Nursing A Concept Based Approach to Learning Volume II 2nd Ed-Test Bank

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Nursing A Concept Based Approach to Learning Volume II 2nd Ed-Test Bank

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Nursing A Concept Based Approach to Learning Volume II 2nd Ed-Test Bank

Nursing: A Concept-Based Approach to Learning, 2e (Pearson)

Module 22   Addiction

 

The Concept of Addiction

1) While practicing at an outpatient addiction clinic, the nurse is summarizing a diagram in the orientation handbook for a new associate she is precepting. Which statement most closely aligns with the meaning of this diagram?

 

 

  1. A) Addiction involves an alteration in the amount of available neurotransmitters.
  2. B) Actions at the neurotransmitter level affecting addiction are not genetic.
  3. C) High self-esteem as a basis for pleasure seeking lowers neurotransmitter levels.
  4. D) An addictive personality is identified by differences in the processing of neurotransmitters.

Answer:  A

Explanation:  A) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.

  1. B) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
  2. C) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.
  3. D) Substances of addiction alter the amount of available neurotransmitters, including dopamine, serotonin, and norepinephrine. Several genes have been identified that seem to influence the risk for alcohol dependence. Low self-esteem increases the risk for addiction. No addictive personality type has been identified.

Page Ref: 1520

Cognitive Level:  Analyzing

Client Need:  Physiological Integrity

Client Need Sub:  Physiological Adaptation

Nursing Process:  Assessment

Learning Outcome:  1. Summarize the physiological and psychological processes that contribute to addiction.

 

2) During a class for college seniors, a participant admits to frequently using alcohol. What is the priority action of the nurse?

  1. A) Initiate a community assessment of the campus.
  2. B) Contact the campus nurse and refer the student.
  3. C) Notify campus security to watch for driving under the influence.
  4. D) Complete a crisis assessment.

Answer:  D

Explanation:  A) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the students permission. There is no evidence that the student is driving under the influence.

  1. B) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the students permission. There is no evidence that the student is driving under the influence.
  2. C) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the students permission. There is no evidence that the student is driving under the influence.
  3. D) In a trusting relationship, the nurse will complete a crisis assessment to determine the appropriate action. Contacting the campus nurse is not advised without the students permission. There is no evidence that the student is driving under the influence.

Page Ref: 1527

Cognitive Level:  Applying

Client Need:  Health Promotion and Maintenance

Nursing Process:  Implementation

Learning Outcome:  4. Differentiate assessments of addictions across the life span.

 

3) A nursing instructor is teaching her students about the comprehensive theory of addiction by George Engel. Which statement or statements indicate that the student understands the theory?

Select all that apply.

  1. A) Addiction occurs due to a lack of emotional attachment.
  2. B) There is a biological factor involved in the development of addiction.
  3. C) There are social factors that contribute to the development of addiction.
  4. D) There is a moral factor involved in the development of addiction.
  5. E) There is a psychological factor involved in the development of addiction.

Answer:  B, C, E

Explanation:  A) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.

  1. B) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
  2. C) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
  3. D) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.
  4. E) The biopsychosocial explanation of addiction is supported by current research and takes a more holistic view of the problem. The biopsychosocial explanation links biological, psychological, and social factors as contributing to the development of addiction. The view of addiction as a moral disease is nontherapeutic. Viewing addiction as only a behavioral or emotional problem oversimplifies a complex issue.

Page Ref: 1520

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  1. Summarize the physiological and psychological processes that contribute to addiction.

 

4) During visitation on the unit, the nurse is observing the family dynamics of an adolescent client who has an addiction problem and recognizes that the family is experiencing behaviors consistent with codependence. Which problems might the nurse expect this family to manifest on an ongoing basis?

  1. A) Frustration intolerance
  2. B) Enabling
  3. C) Argumentative behaviors
  4. D) Impatience

Answer:  B

Explanation:  A) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.

  1. B) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
  2. C) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.
  3. D) Codependents often engage in enabling behavior, which is any action an individual takes that consciously or unconsciously facilitates substance dependence. Although impatience, frustration intolerance, and argumentative behaviors may be present in this family, they are generally not related to the cycle of codependence and addiction.

