Withdrawal cont.
Which of the following is a side effect commonly associated with buprenorphine use during opioid withdrawal?
A. Euphoria without any adverse effects
B. Nausea, vomiting, constipation, muscle aches, insomnia, irritability, and fever
C. Hypotension and hyperactivity
D. Increased energy and appetite
Answer: B. Nausea, vomiting, constipation, muscle aches, insomnia, irritability, and fever
Rationale: Common side effects of buprenorphine use during opioid withdrawal include nausea, vomiting, constipation, muscle aches, insomnia, irritability, and fever.
A patient experiencing an overdose of benzodiazepines arrives at the emergency department unconscious. What is the nurse's priority action?
A. Administer an antidote
B. Perform gastric lavage
C. Monitor vital signs and prepare for potential ventilation
D. Induce vomiting
Answer: C. Monitor vital signs and prepare for potential ventilation
Rationale: In cases of benzodiazepine overdose with unconsciousness, the priority is to monitor vital signs and prepare for potential ventilation to ensure airway patency and adequate breathing.
Which medication is not typically used in the treatment of gambling disorder?
A. SSRIs
B. Lithium
C. Topiramate (Topamax)
D. Methadone
Answer: D. Methadone
Rationale: Methadone is not typically used in the treatment of gambling disorder. SSRIs, bupropion, lithium, topiramate, second-generation antipsychotics, and naltrexone are commonly used.
Which medication is commonly given to manage seizures in patients undergoing alcohol withdrawal?
A. Naloxone
B. Chlordiazepoxide (Librium)
C. Methadone
D. Clonidine
Answer: B. Chlordiazepoxide (Librium)
Rationale: Chlordiazepoxide (Librium) is given to manage withdrawal symptoms and prevent seizures in patients undergoing alcohol withdrawal. Other benzodiazepines like lorazepam (Ativan) and diazepam (Valium) are also used.
A nurse is educating a patient with a history of heavy drinking about the risks of alcohol withdrawal delirium (DTs). The nurse explains that DTs can occur:
A. Within the first 24 hours after the last drink
B. Within the first 48 hours after the last drink
C. Anytime within the first 72 hours after the last drink
D. After the first week of abstinence
Answer: C. Anytime within the first 72 hours after the last drink
Rationale: Alcohol withdrawal delirium (DTs) can occur anytime within the first 72 hours after the last drink and is a medical emergency requiring prompt intervention.
A patient experiencing opioid withdrawal is prescribed both methadone and clonidine. What is the rationale for using these medications together?
A. Methadone and clonidine together enhance the euphoric effects of opioids
B. Methadone decreases pain of withdrawal and blocks euphoric effects, while clonidine reduces specific withdrawal symptoms like sweating and anxiety
C. Methadone treats withdrawal symptoms, and clonidine induces withdrawal symptoms
D. Methadone is used for long-term maintenance, while clonidine is only for short-term detox
Answer: B. Methadone decreases pain of withdrawal and blocks euphoric effects, while clonidine reduces specific withdrawal symptoms like sweating and anxiety
Rationale: Methadone helps with overall withdrawal management by decreasing pain and blocking euphoric effects, while clonidine is effective in reducing specific symptoms like sweating, anxiety, and restlessness.
What is the most effective strategy to prevent seizures and other withdrawal symptoms in a patient discontinuing benzodiazepines?
A. Abrupt cessation of the medication
B. Gradual reduction of the medication
C. Switching to a different class of medication
D. Providing a high-protein diet
Answer: B. Gradual reduction of the medication
Rationale: Gradual reduction of benzodiazepines is necessary to prevent seizures and other withdrawal symptoms that can occur with abrupt cessation.
A patient who has recently quit smoking is concerned about weight gain. How much weight gain should the nurse inform the patient is typical within the first year after smoking cessation?
A. 1 to 3 pounds
B. 4 to 7 pounds
C. 8 to 10 pounds
D. 11 to 15 pounds
Answer: B. 4 to 7 pounds
Rationale: Within the first year after smoking cessation, people typically increase their weight by an average of 4 to 7 pounds.
A patient is brought to the emergency department with generalized tonic-clonic seizures. The nurse suspects alcohol withdrawal seizures. How long after alcohol cessation do these seizures typically occur?
