Question 1

An 80-year-old client with heart disease tells the nurse, "I am sick because I sinned by smoking cigarettes." Which response by the nurse is appropriate?

Accepted Answer

A)This client is in distress and seeking forgiveness. The nurse should offer this forgiveness and a reason why the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that the client's distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.
B)This client is in distress and seeking forgiveness. The nurse should offer this forgiveness and a reason why the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that the client's distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.
C)This client is in distress and seeking forgiveness. The nurse should offer this forgiveness and a reason why the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that the client's distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.
D)This client is in distress and seeking forgiveness. The nurse should offer this forgiveness and a reason why the forgiveness is valid. If the nurse tells the client that it is too late to do anything about the problem, there is a possibility that the client's distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking is a sin. Saying there are worse habits minimizes the client's concerns and does not offer forgiveness.

Question 2

A nurse is teaching a client about the effects of smoking during pregnancy. Upon conclusion of the teaching session, which of the following client statements would suggest that further education is necessary?

Accepted Answer

A)Nicotine crosses the placenta, and fetal concentrations of nicotine can be 15% higher than maternal concentrations. Smoking during pregnancy is associated with increased risk for spontaneous abortion, preterm delivery, respiratory disease, immune system difficulties, and cancer later in life. Various studies link placental complications to prenatal exposure to cigarette smoke. Prenatal tobacco exposure has been associated with serious neurodevelopmental and behavioral consequences in children, including attention deficits and issues with learning and memory.
B)Nicotine crosses the placenta, and fetal concentrations of nicotine can be 15% higher than maternal concentrations. Smoking during pregnancy is associated with increased risk for spontaneous abortion, preterm delivery, respiratory disease, immune system difficulties, and cancer later in life. Various studies link placental complications to prenatal exposure to cigarette smoke. Prenatal tobacco exposure has been associated with serious neurodevelopmental and behavioral consequences in children, including attention deficits and issues with learning and memory.
C)Nicotine crosses the placenta, and fetal concentrations of nicotine can be 15% higher than maternal concentrations. Smoking during pregnancy is associated with increased risk for spontaneous abortion, preterm delivery, respiratory disease, immune system difficulties, and cancer later in life. Various studies link placental complications to prenatal exposure to cigarette smoke. Prenatal tobacco exposure has been associated with serious neurodevelopmental and behavioral consequences in children, including attention deficits and issues with learning and memory.
D)Nicotine crosses the placenta, and fetal concentrations of nicotine can be 15% higher than maternal concentrations. Smoking during pregnancy is associated with increased risk for spontaneous abortion, preterm delivery, respiratory disease, immune system difficulties, and cancer later in life. Various studies link placental complications to prenatal exposure to cigarette smoke. Prenatal tobacco exposure has been associated with serious neurodevelopmental and behavioral consequences in children, including attention deficits and issues with learning and memory.

Question 3

A nurse is providing preconception counseling and education to an adult client with no prior pregnancies. Which client statement indicates that the nurse's teaching has been effective?

Accepted Answer

A)Women should stop drinking alcohol when they attempt to become pregnant. It is not known how much alcohol will cause fetal damage; therefore, any amount of alcohol, even one beer, during pregnancy is contraindicated. Alcohol passes readily into breast milk; therefore, women should abstain from alcohol while breastfeeding, or the milk should be pumped and dumped after alcohol consumption.
B)Women should stop drinking alcohol when they attempt to become pregnant. It is not known how much alcohol will cause fetal damage; therefore, any amount of alcohol, even one beer, during pregnancy is contraindicated. Alcohol passes readily into breast milk; therefore, women should abstain from alcohol while breastfeeding, or the milk should be pumped and dumped after alcohol consumption.
C)Women should stop drinking alcohol when they attempt to become pregnant. It is not known how much alcohol will cause fetal damage; therefore, any amount of alcohol, even one beer, during pregnancy is contraindicated. Alcohol passes readily into breast milk; therefore, women should abstain from alcohol while breastfeeding, or the milk should be pumped and dumped after alcohol consumption.
D)Women should stop drinking alcohol when they attempt to become pregnant. It is not known how much alcohol will cause fetal damage; therefore, any amount of alcohol, even one beer, during pregnancy is contraindicated. Alcohol passes readily into breast milk; therefore, women should abstain from alcohol while breastfeeding, or the milk should be pumped and dumped after alcohol consumption.

