A patient is prescribed nicotine gum as part of smoking cessation therapy. Which of the following is the correct instruction regarding chewing nicotine gum?

Appeared in: NORCET 9 Mains - 2025

Explanation

The correct technique for using nicotine gum is the 'Chew and Park' method.
The patient should chew the gum slowly until a tingling or peppery sensation is felt.
This tingling indicates that nicotine has been released from the gum.
At this point, the patient should stop chewing and 'park' the gum between the cheek and gums to allow for buccal absorption of the nicotine.
This method maximizes the therapeutic effect by ensuring the nicotine enters the bloodstream directly, bypassing the digestive system.

Option B: Chewing the gum quickly releases too much nicotine at once, and swallowing it leads to gastrointestinal irritation (nausea, hiccups) and reduced effectiveness due to first-pass metabolism in the liver.
Option C: Food and beverages, particularly acidic ones like coffee or juice, alter the pH of the mouth, which significantly decreases the buccal absorption of nicotine, rendering the therapy less effective.
Option D: Chewing and swallowing immediately prevents the nicotine from being absorbed through the lining of the mouth (buccal mucosa), which is the intended route of administration. This makes the gum ineffective and can cause stomach upset.

Visual 1: Diagram - An infographic illustrating the 'Chew and Park' method in three simple steps: 1) Chew slowly until tingle, 2) Park between cheek and gum, 3) Repeat when tingle fades. This visual helps reinforce the correct patient action.

Clinical Relevance

Nursing practice connection: Use the key finding related to Correct administration technique for nicotine gum as a form of Nicotine Replacement Therapy (NRT) to guide bedside assessment, documentation, and the next nursing action.
Proper patient education on NRT techniques is a critical nursing responsibility to ensure treatment adherence and success in smoking cessation.
Incorrect use not only reduces the effectiveness of the therapy but can also lead to unpleasant side effects, causing the patient to abandon the treatment.
What if? If a patient using nicotine gum complains of frequent hiccups, nausea, or a sore throat, the nurse should suspect they are chewing the gum too quickly and swallowing the nicotine-laced saliva. The nurse should re-educate the patient on the 'Chew and Park' method.

How to Approach the Question

First, identify the core subject of the question: the correct procedure for using nicotine gum.
This is a process-based question requiring knowledge of a specific administration technique.
Recall the standard 'Chew and Park' method for nicotine gum.
Step 1: Chew slowly until a tingle or peppery taste is felt.
Step 2: Stop chewing and park the gum between the cheek and gum.
Evaluate each option against these steps. The first option directly matches the first step of the correct procedure.

Concept Tested & Keywords

Concept Tested: Correct administration technique for nicotine gum as a form of Nicotine Replacement Therapy (NRT).
Stem keywords: nicotine gum, smoking cessation, chewing gum, instruction
Lead-in keywords: correct instruction
Negative lead-in flag: false

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Practise the full NORCET 9 Mains - 2025

Attempt every question from this paper in a timed mock, then review the full solution for each one.