gum rather than the transdermal patch.&#10;D) The nicotine gum can be used only up to six times per day.

Accepted Answer

The answer of The nurse is conducting a smoking-cessation program....

Deck 17: Substance Use Disorder