Page Ref: 1526

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  2. Examine the relationship between addiction and other concepts/systems.

 

5) A new nurse orienting to the unit is preparing to assist with obtaining data for a screening tool to determine whether a client is addicted to alcohol. Which tool or tools will be used to assess the client?

Select all that apply.

  1. A) OOWS
  2. B) MAST
  3. C) CAGE questionnaire
  4. D) B-DAST
  5. E) CIWA-ar

Answer:  B, C, E

Explanation:  A) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.

  1. B) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.
  2. C) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.
  3. D) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.
  4. E) The CAGE questionnaire, MAST (Michigan Alcohol Screening Test), and CIWA-ar (Clinical Institute Withdrawal Assessment of Alcohol Revised) are all used to assess for alcohol-related problems. The B-DAST (Brief Drug Abuse Screening Test) is used to assess for addiction to substances other than alcohol. The OOWS (Objective Opiate Withdrawal Scale) is useful for assessing clients who are experiencing opiate withdrawal.

Page Ref: 1540

Cognitive Level:  Understanding

Client Need:  Psychosocial Integrity

Nursing Process:  Assessment

Learning Outcome:  3. Illustrate the nursing process in providing culturally competent care across the life span for individuals who abuse alcohol.

 

6) The client enters the Emergency Department with signs of drug use. The client reports having ingested Percocet. Which medications will be indicated to manage a potential overdose?

  1. A) Diazepam
  2. B) Haldol
  3. C) Vitamin B12
  4. D) Narcan

Answer:  D

Explanation:  A) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.

  1. B) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.
  2. C) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.
  3. D) Percocet is a type of opiate. Narcan is used to treat an overdose of opiates. Diazepam can be prescribed to manage signs of an overdose. Haldol can be administered to manage an overdose of phencyclidine piperidine (PCP). Vitamin B12 is used to manage the neurologic symptoms that might accompany a nitrate overdose.

Page Ref: 1540

Cognitive Level:  Analyzing

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  6. Explain prevention and management of addictions.

 

7) At a neighborhood clinic, the nurse is planning addiction treatment groups. What knowledge of addictions and related therapies will facilitate implementation of the groups?

  1. A) Relapse is a common feature of substance abuse.
  2. B) Hereditary, as well as complex environmental influences, predisposes one to substance dependence.
  3. C) Clients with a substance dependence cannot be held accountable for their actions.
  4. D) Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are accepted treatment approaches.

Answer:  B

Explanation:  A) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

  1. B) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
  2. C) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.
  3. D) Knowing the psychobiology aspects of heritability and predisposition to substance dependence, as well as the complex environmental influences, helps diminish stigma. Acknowledging relapse, treatment approaches, and behavioral intentions does not address the psychobiology of the illness.

Page Ref: 1521

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  3. Identify commonly occurring addictions and their related therapies.

 

8) The nurse is called to an injury accident of an employee who has a history of addiction and is currently enrolled in a 12-step recovery program. In accordance with company policy, which test will the nurse perform?

  1. A) Liver enzymes
  2. B) Stool guaiac
  3. C) Urine specific gravity
  4. D) Hair testing

Answer:  D

Explanation:  A) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.

  1. B) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.
  2. C) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.
  3. D) Hair testing can detect substance use for up to 90 days. Liver enzymes detect liver damage but are not specific to damage from substance abuse. A stool guaiac tests for blood. Urine specific gravity is used to detect dilute or concentrated urine.

Page Ref: 1528

Cognitive Level:  Understanding

Client Need:  Health Promotion and Maintenance

Nursing Process:  Assessment

Learning Outcome:  5. Describe diagnostic and laboratory tests to determine an individuals addiction status.

 

9) An older woman who emigrated from the Middle East lives with her son. She accompanies him to a clinic where he participates in AA. Which independent nursing action will be most helpful for the nurse to implement with this client?