A. 1 to 6 hours
B. 6 to 12 hours
C. 12 to 24 hours
D. 24 to 48 hours
Answer: C. 12 to 24 hours
Rationale: Alcohol withdrawal seizures may occur within 12 to 24 hours after alcohol cessation and are typically generalized and tonic-clonic.
A nurse is caring for a patient with alcohol use disorder who has been abstinent for 12 hours. The patient complains of nausea, vomiting, and insomnia. Which of the following medications should the nurse anticipate administering?
A. Methadone
B. Diazepam (Valium)
C. Naloxone
D. Disulfiram (Antabuse)
Answer: B. Diazepam (Valium)
Rationale: Diazepam (Valium) is a benzodiazepine used to manage alcohol withdrawal symptoms, including nausea, vomiting, insomnia, and to prevent the progression of withdrawal symptoms.
A patient with a history of opioid use disorder is prescribed naltrexone (ReVia). Which statement by the patient indicates a need for further teaching?
A. "Naltrexone will help prevent intoxication if I relapse."
B. "I can take naltrexone in an IM form that lasts for weeks."
C. "Naltrexone will help reduce my cravings for opioids."
D. "Naltrexone is helpful for people who struggle with adherence to daily medication."
Answer: C. "Naltrexone will help reduce my cravings for opioids."
Rationale: Naltrexone is an opioid antagonist that prevents intoxication but does not reduce cravings for opioids. It is often used in maintenance therapy to help prevent relapse by blocking the effects of opioids if taken
A nurse is assessing a patient with a history of stimulant use disorder. Which of the following withdrawal symptoms should the nurse anticipate?
A. Increased energy and euphoria
B. Tiredness, vivid nightmares, and increased appetite
C. Increased sociability and confidence
D. Decreased appetite and insomnia
Answer: B. Tiredness, vivid nightmares, and increased appetite
Rationale: Common withdrawal symptoms from stimulant use include tiredness, vivid nightmares, increased appetite, insomnia or hypersomnia, and psychomotor retardation or agitation.
Which medication is commonly used to reduce cravings and mimic the effects of nicotine in patients trying to quit smoking?
A. Methadone
B. Bupropion
C. Clonidine
D. Phenobarbital
Answer: B. Bupropion
Rationale: Bupropion and varenicline are commonly used to reduce cravings and mimic the effects of nicotine in patients trying to quit smoking.
A nurse is assessing a patient for alcohol withdrawal symptoms. Which question is the most critical to ask?
A. "How much alcohol do you usually drink?"
B. "When did you have your last drink?"
C. "Do you have a family history of alcohol use disorder?"
D. "What type of alcohol do you usually consume?"
Answer: B. "When did you have your last drink?"
Rationale: The time since the last drink is the critical and priority question when assessing for alcohol withdrawal symptoms, as withdrawal symptoms can begin as early as 6 to 8 hours after cessation.
A nurse is assessing a patient with chronic alcohol use who complains of numbness and a "pins and needles" feeling in their extremities. Which condition is the patient likely experiencing?
A. Myopathy
B. Cardiomyopathy
C. Peripheral neuropathy
D. Esophagitis
Answer: C. Peripheral neuropathy
Rationale: Peripheral neuropathy, caused by nutritional (THIAMINE) deficiencies and damage to the peripheral nervous system due to chronic alcohol use, often presents with numbness, a "pins and needles" sensation, muscle weakness, and sensitivity to touch.
A patient is being treated with buprenorphine/naloxone for opioid dependence. What is the primary goal of this treatment?
A. To induce withdrawal symptoms
B. To maintain continued abstinence and reduce cravings
C. To block the euphoric effects of opioids without any side effects
D. To provide a short-term solution to opioid dependence
Answer: B. To maintain continued abstinence and reduce cravings
Rationale: The primary goal of maintenance therapy with buprenorphine/naloxone is to maintain continued abstinence and reduce cravings in patients who have achieved sobriety and completed detoxification.
A patient with stimulant use disorder exhibits psychomotor agitation and confusion. Which initial intervention is most appropriate?
