Chapter 72: Smoking Cessation

Chapter 72: Smoking Cessation

Complete Chapter Questions With Answers

Sample Questions Are Posted Below

MULTIPLE CHOICE

1. A patient who smokes reports repeated attempts to quit smoking using a nicotine replacement patch. The patient says, “I always do well for a few weeks and then I just start smoking again.” The primary care nurse practitioner (NP) should prescribe:

ANS:  D

Varenicline interferes with the enjoyment of nicotine so that smokers do not get pleasure when they smoke. Nicotine replacement medications do not improve relapse rates, and this patient has relapsed several times. Nortriptyline is not a first-line smoking cessation medication.

DIF:    Cognitive Level: Applying (Application)                           REF:   780

2. An adolescent patient has recently begun smoking and reports a habit of fewer than five or six cigarettes per day. The patient does not want to quit smoking now but plans to do so after college. The primary care nurse practitioner should:

ANS:  D

For all patients who smoke, the provider should assess their willingness to quit. For patients unwilling to quit, the provider should focus on motivational issues. Chantix, nicotine transdermal patches, and smoking cessation programs are treatments for smoking, but if they are used by a patient who is unwilling to quit, they will be ineffective.

DIF:    Cognitive Level: Applying (Application)                           REF:   782

3. A primary care NP has been working with a young woman who wants to quit smoking before she begins having children. She has made several attempts to quit using nicotine replacement therapy and is feeling discouraged. She does not want to take medication at this time. The NP should:

ANS:  B

Each attempt to quit smoking should not be seen as a failure but as a trial for the next attempt. Asking a patient who is motivated to quit to write down things that may have contributed to the relapse will help the patient learn from the previous attempts. The patient already knows about the effects of smoking on fetal development because that is her motivation for quitting. Offering medication may be necessary, but only if the patient desires it.

DIF:    Cognitive Level: Applying (Application)                           REF:   781