  1. A) Assertiveness training
  2. B) Milieu therapy
  3. C) Family therapy
  4. D) Communication training

Answer:  D

Explanation:  A) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.

  1. B) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.
  2. C) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.
  3. D) Many clients and families with addiction need training in communication skills. Verbal and nonverbal communication training is a vital independent nursing action. Cultural norms must be carefully considered prior to implementing assertiveness training. Milieu therapy and family therapy are interventions involving collaboration with therapists.

Page Ref: 1528

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  7. Demonstrate the nursing process in providing culturally competent and caring interventions across the life span for individuals with addictions.

 

10) The client with a history of alcohol abuse is being discharged. Which intervention is the discharge priority of choice for the multidisciplinary care team in collaboration with the client?

  1. A) Disulfiram
  2. B) AA
  3. C) Contingency contract
  4. D) Varenicline

Answer:  A

Explanation:  A) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. AA (Alcoholics Anonymous) and a contingency contract are appropriate tools but are not as urgent as Disulfiram. Varenicline is a drug for smoking cessation.

  1. B) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. AA (Alcoholics Anonymous) and a contingency contract are appropriate tools but are not as urgent as Disulfiram. Varenicline is a drug for smoking cessation.
  2. C) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. AA (Alcoholics Anonymous) and a contingency contract are appropriate tools but are not as urgent as Disulfiram. Varenicline is a drug for smoking cessation.
  3. D) Disulfiram (Antabuse) causes the client to become immediately and violently ill when consuming alcohol. AA (Alcoholics Anonymous) and a contingency contract are appropriate tools but are not as urgent as Disulfiram. Varenicline is a drug for smoking cessation.

Page Ref: 1533

Cognitive Level:  Understanding

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  8. Compare and contrast common independent and collaborative interventions for addiction.

 

Exemplar 22.1  Alcohol Abuse

 

1) A formerly homeless client has been treated for alcoholism. The clients physical examination reveals the client has a BMI of 18. Which medications does the nurse expect the physician to prescribe to manage the clients nutritional status?

  1. A) Sertraline (Zoloft)
  2. B) Methadone
  3. C) Narcan
  4. D) Multivitamin with folic acid

Answer:  D

Explanation:  A) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Narcan is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline (Zoloft) is used to reduce anxiety and stabilize mood.

  1. B) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Narcan is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline (Zoloft) is used to reduce anxiety and stabilize mood.
  2. C) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Narcan is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline (Zoloft) is used to reduce anxiety and stabilize mood.
  3. D) A client with alcohol dependence may suffer from numerous nutritional deficiencies, including deficiencies in thiamine, folic acid, vitamin A, magnesium, and zinc. A multivitamin may be prescribed to help with these deficiencies. Narcan is used to manage an opiate overdose. Methadone is prescribed to manage heroin cravings. Sertraline (Zoloft) is used to reduce anxiety and stabilize mood.

Page Ref: 1566

Cognitive Level:  Applying

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative care of an individual who abuses alcohol.

 

2) A college student attends a seminar on alcohol abuse. Which statement would alert the nurse that the student needs more education?

  1. A) The children of alcoholics are less likely to become alcoholics.
  2. B) Native Americans are more likely to become alcoholics.
  3. C) Married college graduates are less likely to become alcoholics.
  4. D) Childless people are more likely to become alcoholics than parents.

Answer:  A

Explanation:  A) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.

  1. B) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.
  2. C) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.
  3. D) A genetic predisposition to alcoholism is established for Native Americans and the children of alcoholics. Married people, college graduates, and parents are less likely to become alcoholics.

Page Ref: 1536

Cognitive Level:  Analyzing

Client Need:  Health Promotion and Maintenance

Nursing Process:  Implementation

Learning Outcome:  2. Identify risk factors associated with alcohol use.

 

3) The nurse has completed her assessment of 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?

  1. A) Ineffective Coping
  2. B) Imbalanced Nutrition: Less Than Body Requirements
  3. C) Disturbed Sensory Perception
  4. D) Disturbed Thought Processes

Answer:  B

Explanation:  A) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.