A. Administer antipsychotic medication for a few days
B. Begin long-term antidepressant therapy
C. Perform gastric lavage
D. Provide IV fluids
Answer: A. Administer antipsychotic medication for a few days
Rationale: Antipsychotic medications are often prescribed for a few days to manage acute agitation and confusion in patients with stimulant use disorder.
A patient with alcohol use disorder is at increased risk for which of the following conditions due to its comorbidity?
A. Hypertension and diabetes
B. Bipolar disorder and schizophrenia
C. COPD and asthma
D. Osteoarthritis and osteoporosis
Answer: B. Bipolar disorder and schizophrenia
Rationale: Alcohol use disorder is commonly comorbid with bipolar disorder, schizophrenia, and antisocial personality disorder.
A patient arrives in the emergency room for a legal blood draw to determine intoxication. The nurse understands that the legal definition of intoxication in most states requires a blood alcohol concentration of:
A. 40 to 60 mg/dL
B. 60 to 80 mg/dL
C. 80 to 100 mg/dL
D. 100 to 120 mg/dL
Answer: C. 80 to 100 mg/dL
Rationale: The legal definition of intoxication in most states requires a blood concentration of 80 to 100 mg ethanol per deciliter of blood (mg/dL).
A patient presents with symptoms of Wernicke's encephalopathy. Which of the following findings would the nurse expect to observe?
A. Severe memory loss and confabulation
B. Acute and reversible altered gait, vestibular dysfunction, and confusion
C. Chronic muscle weakness and peripheral neuropathy
D. Fatigue, shortness of breath, and edema in the legs and feet
Answer: B. Acute and reversible altered gait, vestibular dysfunction, and confusion
Rationale: Wernicke's encephalopathy is an acute and reversible condition characterized by altered gait, vestibular dysfunction, confusion, motility abnormalities, and other neurological symptoms due to thiamine deficiency.
A patient with chronic alcohol use presents with signs of esophagitis. Which symptom should the nurse be most concerned about?
A. Nausea and vomiting
B. Loss of appetite
C. Belching and bloating
D. Varices at risk of bursting
Answer: D. Varices at risk of bursting
Rationale: Esophagitis can lead to varices (distended veins in the esophagus or stomach), which are at risk of bursting and causing a medical emergency due to significant bleeding.
A patient is being treated for barbiturate withdrawal. Which medication is commonly used to aid in this process?
A. Clonidine
B. Methadone
C. Phenobarbital
D. Naloxone
Answer: C. Phenobarbital
Rationale: A long-acting barbiturate, such as phenobarbital, is commonly used to aid in the withdrawal process from barbiturates.
During an assessment of a patient experiencing alcohol withdrawal, the nurse notes autonomic hyperactivity, including tachycardia and hypertension. Which of the following is the most appropriate intervention?
A. Administer naloxone
B. Provide a high-protein diet
C. Administer IV lorazepam (Ativan)
D. Encourage the patient to rest
Answer: C. Administer IV lorazepam (Ativan)
Rationale: Autonomic hyperactivity, such as tachycardia and hypertension, is a sign of severe alcohol withdrawal, which can progress to delirium tremens (DTs). Administering IV lorazepam (Ativan) helps manage these symptoms and prevent further complications.
A nurse is monitoring a patient with alcohol use disorder who has recently stopped drinking. The patient begins experiencing generalized tonic-clonic seizures. The nurse knows that additional seizures may occur within:
A. 30 minutes to 1 hour
B. 2 to 4 hours
C. 6 to 12 hours
D. 24 to 48 hours
Answer: B. 2 to 4 hours
Rationale: Additional seizures may occur within hours of the first seizure, making it crucial to monitor the patient closely and provide appropriate intervention.
A patient with chronic alcohol use disorder is diagnosed with Korsakoff's syndrome. Which statement by the nurse is most accurate?
A. "Korsakoff's syndrome is a mild condition that will improve with time."
B. "Korsakoff's syndrome is a chronic condition with a low recovery rate."
C. "Korsakoff's syndrome is an acute condition that responds well to thiamine treatment."
D. "Korsakoff's syndrome primarily affects the cardiovascular system."
Answer: B. "Korsakoff's syndrome is a chronic condition with a low recovery rate."
Rationale: Korsakoff's syndrome is a chronic condition with a low recovery rate, often following Wernicke's encephalopathy, and involves severe memory impairment and confabulation.