An adolescent patient has recently begun smoking and reports a ...

[rachel9]

An adolescent patient has recently begun smoking and reports a habit of fewer than five or six cigarettes per day. The patient does not want to quit smoking now but plans to do so after college. The primary care nurse practitioner should:
 
  a. prescribe varenicline (Chantix).
  b. recommend a nicotine transdermal patch.
  c. refer the patient to a smoking cessation program.
  d. begin a discussion about the negative effects of smoking.

Question 2

A patient who smokes reports repeated attempts to quit smoking using a nicotine replacement patch. The patient says, I always do well for a few weeks and then I just start smoking again.
 
   The primary care nurse practitioner (NP) should prescribe: a. nortriptyline.
  b. Nicorette gum.
  c. a Nicotrol inhaler.
  d. varenicline (Chantix).

[diesoon]

Answer to Question 1

D
For all patients who smoke, the provider should assess their willingness to quit. For patients unwilling to quit, the provider should focus on motivational issues. Chantix, nicotine transdermal patches, and smoking cessation programs are treatments for smoking, but if they are used by a patient who is unwilling to quit, they will be ineffective.

Answer to Question 2

D
Varenicline interferes with the enjoyment of nicotine so that smokers do not get pleasure when they smoke. Nicotine replacement medications do not improve relapse rates, and this patient has relapsed several times. Nortriptyline is not a first-line smoking cessation medication.

[rachel9]

TYSM

[alvinum]

Thanks for the timely response, appreciate it