  1. B) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.
  2. C) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.
  3. D) An alcoholic client with anorexia is at risk for Imbalanced Nutrition, Less Than Body Requirements. Ineffective Coping is a potential diagnosis used in substance abuse. Disturbed Thought Processes and Disturbed Sensory Perceptions are diagnoses used for delusions, hallucinations, and illusions that may occur during delirium tremens.

Page Ref: 1541

Cognitive Level:  Applying

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  4. Formulate priority nursing diagnoses appropriate for an individual who abuses alcohol.

 

4) A client with alcoholism is receiving court-ordered care in a residential treatment facility. After alcohol is discovered in the clients room, she denies that it belongs to her. Which statement(s) by the nurse will support the treatment plan made in collaboration with the physician and the addiction therapist?

Select all that apply.

  1. A) You will lose your day pass privileges for this Sunday.
  2. B) We have a video of you accepting the alcohol from your brother.
  3. C) What do you think about sharing this at AA tonight?
  4. D) You wont be allowed to go to dinner tonight.
  5. E) You have violated our behavior contract.

Answer:  A, B, C, E

Explanation:  A) Used with care and a calm attitude, confrontation interferes with the clients ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.

  1. B) Used with care and a calm attitude, confrontation interferes with the clients ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
  2. C) Used with care and a calm attitude, confrontation interferes with the clients ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
  3. D) Used with care and a calm attitude, confrontation interferes with the clients ability to use denial or rationalization. Losing privileges is a consequence of the violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.
  4. E) Used with care and a calm attitude, confrontation interferes with the clients ability to use denial or rationalization. Losing privileges is a consequence of violating the behavior contract. Participation in AA will provide peer feedback. Withholding food is inappropriate, particularly for a client with potential nutritional deficits.

Page Ref: 1541

Cognitive Level:  Evaluating

Client Need:  Psychosocial Integrity

Nursing Process:  Caring

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative care of an individual who abuses alcohol.

 

5) The nurse is evaluating outcome goals written by a student for an alcoholic client being discharged from a detoxification program. Which outcome or outcomes now are appropriate for this client?

Select all that apply.

  1. A) Follow a 2000-calorie high-carbohydrate diet.
  2. B) Sponsor a participant in Alcoholics Anonymous (AA) meetings.
  3. C) Obtain at least 6-8 hours of sleep per night.
  4. D) Acknowledge the blame that family members must take for codependent behavior.
  5. E) Enroll in the Employee Assistance Program (EAP) through his employer.

Answer:  C, E

Explanation:  A) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the clients employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.

  1. B) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the clients employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
  2. C) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the clients employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
  3. D) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the clients employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.
  4. E) Outcome measures for a client discharging from alcohol detoxification are to obtain at least 6-8 hours of sleep a night and to enroll in the Employee Assistance Program if offered through the clients employer. The calorie requirement should be individualized and may not be 2000 calories. New or returning members to AA should be sponsored and are not ready to sponsor another person. This client should accept responsibility for his behavior in the family unit instead of assigning blame for codependent behavior.

Page Ref: 1541

Cognitive Level:  Analyzing

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  6. Evaluate expected outcomes for an individual who abuses alcohol.

 

6) A client is admitted for the fourth time in 4 years for alcohol detoxification. Which aspect(s) of the pathophysiology of alcoholism will impact the plan of care?

  1. A) Aging can impact the ability of the body to handle detoxification from alcohol and drugs.
  2. B) The withdrawal may be greater this time.
  3. C) The dependency might have been greater this time.
  4. D) Increased difficulty with alcohol detoxification is likely the result of an addiction to another substance at the same time.

Answer:  B

Explanation:  A) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.

  1. B) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.
  2. C) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.
  3. D) Subsequent episodes of withdrawal tend to get progressively worse due to kindling. Kindling refers to long-term changes in brain neurotransmission that occur after repeated detoxifications. Aging does not play a role in the process. There is no evidence to support the suspicion that the client is addicted to additional substances or has an increased degree of dependence.

