The nurse is caring for a client who is withdrawing from long-term use of opioids. The nurse will monitor using a Clinical Opioid Withdrawal Scale (COWS). Which of the following cluster of symptoms would indicate to the nurse the client was withdrawing from opioids?

Diaphoresis, piloerection, tremors, irritability, insomnia, nausea, and vomiting.

Diaphoresis, hypertension, hand tremors, hallucination/illusions, and potential seizures.

Cravings, depression, fatigue, hypersomnolence, and impaired judgment.

Heightened sense of self, hallucinations, flashbacks, incoordination, and panic attacks.

Answer and Explanation

The Correct Answer is A

A) Correct. These symptoms are indicative of opioid withdrawal. Opioid withdrawal symptoms include sweating (diaphoresis), goosebumps (piloerection), tremors, irritability, insomnia, and gastrointestinal symptoms like nausea and vomiting.

B) Incorrect. These symptoms are more indicative of withdrawal from substances like alcohol or benzodiazepines, rather than opioids.

C) Incorrect. These symptoms are not specific to opioid withdrawal and may be seen in various conditions.

D) Incorrect. This cluster of symptoms is not characteristic of opioid withdrawal.

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Correct Answer is D

Explanation

A. While medication review may be necessary, the immediate concern is the client's current symptoms and potential need for urgent intervention.
B. Encouraging the client to eat more slowly does not address the urgent nature of the client's symptoms.

C. "Assessment security" is not a standard term or intervention. It does not provide specific guidance for addressing the client's symptoms.
D. Given the client's complaints of swelling and tightness, along with difficulty swallowing, further assessment is needed to determine the cause. This information should be reported to the provider promptly.

A. "You are safe here. We will make sure nothing happens to you." B. "You're just lucky your roommate came home to help you when she did." C. "What exactly do you plan to do?" D. "I don't understand. You have so much to live for."

Correct Answer is C

Explanation

A. While providing reassurance is important, this response does not directly address the client's statement about future attempts.
B. This response may minimize the seriousness of the client's statement and is not the best way to address the situation.
C. This response directly addresses the client's statement, seeking clarification on her plans. It is important to assess the level of risk and ensure the client's safety.
D. While expressing empathy and highlighting the client's positive qualities can be helpful, it may not directly address the immediate concern of the client's statement about future attempts.

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The nurse is caring for a client who is withdrawing from long-term use of opioids. The nurse will monitor using a Clinical Opioid Withdrawal Scale (COWS). Which of the following cluster of symptoms would indicate to the nurse the client was withdrawing from opioids?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse observes a client drooling during mealtime. The client complains that his tongue feels swollen, and his jaw feels tight. What is the first action by the nurse?

Correct Answer is D

Explanation

A client is hospitalized following a suicide attempt after breaking up with her significant other. The client says to the nurse, "When I get out of here, I'm going to try this again, and next time I'll get it right?" Which is the best response by the nurse?

Correct Answer is C

Explanation

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