A nurse is evaluating a client in the emergency department, who states that they take oxycodone chronically for cancer-related pain but forgot their medication at home while on vacation. The client is experiencing severe pain, diarrhea, piloerection, sweating, and malaise. Which of the following phenomena should the nurse tell the client they are experiencing?
Tolerance
Substance abuse
Withdrawal
✓
Psychological dependence
Correct Answer
Withdrawal
This client had a sudden discontinuation of their oxycodone, leading to typical opioid withdrawal effects.
Question 2
A nurse is talking with a client at a primary care office, and the client states that they normally smoke a half pack of cigarettes per day but have recently stopped smoking abruptly. The client states they are physically fine, but they frequently find themselves thinking about smoking again and experiencing intense cravings to smoke another cigarette. Which of the following phenomena should the nurse tell the client they are experiencing?
Psychological dependence
✓
Intoxication
Tolerance
Physical dependence
Correct Answer
Psychological dependence
This client is experiencing the behavioral aspects of discontinuation of a substance, leading to intense cravings.
Question 3
What is the primary purpose of the Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) assessment instrument?
Manage withdrawal symptoms
✓
Estimate the client's alcohol consumption
Assess for system disorders related to alcohol intake
Plan outpatient behavioral therapy
Correct Answer
Manage withdrawal symptoms
The Clinical Institute Withdrawal Assessment for Alcohol-Revised (CIWA-Ar) uses a symptoms-based approach to manage the symptoms of alcohol withdrawal as they occur.
Question 4
A client is brought to the emergency department via emergency services after being found in their car unresponsive to any stimuli. The nurse evaluating the client notices that they have slow, shallow breathing, are unresponsive to painful stimuli, and have pinpoint pupils. Which medication does the nurse anticipate the provider will prescribe for this client?
Methadone
Disulfiram
Chlordiazepoxide
Naloxone
✓
Correct Answer
Naloxone
This client is experiencing the triad of opioid overdose symptoms (respiratory depression, CNS depression, and miosis). This client requires quick reversal of these effects, so naloxone should be administered.
Question 5
A nurse is evaluating a client for treatment of their opioid use disorder. They have a history of intravenous use of agents such as oxycodone and heroin. Which medication is the prescriber most likely to order to deter intravenous abuse of the medication?
Lorazepam
Methadone
Chlordiazepoxide
Buprenorphine-naloxone
✓
Correct Answer
Buprenorphine-naloxone
The naloxone in this drug makes it so that if it is injected instead of being used orally, it will prevent the buprenorphine from causing as much euphoria as it would by itself.
Question 6
A nurse is educating a client with an opioid use disorder and their parent about how to recognize the signs and symptoms of opioid overdose and when to administer naloxone. Which of the following statements should the nurse make?
Because of the short-acting nature of naloxone, it is imperative to call emergency services after naloxone administration to get definitive care prior to the client re-sedating.
Question 7
A nurse is collaborating with a client with a known alcohol use disorder who has recently been prescribed disulfiram. Which clinical effect should the nurse educate the client about if they decide to consume alcohol?
CNS depression
Seizures
Flushing
✓
Withdrawal
Correct Answer
Flushing
Facial flushing is one of the most characteristic reactions seen in clients consuming alcohol while using disulfiram.
Question 8
A client is being admitted to the hospital for pancreatitis, and the nurse managing the client learns that the client has a previously undisclosed alcohol use disorder and has been without any alcohol for the past 2 days. Which of the following withdrawal effects would the nurse expect this client to develop?
Respiratory depression
Seizures
✓
Facial flushing
CNS depression
Correct Answer
Seizures
Seizures are one of the most severe and potentially life-threatening effects that can be seen with alcohol withdrawal.
Question 9
A client is starting nicotine replacement therapy (NRT) for their nicotine use disorder. The nurse educating the client about the medication should make which of the following points?
"If a child consumes any type of NRT, it should not cause any problems."
"You should stop the NRT if you begin using tobacco again."
✓
"NRT therapy will prevent tobacco products from working as well if you relapse."
"NRT can make you sleepy, so no driving a car while using it."
Correct Answer
"You should stop the NRT if you begin using tobacco again."
This is an important counseling point to avoid having the client receive excessive doses of nicotine, leading to toxicity.
Question 10
A client is being evaluated for therapy for their nicotine use disorder. The nurse notes in their history that the client has been diagnosed with a major depressive disorder but is not currently receiving any treatment for that condition. Which of the medications used for smoking cessation would the nurse anticipate the prescribing provider will initiate to both treat the client's depression and help with smoking cessation?
Naltrexone
Bupropion
✓
Chlordiazepoxide
Varenicline
Correct Answer
Bupropion
Because bupropion is primarily used as an antidepressant and can reduce cravings during smoking cessation, it is an ideal medication to treat both conditions.