Question 1

A patient with asthma has been using a nicotine transdermal 24-hour patch for 3 weeks to quit smoking.The patient reports having difficulty sleeping.What action will the nurse take?

Accepted Answer

The patient should try an 18-hour patch to help with sleep.Nicotrol is not a good option for patients with asthma.

Question 2

The nurse is caring for a patient who is being treated for chronic alcohol intoxication.The nurse notes that the patient's serum alcohol level is 0.40 mg%.The patient is awake and talkative even though this is a potentially lethal dose.The nurse recognizes this as alcohol

Accepted Answer

Intoxication is a state of being influenced by a drug or other substance and may be a very small amount in the drug-naïve person or a potentially lethal amount in the chronic user.This person has developed tolerance to alcohol and is able to have a potentially lethal amount without severe effects.Addiction describes a state of emotional,mental,and physical dependence on a drug.Dependence describes physical need for the drug such that when the drug is stopped,withdrawal symptoms occur.Misuse refers to using a drug or substance to excess.

Question 3

The nurse is caring for a patient who is chronically irritable and anxious and prone to violent behaviors.The patient has several teeth missing and has dental caries in the remaining teeth.The nurse suspects previous chronic use of which drug?

Accepted Answer

Patients previously exposed to methamphetamine use will exhibit these symptoms,and the physical effects of extended methamphetamine use are notable tooth decay and dermatologic deterioration.

Question 4

The nurse is teaching a group in the community about drug abuse.Which statement by the nurse is correct?

Accepted Answer

Drug addiction occurs when emotional and mental dependence on a drug are present.Although physical dependence may often occur,it is not always present.Cue-induced cravings may diminish after long abstinence but do not disappear completely.Drug abuse may occur without addiction.

Question 5

The nurse is teaching a patient who will be discharged home with naltrexone (ReVia)after treatment for opioid addiction.What information will the nurse include in the teaching for this patient?

Accepted Answer

ReVia acts by blocking the pleasurable effects of opioids.It can precipitate withdrawal when given to opioid-dependent patients.This drug does not control cravings,and it is taken once daily or every other day.

Question 6

The nurse is discussing smoking cessation with a nurse colleague who smokes.Which statement indicates a readiness to quit smoking?

Accepted Answer

Patients exhibit readiness when they state a desire to quit along with a request for professional assistance.Other factors,such as children or co-workers,do not indicate a desire to quit.

Question 7

The nurse is teaching a patient who has completed detoxification for alcohol abuse who will be discharged home with a prescription for disulfiram (Antabuse).Which statement by the patient indicates understanding of the teaching?

Accepted Answer

Disulfiram causes an unpleasant and potentially fatal reaction if alcohol is consumed while taking it and can even occur with topical products containing alcohol.Drowsiness and skin rash aren't common adverse effects.The effects of disulfiram do not wear off for up to 2 weeks after the last dose.It does not block the pleasurable effects of alcohol.

Question 8

What does the nurse understand must occur in order to produce withdrawal syndrome?

Accepted Answer

Patients who develop a physical dependence on a drug will experience withdrawal syndrome when the drug is stopped.Addiction and cravings can occur without physical dependence.Tolerance refers to a decrease in drug effects with repeated use.

Question 9

The nurse is counseling a patient who wants to stop smoking.Which statement by the nurse is correct?

Accepted Answer

Headaches and increased appetite are common during nicotine withdrawal and may last for several months.Bupropion is effective but has many serious effects.Nicotine replacement therapy does not eliminate the need for behavioral therapy.Varenicline is used for at least 4 months.

Question 10

A patient is brought to the emergency department after ingesting an overdose of lorazepam (Ativan)several hours prior.The patient has a respiratory rate of 6 to 10 breaths per minute and is unconscious.The nurse will prepare to perform which action?

Accepted Answer

Flumazenil is the antidote for benzodiazepine overdose.Activated charcoal is used for asymptomatic patients who have recently consumed the drug.Gastric lavage should no longer be performed for treatment.

Question 11

A patient is brought to the emergency department by a family member.The patient reports seeing colored lights and describes feeling bugs crawling under the skin.The nurse suspects that this patient is abusing which drug?

Accepted Answer

A stimulant psychosis can occur with chronic use of any stimulant and,with cocaine,progresses to visual hallucinations of colored lights and tactile hallucinations of bugs crawling under the skin.These are not signs of abuse with alcohol,LSD,or methamphetamine.

Question 12

A patient with a history of opioid abuse will be discharged home with buprenorphine to help prevent relapse.Which product will the nurse anticipate the provider to order?

Accepted Answer

Buprenex is an agonist-antagonist opioid that can be used for detoxification and maintenance therapy because it has a low potential for abuse.Suboxone and Subutex have abuse potential.Vivitrol does not contain buprenorphine and does not prevent cravings.

Question 13

A patient is using the Commit lozenge 2 mg to help quit smoking and reports nausea and indigestion.The nurse will instruct the patient to perform which action?

Accepted Answer

The patient should allow the lozenge to dissolve slowly.Chewing or swallowing the lozenge increases gastrointestinal side effects.Increasing the dose and decreasing the frequency are not recommended.

Question 14

A patient who has a long history of alcohol abuse is admitted to the hospital for detoxification.In addition to medications needed to treat withdrawal symptoms,the nurse will anticipate giving intravenous

Accepted Answer

Thiamine should be given to prevent Wernicke's encephalopathy in patients treated for alcoholism.If glucose is indicated,the thiamine should be given first.Other treatments are given as indicated.

Question 15

A patient who is unconscious arrives in the emergency department with clammy skin and constricted pupils.The nurse assesses a respiratory rate of 8 to 10 breaths per minute.The paramedics report obvious signs of drug abuse in the patient's home.The nurse suspects that this patient has had an overdose of which substance?

Accepted Answer

Opioid overdose is characterized by constricted pupils and respiratory depression.

Question 16

A patient arrives in the emergency department in an acute state of alcohol intoxication and reports chronic consumption of "several six packs" of beer every day for the past year.The nurse anticipates administering which medication or treatment?

Accepted Answer

To prevent acute withdrawal and delirium tremens,a long-acting benzodiazepine,such as chlordiazepoxide,is given.Disulfiram would cause an acute drug interaction.Gastric lavage should no longer be performed,and vasoconstrictors are not indicated.

Quiz 5: Drugs of Abuse