Chapter 11 Quiz
A patient being discharged to home is prescribed an oxycodone-acetaminophen combination for pain management. Which precaution is most important to teach this patient?
"Avoid drinking alcohol while taking this drug."
The healthcare provider asks you to rate a patient's postoperative pain. What is your best response?
"I think we need to ask the patient to rate his own pain."
Indicate which analgesics are considered strong opioid agonists. (Select all that apply.)
- Fentanyl - Hydromorphone - Morphine
Which patient should be assessed closely for complications of pain management with methocarbamol?
75-year-old man with benign prostatic hyperplasia
What types of drugs have the main purpose of relieving pain?
Analgesics
Which of the following conditions is most likely to increase a patient's perception of pain?
Anxiety and/or depression
When assessing the blood pressure of a patient receiving pentazocine 30 mg orally for pain control two days after surgery, the reading is 166/100, which is much higher than the patient's presurgical blood pressure. What is your best action?
Assess the patient for other cardiac changes.
When you assess a patient's pain level an hour after giving 2 mg of hydromorphone intravenously, you find the patient sleeping with a respiratory rate of 10 breaths per minute. What is your best first action?
Assess the patient's oxygen saturation with pulse oximetry.
How does tramadol help control pain?
Binding to adrenergic receptors in the spinal cord preventing pain signals from reaching the brain
How do nonopioid centrally acting analgesics, such as clonidine and tramadol, help manage pain?
Blocking activity in the CNS
Which of the following would not be included in a premedication nursing assessment before opioid administration?
Blood clotting values
Which of the following assessments is most important to perform on a patient newly prescribed to take cyclobenzaprine for severe muscle pain?
Blood pressure and heart rate
How do you assess whether a patient is experiencing pain?
By asking the patient to identify whether he or she is in pain
Analgesics are a category of drug developed specifically to reduce pain. How do these drugs work when given to a patient who is in pain?
Change the patient's perception of pain or reduce painful stimulation at its source
Which drug can lead to hypotension through dilation of blood vessels?
Clonidine
Which narcotic is combined with acetaminophen (Tylenol) for the antitussive effect?
Codeine
Which of the following drugs is used to reduce pain from muscular contractions or spasms?
Cyclobenzaprine
Morphine is the drug by which all other pain- management drugs are compared for effectiveness. Which drug from the list below is actually stronger than morphine?
Delaudid
If a patient taking an opioid agonist, such as morphine, has a strong adverse reaction or overdose, how can the effects be reversed?
Give an opioid antagonist such as naloxone.
The postoperative orders for a large adult patient who has just arrived on your unit after major abdominal surgery reads morphine 15 mg IM every 4 to 6 h as needed for pain. What is the best schedule for pain relief during the first postoperative day for this patient?
Give the drug automatically every 4 h around the clock for the 24 h.
Which health problem is a severe adverse reaction to chronic acetaminophen therapy?
Liver toxicity
Opioids are an analgesic drug used to manage severe pain. Natural opioids are derived from opium. What are synthetic opioids, such as hydrocodone and oxycodone, made from?
Morphine
Which medication is given for relief of moderate to severe pain?
Morphine sulfate
Identify which of the following is not an Agency for Healthcare Research and Quality principle for pain management.
Not trusting the patient or family regarding their perceptions or opinions regarding pain
You accidentally give a patient 30 mg orally of hydromorphone instead of the ordered hydrocodone. What is your first best action?
Notify the RN in charge immediately.
Miscellaneous analgesics are used to treat less severe pain and, unlike opioids, can reduce symptoms of pain by which of the following methods?
Reducing the symptoms of inflammation by helping stop tissue production of the chemical of inflammation
Mr. Corona has been experiencing left arm and jaw pain for the last 2 days. Upon exam, Mr. Corona is admitted to the hospital, and further tests confirm he has experienced a myocardial infarction. Which descriptor best identifies the type of pain Mr. Corona experienced?
Referred
Opioid agonist-antagonists are used for less severe pain and are less addictive than opioid agonists but can be responsible for causing which of the following reactions?
Severe cardiac reactions
You are caring for a patient who is paralyzed from the waist down and has a large open wound on her right heel. When asked about her pain in that foot, she tells you it is a 0 on a 0 to 10 pain rating scale. What does this response indicate?
The paralysis prevents her brain from perceiving the pain.
Why are natural and synthetic opioids considered "high-alert drugs?"
They have an increased risk for causing a patient harm if given in error
What is the reason all opioids, both natural and synthetic, are labeled high-alert drugs?
They have an increased risk for causing patient harm.
Long-term narcotic use will lead to:
drug tolerance.
A basal rate is set on a PCA (patient-controlled analgesia pump) with a narcotic to:
empower the patient to participate in care.
Mr. Jones is receiving Demerol through an epidural infusion and has a markedly diminished respiratory effort. The drug of choice to counteract the Demerol effect is:
naloxone hydrochloride (Narcan)
The primary indication for analgesic administration is the need for:
pain relief
The healthcare provider encourages a patient with chronic pain to self-administer Tylenol between scheduled opioid doses. The reason for the Tylenol is to:
provide an additive effect.
Pain that is related to psychological versus physical factors is referred to as:
psychogenic pain.
