A nurse is reinforcing teaching with a client about naltrexone. Which of the following statements by the client indicates an understanding of the teaching?

Choice A reason: Weight gain is a common manifestation after cessation of nicotine use. Nicotine is an appetite suppressant, and its absence can lead to increased appetite and caloric intake. Additionally, some individuals may turn to food as a substitute for smoking, leading to weight gain. Understanding this can help in planning strategies to manage weight during the cessation process.

Choice B reason: Difficulty concentrating is another common symptom experienced during nicotine withdrawal. Nicotine has stimulant effects on the brain, enhancing concentration and alertness. When a person stops using nicotine, they may experience cognitive difficulties, including trouble focusing and memory issues. These symptoms are typically temporary but can be challenging during the withdrawal period.

Choice C reason: Diarrhea is not a common manifestation of nicotine cessation. Gastrointestinal symptoms like constipation are more frequently reported during nicotine withdrawal. The body's digestive system adjusts to the absence of nicotine, which can result in changes in bowel habits, but diarrhea is less typical.

Choice D reason: Restlessness is a well-documented symptom of nicotine withdrawal. The body and mind are accustomed to the stimulant effects of nicotine, and its absence can lead to increased agitation and restlessness. This symptom can contribute to the difficulty of quitting smoking, as it creates a sense of discomfort and unease.

Choice E reason: Decreased appetite is not typically associated with nicotine cessation. Instead, increased appetite is more commonly observed due to the removal of nicotine's appetite-suppressing effects. Therefore, decreased appetite is not a typical manifestation of nicotine withdrawal.

Choice A reason: A client who is hearing command hallucinations should be prioritized first because command hallucinations can be particularly dangerous. These hallucinations can involve voices instructing the client to harm themselves or others. Immediate assessment and intervention are crucial to ensure the client's safety and to prevent potential harm. The nurse needs to address the client's safety concerns and implement necessary precautions.

Choice B reason: A client verbalizing ideas of reference, which involve misinterpreting events or remarks as having personal significance, may experience distress and paranoia. While these symptoms require attention and management, they do not typically pose an immediate risk to the client's or others' safety. The nurse should monitor and support the client but prioritize more urgent safety concerns first.

Choice C reason: A client using neologisms, or creating new words that are not understood by others, indicates a thought disorder. While this is a significant symptom that requires intervention, it does not typically pose an immediate risk to safety. The nurse should evaluate the client's communication and thought processes and provide appropriate care.

Choice D reason: A client demonstrating clang associations, which involve linking words based on sound rather than meaning, also indicates a thought disorder. This symptom requires attention, but it does not usually pose an immediate threat to the client's or others' safety. The nurse should assess the client's condition and provide appropriate interventions but prioritize more urgent safety concerns first.