Chapter 39: Drug Abuse III: Nicotine and Smoking

Chapter 39: Drug Abuse III: Nicotine and Smoking

 

Complete Chapter Questions With Answers

 

Sample Questions Are Posted Below

 

MULTIPLE CHOICE

 

1. A patient who has just found out she is pregnant tells the nurse she wants to quit smoking. She asks about pharmacologic aids to help her quit. The nurse is correct to tell her what?

a.	“Nicotine replacement therapy is harmful, but it is safer than smoking, so it can be used.”
b.	“Psychosocial support is the only recommended treatment for smoking cessation during pregnancy.”
c.	“Varenicline [Chantix] is safe to use during pregnancy.”
d.	“You should try to taper off your smoking gradually, because none of the drugs are safe.”

 

 

ANS:  A

Because nicotine is a component of nicotine replacement therapy (NRT), NRT is not safe during pregnancy. However, it is safer than smoking, and if it can help the patient stop smoking, it is recommended with caution. Psychosocial support is more effective when combined with a first-line pharmacologic agent. Varenicline has been shown to have harmful effects on fetuses in animal testing, so it should be avoided during pregnancy. Tapering nicotine withdrawal only seems to prolong the withdrawal symptoms; abrupt cessation is better than a taper.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 424 | p. 426

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

2. The spouse of a patient who smokes wonders why anyone would want to engage in “such a disgusting habit.” What will the nurse tell the spouse?

a.	Nicotine causes relaxation and helps with sleep.
b.	Nicotine increases alertness and promotes dopamine release.
c.	Nicotine lowers blood pressure.
d.	Nicotine settles the stomach and reduces nausea and vomiting.

 

 

ANS:  B

Nicotine increases alertness, facilitates memory, and improves cognition. Even though users report feeling relaxed when using nicotine, it actually increases arousal and does not cause relaxation. Nicotine elevates blood pressure. Nicotine causes the gastrointestinal (GI) side effects of nausea, vomiting, and increased motility.

 

PTS:   1                    DIF:    Cognitive Level: Analysis                REF:   pp. 423-424

TOP:   Nursing Process: Implementation

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies

 

3. A 4-year-old child is brought to the emergency department with symptoms of nausea and vomiting and a weak, thready pulse of 120 beats per minute after ingesting several cigarettes at home. The nurse caring for this child will expect to provide which treatment?

a.	Gastric lavage
b.	Hemodialysis
c.	Respiratory support
d.	Vasoconstrictors

 

 

ANS:  C

Nicotine is highly toxic, and the most prominent symptoms are those involving the cardiovascular, GI, and central nervous systems. This child is showing signs of toxicity. Respiratory arrest can occur, because nicotine affects the muscles of respiration. Respiratory support is the key to management; no antidote is available to nicotine poisoning. Nicotine undergoes rapid metabolism, so recovery can occur in a few hours. Gastric lavage, hemodialysis, and vasoconstrictors are not recommended.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   p. 425

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Reduction of Risk Potential

 

4. A patient reports a desire to stop smoking and asks what is available without a prescription to help with smoking cessation. The nurse tells the patient that which method is best?

a.	Abrupt discontinuation to shorten withdrawal effects
b.	Nicotine replacement and 1-800-QUITNOW
c.	Nicotine replacement products tapered over a year
d.	Support groups without the use of medications

 

 

ANS:  B

Nicotine addiction can be treated with pharmacologic agents or counseling, but the combination of these two approaches is more effective than either one alone. Abrupt cessation is better than tapering off, because the withdrawal effects are not so prolonged; however, this approach is not recommended as the best way to quit. Nicotine replacement products should be discontinued after a few weeks to months after quitting smoking, because they contain nicotine, which is both harmful and addicting. Support groups alone can work but are not as effective as the combination of support groups and medications.

 

PTS:   1                    DIF:    Cognitive Level: Application           REF:   pp. 425-426

TOP:   Nursing Process: Planning

MSC:  NCLEX Client Needs Category: Physiologic Integrity: Pharmacologic and Parenteral Therapies