Question 4

Which of the following tools is considered the best scale for assessing the severity of symptoms of acute alcohol withdrawal?

Accepted Answer

A)The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar)scale is currently recommended as the best scale for assessing the severity of symptoms of acute alcohol withdrawal. The Michigan Alcohol Screening Test (MAST)and the Brief Drug Abuse Screening Test (B-DAST)are used to determine the degree of severity of alcohol abuse or dependence. The CAGE questionnaire is useful when the client may not recognize that he or she has an alcohol problem or is uncomfortable acknowledging it.
B)The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar)scale is currently recommended as the best scale for assessing the severity of symptoms of acute alcohol withdrawal. The Michigan Alcohol Screening Test (MAST)and the Brief Drug Abuse Screening Test (B-DAST)are used to determine the degree of severity of alcohol abuse or dependence. The CAGE questionnaire is useful when the client may not recognize that he or she has an alcohol problem or is uncomfortable acknowledging it.
C)The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar)scale is currently recommended as the best scale for assessing the severity of symptoms of acute alcohol withdrawal. The Michigan Alcohol Screening Test (MAST)and the Brief Drug Abuse Screening Test (B-DAST)are used to determine the degree of severity of alcohol abuse or dependence. The CAGE questionnaire is useful when the client may not recognize that he or she has an alcohol problem or is uncomfortable acknowledging it.
D)The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar)scale is currently recommended as the best scale for assessing the severity of symptoms of acute alcohol withdrawal. The Michigan Alcohol Screening Test (MAST)and the Brief Drug Abuse Screening Test (B-DAST)are used to determine the degree of severity of alcohol abuse or dependence. The CAGE questionnaire is useful when the client may not recognize that he or she has an alcohol problem or is uncomfortable acknowledging it.

Question 5

The nurse is evaluating a list of outcome goals for a client with alcoholism who is being discharged from a detoxification program. The list was written by a nursing student who is being mentored by the nurse. Which of the following outcomes are appropriate for this client? Select all that apply.

Accepted Answer

A)Appropriate outcomes for a client who is being discharged from alcohol detoxification are to obtain at least 6-8 hours of sleep per night and to enroll in an Employee Assistance Program if one is offered through the client's employer. The client's calorie requirement should be individualized and may not be 2000 calories. New or returning AA members should be sponsored; they are not ready to sponsor another person. The client should accept responsibility for his or her behavior in the family unit instead of assigning blame for codependent behavior.
B)Appropriate outcomes for a client who is being discharged from alcohol detoxification are to obtain at least 6-8 hours of sleep per night and to enroll in an Employee Assistance Program if one is offered through the client's employer. The client's calorie requirement should be individualized and may not be 2000 calories. New or returning AA members should be sponsored; they are not ready to sponsor another person. The client should accept responsibility for his or her behavior in the family unit instead of assigning blame for codependent behavior.
C)Appropriate outcomes for a client who is being discharged from alcohol detoxification are to obtain at least 6-8 hours of sleep per night and to enroll in an Employee Assistance Program if one is offered through the client's employer. The client's calorie requirement should be individualized and may not be 2000 calories. New or returning AA members should be sponsored; they are not ready to sponsor another person. The client should accept responsibility for his or her behavior in the family unit instead of assigning blame for codependent behavior.
D)Appropriate outcomes for a client who is being discharged from alcohol detoxification are to obtain at least 6-8 hours of sleep per night and to enroll in an Employee Assistance Program if one is offered through the client's employer. The client's calorie requirement should be individualized and may not be 2000 calories. New or returning AA members should be sponsored; they are not ready to sponsor another person. The client should accept responsibility for his or her behavior in the family unit instead of assigning blame for codependent behavior.
E)Appropriate outcomes for a client who is being discharged from alcohol detoxification are to obtain at least 6-8 hours of sleep per night and to enroll in an Employee Assistance Program if one is offered through the client's employer. The client's calorie requirement should be individualized and may not be 2000 calories. New or returning AA members should be sponsored; they are not ready to sponsor another person. The client should accept responsibility for his or her behavior in the family unit instead of assigning blame for codependent behavior.

