Author Question: A patient admitted with shortness of breath and chest pain who is a pack-a-day smoker tells the ... (Read 124 times)

silviawilliams41 · **on:** Jun 25, 2018

A patient admitted with shortness of breath and chest pain who is a pack-a-day smoker tells the nurse, I am just not ready to quit smoking yet. Which response by the nurse is best?

a. This would be a really good time to quit.
b. Your smoking is the cause of your chest pain.
c. What health problems do you think smoking has caused?
d. Are you familiar with the various nicotine replacement options?

Question 2

A 75-year-old patient is admitted for pancreatitis. Which tool would be the most appropriate for the nurse to use during the admission assessment?

a. Drug Abuse Screening Test (DAST-10)
b. Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised (CIWA-Ar)
c. Screening Test-Geriatric Version (SMAST-G)
d. Mini-Mental State Examination

scrocafella · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: C
The patient is in the precontemplation stage of change, and the nurse's role is to assist the patient to become motivated to quit. The current Clinical Practice Guidelines indicate that the nurse should ask the patient to identify any negative consequences from smoking. The responses This would be a really good time to quit and Your smoking is the cause of your chest pain express judgmental feelings by the nurse and are not likely to motivate the patient. Providing information about the various nicotine replacement options would be appropriate for a patient who has expressed a desire to quit smoking.

Answer to Question 2

ANS: C
Because the abuse of alcohol is a common factor associated with the development of pancreatitis, the first assessment step is to screen for alcohol use using a validated screening questionnaire. The SMAST-G is a short-form alcoholism screening instrument tailored specifically to the needs of the older adult. If the patient scores positively on the SMAST-G, then the CIWA-Ar would be a useful tool for determining treatment. The DAST-10 provides more general information regarding substance use. The Mini-Mental State Examination is used to screen for cognitive impairment.