NURS 2042 Exam 1 Questions With
Accurate Answers
A patient needs to switch analgesic drugs secondary to an adverse reaction to
the current treatment regimen. The patient is concerned that the new
prescription will not provide optimal pain control. The nurse's response is based
on knowledge that doses of analgesics are determined using an equianalgesic
table with which drug prototype?
a. meperdine
b. fentanyl
c. codeine
d. morphine - ANSWER d. morphine
An equianalgesic table is a conversion chart for commonly used opioids. It
identifies oral and parenteral dosages that provide comparable analgesia. The
equianalgesic table identifies dosages of various narcotics that are equal to 10
mg of morphine. It is important to use when changing to a new opioid or different
route. Morphine is the drug prototype for all opioid drugs.
The nurse is caring for a patient with opioid addiction. The nurse anticipates that
the patient will be prescribed which medication?
a. naloxone (narcan)
b. meperdine (demerol)
c. morphine (MS contin)
d. methadone (dolophine) - ANSWER d. methadone (dolophine)
Methadone is a synthetic opioid analgesic with gentler withdrawal symptoms
and is the drug of choice for detoxification treatment.
While admitting a patient for treatment of an acetaminophen (Tylenol) overdose,
the nurse prepares to administer which medication to prevent toxicity?
a. naloxone (narcan)
b. phytonadiode (vit K)
c. acetylcysteine (mucomyst)
d. methylprednisolone (solu-medrol) - ANSWER c. acetylcysteine (mucomyst)
Acetylcysteine is the antidote for acetaminophen overdose. It must be
administered as a loading dose followed by subsequent doses every 4 hours for
,17 additional doses and started as soon as possible after the acetaminophen
ingestion (ideally within 12 hours).
A patient prescribed massage therapy for musculoskeletal pain asks the nurse,
"How is rubbing my muscles going to make the pain go away?" What is the
nurse's best response?
a. "Massaging muscles helps relax the contracted fibers and decrease painful
stimuli."
b. "Massaging muscles decreases the inflammatory response that initiates the
painful stimuli."
c. "Massaging muscles activates large sensory nerve fibers that send signals to
the spinal cord to close the gate, thus blocking painful stimuli from reaching the
brain."
d. "Massaging muscles activates small sensory nerve fibers that send signals to
the spinal cord to open the gate and allow endorphins to reach the muscles and
relieve the pain." - ANSWER c. "Massaging muscles activates large sensory
nerve fibers that send signals to the spinal cord to close the gate, thus blocking
painful stimuli from reaching the brain."
The gate theory of pain control identifies large sensory nerve fibers that, when
stimulated, send signals to the spinal cord to close the gate, blocking pain
stimuli from reaching the brain. Therefore, the patient is not having the
sensation of pain even if the stimulus is still present.
When assessing for the MOST serious adverse effect to an opioid analgesic,
what does the nurse monitor for in this patient?
a. heart rate
b. mental status
c. BP
d. resp rate - ANSWER d. resp rate
The most serious adverse effect of opioid analgesics is respiratory depression.
Which medication is used to treat a patient with severe adverse effects of a
narcotic analgesic?
a. naloxone (narcan)
b. acetylcysteine (mucomyst)
c. mythylprednisolone (solu-medrol)
d. flumazenil (romazicon) - ANSWER a. naloxone (narcan)
Naloxone is the narcotic antagonist that will reverse the effects, both adverse
and therapeutic, of opioid narcotic analgesics.
,A patient with a diagnosis of pneumonia asks the nurse, "Why am I receiving
codeine when I have no pain?" The nurse's response is based on knowledge that
codeine also has what effect?
a. expectorant.
b. bronchodilation
c. cough suppressant
d. increases sputum production - ANSWER c. cough suppressant
codeine provide both analgesic and antitussive therapeutic effects
In monitoring a patient for adverse effects related to morphine sulfate (MS
Contin), the nurse assesses for stimulation of which area in the central nervous
system (CNS)?
a. the cough reflex center
b. sympathetic baroreceptors
c. the chemoreceptor trigger zone
d. autonomic control over circulation - ANSWER c. the chemoreceptor trigger
zone
Morphine sulfate can irritate the gastrointestinal (GI) tract, causing stimulation
of the chemoreceptor trigger zone in the brain, which in turn causes nausea and
vomiting.
