Pharm ch26

As the nurse settles the patient into his room after returning from the post-anesthesia care unit (PACU), the patient says he is in severe pain. The nurse checks the medical record and sees the patient has an order for morphine 4 to 8 mg every 1 to 2 hour IV as needed for pain. The nurse sees this medication has not been administered yet so the nurse administers 4 mg. After administering the drug, the PACU nurse calls to say a dose of morphine was given and not documented. What drug will the nurse be prepared to administer if the patient's respiratory rate is depressed? A) Naloxone hydrochloride tartrate (Narcan) B) Butorphanol C) Buprenorphine (Buprenex) D) Nalbuphine hydrochloride (Nubain)

A

The nurse is caring for a patient experiencing postoperative pain. The physician orders 2.5 mg of morphine IV every two hours. Morphine is supplied in 10 mg/mL vials. How many mL will the nurse administer? A) 0.25 mL B) 0.5 mL C) 1 mL D) 2 mL

A

The nurse receives an order for morphine sulfate 8 mg IV every 1 hour as needed for pain. For which patient would the nurse need to question this order? A) A 78-year-old with osteoarthritis B) A 45-year-old, 1-day postoperative mastectomy C) A 28-year-old with a fractured tibia D) A 17-year-old, 1-day postoperative appendectomy

A

The nursing instructor asks the student nurse to explain the action of sumatriptan. What is the student's best response? A) Vasoconstrictive on cranial blood vessels B) Depresses pain response in the central nervous system C) Vasodilation of peripheral blood vessels D) Binds to acetylcholine receptors to prevent nerve transmission

A

The patient in labor receives morphine every 2 hours to manage labor pain. After 22 hours of labor the woman delivers a baby boy. What is the nurse's priority action related to the newborn? A) Monitor for opioid effects. B) Administer naloxone. C) Monitor for withdrawal syndrome. D) Assess for congenital anomaly.

A

What drug might the nurse administer for both analgesic and antitussive effects? A) Codeine B) Aspirin C) Ibuprofen D) Acetaminophen

A

When evaluating the effects of narcotic agonist-antagonists on a patient, what adverse effects would the nurse monitor for? A) Hypertension B) Bleeding C) Suppressed bone marrow function D) Increased pulse pressure

A

The patient is brought to the emergency department in respiratory arrest after overdosing on heroin. The person accompanying the patient says he has been using heroin for years. After being administered one dose of a narcotic antagonist, the patient begins to breathe spontaneously but remains nonresponsive to stimuli so another dose of narcotic antagonist is ordered. What symptoms would indicate the patient is experiencing acute narcotic abstinence syndrome? (Select all that apply.) A) Tachycardia B) Hypertension C) Vomiting D) Confusion E) Sedation

A,B,C

What is the nurse's priority assessment when administering narcotics to older adults? (Select all that apply.) A) Central nervous system (CNS) effects B) Gastrointestinal effects C) Cardiovascular effects D) Urinary effects E) Developmental effects

A,B,C

Narcotic agonists-antagonists have what function? (Select all that apply.) A) Relief of moderate-to-severe pain B) Adjunctive therapies to nonsteroidal anti-inflammatory drugs (NSAIDs) C) Relief of pain during labor and delivery D) Relief of orthopedic pain E) Adjuncts to general anesthesia

A,C,E

The anatomy and physiology instructor is talking about pain sensations. What produces pain sensations when stimulated by generating nerve impulses? (Select all that apply) A) A-delta fibers B) D-delta sensory nerves C) Mu receptors D) Sigma-receptors E) C fibers

A,E

The nurse administers pentazocine cautiously to what population? A) Patients with known GI disease B) Patients with known heart disease C) Patients with known urinary disease D) Patients with known respiratory disease

B

By what route will the nurse administer methylnaltrexone (Relistor)? A) IV B) Subcutaneously C) Intranasally D) Orally

B

The nurse administers a narcotic analgesic to the postoperative patient. What is the best way for the nurse to evaluate response to the medication? A) Observe the patient without her awareness. B) Use a pain assessment tool before and 30 minutes after administration. C) Assess vital signs. D) Measure oxygen saturation.

B

A patient with a migraine took a dose of a prescribed triptan, eletriptan (Relpax), and 1 hour later the headache is still intense. The patient's husband calls the clinic and asks the nurse what they should do. What is an appropriate nursing response? A) "Tell her to lie down in a quiet cool room and just wait it out. It will subside." B) "She can take another dose of the drug 2 hours after the initial dose if the headache continues." C) "Give her a dose of an ergot drug if you have it. It will decrease the intensity of the pain." D) "Ibuprofen may increase the action of the triptan."