Question 6

The nurse is providing care to a client with a history of chronic obstructive pulmonary disease (COPD)who wants help and information regarding nicotine addiction and ways to quit smoking. After the nurse has provided education regarding smoking cessation, which client statement would indicate appropriate understanding of the information presented?

Accepted Answer

A)When providing education regarding smoking cessation, it is important for the nurse to include adaptive coping mechanisms for the client to use during times of stress. Expressing the intention to use a healthy coping mechanism-such as chewing sugar-free gum-when the urge to smoke arises indicates appropriate understanding of the information presented. Tapering off smoking and keeping cigarettes close by are examples of behaviors that indicate the client is not wholly committed to cessation. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.
B)When providing education regarding smoking cessation, it is important for the nurse to include adaptive coping mechanisms for the client to use during times of stress. Expressing the intention to use a healthy coping mechanism-such as chewing sugar-free gum-when the urge to smoke arises indicates appropriate understanding of the information presented. Tapering off smoking and keeping cigarettes close by are examples of behaviors that indicate the client is not wholly committed to cessation. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.
C)When providing education regarding smoking cessation, it is important for the nurse to include adaptive coping mechanisms for the client to use during times of stress. Expressing the intention to use a healthy coping mechanism-such as chewing sugar-free gum-when the urge to smoke arises indicates appropriate understanding of the information presented. Tapering off smoking and keeping cigarettes close by are examples of behaviors that indicate the client is not wholly committed to cessation. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.
D)When providing education regarding smoking cessation, it is important for the nurse to include adaptive coping mechanisms for the client to use during times of stress. Expressing the intention to use a healthy coping mechanism-such as chewing sugar-free gum-when the urge to smoke arises indicates appropriate understanding of the information presented. Tapering off smoking and keeping cigarettes close by are examples of behaviors that indicate the client is not wholly committed to cessation. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.

Question 7

Which of the following signs and symptoms would least likely be observed in a client who is experiencing alcohol withdrawal syndrome?

Accepted Answer

A)Signs and symptoms of alcohol withdrawal syndrome include anorexia, hallucinations, and hyperthermia. Hypotension is not associated with alcohol withdrawal syndrome, but hypertension is.
B)Signs and symptoms of alcohol withdrawal syndrome include anorexia, hallucinations, and hyperthermia. Hypotension is not associated with alcohol withdrawal syndrome, but hypertension is.
C)Signs and symptoms of alcohol withdrawal syndrome include anorexia, hallucinations, and hyperthermia. Hypotension is not associated with alcohol withdrawal syndrome, but hypertension is.
D)Signs and symptoms of alcohol withdrawal syndrome include anorexia, hallucinations, and hyperthermia. Hypotension is not associated with alcohol withdrawal syndrome, but hypertension is.

Question 8

As compared to men, women are

Accepted Answer

A)No gender difference has been noted for age at onset of regular alcohol use, but women typically use alcohol for fewer years than men before entering treatment. Compared with men, women experience greater cognitive impairment by alcohol and are more susceptible to alcohol-related organ damage.
B)No gender difference has been noted for age at onset of regular alcohol use, but women typically use alcohol for fewer years than men before entering treatment. Compared with men, women experience greater cognitive impairment by alcohol and are more susceptible to alcohol-related organ damage.
C)No gender difference has been noted for age at onset of regular alcohol use, but women typically use alcohol for fewer years than men before entering treatment. Compared with men, women experience greater cognitive impairment by alcohol and are more susceptible to alcohol-related organ damage.
D)No gender difference has been noted for age at onset of regular alcohol use, but women typically use alcohol for fewer years than men before entering treatment. Compared with men, women experience greater cognitive impairment by alcohol and are more susceptible to alcohol-related organ damage.