The nurse is preparing to administer an intravenous injection of morphine to a
patient. The nurse assesses a respiratory rate of 10 breaths/min. Which action
should the nurse perform?
a. administer the next prescribed dose IM
b. administer a smaller dose and document in the pt's record.
c. withhold the medication and notify the HCP
d. check the pulse oximeter reading and reevaluate RR in 1 hr. - ANSWER c.
withhold the medication and notify the HCP
Respiratory depression is an adverse effect of opioid analgesia. Therefore,
because the patient's respiratory rate is below normal, the nurse should
withhold the morphine and notify the health care provider.
A patient receiving narcotic analgesics for chronic pain can minimize the GI side
effects by:
a. taking Lomotil with each dose.
b. eating foods high in lactobacilli.
c. taking the medication on an empty stomach.
, d. increasing fluid and fiber in the diet. - ANSWER d. increasing fluid and fiber in
the diet
Narcotic analgesics decrease intestinal motility, leading to constipation.
Increasing fluid and fiber in the diet can prevent constipation.
A patient is prescribed an opioid analgesic for chronic pain. Which information
should the nurse discuss with the patient to minimize the GI adverse effects?
a. Avoid eating foods high in lactobacilli.
b. Increase fluid intake and fiber in the diet.
c. Take the medication on an empty stomach.
d. Take diphenoxylate-atropine (Lomotil) with each dose. - ANSWER b. increase
fluid intake and fiber in the diet
Opioid analgesics decrease GI intestinal motility (peristalsis), leading to
constipation. Increasing fluid and fiber in the diet or use of stool softener or mild
laxative can prevent constipation.
The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal
delivery system to change the patch at what interval?
a. once a wk
b. every 24 hrs
c. every 72 hrs
d. when pain recurs - ANSWER c. every 72 hrs
The fentanyl transdermal delivery system is designed to slowly release
analgesic over a 72-hour time frame.
The nurse plans pharmacologic management for a patient with pain. The nurse
should administer the pain medication based on what dosage schedule?
a. Pain relief is best obtained by administering analgesics around the clock.
b. Administer the analgesic when the pain level reaches a "6" on a scale of 1 to
10.
c. Opioid analgesics should not be used for more than 24 hours to prevent drug
addiction.
d. Analgesics should be administered as needed (prn) to minimize adverse
effects. - ANSWER a. Pain relief is best obtained by administering analgesics
around the clock.
When pain is present for more than 12 hours a day, analgesic dosages are best
administered around the clock rather than on an as-needed basis, but dosages
should always be within the dosage guidelines for each drug used. The around-
Accurate Answers
A patient needs to switch analgesic drugs secondary to an adverse reaction to
the current treatment regimen. The patient is concerned that the new
prescription will not provide optimal pain control. The nurse's response is based
on knowledge that doses of analgesics are determined using an equianalgesic
table with which drug prototype?
a. meperdine
b. fentanyl
c. codeine
d. morphine - ANSWER d. morphine
An equianalgesic table is a conversion chart for commonly used opioids. It
identifies oral and parenteral dosages that provide comparable analgesia. The
equianalgesic table identifies dosages of various narcotics that are equal to 10
mg of morphine. It is important to use when changing to a new opioid or different
route. Morphine is the drug prototype for all opioid drugs.
The nurse is caring for a patient with opioid addiction. The nurse anticipates that
the patient will be prescribed which medication?
a. naloxone (narcan)
b. meperdine (demerol)
c. morphine (MS contin)
d. methadone (dolophine) - ANSWER d. methadone (dolophine)
Methadone is a synthetic opioid analgesic with gentler withdrawal symptoms
and is the drug of choice for detoxification treatment.
While admitting a patient for treatment of an acetaminophen (Tylenol) overdose,
the nurse prepares to administer which medication to prevent toxicity?
a. naloxone (narcan)
b. phytonadiode (vit K)
c. acetylcysteine (mucomyst)
d. methylprednisolone (solu-medrol) - ANSWER c. acetylcysteine (mucomyst)
Acetylcysteine is the antidote for acetaminophen overdose. It must be
administered as a loading dose followed by subsequent doses every 4 hours for
,17 additional doses and started as soon as possible after the acetaminophen
ingestion (ideally within 12 hours).
A patient prescribed massage therapy for musculoskeletal pain asks the nurse,
"How is rubbing my muscles going to make the pain go away?" What is the
nurse's best response?
a. "Massaging muscles helps relax the contracted fibers and decrease painful
stimuli."
b. "Massaging muscles decreases the inflammatory response that initiates the
painful stimuli."
c. "Massaging muscles activates large sensory nerve fibers that send signals to
the spinal cord to close the gate, thus blocking painful stimuli from reaching the
brain."
d. "Massaging muscles activates small sensory nerve fibers that send signals to
the spinal cord to open the gate and allow endorphins to reach the muscles and
relieve the pain." - ANSWER c. "Massaging muscles activates large sensory
nerve fibers that send signals to the spinal cord to close the gate, thus blocking
painful stimuli from reaching the brain."
