Chapter 49: Drug Therapy With Opioids Test Bank For Abrams' Clinical Drug Therapy: Rationales for Nursing Practice 12th Edition, Geralyn Frandsen

Chapter 49, Drug Therapy With Opioids 1. A client experiencing cancer pain is receiving morphine every 2 hours. What assessment should the nurse teach family members to make while caring for this client at home? A. Diarrhea B. Respiratory depression C. Lung sounds D. Urinary incontinence ANS: B Rationale: The administration of morphine can result in respiratory depression. The family should be taught to assess the client for respiratory depression. Morp hine sulfate can be administered to treat severe diarrhea. The client’s lung sounds are important to assess but only after the nurse assesses for respiratory depression. Morphine does not cause urinary incontinence. PTS: 1 REF: p. 974, Opioid Agonists OBJ: 3 NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies TOP: Chapter: 49: Drug Therapy With Opioids KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 2. A client admitted to t he surgical division after a mastectomy has a PCA pump and states being fearful about being overdosed on morphine. Which response is most appropriate when addressing the client’s concern of being overmedicated? A. “The pump will administer all of the doses, so you don’t have to worry.” B. “If you follow the instructions, that won’t happen to you.” C. “The device is preset, so you cannot receive more than you need.” D. “The device will give you a placebo when you a ctivate it too often.” ANS: C Rationale: A PCA pump will administer a basal rate of analgesic, but the client can initiate bolus doses when the basal rate is insufficient for pain relief. The total amount of the drug is preset and limited to prevent ove rdose due to frequent client activation. Telling the client not to worry or to follow instructions is not effective teaching or use of therapeutic communication. The pump does not deliver a placebo at any time. PTS: 1 REF: p. 974, Opioid Agonists OBJ: 3 NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies TOP: Chapter: 49: Drug Therapy With Opioids KEY: Integrated Process: Teaching/Learning BLM: Cognitive Level: Apply NOT: Multiple Choice 3. The nurse caring for a po stanesthesia client notes a respiratory rate of 6 breaths/min. What drug should be administered? A. Naloxone B. Hydrocodone C. Butorphanol D. Pentazocine ANS: A Rationale: Naloxone has long been the drug of choice to treat respiratory depres sion caused by an opioid. The remaining options are all opioids. PTS: 1 REF: p. 974, Opioid Agonists OBJ: 6 NAT: Client Needs: Psychosocial Integrity TOP: Chapter: 49: Drug Therapy With Opioids KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Analyze NOT: Multiple Choice 4. A client has been administered an opioid. For what effect should the nurse regularly assess? A. Oliguria B. Level of consciousness (LOC) C. Edema D. Tachycardia ANS: B Rationale: Opioids will produce decreased LOC. Oliguria, edema, and tachycardia do not result from the administration of an opioid. PTS: 1 REF: p. 971, Overview of Pain OBJ: 3 NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies TOP: Chapter: 49: Drug Therapy With Opioids KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 5. A client is in the end of life and has developed increased respiratory secretions and labored breathing. The health care provider will order which medication to decrease these symptoms? A. Meclizine B. Ampicillin C. Azithromycin D. Morphine sulfate ANS: D Rationale: Morphine is used for the treatment of acute pulmonary edema. Meclizine is given for dizziness. Ampicillin is used to treat infection, as is azithromycin. PTS: 1 REF: p. 974, Opioid Agonists OBJ: 3 NAT: Client Needs: Physiological Integrity: Pharmacological and Parenteral Therapies TOP: Chapter: 49: Drug Therapy With Opioids KEY: Integrated Process: Nursing Process BLM: Cognitive Level: Apply NOT: Multiple Choice 6. A client receiving morphine sul fate 5 mg IV every 4 hours for the past several days now states that the pain is not being relieved as well as it was in the past. What is the reason for this development? A. A dependency on the morphine B. Natural response to metastatic cancer