Question 9

A nurse is caring for a client who smokes cigarettes and wants information about nicotine replacement therapy (NRT). Which statement is appropriate for the nurse to include in the teaching session?

Accepted Answer

A)Nicotine replacement therapy (NRT)does not address addictive behavior. Although it helps relieve some physiologic effects of nicotine withdrawal, it does not address the psychologic effects. Over-the-counter NRT products include transdermal patches and gums; nicotine inhalers and nasal sprays are available by prescription only. Using NRT in conjunction with a smoking cessation program is more effective than using NRT alone.
B)Nicotine replacement therapy (NRT)does not address addictive behavior. Although it helps relieve some physiologic effects of nicotine withdrawal, it does not address the psychologic effects. Over-the-counter NRT products include transdermal patches and gums; nicotine inhalers and nasal sprays are available by prescription only. Using NRT in conjunction with a smoking cessation program is more effective than using NRT alone.
C)Nicotine replacement therapy (NRT)does not address addictive behavior. Although it helps relieve some physiologic effects of nicotine withdrawal, it does not address the psychologic effects. Over-the-counter NRT products include transdermal patches and gums; nicotine inhalers and nasal sprays are available by prescription only. Using NRT in conjunction with a smoking cessation program is more effective than using NRT alone.
D)Nicotine replacement therapy (NRT)does not address addictive behavior. Although it helps relieve some physiologic effects of nicotine withdrawal, it does not address the psychologic effects. Over-the-counter NRT products include transdermal patches and gums; nicotine inhalers and nasal sprays are available by prescription only. Using NRT in conjunction with a smoking cessation program is more effective than using NRT alone.

Question 10

A nurse who works in an outpatient primary care clinic is caring for a client with asthma who has an 80 pack-year smoking history. When assessing the client's current use of nicotine, which question is most appropriate?

Accepted Answer

A)Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Of the choices provided, only "What prior attempts have you made to quit using nicotine?" meets these criteria.
B)Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Of the choices provided, only "What prior attempts have you made to quit using nicotine?" meets these criteria.
C)Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Of the choices provided, only "What prior attempts have you made to quit using nicotine?" meets these criteria.
D)Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Of the choices provided, only "What prior attempts have you made to quit using nicotine?" meets these criteria.

Question 11

A nurse is caring for a client with congestive heart failure (CHF)who currently smokes cigarettes and has a 50 pack-year smoking history. When providing smoking cessation education to this client, which statements regarding the pathophysiology of nicotine use are appropriate? Select all that apply.

Accepted Answer

A)In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. This response is associated with the sympathetic nervous system, not the parasympathetic nervous system. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco. Gradual reduction in nicotine use seems to prolong the suffering of withdrawal and is not a recommended method of cessation.
B)In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. This response is associated with the sympathetic nervous system, not the parasympathetic nervous system. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco. Gradual reduction in nicotine use seems to prolong the suffering of withdrawal and is not a recommended method of cessation.
C)In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. This response is associated with the sympathetic nervous system, not the parasympathetic nervous system. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco. Gradual reduction in nicotine use seems to prolong the suffering of withdrawal and is not a recommended method of cessation.
D)In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. This response is associated with the sympathetic nervous system, not the parasympathetic nervous system. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco. Gradual reduction in nicotine use seems to prolong the suffering of withdrawal and is not a recommended method of cessation.
E)In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. This response is associated with the sympathetic nervous system, not the parasympathetic nervous system. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco. Gradual reduction in nicotine use seems to prolong the suffering of withdrawal and is not a recommended method of cessation.

Question 12

The nurse is conducting a health history and wants to determine the client's level of alcohol use. What question from the nurse will provide the greatest amount of information?

