NR546 Week 6 test your
knowledge quiz / NR546 Week
6 Test Bank QUESTIONS AND
CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIED ANSWERS)
|ALREADY GRADED A+
,A 40-year-old male presents to your emergency department
(ED) with severe anxiety, generalized tremors, complaints of
dizziness, diaphoresis, and agitation. He was incarcerated 2
days ago and is brought to the ED today by the police due to
the development of acute symptoms. His social history is
significant for heavy alcohol use. A Clinical Institutes
Withdrawal Assessment Scale for Alcohol (CIWA) score is
39.
The client tells you he has had withdrawal seizures in the
past when he stops drinking. Which medication should you
order? - CORRECT ANSWER-lorazepam (Ativan)
Rationale: Benzodiazepines are the first-line treatment for
clients having psychomotor agitation associated with
alcohol withdrawal. This client has an increased risk of an
alcohol-related withdrawal seizure, especially since he had
one in the past. carbamazepine, levetiracetam, and
phenytoin are not routinely used for alcohol withdrawal due
to the lack of evidence demonstrating increased efficacy.
Additionally, these drugs may potentially mask
hemodynamic signs of withdrawal.
,Addiction is often driven by the client's attempts to: -
CORRECT ANSWER-self-medicate an underlying mental
health disorder
adverse effects associated with the acute use of opioids: -
CORRECT ANSWER--Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation
Opioid medication: Morphine - CORRECT ANSWER--
Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending
pain pathways, altering the perception & response to pain
-also produces CNS depression and potentially respiratory
depression
*may be life-threatening, especially if utilized with
benzodiazepines, CNS depressants, or alcohol
onset of action:
, -immediate release formulation is patient-dependent, with
variable absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin)
and extended-release morphine (Avinza).
Opioid medication: Fentanyl - CORRECT ANSWER--has an
almost immediate onset of action when given IV, with a
duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine
or hydromorphone and in those with severe hepatic and
renal disease
-same indications as morphine and is also used frequently
in procedural sedation and general anesthesia
-Conversion between fentanyl products is NOT mcg for mcg
Opioid medication: Hydromorphone - CORRECT ANSWER--
Similar opioid agonist as morphine but more potent
-Oral and parenteral doses are not equivalent (parenteral
doses up to 5 times more potent)
knowledge quiz / NR546 Week
6 Test Bank QUESTIONS AND
CORRECT DETAILED
ANSWERS WITH RATIONALES
(VERIFIED ANSWERS)
|ALREADY GRADED A+
,A 40-year-old male presents to your emergency department
(ED) with severe anxiety, generalized tremors, complaints of
dizziness, diaphoresis, and agitation. He was incarcerated 2
days ago and is brought to the ED today by the police due to
the development of acute symptoms. His social history is
significant for heavy alcohol use. A Clinical Institutes
Withdrawal Assessment Scale for Alcohol (CIWA) score is
39.
The client tells you he has had withdrawal seizures in the
past when he stops drinking. Which medication should you
order? - CORRECT ANSWER-lorazepam (Ativan)
Rationale: Benzodiazepines are the first-line treatment for
clients having psychomotor agitation associated with
alcohol withdrawal. This client has an increased risk of an
alcohol-related withdrawal seizure, especially since he had
one in the past. carbamazepine, levetiracetam, and
phenytoin are not routinely used for alcohol withdrawal due
to the lack of evidence demonstrating increased efficacy.
Additionally, these drugs may potentially mask
hemodynamic signs of withdrawal.
,Addiction is often driven by the client's attempts to: -
CORRECT ANSWER-self-medicate an underlying mental
health disorder
adverse effects associated with the acute use of opioids: -
CORRECT ANSWER--Itching
-Constipation
-Respiratory depression
-Urinary retention
-Sedation
Opioid medication: Morphine - CORRECT ANSWER--
Prototype opioid agonist
-indicated for acute pain
-binds to opioid receptors in the CNS, inhibiting ascending
pain pathways, altering the perception & response to pain
-also produces CNS depression and potentially respiratory
depression
*may be life-threatening, especially if utilized with
benzodiazepines, CNS depressants, or alcohol
onset of action:
, -immediate release formulation is patient-dependent, with
variable absorption.
-IV is 5-10 minutes, with a duration 3-5 hours.
-Also available in controlled release formulation (MS Contin)
and extended-release morphine (Avinza).
Opioid medication: Fentanyl - CORRECT ANSWER--has an
almost immediate onset of action when given IV, with a
duration of 0.5-1 hour
-More potent than morphine, but short duration of action
-the preferred opioid for those unable to tolerate morphine
or hydromorphone and in those with severe hepatic and
renal disease
-same indications as morphine and is also used frequently
in procedural sedation and general anesthesia
-Conversion between fentanyl products is NOT mcg for mcg
Opioid medication: Hydromorphone - CORRECT ANSWER--
Similar opioid agonist as morphine but more potent
-Oral and parenteral doses are not equivalent (parenteral
doses up to 5 times more potent)