Page Ref: 1539

Cognitive Level:  Applying

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  1. Describe the pathophysiology, psychopathology, etiology, clinical manifestations, and direct and indirect causes of alcohol abuse.

 

7) The nurse is collecting data from a client regarding alcohol use history. What question will provide the greatest amount of information?

  1. A) Are you a heavy drinker?
  2. B) How many alcoholic beverages do you drink each day?
  3. C) Is alcohol use a concern for you?
  4. D) Drinking doesnt cause any problems for you, does it?

Answer:  B

Explanation:  A) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a yes or no will limit the information obtained.

  1. B) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a yes or no, such as those in the other options, will limit the information obtained.
  2. C) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a yes or no will limit the information obtained.
  3. D) Open-ended questions will elicit the greatest amount of information. Asking closed questions that can be answered with a yes or no will limit the information obtained.

Page Ref: 1548

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  3. Illustrate the nursing process in providing culturally competent care across the life span for individuals who abuse alcohol.

 

Exemplar 22.2  Nicotine Addiction

 

1) A client who has smoked 2 packs of cigarettes per day for 34 years has a history of intermittent claudication, chronic bronchitis, and emphysema. After 6 weeks of cessation the client reports yelling at his spouse and flying off the handle. Which effect or effects of cigarette smoking are associated with this scenario?

Select all that apply.

  1. A) Nicotine causes destruction of the alveoli.
  2. B) The release of epinephrine causes vasoconstriction.
  3. C) Dopaminergic processes are implicated in withdrawal symptoms.
  4. D) Tar causes the mucus production seen in chronic bronchitis.
  5. E) Tobacco use causes atherosclerosis.

Answer:  B, C, D, E

Explanation:  A) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use 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.

  1. B) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use 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.
  2. C) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use 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.
  3. D) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use 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.
  4. E) Nicotine causes the release of epinephrine, which triggers vasoconstriction, exacerbating intermittent claudication. Tobacco use 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.

Page Ref: 1546

Cognitive Level:  Analyzing

Client Need:  Physiological Integrity

Client Need Sub:  Physiological Adaptation

Nursing Process:  Planning

Learning Outcome:  1. Describe the pathophysiology, etiology, clinical manifestations, and direct and indirect causes of nicotine addiction.

 

2) The 70-year-old client with heart disease tells the nurse, I am sick because I sinned by smoking cigarettes. What is the nurses best response to this dying client?

  1. A) Smoking cigarettes isnt a sin. There are many worse habits you could have.
  2. B) Cigarette smoking was desirable when you began smoking. We didnt know about the problems it could cause.
  3. C) Why dont we call the hospital chaplain and you can pray about your sins?
  4. D) You are correct, but it is too late to do anything about it now.

Answer:  B

Explanation:  A) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason 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 distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the clients concerns and does not offer forgiveness.

  1. B) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason 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 distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the clients concerns and does not offer forgiveness.
  2. C) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason 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 distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the clients concerns and does not offer forgiveness.
  3. D) This client is in distress and is seeking forgiveness. The nurse should offer this forgiveness and a reason 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 distress will increase. Suggesting that the hospital chaplain be called for prayer reinforces the idea that smoking cigarettes is a sin. Saying there are worse habits minimizes the clients concerns and does not offer forgiveness.

Page Ref: 1629

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Caring

Learning Outcome:  3. Illustrate the nursing process in providing culturally competent care across the life span for individuals with nicotine addiction.

 

3) The nurse is giving a health promotion class to adolescents. Which point is most important to convey to this audience?

  1. A) Teens are not strongly influenced by tobacco advertising.
  2. B) Smoking causes lung cancer.
  3. C) Cost is no deterrent to smoking.
  4. D) Alcohol use is strongly associated with smoking.

Answer:  B

Explanation:  A) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.

  1. B) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.
  2. C) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.
  3. D) Although alcohol abuse, a sedentary lifestyle, and drug abuse are preventable causes of mortality in the United States, smoking is now the number one cause of preventable death and disease for both men and women.