Accepted Answer

A)Open-ended questions will elicit the greatest amount of information about the client's alcohol use. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained by the nurse.
B)Open-ended questions will elicit the greatest amount of information about the client's alcohol use. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained by the nurse.
C)Open-ended questions will elicit the greatest amount of information about the client's alcohol use. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained by the nurse.
D)Open-ended questions will elicit the greatest amount of information about the client's alcohol use. Asking closed questions that can be answered with a "yes" or "no" will limit the information obtained by the nurse.

Question 13

The nurse is teaching a class of adolescents about smoking. Which of the following points is most important to convey to this audience?

Accepted Answer

A)Smoking is a main cause of lung cancer, and it also directly contributes to the development of many other diseases, including heart disease and stroke. Teenagers and young adults tend to be strongly influenced by both tobacco advertising and counteradvertising mass media campaigns. Increasing the cost of cigarettes has been found to be an effective deterrent to smoking. Teenagers who smoke regularly tend to continue smoking during adulthood, which makes prevention particularly important among the adolescent population.
B)Smoking is a main cause of lung cancer, and it also directly contributes to the development of many other diseases, including heart disease and stroke. Teenagers and young adults tend to be strongly influenced by both tobacco advertising and counteradvertising mass media campaigns. Increasing the cost of cigarettes has been found to be an effective deterrent to smoking. Teenagers who smoke regularly tend to continue smoking during adulthood, which makes prevention particularly important among the adolescent population.
C)Smoking is a main cause of lung cancer, and it also directly contributes to the development of many other diseases, including heart disease and stroke. Teenagers and young adults tend to be strongly influenced by both tobacco advertising and counteradvertising mass media campaigns. Increasing the cost of cigarettes has been found to be an effective deterrent to smoking. Teenagers who smoke regularly tend to continue smoking during adulthood, which makes prevention particularly important among the adolescent population.
D)Smoking is a main cause of lung cancer, and it also directly contributes to the development of many other diseases, including heart disease and stroke. Teenagers and young adults tend to be strongly influenced by both tobacco advertising and counteradvertising mass media campaigns. Increasing the cost of cigarettes has been found to be an effective deterrent to smoking. Teenagers who smoke regularly tend to continue smoking during adulthood, which makes prevention particularly important among the adolescent population.

Question 14

A nurse works at a clinic that provides care to a community with a high population of smokers. The nurse is planning an educational session entitled "Tips for Quitting." Which action by the nurse is appropriate for inclusion in this session?

Accepted Answer

A)The nurse should include information about available pharmacologic adjuncts to cessation in a "Tips for Quitting" session. Simply telling the participants that smoking is unacceptable is not effective in promoting wellness. Although it is true that smoking contributes to cancer and liver disease, this information will not help participants identify and apply effective strategies for tobacco cessation. Hypnosis can be useful for clients who are trying to quit smoking, but the nurse should recommend that clients seek hypnosis only from a trained healthcare professional.
B)The nurse should include information about available pharmacologic adjuncts to cessation in a "Tips for Quitting" session. Simply telling the participants that smoking is unacceptable is not effective in promoting wellness. Although it is true that smoking contributes to cancer and liver disease, this information will not help participants identify and apply effective strategies for tobacco cessation. Hypnosis can be useful for clients who are trying to quit smoking, but the nurse should recommend that clients seek hypnosis only from a trained healthcare professional.
C)The nurse should include information about available pharmacologic adjuncts to cessation in a "Tips for Quitting" session. Simply telling the participants that smoking is unacceptable is not effective in promoting wellness. Although it is true that smoking contributes to cancer and liver disease, this information will not help participants identify and apply effective strategies for tobacco cessation. Hypnosis can be useful for clients who are trying to quit smoking, but the nurse should recommend that clients seek hypnosis only from a trained healthcare professional.
D)The nurse should include information about available pharmacologic adjuncts to cessation in a "Tips for Quitting" session. Simply telling the participants that smoking is unacceptable is not effective in promoting wellness. Although it is true that smoking contributes to cancer and liver disease, this information will not help participants identify and apply effective strategies for tobacco cessation. Hypnosis can be useful for clients who are trying to quit smoking, but the nurse should recommend that clients seek hypnosis only from a trained healthcare professional.

