1
,a. His pulse rate
b. His respiratory rate
c. The appearance of the incision
d. The date of his last bowel movement
ANS: B
One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient’s
respiratory rate before administering an opioid. The other options are incorrect.
4. A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually
awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very
lethargic and his respirations are shallow, with a rate of 7 per minute. The nurse prepares for which priority action at
this time?
a. Assessment of the patient’s pain level
b. Immediate intubation and artificial ventilation
c. Administration of naloxone (Narcan)
d. Close observation of signs of opioid tolerance
ANS: C
Naloxone, an opioid-reversal agent, is used to reverse the effects of acute opioid overdose and is the drug of choice
for reversal of opioid-induced respiratory depression. This situation is describing an opioid overdose, not opioid
tolerance. Intubation and artificial ventilation are not appropriate because the patient is still breathing at 7 breaths per
minute. It would be inappropriate to assess the patient’s level of pain.
5. A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal
surgery. The nurse will include which information in the teaching plan?
a. How to prevent dehydration due to diarrhea
b. Importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. Importance of taking the drug on an empty stomach
ANS: C
Gastrointestinal adverse effects, such as nausea, vomiting, and constipation, are the most common adverse effects
associated with opioid analgesics. Physical dependence usually occurs in patients undergoing long-term treatment.
Diarrhea is not an effect of opioid analgesics. Taking the dose with food may help minimize GI upset.
,6. A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the
opioid analgesic is not helping as much as it had previously and more medication is needed for the same pain relief.
The nurse is aware that this patient is experiencing opioid
a. addiction.
b. tolerance.
c. toxicity.
d. abstinence syndrome.
ANS: B
Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid tolerance require larger
doses of the opioid agent to maintain the same level of analgesia. This situation does not describe toxicity
(overdose), addiction, or abstinence syndrome (withdrawal).
7. A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He
says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands
the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute
acetaminophen overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy
ANS: C
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen. The other options are
incorrect.
8. A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as
part of the management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of
pain to be managed by
a. administering NSAIDs.
b. administering an immediate-release opioid.
c. changing the opioid route to the rectal route.
d. not changing the current therapy.
ANS: B
, If a patient is taking long-acting opioid analgesics, breakthrough pain must be treated with an immediate-release
dosage form that is given between scheduled doses of the long-acting opioid. The other options are not appropriate
actions.
9. The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
a. Muscle aches
b. Migraine headaches
c. Leg cramps
d. Incision pain after surgery
ANS: B
Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever. Possible adverse
effects include muscle stiffness and muscle and joint pain.
10. A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol)
overdose. Which action by the nurse is appropriate when giving this medication?
a. Giving the medication undiluted for full effect
b. Avoiding the use of a straw when giving this medication
c. Disguising the flavor with soda or flavored water
d. Preparing to give this medication via a nebulizer
ANS: C
Acetylcysteine has the flavor of rotten eggs and so is better tolerated if it is diluted and disguised by mixing with a
drink such as cola or flavored water to help increase its palatability. The use of a straw helps to minimize contact with
the mucous membranes of the mouth and is recommended. The nebulizer form of this medication is used for certain
types of pneumonia, not for acetaminophen overdose.
11. A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse
expects that the patient is receiving this drug for which condition?
a. Inflammation pain
b. Pain associated with peripheral neuropathy
c. Depression associated with chronic pain
d. Prevention of seizures
ANS: B
,a. His pulse rate
b. His respiratory rate
c. The appearance of the incision
d. The date of his last bowel movement
ANS: B
One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient’s
respiratory rate before administering an opioid. The other options are incorrect.
4. A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is gradually
awakening, he requests pain medication. Within 10 minutes after receiving a dose of morphine sulfate, he is very
lethargic and his respirations are shallow, with a rate of 7 per minute. The nurse prepares for which priority action at
this time?
a. Assessment of the patient’s pain level
b. Immediate intubation and artificial ventilation
c. Administration of naloxone (Narcan)
d. Close observation of signs of opioid tolerance
ANS: C
Naloxone, an opioid-reversal agent, is used to reverse the effects of acute opioid overdose and is the drug of choice
for reversal of opioid-induced respiratory depression. This situation is describing an opioid overdose, not opioid
tolerance. Intubation and artificial ventilation are not appropriate because the patient is still breathing at 7 breaths per
minute. It would be inappropriate to assess the patient’s level of pain.
5. A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal
surgery. The nurse will include which information in the teaching plan?
a. How to prevent dehydration due to diarrhea
b. Importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. Importance of taking the drug on an empty stomach
ANS: C
Gastrointestinal adverse effects, such as nausea, vomiting, and constipation, are the most common adverse effects
associated with opioid analgesics. Physical dependence usually occurs in patients undergoing long-term treatment.
Diarrhea is not an effect of opioid analgesics. Taking the dose with food may help minimize GI upset.
,6. A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has noticed that the
opioid analgesic is not helping as much as it had previously and more medication is needed for the same pain relief.
The nurse is aware that this patient is experiencing opioid
a. addiction.
b. tolerance.
c. toxicity.
d. abstinence syndrome.
ANS: B
Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid tolerance require larger
doses of the opioid agent to maintain the same level of analgesia. This situation does not describe toxicity
(overdose), addiction, or abstinence syndrome (withdrawal).
7. A 38-year-old man has come into the urgent care center with severe hip pain after falling from a ladder at work. He
says he has taken several pain pills over the past few hours but cannot remember how many he has taken. He hands
the nurse an empty bottle of acetaminophen (Tylenol). The nurse is aware that the most serious toxic effect of acute
acetaminophen overdose is which condition?
a. Tachycardia
b. Central nervous system depression
c. Hepatic necrosis
d. Nephropathy
ANS: C
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen. The other options are
incorrect.
8. A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid analgesic as
part of the management of pain. Lately, she has been experiencing breakthrough pain. The nurse expects this type of
pain to be managed by
a. administering NSAIDs.
b. administering an immediate-release opioid.
c. changing the opioid route to the rectal route.
d. not changing the current therapy.
ANS: B
, If a patient is taking long-acting opioid analgesics, breakthrough pain must be treated with an immediate-release
dosage form that is given between scheduled doses of the long-acting opioid. The other options are not appropriate
actions.
9. The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
a. Muscle aches
b. Migraine headaches
c. Leg cramps
d. Incision pain after surgery
ANS: B
Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever. Possible adverse
effects include muscle stiffness and muscle and joint pain.
10. A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol)
overdose. Which action by the nurse is appropriate when giving this medication?
a. Giving the medication undiluted for full effect
b. Avoiding the use of a straw when giving this medication
c. Disguising the flavor with soda or flavored water
d. Preparing to give this medication via a nebulizer
ANS: C
Acetylcysteine has the flavor of rotten eggs and so is better tolerated if it is diluted and disguised by mixing with a
drink such as cola or flavored water to help increase its palatability. The use of a straw helps to minimize contact with
the mucous membranes of the mouth and is recommended. The nebulizer form of this medication is used for certain
types of pneumonia, not for acetaminophen overdose.
11. A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse
expects that the patient is receiving this drug for which condition?
a. Inflammation pain
b. Pain associated with peripheral neuropathy
c. Depression associated with chronic pain
d. Prevention of seizures
ANS: B
