A nurse is talking with a client 57 years of age who has been a ...

[AEWBW]

A nurse is talking with a client 57 years of age who has been a heavy drinker for many years. The client is being treated for alcoholism, and this is her second week as an inpatient on the psychiatric unit.
 
  It is 5 a.m. and the client has been having difficulty sleeping. The client is an orthopedic nurse, and although she is clothed in a hospital-issued gown and robe, she is wearing a stethoscope around her neck that the nurse recognizes as belonging to one of the staff nurses. When the nurse asks her why she is wearing the stethoscope and where she got it, the client gives her a long and involved reply that describes how her nursing supervisor came to visit and gave it to her to wear so she'd remember to get well. The nurse suspects that the client may be experiencing which of the following?
 
  A) Wernicke's syndrome
  B) Delirium tremens
  C) Korsakoff's amnesic syndrome
  D) Malignant hyperthermia

Question 2

A client tells a nurse that he is committed to trying to quit smoking. When educating the client on smoking cessation, which of the following would the nurse include?
 
  A) Success usually involves more than one type of intervention.
  B) Relapse is fairly rare within the first year of quitting.
  C) Ear acupressure is a highly proven method for quitting.
  D) The drug varenicline is widely used among patients with psychiatric disorders.

[jomama]

Answer to Question 1

Ans: C
Korsakoff's amnesic syndrome, also known as psychosis, is associated with alcoholism and involves the heart and the vascular and nervous systems, but the primary problem is acquiring new information and retrieving memories. Symptoms include amnesia, confabulation, (i.e., telling a plausible but imagined scenario to compensate for memory loss), attention deficit, disorientation, and vision impairment. Wernicke's encephalopathy, a degenerative brain disorder caused by thiamine deficiency, is characterized by vision impairment, ataxia, hypotension, confusion, and coma. Delirium tremens is an acute withdrawal syndrome characterized by autonomic hyperarousal, disorientation, hallucinations, and tremors. Malignant hyperthermia is characterized by a sharp increase in body temperature leading to muscle breakdown, kidney and cardiovascular failure, and death.

Answer to Question 2

Ans: A
Successful smoking cessation usually requires more than one type of intervention, including social support and education. Recent research has shown that nicotine addiction is extremely powerful and is at least as strong as addictions to other drugs, such as heroin and cocaine; 70 of those who quit relapse within 1 year. Auricular therapy, or ear acupressure, is being studied as a potential adjunctive treatment for nicotine addiction. Varenicline tartrate reduces the craving and rewarding effects of nicotine by preventing nicotine from accessing one of the acetylcholine receptor sites involved with nicotine dependence, but it can cause depression and related psychiatric symptoms in some people. This side effect limits its usefulness for people with psychiatric disorders.