Which assessment finding is most important in determining nursing care of a client withdrawing from cocaine?

Facial burns

Perforated septum

Suicide precautions

Nutritional support

Answer and Explanation

The Correct Answer is C

A. Facial burns: Facial burns may occur with methods of drug use, such as smoking crack cocaine, but they are not the most urgent concern during withdrawal. Physical injuries are important but do not guide immediate safety-related nursing priorities.
B. Perforated septum: A perforated nasal septum results from chronic intranasal cocaine use. While it indicates long-term damage, it is not a critical issue during the acute withdrawal phase and does not require urgent intervention.
C. Suicide precautions: Cocaine withdrawal is often associated with severe depression, anxiety, and suicidal ideation. Suicide precautions are essential because of the high risk for self-harm, making this the top priority in nursing care.
D. Nutritional support: Cocaine users may suffer from malnutrition due to poor appetite and lifestyle, but nutritional support is not the immediate concern during withdrawal. Safety and mental health monitoring take precedence.

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Correct Answer is B

Explanation

A. "There are many other medications that can be offered.": This prematurely suggests changing the medication without allowing adequate time for therapeutic effect. Buspirone requires consistent use over time to evaluate effectiveness.
B. "It may take up to 4 weeks for full therapeutic response.": Buspirone is a non-benzodiazepine anxiolytic that works gradually, with therapeutic effects typically developing over 2 to 4 weeks. This response provides accurate information and helps manage expectations.
C. "Call back in one week if the symptoms continue.": While follow-up is important, this response delays giving the client valuable information about the expected time frame for symptom relief, which could lead to premature discontinuation.
D. "Buspar will not eliminate all symptoms associated with anxiety.": While it's true that the goal of anxiety treatment is often symptom management rather than complete elimination, this response doesn't address the client's concern about the lack of any symptom relief after one week. It also doesn't provide information about when they might start to experience benefits.

A. Notify the physician. B. Recheck the apical pulse in 30 minutes. C. Administer the digoxin. D. Hold the digoxin.

Correct Answer is C

Explanation

A. Notify the physician: There is no immediate need to notify the provider since the heart rate is above the standard threshold for withholding digoxin. Clinical parameters are still within safe limits for administration.
B. Recheck the apical pulse in 30 minutes: Rechecking later may delay necessary therapy without cause. The heart rate is currently adequate, and there is no indication of bradycardia or instability.
C. Administer the digoxin: Digoxin is generally held if the apical heart rate is below 60 beats/minute in adults. Since the pulse is 62 and the client’s baseline is slightly higher, it is safe to administer the medication while continuing to monitor for any signs of bradycardia.
D. Hold the digoxin: Holding the dose is unnecessary unless the heart rate falls below 60 or there are signs of toxicity. In this case, the current rate does not warrant withholding the drug.

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Which assessment finding is most important in determining nursing care of a client withdrawing from cocaine?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

One week ago, the client was prescribed Buspirone (Buspar) for anxiety. The client phones the office and reports the medication has not eliminated the symptoms. Which is the best response by the nurse?

Correct Answer is B

Explanation

Before administering digoxin to a client with valvular disease, the nurse assesses the apical heart rate as 62 beats/minute. The client's usual rate ranges between 66 to 72 beats/minute. Which is the best action for the nurse to take?

Correct Answer is C

Explanation

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