Question 15

The nurse is planning care for a client with esophageal cancer caused by years of nicotine abuse. Which of the following would be the priority nursing diagnosis for this client?

Accepted Answer

A)The nurse should anticipate that a client with esophageal cancer related to tobacco use may have issues with airway edema. Because proper breathing and oxygenation are crucial, Ineffective Airway Clearance would be the highest priority nursing diagnosis of the options listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.
B)The nurse should anticipate that a client with esophageal cancer related to tobacco use may have issues with airway edema. Because proper breathing and oxygenation are crucial, Ineffective Airway Clearance would be the highest priority nursing diagnosis of the options listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.
C)The nurse should anticipate that a client with esophageal cancer related to tobacco use may have issues with airway edema. Because proper breathing and oxygenation are crucial, Ineffective Airway Clearance would be the highest priority nursing diagnosis of the options listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.
D)The nurse should anticipate that a client with esophageal cancer related to tobacco use may have issues with airway edema. Because proper breathing and oxygenation are crucial, Ineffective Airway Clearance would be the highest priority nursing diagnosis of the options listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.

Question 16

Which of the following nursing interventions would be most appropriate when caring for clients who are experiencing acute alcohol withdrawal?

Accepted Answer

A)When caring for clients who are experiencing acute alcohol withdrawal, the nurse should minimize environmental stimuli to decrease the likelihood of agitation. The nurse should also administer benzodiazepines according to the detoxification protocol to help minimize the discomfort of withdrawal symptoms; express reasonable doubt if clients relay suspicious or paranoid beliefs; and avoid arguing with clients who are experiencing delusions or hallucinations.
B)When caring for clients who are experiencing acute alcohol withdrawal, the nurse should minimize environmental stimuli to decrease the likelihood of agitation. The nurse should also administer benzodiazepines according to the detoxification protocol to help minimize the discomfort of withdrawal symptoms; express reasonable doubt if clients relay suspicious or paranoid beliefs; and avoid arguing with clients who are experiencing delusions or hallucinations.
C)When caring for clients who are experiencing acute alcohol withdrawal, the nurse should minimize environmental stimuli to decrease the likelihood of agitation. The nurse should also administer benzodiazepines according to the detoxification protocol to help minimize the discomfort of withdrawal symptoms; express reasonable doubt if clients relay suspicious or paranoid beliefs; and avoid arguing with clients who are experiencing delusions or hallucinations.
D)When caring for clients who are experiencing acute alcohol withdrawal, the nurse should minimize environmental stimuli to decrease the likelihood of agitation. The nurse should also administer benzodiazepines according to the detoxification protocol to help minimize the discomfort of withdrawal symptoms; express reasonable doubt if clients relay suspicious or paranoid beliefs; and avoid arguing with clients who are experiencing delusions or hallucinations.

Question 17

The nurse is providing care to a client who admits to smoking two packs of cigarettes per day for 34 years. The client also has a history of intermittent claudication, chronic bronchitis, and emphysema. After 6 weeks of smoking cessation, the client reports that he is frequently "yelling" at his spouse and "flying off the handle." Which effects of cigarette smoking are associated with the data the nurse has collected from the client? Select all that apply.

