After being treated in the emergency department for an opioid overdose two weeks ago, a client arrives to an outpatient treatment clinic. During the admission interview with the nurse, the client denies having a problem with opioid addiction, but admits to gradually increasing the dosage. Which approach is best for the nurse to make?
Recommend substituting opioids with other pain medication.
Explore other coping stategies aside from using medications.
Provide a list of local Narcotics Anonymous meetings.
Explain that opioid abuse poses a great risk to life.
The Correct Answer is B
A. Recommend substituting opioids with other pain medication: Simply switching to another pain medication without addressing underlying misuse behaviors may reinforce dependency. This overlooks the denial and psychological aspects of addiction.
B. Explore other coping strategies aside from using medications: This client-centered approach gently addresses the issue without direct confrontation. It encourages self-reflection, promotes healthy alternatives, and meets the client where they are in terms of readiness for change, which is essential in early recovery.
C. Provide a list of local Narcotics Anonymous meetings: Although this is useful, offering it during the first interaction with a client in denial may lead to resistance. Engagement and trust-building through conversation about alternatives are more effective initially.
D. Explain that opioid abuse poses a great risk to life: Providing factual information about risk can be helpful, but directly labeling it as abuse when the client is in denial may trigger defensiveness. It is more therapeutic to explore behaviors and build insight before confrontation.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","C","D","E","G"]
Explanation
Rationale for Correct Findings:
- The client dilates quickly to 10 cm and feels a strong urge to push: Rapid dilation and the strong urge to push indicate that the client is progressing effectively through labor, with no signs of obstruction or delays.
- The fetal heart rate is reassuring with a baseline of 145 and moderate variability: A reassuring fetal heart rate with moderate variability is a good sign that the baby is not experiencing any distress during labor, indicating a healthy fetal condition.
- The head is born easily over an intact perineum: The ease of the baby's head being born over an intact perineum suggests that the delivery is progressing smoothly, with minimal risk of perineal trauma.
- Apgar of 7 at 1 minute, then 9 at 5 minutes: The Apgar scores of 7 at 1 minute and 9 at 5 minutes show a positive outcome in neonatal assessment, with a good recovery.
- The fasting blood glucose (FSBG) is 86 (4.8 mmol/L): A fasting blood glucose of 86 mg/dL is within the normal range (74 to 106 mg/dL), indicating that the client’s blood glucose levels are well-controlled, which is a positive sign for managing her gestational diabetes.
Rationale for Negative Finding:
- The infant weighs 9 lbs. 9 oz (4.34 kgs): Macrosomia (a term used for babies born weighing more than 4 kg) can be associated with gestational diabetes, which increases the likelihood of delivering a larger baby. Macrosomia may lead to potential complications such as shoulder dystocia or increased risk for cesarean delivery.
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"B"}
Explanation
Rationale:
- Respirations: After administering morphine, it is crucial to monitor the client's respirations because opioids can cause respiratory depression, which may be more pronounced in elderly patients or those who are in pain and immobile.
- Deep breathing techniques: The nurse should encourage deep breathing techniques. This helps improve lung expansion and reduces the risk of respiratory complications such as pneumonia and atelectasis, especially in a client with decreased mobility due to pain and injury.
Rationale for Incorrect Options:
- Heart rate: While heart rate monitoring is important, it is not the primary concern immediately after morphine administration. The client's respiratory status takes precedence, especially considering the risk of opioid-induced respiratory depression.
- Blood pressure: While blood pressure monitoring is essential, morphine administration primarily affects the respiratory system, not the circulatory system. The nurse should prioritize respiratory monitoring over blood pressure unless the patient exhibits signs of hypotension.
- Range of motion exercises: Range of motion exercises are important for mobility and rehabilitation, but they are not a priority immediately following the trauma and morphine administration. The client should be assessed and stabilized before beginning exercises.
- Joint protection techniques: Joint protection techniques are beneficial in long-term rehabilitation, but in the acute phase, the priority is to manage the fracture, pain, and prevent further complications.
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