NURSING 334 EXAM 3 QUESTIONS AND
ANSWERS (VERIFIED AND UPDATED)
Opioid Agonist - ANS Morphine
Indications for Morphine - ANS Moderate to severe acute and chronic pain, acute myocardial
infarction pain management, preoperative sedation, pulmonary edema (reduces
preload/anxiety).
Routes of Administration for Morphine - ANS PO, IM, SC, IV, epidural and intrathecal.
CNS Depression Effects of Morphine - ANS Dizziness, sedation, respiratory depression,
nausea and vomiting, constipation, itching (due to release of histamines), orthostatic
hypotension.
Action of Morphine - ANS Binds to mu-opioid receptors in the CNS, causes analgesia,
sedation, and euphoria, reduces respiratory rate via action in the medulla, causes blood vessel
dilation and smooth muscle relaxation.
Client Instructions for Morphine - ANS Take the drug only when needed and short-term,
cough regularly to clear secretions, do not take prior to driving or activities requiring mental
alertness, sit or lie down if dizzy, change position gradually, rise slowly from reclined or sitting
@2026/2027 ALLRIGHTS RESERVED.
,position, take with food or milk, increase fluid and fiber intake, increase exercise, report inability
or difficulty to urinate.
Interventions for Morphine - ANS Stool softener, fiber supplements, monitor bowel function,
methylnaltrexone (opioid antagonist) to treat constipation in dependent patients, monitor
vitals, monitor for tolerance/dependence and withdrawal, urinary retention, monitor I&O,
encourage to urinate every 4 hours, may need to enter catheter, monitor vital signs, administer
naloxone, provide mechanical ventilation with toxicity, monitor BP, administer an antiemetic for
nausea/vomiting.
Black Box Warning for Morphine - ANS Respiratory dysfunction, COPD, risk for abuse and
dependence, restricted use in pediatrics.
Withdrawal Symptoms of Morphine - ANS Tremors, agitation, vomiting, emotionally labile.
Clinical Opioid Withdrawal Scale (COWS) - ANS Used to assess withdrawal symptoms.
Narcotic Antagonist - ANS Naloxone (Narcan)
Indications for Naloxone - ANS Antidote for opioid/narcotic overdose.
Effects of Naloxone - ANS Reverses the effects of opioids including respiratory depression,
sedation, psychomimetic effects, and hypotension.
Withdrawal Symptoms from Naloxone - ANS Agitation, nausea, vomiting, sweating, fast
heartbeat.
@2026/2027 ALLRIGHTS RESERVED.
, Monitoring for Naloxone Administration - ANS Monitor vital signs especially BP and HR, have
oxygen and resuscitation equipment ready, anticipate acute withdrawal for clients with opioid
dependence.
Administration Frequency for Naloxone - ANS Prepare to administer every 2-3 minutes until
reversal.
Signs of Opioid Reversal - ANS Observe for nausea/vomiting, tachycardia, and diaphoresis.
Related Medications to Naloxone - ANS Naltrexone (alcohol or narcotic dependence),
methadone (opioid use disorder).
Adverse Effects of Naloxone - ANS Nausea, vomiting, sweating, tachycardia, hypertension,
tremulousness, feelings of anxiety.
Potential Risks of Opioid Withdrawal - ANS Abstinence syndrome HTN (can cause high blood
pressure in a person who stops using substances).
Ventricular Arrhythmias - ANS Can occur as a result of opioid withdrawal.
Opioid Agonist-Antagonist - ANS Butorphanol
Indications - ANS Treats moderate to severe pain.
Method of action - ANS Agonist at kappa opioid receptors: provides analgesia and sedation.
Partial agonist/antagonist at mu receptors, weaker effect at mu receptors compared to full
agonist.
@2026/2027 ALLRIGHTS RESERVED.
ANSWERS (VERIFIED AND UPDATED)
Opioid Agonist - ANS Morphine
Indications for Morphine - ANS Moderate to severe acute and chronic pain, acute myocardial
infarction pain management, preoperative sedation, pulmonary edema (reduces
preload/anxiety).
Routes of Administration for Morphine - ANS PO, IM, SC, IV, epidural and intrathecal.
CNS Depression Effects of Morphine - ANS Dizziness, sedation, respiratory depression,
nausea and vomiting, constipation, itching (due to release of histamines), orthostatic
hypotension.
Action of Morphine - ANS Binds to mu-opioid receptors in the CNS, causes analgesia,
sedation, and euphoria, reduces respiratory rate via action in the medulla, causes blood vessel
dilation and smooth muscle relaxation.
Client Instructions for Morphine - ANS Take the drug only when needed and short-term,
cough regularly to clear secretions, do not take prior to driving or activities requiring mental
alertness, sit or lie down if dizzy, change position gradually, rise slowly from reclined or sitting
@2026/2027 ALLRIGHTS RESERVED.
,position, take with food or milk, increase fluid and fiber intake, increase exercise, report inability
or difficulty to urinate.
Interventions for Morphine - ANS Stool softener, fiber supplements, monitor bowel function,
methylnaltrexone (opioid antagonist) to treat constipation in dependent patients, monitor
vitals, monitor for tolerance/dependence and withdrawal, urinary retention, monitor I&O,
encourage to urinate every 4 hours, may need to enter catheter, monitor vital signs, administer
naloxone, provide mechanical ventilation with toxicity, monitor BP, administer an antiemetic for
nausea/vomiting.
Black Box Warning for Morphine - ANS Respiratory dysfunction, COPD, risk for abuse and
dependence, restricted use in pediatrics.
Withdrawal Symptoms of Morphine - ANS Tremors, agitation, vomiting, emotionally labile.
Clinical Opioid Withdrawal Scale (COWS) - ANS Used to assess withdrawal symptoms.
Narcotic Antagonist - ANS Naloxone (Narcan)
Indications for Naloxone - ANS Antidote for opioid/narcotic overdose.
Effects of Naloxone - ANS Reverses the effects of opioids including respiratory depression,
sedation, psychomimetic effects, and hypotension.
Withdrawal Symptoms from Naloxone - ANS Agitation, nausea, vomiting, sweating, fast
heartbeat.
@2026/2027 ALLRIGHTS RESERVED.
, Monitoring for Naloxone Administration - ANS Monitor vital signs especially BP and HR, have
oxygen and resuscitation equipment ready, anticipate acute withdrawal for clients with opioid
dependence.
Administration Frequency for Naloxone - ANS Prepare to administer every 2-3 minutes until
reversal.
Signs of Opioid Reversal - ANS Observe for nausea/vomiting, tachycardia, and diaphoresis.
Related Medications to Naloxone - ANS Naltrexone (alcohol or narcotic dependence),
methadone (opioid use disorder).
Adverse Effects of Naloxone - ANS Nausea, vomiting, sweating, tachycardia, hypertension,
tremulousness, feelings of anxiety.
Potential Risks of Opioid Withdrawal - ANS Abstinence syndrome HTN (can cause high blood
pressure in a person who stops using substances).
Ventricular Arrhythmias - ANS Can occur as a result of opioid withdrawal.
Opioid Agonist-Antagonist - ANS Butorphanol
Indications - ANS Treats moderate to severe pain.
Method of action - ANS Agonist at kappa opioid receptors: provides analgesia and sedation.
Partial agonist/antagonist at mu receptors, weaker effect at mu receptors compared to full
agonist.
@2026/2027 ALLRIGHTS RESERVED.
