PHARM CHAPTER TEN QUIZ

Which drugs are derived from the poppy plant? Select all that apply. Codeine Meperidine Morphine Ibuprofen Naproxen Acetaminophen

codeine morphine

Which opioid is used to relieve coughing? Fentanyl Meperidine Codeine sulfate Hydromorphone

codeine sulfate

The other analgesic medication listed for Mrs. Coulter is oral morphine. Mrs. Coulter takes this medication for a previous back injury. Mrs. Coulter might experience which common side effect of this medication? Select all that apply. CASE STUDY DETAILS Dizziness Excitability Constipation Frequent Urination Respiratory depression

dizziness constipation respiratory depression

Which symptoms, if experienced by a patient taking morphine, should be reported to the health care provider? Select all that apply. Fatigue Dizziness Analgesia Headaches Constipation Difficulty breathing

dizziness ha diff. breathing

Acetaminophen is approved for the treatment of which conditions? Select all that apply. Fever Gout Headaches Severe pain Mild to moderate pain

fever ha mild-moderate pain

Which characteristic aligns with chronic pain? Sharp Persistent Sudden onset Sympathetic nervous system response

persistent

Which condition is a contraindication for the administration of acetaminophen? Anemia Asthma Joint pain Severe liver disease

severe liver disease (safe for a patient who has anemia, asthma, or joint pain.)

A patient with ulcers in the mouth is complaining of pain. Which type of pain is the patient experiencing? Deep pain Somatic pain Visceral pain Superficial pain

superficial pain

Which phrase describes the primary indication for the administration of morphine? To treat ischemic pain To diminish feelings of anxiety To relieve acute and chronic pain To induce a state of unconsciousness

to relieve acute andchronic pain

Because acetaminophen has a short half-life, it can be administered every hours as needed for pain relief.

4

Which dose is the maximum daily dosage of acetaminophen for adults? 1000 mg/day 2000 mg/day 4000 mg/day 6000 mg/day NOT SURE

4000 mg/day

The nurse is preparing to administer an opioid analgesic. Which factors should be assessed before the dose is given? a. Blood clotting times b. The level of pain rated on a scale c. Prior analgesic use (time, type, amount and effectiveness) d. Dietary history e, Allergies

ANSWER B, C, E

The emergency department nurse is caring for a client with a migraine headache. Which drug would the nurse anticipate administering to abort the client's migraine headache attack? A.Propanolol (Inderal). B.Dihydroergotamine (Migranal). C.Morphine D.Ibuprofen (Motrin).

ANSWER B. MIGRANAL (inderal=chest pain/angina morphine=severe pain motrin=less pain)

Moderate to severe pain is best treated with which medication? A.Fentanyl B.Alprazolam C.Acetaminophen D.Aspirin

ANSWER IS A. FENTANYL (alprazolam = anxiety med acetaminophen=tylenol less severe aspirin=pain/blood thinner)

During a marathon, a runner had to drop out after 16 miles because of severe muscle spasms. Which type of pain is the runner experiencing? A.Somatic pain B.Chronic pain C.Visceral pain D.Superficial pain

ANSWER: A. SOMATIC PAIN (somatic pain= skeletal muscles, ligaments & joints, chronic pain=never goes away visceral pain=organs & smooth tissues superficial pain=skin & mucous membranes)

When evaluating the patient's drug history, the nurse notes the patient is taking an opiod twice a day for pain. Which additional drug, taken concurrently would concern the nurse the most? A.A disease modifying anti rheumatic B.A calcium channel blocker C.An antihistamine D.A monoamine oxidase inhibitor

ANSWER: D. MONOAMINE OXIDASE INHIBITOR (which is a depression medication. anti-rheumatic=arthritis calcium channel blocker=heart antihistamine=antiinflammatory)

Which statement correctly identifies the pharmacologic properties of acetaminophen? Acetaminophen is a nonopioid drug and a nonsteroidal antiinflammatory drug (NSAID) Acetaminophen is an opioid drug and an antipyretic Acetaminophen is an opioid drug but is not an NSAID Acetaminophen is a nonopioid drug but is not an NSAID

Acetaminophen is a nonopioid drug but is not an NSAID

Which route of administration will result in the fastest onset of action for morphine? Oral Intravenous Intramuscular Subcutaneous

IV

Opioids primarily activate the mu receptors, causing which effects? Select all that apply. Itching Nausea Sedation Euphoria Analgesia Bradycardia

Sedation Euphoria Analgesia

The nurse is caring for a patient who has oral ulcers. Which type of pain, originating from the skin and mucous membranes, does the patient have? Deep pain Visceral pain Somatic pain Superficial pain

Superficial pain

A parent calls the health care provider and reports that her 5-year-old daughter took several acetaminophen tablets. Which intervention is appropriate? Tell the parent to administer ibuprofen rather than acetaminophen for the next 48 hours. Tell the parent to schedule an appointment with her pediatrician. Tell the parent to take her daughter to the emergency department. Tell the parent that an overdose would be impossible unless her daughter took several bottles of pills.