B

Before administering an ergot drug to the patient for the first time, the nurse would assess the patient's currently prescribed medications for what drug? A) Antidiabetic agents B) Beta adrenergic blockers C) Oral contraceptives D) Selective serotonin reuptake inhibitors (SSRIs)

B

The nurse is caring for a patient who is receiving an opioid analgesic. What are the nurse's priority assessments? A) Pain intensity and blood glucose level B) Level of consciousness and respiratory rate C) Respiratory rate and electrolytes D) Urine output and pain intensity

B

A patient with migraine headaches is changed from an ergot to a prescription for a triptan. The nurse has completed teaching related to the drug. What statement would indicate she has a clear understanding of the new drug? A) "My life is over. I can't function not knowing when I'm going to have a headache." B) "I will not have to avoid driving because this medication isn't sedating." C) "I should not experience as many adverse effects from my new medication." D) "I take my medication every hour when I have a headache."

C

A patient, 6 days postoperative, is being weaned off an opioid analgesic. The patient reports he is getting no relief from the pain with the new non-opioid medication he is receiving. What might the nurse suspect is causing this patient's pain? A) The patient needs a higher dose of the opioid analgesic. B) The patient has become addicted to the opioid medication. C) The patient has developed withdrawal syndrome. D) The patient has developed a cross-hypersensitive reaction.

C

According to the Gate Control Theory, what interventions by the nurse could help to block pain impulses? A) Administration of opioid medications B) Administration of narcotic agonist-antagonists C) Back massage D) Acupuncture

C

Before administering an opiate medication, what will the nurse assess? A) The patient's weight B) The patient's heart rate C) The patient's respiratory rate D) The patient's drug tolerance

C

The nurse is providing patient teaching about a prescribed opioid analgesic. What is an important teaching point related to a possible adverse effect of this drug? A) Ataxia B) Blurred vision C) Hypotension D) Dysrhythmias

C

What medication would the nurse administer to the patient in severe pain? A) Codeine B) Hydrocodone C) Hydromorphone D) Opium

C

What order for naloxone would be appropriate for the nurse to administer for reversal of opioid effects? A) 1 mg IV repeat every 2 to 3 minutes B) 5 mg IV repeat every 5 minutes C) 0.1 mg IV repeat every 2 to 3 minutes D) 0.4 mg IV repeat every 3 minutes

C

Which narcotic analgesics can the nurse administer to a child because she has an established pediatric dose? (Select all that apply.) A) Transdermal fentanyl B) Methadone C) Morphine D) Meperidine E) Hydrocodone

C,D,E

A 72-year-old patient is admitted to the hospital for surgery. After the patient returns to the floor, the patient's daughter tells the nurse she is concerned that her mother will overdose on morphine because she keeps pressing the button on her patient-controlled anesthesia (PCA) pump. What is the nurse's best response? A) "You should control how often she presses the button." B) "If she will follow the directions she was given, that will not happen." C) "The PCA device always provides the correct amount, so pressing the button is just for placebo effect." D) "The device is preset, so your mother cannot get more than a specific amount."

D

A geriatric patient received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing action for the nurse receiving the patient on the regular unit? A) Administer a non-steroidal anti-inflammatory drug. B) Encourage fluids. C) Create a restful, dark, quiet environment. D) Put side rails up and place bed in low position.

D

A nurse is caring for a 6-year-old patient after surgery. The child has an order for meperidine (Demerol) 1.8 mg/kg IM every 3 to 4 hour as needed for pain. The child weighs 30 kg and the meperidine is available as 50 mg/mL. How many mL will the nurse administer per dose? A) 1 mL B) 1.8 mL C) 0.8 mL D) 1.08 mL

D

A patient who is experiencing severe pain is administered a narcotic. What would the nurse write in the plan of care as a desirable and measurable outcome for this patient? A) A shorter period of time between requests for medication B) Reduced complaints about limited movement C) Lack of restlessness and ability to sustain one position D) Increased autonomy in providing AM care

D

The health care provider orders oral (PO) codeine as an adjunctive therapy to pain control medication. What order would be appropriate for the nurse to administer? A) Codeine 5 mg PO every 6 hour B) Codeine 10 mg PO every 4 hour C) Codeine 15 mg PO every 2 hour D) Codeine 20 mg PO every 4 hour

D

The home care nurse administers oral morphine to the patient with cancer pain. When will the nurse expect this medication to reach peak activity? A) 10 minutes B) 30 minutes C) 45 minutes D) 60 minutes

D

The nurse is administering morphine to a trauma patient for acute pain. Before administering the morphine, what common adverse effect should the nurse inform the patient about? A) Paresthesia in lower extremities B) Occipital headache C) Increased intracranial pressure D) Drowsiness

D

The nurse receives an order for a triptan for a patient diagnosed with cluster headaches. What drug would be indicated for this purpose? A) Almotriptan (Axert) B) Frovatriptan (Frova) C) Naratriptan (Amerge) D) Sumatriptan (Imitrex)

D

You are caring for a patient taking pentazocine (Talwin). What would be an appropriate nursing diagnosis for this patients care plan? A) Fluid volume deficit related to diarrhea caused by medication B) Risk for pain related to administration of medication C) Monitor timing of analgesic doses. D) Impaired gas exchange related to respiratory depression

D