A nurse is assisting in the care of a client in an outpatient substance use disorder clinic who has been taking naltrexone for the past 30 days. Which of the following client statements indicates an expected response to the treatment?
"My anxiety has been getting a little easier to deal with every day."
"I have not had any cravings to drink since my visit last week."
"When I had one drink last week. I had extreme nausea and vomited several times."
“Since I quit drinking. I have not had any hallucinations."
The Correct Answer is B
Rationale:
A. "My anxiety has been getting a little easier to deal with every day." Naltrexone is not primarily used to treat anxiety. While improvement in anxiety may occur secondarily as alcohol use decreases, this statement does not directly reflect the intended therapeutic effect of naltrexone in substance use treatment.
B. "I have not had any cravings to drink since my visit last week." Naltrexone works by blocking opioid receptors involved in the brain’s reward system, reducing cravings and the pleasurable effects of alcohol. Decreased alcohol craving is a direct and expected response to naltrexone therapy in clients with alcohol use disorder.
C. "When I had one drink last week. I had extreme nausea and vomited several times."
This describes the effect of disulfiram, not naltrexone. Disulfiram causes an aversive reaction to alcohol, while naltrexone does not produce sickness when alcohol is consumed; it simply reduces the reward response.
D. “Since I quit drinking. I have not had any hallucinations." Hallucinations are associated with alcohol withdrawal, not the effect of naltrexone. Naltrexone does not prevent withdrawal symptoms or hallucinations; it is used after detox to help maintain abstinence and reduce relapse.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Librium: Librium (chlordiazepoxide) is a benzodiazepine used primarily during alcohol withdrawal to manage symptoms such as anxiety, tremors, or seizures. It is not used for long-term relapse prevention due to the risk of dependence and lack of deterrent effect on alcohol use.
B. Clonidine: Clonidine is an antihypertensive agent that can help reduce autonomic symptoms during acute alcohol or opioid withdrawal. However, it does not play a role in preventing relapse or deterring future alcohol use.
C. Disulfiram: Disulfiram works by producing unpleasant effects like nausea and vomiting when alcohol is consumed, thereby discouraging the client from drinking. It is specifically used for relapse prevention in clients who are motivated to remain abstinent and understand the consequences of drinking while on the medication.
D. Phenobarbital: Phenobarbital, a barbiturate, may be used in certain alcohol withdrawal protocols for seizure control or severe withdrawal symptoms. However, it is not used for relapse prevention and carries a high potential for dependence and sedation.
Correct Answer is ["A","C","D","E"]
Explanation
A.Provide the caregiver with information on behavior therapy: Behavior therapy is a first-line, evidence-based nonpharmacologic intervention for ADHD, particularly in children. Educating caregivers about behavioral strategies helps improve symptom management and supports long-term success.
B. Screen the child for depression prior to initiating the medication: Although screening for comorbid conditions like depression is important in ADHD management, it is typically part of the initial diagnostic workup, which was already completed with neurology and developmental evaluations.
C. Monitor liver function test results while the child is taking the medication: Atomoxetine carries a risk of rare but serious liver toxicity. Regular monitoring of liver function is essential during treatment, especially if the child shows signs of liver dysfunction (e.g., dark urine, abdominal pain, jaundice).
D. Monitor the child for nightmares while taking the medication: Sleep disturbances, including insomnia and nightmares, are known side effects of atomoxetine. Nurses should monitor and educate caregivers about possible changes in sleep behavior while the child is on this medication.
E.Monitor the child's blood pressure at each visit: Atomoxetine can cause increases in blood pressure and heart rate. Routine monitoring of vital signs at follow-up visits is necessary to ensure cardiovascular safety during treatment.
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