Page Ref: 1549

Cognitive Level:  Applying

Client Need:  Health Promotion and Maintenance

Nursing Process:  Implementation

Learning Outcome:  2. Identify risk factors associated with nicotine addiction.

 

4) The nurse has completed gathering data on a client with esophageal cancer due to years of nicotine abuse. Which nursing diagnosis is a priority for this client?

  1. A) Decisional Conflict
  2. B) Situational Social Isolation
  3. C) Disturbed Body Image
  4. D) Ineffective Airway Clearance

Answer:  D

Explanation:  A) The nurse should anticipate that the client with esophageal cancer may have issues with airway edema and therefore an ineffective airway clearance. This is the priority nursing diagnosis of those listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.

  1. B) The nurse should anticipate that the client with esophageal cancer may have issues with airway edema and therefore an ineffective airway clearance. This is the priority nursing diagnosis of those listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.
  2. C) The nurse should anticipate that the client with esophageal cancer may have issues with airway edema and therefore an ineffective airway clearance. This is the priority nursing diagnosis of those listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.
  3. D) The nurse should anticipate that the client with esophageal cancer may have issues with airway edema and therefore an ineffective airway clearance. This is the priority nursing diagnosis of those listed. There is no evidence that the client has a disturbed body image or experiences decisional conflict or social isolation.

Page Ref: 1549

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  4. Formulate priority nursing diagnoses appropriate for an individual with nicotine addiction.

 

5) A nurse working at a clinic in a community serving a high population of smokers is planning an educational session on Tips to Quit. Which topic will be appropriate for the session?

  1. A) Tell this group that smoking is unacceptable.
  2. B) Make sure the group is aware of the increased risk of liver disease and cancer of the esophagus.
  3. C) Review the available pharmacologic adjuncts to cessation.
  4. D) Recommend hypnosis at a local dinner theater.

Answer:  C

Explanation:  A) Available pharmacologic adjuncts for smoking cessation should be discussed in a Tips to Quit community talk. Simply telling the group that smoking is unacceptable is not effective in promoting wellness. Discussing esophageal cancer and liver disease is inappropriate for a single educational session; lung cancer and cardiovascular disease are the primary health threats that should be discussed.

  1. B) Available pharmacologic adjuncts for smoking cessation should be discussed in a Tips to Quit community talk. Simply telling the group that smoking is unacceptable is not effective in promoting wellness. Discussing esophageal cancer and liver disease is inappropriate for a single educational session; lung cancer and cardiovascular disease are the primary health threats that should be discussed.
  2. C) Available pharmacologic adjuncts for smoking cessation should be discussed in a Tips to Quit community talk. Simply telling the group that smoking is unacceptable is not effective in promoting wellness. Discussing esophageal cancer and liver disease is inappropriate for a single educational session; lung cancer and cardiovascular disease are the primary health threats that should be discussed.
  3. D) Available pharmacologic adjuncts for smoking cessation should be discussed in a Tips to Quit community talk. Simply telling the group that smoking is unacceptable is not effective in promoting wellness. Discussing esophageal cancer and liver disease is inappropriate for a single educational session; lung cancer and cardiovascular disease are the primary health threats that should be discussed.

Page Ref: 1547

Cognitive Level:  Applying

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative care of an individual with nicotine addiction.

 

6) A client has been admitted with chronic obstructive pulmonary disease (COPD) and has asked the nurse for help and information regarding nicotine addiction and ways to quit smoking. The nurse will evaluate the treatment and determine that a goal has been met when the client states:

  1. A) I will keep a pack of cigarettes in my closet in case I need it.
  2. B) I will taper off smoking gradually.
  3. C) I will chew sugar-free gum when I want a cigarette.
  4. D) I will eat a snack when I am feeling nervous.

Answer:  C

Explanation:  A) One goal for clients who are attempting to deal with addiction is stating adaptive coping mechanisms to use when stressed. The goal has been met when the client expresses the intention to use a healthy coping mechanismsuch as chewing sugar-free gumwhen the urge to smoke arises. Tapering off smoking and keeping cigarettes close by are examples of the client who is not wholly committed. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.