Accepted Answer

A)Nicotine causes the release of dopamine (a precursor to norepinephrine)and epinephrine. These substances trigger vasoconstriction, which exacerbates intermittent claudication. Tobacco use also causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis. Dopaminergic processes have a role in regulating the reinforcing effects of nicotine, making cessation difficult and contributing to withdrawal symptoms including nervousness, restlessness, irritability, impatience, and increased hostility.
B)Nicotine causes the release of dopamine (a precursor to norepinephrine)and epinephrine. These substances trigger vasoconstriction, which exacerbates intermittent claudication. Tobacco use also causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis. Dopaminergic processes have a role in regulating the reinforcing effects of nicotine, making cessation difficult and contributing to withdrawal symptoms including nervousness, restlessness, irritability, impatience, and increased hostility.
C)Nicotine causes the release of dopamine (a precursor to norepinephrine)and epinephrine. These substances trigger vasoconstriction, which exacerbates intermittent claudication. Tobacco use also causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis. Dopaminergic processes have a role in regulating the reinforcing effects of nicotine, making cessation difficult and contributing to withdrawal symptoms including nervousness, restlessness, irritability, impatience, and increased hostility.
D)Nicotine causes the release of dopamine (a precursor to norepinephrine)and epinephrine. These substances trigger vasoconstriction, which exacerbates intermittent claudication. Tobacco use also causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis. Dopaminergic processes have a role in regulating the reinforcing effects of nicotine, making cessation difficult and contributing to withdrawal symptoms including nervousness, restlessness, irritability, impatience, and increased hostility.
E)Nicotine causes the release of dopamine (a precursor to norepinephrine)and epinephrine. These substances trigger vasoconstriction, which exacerbates intermittent claudication. Tobacco use also causes atherosclerosis, which is seen in intermittent claudication. Tar and other chemicals, not nicotine, cause the destruction of the alveoli seen in emphysema and the productive cough seen in chronic bronchitis. Dopaminergic processes have a role in regulating the reinforcing effects of nicotine, making cessation difficult and contributing to withdrawal symptoms including nervousness, restlessness, irritability, impatience, and increased hostility.

Question 18

The nurse is providing education to a client who wants to quit smoking. Which statements are appropriate for the nurse to include in the teaching session? Select all that apply.

Accepted Answer

A)When teaching clients about smoking cessation, the nurse should emphasize that most people who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and may be a viable option for this client. The proper use of nicotine gum is to take one piece when the urge to smoke occurs, up to 9-12 times daily. The gum should be chewed several times to soften it, then held in the buccal space for at least 30 minutes to absorb the medication. A client who is wearing a nicotine patch must not smoke because of increased risk for cardiovascular problems, including myocardial infarction. The nurse should always consider alternative therapies in addition to traditional therapies, because they may help the client better deal with the stress that accompanies smoking cessation.
B)When teaching clients about smoking cessation, the nurse should emphasize that most people who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and may be a viable option for this client. The proper use of nicotine gum is to take one piece when the urge to smoke occurs, up to 9-12 times daily. The gum should be chewed several times to soften it, then held in the buccal space for at least 30 minutes to absorb the medication. A client who is wearing a nicotine patch must not smoke because of increased risk for cardiovascular problems, including myocardial infarction. The nurse should always consider alternative therapies in addition to traditional therapies, because they may help the client better deal with the stress that accompanies smoking cessation.
C)When teaching clients about smoking cessation, the nurse should emphasize that most people who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and may be a viable option for this client. The proper use of nicotine gum is to take one piece when the urge to smoke occurs, up to 9-12 times daily. The gum should be chewed several times to soften it, then held in the buccal space for at least 30 minutes to absorb the medication. A client who is wearing a nicotine patch must not smoke because of increased risk for cardiovascular problems, including myocardial infarction. The nurse should always consider alternative therapies in addition to traditional therapies, because they may help the client better deal with the stress that accompanies smoking cessation.
D)When teaching clients about smoking cessation, the nurse should emphasize that most people who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and may be a viable option for this client. The proper use of nicotine gum is to take one piece when the urge to smoke occurs, up to 9-12 times daily. The gum should be chewed several times to soften it, then held in the buccal space for at least 30 minutes to absorb the medication. A client who is wearing a nicotine patch must not smoke because of increased risk for cardiovascular problems, including myocardial infarction. The nurse should always consider alternative therapies in addition to traditional therapies, because they may help the client better deal with the stress that accompanies smoking cessation.
E)When teaching clients about smoking cessation, the nurse should emphasize that most people who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and may be a viable option for this client. The proper use of nicotine gum is to take one piece when the urge to smoke occurs, up to 9-12 times daily. The gum should be chewed several times to soften it, then held in the buccal space for at least 30 minutes to absorb the medication. A client who is wearing a nicotine patch must not smoke because of increased risk for cardiovascular problems, including myocardial infarction. The nurse should always consider alternative therapies in addition to traditional therapies, because they may help the client better deal with the stress that accompanies smoking cessation.