Tell the parent to take her daughter to the emergency department.

Which pharmacokinetic trait is important to consider with oral morphine administration? Has a long half-life Does not cross the placenta Undergoes first hepatic pass Does not cross the blood-brain barrier

Undergoes first hepatic pass

While admitting a patient for treatment of an acetaminophen overdose, the nurse would prepare to administer which medication to prevent toxicity? Naloxone Vitamin K Acetylcysteine Methylprednisolone

acetylcysteine

Which substance should be avoided by patients taking acetaminophen? Alcohol Naproxen Ibuprofen Morphine NOT SURE

alcohol

Which condition in a patient's history is a contraindication to the administration of opioid analgesics? Gout Asthma Diabetes Skin disease

asthma

Which condition listed in the patients' medical history could be a contraindication to administration of morphine sulfate? Cancer Asthma Anorexia Diarrhea

asthma

A patient has started on a fentanyl patch. After 3 hours, the patient continues to complain of pain of "8 on a scale of 0 to 10." Which action would the nurse take? Change the patch. Administer naloxone. Add a second patch. Call the primary health care provider.

call primary

An anticonvulsant drug has been ordered as part of a patient's pain management program. The nurse explains to the patient that the purpose of the anticonvulsant is to A.prevent seizures B.relieve neuropathic pain C.produce sleep D.reduce anxiety

ANSWER IS B.

Several days postoperative bowel surgery, the client is eating soft food, ambulating regularly, and using hydrocodone (Vicodin) for pain. What should the nursing care plan include? A.Monitoring vital signs for respiratory depression. B.Increasing dietary fiber and fluids and administering a stool softener if needed. C.Inserting a urinary catheter for urinary retention. D.Weaning pain medication to prevent addiction.

ANSWER IS D. (although i think b is also correct)

A client with diabetes reports increasing pain and numbness in his legs. "It feels like pins and needles all the time, especially at night." Which drug would the nurse expect to be ordered for this client? A.Naloxone (Narcan). B.Ibuprofen (Motrin). C.Methadone. D.Gabapentin (Neurontin).

ANSWER IS D. GABAPENTIN (narcon=opoid antagonist ibuprofen=less pain methadone=withdrawal)

A young man has been taken to the emergency department because of a suspected overdose of morphine tablets. The nurse prepares to administer which drug? A.Atropine B.Activated charcoal C.Flumazenil D.Naloxone

ANSWER IS D. NALOXONE (atropine=poisons, slow heart rate, nerves. activated charcoal=drug overdose or poisoning flumazenil=counteracts with benzos naloxone=narcan=pure opoid antagonist)

The nurse is monitoring the client for adverse effects associiated with morphine. Which adverse effects would be expected? (Select all that apply.) 1 - Respiratory depresasion 2 - Hypertension 3 - Urinary retention 4 - Constipation 5 - Nausea

ANSWER: 1, 4,5

A patient presents to the emergency department with nausea, vomiting, abdominal pain, and yellow sclera. The patient's liver function tests are elevated, and the serum acetaminophen level is 10. Which conclusion will the nurse draw? Acetaminophen is not likely playing a role. The patient is probably an alcoholic with liver disease. The patient most likely took an overdose of acetaminophen. Acetaminophen has likely caused the liver function test elevation.

Acetaminophen is not likely playing a role. A serum acetaminophen level of 10 is within the normal range of 5 to 25. The nurse can conclude that acetaminophen is not the likely cause of the patient's condition.

Morphine relieves pain though which mechanism? Selectively blocking cyclooxygenase-2 (COX-2) Activating mu and kappa receptors in the central nervous system (CNS) Enhancing the activity of dopamine receptors Inhibiting prostaglandin synthesis

Activating mu and kappa receptors in the central nervous system (CNS) When morphine is administered, it acts similarly to endogenous opioid peptides at the mu receptors within the body, to decrease perception of pain

A patient in the emergency department has mild pain and asks for acetaminophen. Which intervention by the nurse is appropriate? Suggest that the patient take intravenous (IV) morphine instead. Ask the patient how many cigarettes he or she smokes every day. Tell the patient that acetaminophen does not help with mild pain. Ask the patient if he or she has taken any acetaminophen earlier in the day.

Ask the patient if he or she has taken any acetaminophen earlier in the day.