  1. B) One goal for clients who are attempting to deal with addiction is stating adaptive coping mechanisms to use when stressed. The goal has been met when the client expresses the intention to use a healthy coping mechanismsuch as chewing sugar-free gumwhen the urge to smoke arises. Tapering off smoking and keeping cigarettes close by are examples of the client who is not wholly committed. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.
  2. C) One goal for clients who are attempting to deal with addiction is stating adaptive coping mechanisms to use when stressed. The goal has been met when the client expresses the intention to use a healthy coping mechanismsuch as chewing sugar-free gumwhen the urge to smoke arises. Tapering off smoking and keeping cigarettes close by are examples of the client who is not wholly committed. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.
  3. D) One goal for clients who are attempting to deal with addiction is stating adaptive coping mechanisms to use when stressed. The goal has been met when the client expresses the intention to use a healthy coping mechanismsuch as chewing sugar-free gumwhen the urge to smoke arises. Tapering off smoking and keeping cigarettes close by are examples of the client who is not wholly committed. Eating when stressed may lead the client to substitute eating for smoking, which is a form of denial.

Page Ref: 1549-1550

Cognitive Level:  Analyzing

Client Need:  Psychosocial Integrity

Nursing Process:  Implementation

Learning Outcome:  7. Evaluate expected outcomes for an individual with nicotine addiction.

 

7) The nurse is planning an inservice for the multidisciplinary team on smoking cessation care. Which statements should be included in the class?

Select all that apply.

  1. A) There is no adverse risk if the client chooses to smoke while wearing a nicotine patch.
  2. B) Bupropion (Zyban) is used to suppress the craving for tobacco.
  3. C) A piece of nicotine gum should be chewed for 5 minutes of every waking hour then held in the cheek.
  4. D) Most persons quit smoking several times before they are successful.
  5. E) Alternative therapies should be considered to help reduce the stress that accompanies smoking cessation.

Answer:  B, D, E

Explanation:  A) When teaching clients about smoking cessation, the nurse should emphasize that most persons who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and is 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 to 12 times daily. The gum should be chewed several times to soften it and then held in the buccal space for at least 30 minutes to absorb the medication. A client 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, as they may help the client deal with the stress that accompanies smoking cessation.

  1. B) When teaching clients about smoking cessation, the nurse should emphasize that most persons who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and is 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 to 12 times daily. The gum should be chewed several times to soften it and then held in the buccal space for at least 30 minutes to absorb the medication. A client 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, as they may help the client deal with the stress that accompanies smoking cessation.
  2. C) When teaching clients about smoking cessation, the nurse should emphasize that most persons who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and is 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 to 12 times daily. The gum should be chewed several times to soften it and then held in the buccal space for at least 30 minutes to absorb the medication. A client 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, as they may help the client deal with the stress that accompanies smoking cessation.
  3. D) When teaching clients about smoking cessation, the nurse should emphasize that most persons who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and is 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 to 12 times daily. The gum should be chewed several times to soften it and then held in the buccal space for at least 30 minutes to absorb the medication. A client 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, as they may help the client deal with the stress that accompanies smoking cessation.
  4. E) When teaching clients about smoking cessation, the nurse should emphasize that most persons who quit smoking try to quit several times before they are successful. Bupropion is used to suppress the craving for tobacco and is 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 to 12 times daily. The gum should be chewed several times to soften it and then held in the buccal space for at least 30 minutes to absorb the medication. A client 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, as they may help the client deal with the stress that accompanies smoking cessation.

Page Ref: 1533

Cognitive Level:  Applying

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  6. Plan evidence-based caring interventions for an individual with nicotine addiction and his or her family in collaboration with other members of the healthcare team.

 

8) A nurse is caring for a client who smokes cigarettes and asks the nurse about nicotine replacement therapy (NRT). Which statement made by the nurse is appropriate?