The gate theory of pain control identifies large sensory nerve fibers that, when
stimulated, send signals to the spinal cord to close the gate, blocking pain
stimuli from reaching the brain. Therefore, the patient is not having the
sensation of pain even if the stimulus is still present.
When assessing for the MOST serious adverse effect to an opioid analgesic,
what does the nurse monitor for in this patient?
a. heart rate
b. mental status
c. BP
d. resp rate - ANSWER d. resp rate
The most serious adverse effect of opioid analgesics is respiratory depression.
Which medication is used to treat a patient with severe adverse effects of a
narcotic analgesic?
a. naloxone (narcan)
b. acetylcysteine (mucomyst)
c. mythylprednisolone (solu-medrol)
d. flumazenil (romazicon) - ANSWER a. naloxone (narcan)
Naloxone is the narcotic antagonist that will reverse the effects, both adverse
and therapeutic, of opioid narcotic analgesics.
,A patient with a diagnosis of pneumonia asks the nurse, "Why am I receiving
codeine when I have no pain?" The nurse's response is based on knowledge that
codeine also has what effect?
a. expectorant.
b. bronchodilation
c. cough suppressant
d. increases sputum production - ANSWER c. cough suppressant
codeine provide both analgesic and antitussive therapeutic effects
In monitoring a patient for adverse effects related to morphine sulfate (MS
Contin), the nurse assesses for stimulation of which area in the central nervous
system (CNS)?
a. the cough reflex center
b. sympathetic baroreceptors
c. the chemoreceptor trigger zone
d. autonomic control over circulation - ANSWER c. the chemoreceptor trigger
zone
Morphine sulfate can irritate the gastrointestinal (GI) tract, causing stimulation
of the chemoreceptor trigger zone in the brain, which in turn causes nausea and
vomiting.
The nurse is preparing to administer an intravenous injection of morphine to a
patient. The nurse assesses a respiratory rate of 10 breaths/min. Which action
should the nurse perform?
a. administer the next prescribed dose IM
b. administer a smaller dose and document in the pt's record.
c. withhold the medication and notify the HCP
d. check the pulse oximeter reading and reevaluate RR in 1 hr. - ANSWER c.
withhold the medication and notify the HCP
Respiratory depression is an adverse effect of opioid analgesia. Therefore,
because the patient's respiratory rate is below normal, the nurse should
withhold the morphine and notify the health care provider.
A patient receiving narcotic analgesics for chronic pain can minimize the GI side
effects by:
a. taking Lomotil with each dose.
b. eating foods high in lactobacilli.
c. taking the medication on an empty stomach.
, d. increasing fluid and fiber in the diet. - ANSWER d. increasing fluid and fiber in
the diet
Narcotic analgesics decrease intestinal motility, leading to constipation.
Increasing fluid and fiber in the diet can prevent constipation.
A patient is prescribed an opioid analgesic for chronic pain. Which information
should the nurse discuss with the patient to minimize the GI adverse effects?
a. Avoid eating foods high in lactobacilli.
b. Increase fluid intake and fiber in the diet.
c. Take the medication on an empty stomach.
d. Take diphenoxylate-atropine (Lomotil) with each dose. - ANSWER b. increase
fluid intake and fiber in the diet
Opioid analgesics decrease GI intestinal motility (peristalsis), leading to
constipation. Increasing fluid and fiber in the diet or use of stool softener or mild
laxative can prevent constipation.
The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal
delivery system to change the patch at what interval?
a. once a wk
b. every 24 hrs
c. every 72 hrs
d. when pain recurs - ANSWER c. every 72 hrs
The fentanyl transdermal delivery system is designed to slowly release
analgesic over a 72-hour time frame.
The nurse plans pharmacologic management for a patient with pain. The nurse
should administer the pain medication based on what dosage schedule?
a. Pain relief is best obtained by administering analgesics around the clock.
b. Administer the analgesic when the pain level reaches a "6" on a scale of 1 to
10.
c. Opioid analgesics should not be used for more than 24 hours to prevent drug
addiction.
d. Analgesics should be administered as needed (prn) to minimize adverse
effects. - ANSWER a. Pain relief is best obtained by administering analgesics
around the clock.
When pain is present for more than 12 hours a day, analgesic dosages are best
administered around the clock rather than on an as-needed basis, but dosages
should always be within the dosage guidelines for each drug used. The around-