A patient is admitted to the emergency department with a diagnosis of "acetaminophen overdose." Which lab value is essential for the nurse to assess? Platelet count Neutrophil count Blood urea nitrogen (BUN) and creatinine levels Aspartate transaminase (AST) and alanine transaminase (ALT) levels

Aspartate transaminase (AST) and alanine transaminase (ALT) levels

Which medications are classified as nonopioid analgesics? Select all that apply. Aspirin Codeine Meperidine Naproxen Ibuprofen Acetaminophen

Aspirin naproxen ibuprofen acetaminophen

The nurse prepares to administer 5 mg of intravenous (IV) morphine sulfate to a patient who underwent surgery 30 minutes earlier. Which morphine effect is the most important reason for the nurse to record baseline vital signs before administering this drug? Dilates vascular smooth muscle Depresses the respiratory center Causes the release of histamines Reduces the level of consciousness

Depresses the respiratory center

A patient is recovering from surgery and wishes to avoid taking morphine if possible. Which intervention by the nurse is appropriate? Suggest that the patient use codeine instead. Suggest that the patient use meperidine instead. Encourage nonpharmacologic measures to relieve pain. Tell the patient to take the morphine so his or her pain will not get worse.

Encourage nonpharmacologic measures to relieve pain. The nurse would encourage all postoperative patients to use nonpharmacologic measures to relieve pain. These may include distraction, repositioning, or music therapy.

Acetaminophen reduces fever by which mechanism of action? Inhibiting prostaglandin synthesis in the central nervous system (CNS) Stimulating prostaglandin synthesis Inhibiting the chemoreceptor trigger zone within the medulla Stimulating the hypothalamic heat-regulator center

Inhibiting prostaglandin synthesis in the central nervous system (CNS) Acetaminophen inhibits prostaglandin synthesis within the CNS. The inhibition of prostaglandins results in pain and fever reduction.

Which drugs are opioid agonists-antagonists? Select all that apply. Select all that apply Fentanyl Tapentadol Nalbuphine Butorphanol Buprenorphine

Nalbuphine Butorphanol Buprenorphine

A patient with respiratory depression secondary to opioid toxicity is being treated in the emergency department. Which action is the nurse's priority? Administer naloxone. Prepare for intubation. Assess arterial blood gases. Call the respiratory team stat.

administer naloxone (narcan)

A patient is prescribed levorphanol to treat chronic pain. The nurse instructs the patient to increase fluid to reduce the risk of which adverse effect of levorphanol? Diarrhea Constipation Dizziness Miosis

constipation

A patient with nausea and vomiting is not able to tolerate oral medications. The patient has a fever, and the health care provider prescribes acetaminophen to be given rectally. The nurse understands that the medication may not be absorbed properly in a patient with which concurrent condition? Headache Constipation Hypertension Abdominal pain

constipation

An overdose of acetaminophen may result in which complication? Pruritus Hepatotoxicity Nephrotoxicity Urinary retention

hepatotoxicity

The nurse sees that one of the analgesic medications listed for Mrs. Coulter is acetaminophen. Which assessment would the nurse make for Mrs. Coulter related to this drug? CASE STUDY DETAILS Blood pressure (BP) Respiratory rate (RR) History of liver dysfunction Use of nonpharmacologic pain interventions

history of liver dysfunction

Which questions would the nurse ask a patient who is taking acetaminophen? Select all that apply. Do you take nonsteroidal antiinflammatory drugs (NSAIDs)? How often do you drink alcohol? How often do you smoke cigarettes? Do you have any history of liver disease? Do you have any history of renal disease?

how often do you drink alcohol do you have a history of liver disease

The nurse will advise a patient receiving opioid analgesics for chronic pain to perform which action to minimize the gastrointestinal (GI) side effects? Eat foods high in lactobacilli. Increase fluid and fiber in the diet. Take the medication on an empty stomach. Take diphenoxylate/atropine with each dose.

increase fluid and fiber

A patient has been taking morphine frequently after a recent surgery. The nurse would suggest monitoring of which laboratory test? Liver function panel Basic metabolic panel Complete blood count (CBC) Complete metabolic panel

liver function panel

Which medication will assist a patient's recovery from a narcotic addiction? Naloxone Methadone Vitamin K 1 Protamine sulfate

methadone

A patient in severe pain is unable to swallow and does not have intravenous (IV) access. Which prescription would the nurse request from the health care provider? Morphine by mouth (PO) Morphine by rectum (PR) Acetaminophen PO Acetaminophen PR

morphine by rectum

Respiratory depression is a side effect of activation of which central nervous system (CNS) receptors? Mu Beta Alpha Kappa

mu

Which medication is used to treat a patient experiencing severe adverse effects of an opioid analgesic? Naloxone Flumazenil Acetylcysteine Methylprednisolone

naloxone

Which assessment findings does the nurse determine are possible adverse effects associated with morphine sulfate administration? Select all that apply. Select all that apply Nausea Diarrhea Urinary retention Decreased peristalsis Delayed gastric emptying

nausea Urinary retention Decreased peristalsis Delayed gastric emptying

A patient diagnosed with cholecystitis reports pain in the back and scapular areas. The nurse infers the patient has which type of pain? Referred pain Vascular pain Phantom pain Neuropathic pain

referred pain

A patient is on a continuous infusion of morphine after surgery. Which interventions will the nurse perform? Select all that apply. Monitor urinary output Monitor respiratory rate Assess for epigastric pain Auscultate bowel sounds Assess for peripheral edema

urinary output respiratory rate bowel sounds