  1. A) Over-the-counter (OTC) NRTs include transdermal patches, gums, nicotine inhalers, and nasal sprays.
  2. B) NRT helps to relieve the psychological and physiological effects of nicotine withdrawal.
  3. C) NRT does not address addictive behavior.
  4. D) Combining the use of NRT and a smoking cessation program is no more effective than NRT use alone.

Answer:  C

Explanation:  A) Nicotine replacement therapy (NRT) does not address addictive behavior. NRT helps to relieve some physiological, not psychological, effects of nicotine withdrawal. Over-the-counter (OTC) NRTs include transdermal patches and gums. Nicotine inhalers and nasal sprays are available by prescription only. Combining the use of NRT and a smoking cessation program is more effective than the use of NRT alone.

  1. B) Nicotine replacement therapy (NRT) does not address addictive behavior. NRT helps to relieve some physiological, not psychological, effects of nicotine withdrawal. Over-the-counter (OTC) NRTs include transdermal patches and gums. Nicotine inhalers and nasal sprays are available by prescription only. Combining the use of NRT and a smoking cessation program is more effective than the use of NRT alone.
  2. C) Nicotine replacement therapy (NRT) does not address addictive behavior. NRT helps to relieve some physiological, not psychological, effects of nicotine withdrawal. Over-the-counter (OTC) NRTs include transdermal patches and gums. Nicotine inhalers and nasal sprays are available by prescription only. Combining the use of NRT and a smoking cessation program is more effective than the use of NRT alone.
  3. D) Nicotine replacement therapy (NRT) does not address addictive behavior. NRT helps to relieve some physiological, not psychological, effects of nicotine withdrawal. Over-the-counter (OTC) NRTs include transdermal patches and gums. Nicotine inhalers and nasal sprays are available by prescription only. Combining the use of NRT and a smoking cessation program is more effective than the use of NRT alone.

Page Ref: 1547

Cognitive Level:  Applying

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  5. Summarize therapies used by interdisciplinary teams in the collaborative care of an individual with nicotine addiction.

 

9) A nurse is caring for a client with congestive heart failure who currently smokes cigarettes and has a 50 pack-year smoking history. When providing smoking cessation education to the client, the nurse will include which statement(s) regarding the pathophysiology of nicotine use?

Select all that apply.

  1. A) In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine.
  2. B) In high doses, nicotine stimulates the parasympathetic system to release epinephrine, causing vasoconstriction.
  3. C) Initially, nicotine increases mental alertness and cognitive ability.
  4. D) Nicotine is a nonpsychoactive substance found in tobacco.
  5. E) Gradual reduction of nicotine appears to be the best method of cessation.

Answer:  A, C

Explanation:  A) In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco.

  1. B) In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco.
  2. C) In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco.
  3. D) In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco.
  4. E) In low doses, nicotine stimulates nicotinic receptors in the brain to release dopamine and epinephrine, causing vasoconstriction. Initially, nicotine increases mental alertness and cognitive ability, but eventually it depresses those responses. Nicotine is a psychoactive substance found in tobacco.

Page Ref: 1546

Cognitive Level:  Applying

Client Need:  Physiological Integrity

Nursing Process:  Implementation

Learning Outcome:  3. Illustrate the nursing process in providing culturally competent care across the life span for individuals with nicotine addiction.

 

10) A nurse working in an outpatient primary care clinic is caring for a client with asthma who has an 80 pack-year smoking history. What statement made by the nurse is most appropriate when assessing the clients nicotine use?

  1. A) Have you tried a nicotine patch for quitting smoking?
  2. B) Do you smoke cigarettes with filters or without?
  3. C) Do you smoke upon waking?
  4. D) Tell me about any attempts youve made to quit using nicotine.

Answer:  D

Explanation:  A) Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Tell me about any attempts youve made to quit using nicotine is the only open-ended phrase that is effective in assessing this client.

  1. B) Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Tell me about any attempts youve made to quit using nicotine is the only open-ended phrase that is effective in assessing this client.
  2. C) Appropriate assessment questions should be open-ended and allow the client to elaborate on the answers. Tell me about any attempts youve made to quit using nicotine is t

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