Question 19

The nurse assesses a client with a history of alcoholism who is hospitalized with anorexia, dysphagia, odynophagia, and chest pressure after eating. Which nursing diagnosis is a priority for this client?

Accepted Answer

A)A client with anorexia and a history of alcoholism is at risk for a diagnosis of Imbalanced Nutrition: Less than Body Requirements. The client's symptoms of dysphagia, odynophagia, and chest pressure after eating further support this diagnosis. Ineffective Coping is a potential diagnosis associated with substance abuse, but it is not suggested by the symptoms given here. Disturbed Thought Processes and Disturbed Sensory Perception are diagnoses appropriate for clients who are experiencing delusions, hallucinations, and illusions associated with delirium tremens, but again, these diagnoses are not suggested by the symptoms listed here.
B)A client with anorexia and a history of alcoholism is at risk for a diagnosis of Imbalanced Nutrition: Less than Body Requirements. The client's symptoms of dysphagia, odynophagia, and chest pressure after eating further support this diagnosis. Ineffective Coping is a potential diagnosis associated with substance abuse, but it is not suggested by the symptoms given here. Disturbed Thought Processes and Disturbed Sensory Perception are diagnoses appropriate for clients who are experiencing delusions, hallucinations, and illusions associated with delirium tremens, but again, these diagnoses are not suggested by the symptoms listed here.
C)A client with anorexia and a history of alcoholism is at risk for a diagnosis of Imbalanced Nutrition: Less than Body Requirements. The client's symptoms of dysphagia, odynophagia, and chest pressure after eating further support this diagnosis. Ineffective Coping is a potential diagnosis associated with substance abuse, but it is not suggested by the symptoms given here. Disturbed Thought Processes and Disturbed Sensory Perception are diagnoses appropriate for clients who are experiencing delusions, hallucinations, and illusions associated with delirium tremens, but again, these diagnoses are not suggested by the symptoms listed here.
D)A client with anorexia and a history of alcoholism is at risk for a diagnosis of Imbalanced Nutrition: Less than Body Requirements. The client's symptoms of dysphagia, odynophagia, and chest pressure after eating further support this diagnosis. Ineffective Coping is a potential diagnosis associated with substance abuse, but it is not suggested by the symptoms given here. Disturbed Thought Processes and Disturbed Sensory Perception are diagnoses appropriate for clients who are experiencing delusions, hallucinations, and illusions associated with delirium tremens, but again, these diagnoses are not suggested by the symptoms listed here.

Question 20

A pregnant client tells the nurse that she and her husband are going to a 50th wedding anniversary party for her grandparents this weekend. The client asks the nurse if it will be okay for her to have a few glasses of wine at the party. Which response by the nurse is appropriate?

Accepted Answer

A)Drinking any alcohol, no matter what type and what quantity, during pregnancy increases the risk for accidents and damage to the infant. Women should be encouraged to drink no alcohol at all during pregnancy. Wine can put the mother and fetus at risk as much as hard liquor.
B)Drinking any alcohol, no matter what type and what quantity, during pregnancy increases the risk for accidents and damage to the infant. Women should be encouraged to drink no alcohol at all during pregnancy. Wine can put the mother and fetus at risk as much as hard liquor.
C)Drinking any alcohol, no matter what type and what quantity, during pregnancy increases the risk for accidents and damage to the infant. Women should be encouraged to drink no alcohol at all during pregnancy. Wine can put the mother and fetus at risk as much as hard liquor.
D)Drinking any alcohol, no matter what type and what quantity, during pregnancy increases the risk for accidents and damage to the infant. Women should be encouraged to drink no alcohol at all during pregnancy. Wine can put the mother and fetus at risk as much as hard liquor.

Quiz 22: Addiction