A
27. client is receiving drugs through a PCA infusion pump. When teaching the client about
this therapy, which of the following would the nurse include?
A) Pain relief should occur 1 hour after pushing the control button.
B) The control button and the button to call the nurse are the same.
C) The control button activates administration of the drug.
D) The machine delivers the drug every time the control button is used. Answer: C
Response:
The nurse should inform the client that the control button activates administration of the
drug. Pain relief occurs shortly after, and not an hour after, pushing the button. The
nurse should educate the client on the difference between the control button and the
button to call the nurse, especially when they are similar in appearance and feel. The
machine does not deliver the drug every time the control button is used; the machine
regulates the dose of the drug as well as the time interval between doses. If the control
button is used too soon after the last dose, the machine will not deliver the drug until
the correct time.
28. A nurse is caring for a client who is addicted to opioids. The physician has prescribed
maintenance therapy using methadone for detoxification. Which of the following
should the nurse keep in mind when caring for the client undergoing this therapy? A)
Dosages vary according to length of the client's addiction.
B) Methadone is discontinued on an outpatient basis.
C) Dosages vary according to the client's weight.
D) Male clients are prescribed higher doses than female clients. Answer: A
Response:
The nurse must keep in mind that dosages vary with clients, the length of addiction, and
the average amount of drug used each day. Dosages do not vary according to clients'
weights. Methadone is not discontinued on an outpatient basis. Clients enrolled in an
outpatient methadone program for detoxification or maintenance therapy on methadone
must continue to receive methadone when hospitalized. Male clients are not prescribed
higher doses than females.
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11
29. After teaching a group of nursing students about opioids, the instructor determines that
additional teaching is needed when the students identify which of the following as a
natural opioid?
A) Meperidine
B) Morphine
C) Codeine
D) Opium
Answer: A Response:
Meperidine is a synthetic opioid. Natural opioids include morphine sulfate, codeine,
opium alkaloids, and tincture of opium.
30. A client is prescribed a transwerdermal opioid. After teaching the client and family how
to administer this drug, the nurse determines that the teaching was successful when they
state which of the following?
A) ―The drug should be reapplied every 24 hours.‖
B) ―We should try to apply the patch to about the same site each time.‖
C) ―The site should only be cleaned with water before each application.‖
D) ―A hairy area, like the forearm, is an appropriate place to apply the patch.‖
Answer: C
Response:
Only water is used to clean the site because soap and other substances may irritate the
skin. The patch is applied for 72 hours and sites should be rotated. Any site that is used
should be free of hair.
31. A client is receiving an opioid analgesic following abdominal surgery. The client has
been out of bed to the chair and is encouraged to ambulate with assistance. The nurse is
also encouraging the client to increase his fluids. He reports that his appetite is good
and he has been finishing most of his meals. His bowel sounds are active but he is
having difficulty passing stools. A laxative is ordered. Which nursing diagnosis would
be most appropriate?
A) Imbalanced Nutrition: Less Than Body Requirements
B) Constipation
C) Risk for Injury
D) Deficient Knowledge Answer: B
Response:
The client is most likely experiencing constipation from the opioid therapy as well as
from the lack of ambulation and activity. The client is eating, so imbalanced nutrition is
not necessarily a problem. He is at risk for injury if he is experiencing adverse reactions
related to the opioid therapy, but this is not apparent. Although he may have deficient
knowledge about the drug, this, too, is not seen in this case.
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27. client is receiving drugs through a PCA infusion pump. When teaching the client about
this therapy, which of the following would the nurse include?
A) Pain relief should occur 1 hour after pushing the control button.
B) The control button and the button to call the nurse are the same.
C) The control button activates administration of the drug.
D) The machine delivers the drug every time the control button is used. Answer: C
Response:
The nurse should inform the client that the control button activates administration of the
drug. Pain relief occurs shortly after, and not an hour after, pushing the button. The
nurse should educate the client on the difference between the control button and the
button to call the nurse, especially when they are similar in appearance and feel. The
machine does not deliver the drug every time the control button is used; the machine
regulates the dose of the drug as well as the time interval between doses. If the control
button is used too soon after the last dose, the machine will not deliver the drug until
the correct time.
28. A nurse is caring for a client who is addicted to opioids. The physician has prescribed
maintenance therapy using methadone for detoxification. Which of the following
should the nurse keep in mind when caring for the client undergoing this therapy? A)
Dosages vary according to length of the client's addiction.
B) Methadone is discontinued on an outpatient basis.
C) Dosages vary according to the client's weight.
D) Male clients are prescribed higher doses than female clients. Answer: A
Response:
The nurse must keep in mind that dosages vary with clients, the length of addiction, and
the average amount of drug used each day. Dosages do not vary according to clients'
weights. Methadone is not discontinued on an outpatient basis. Clients enrolled in an
outpatient methadone program for detoxification or maintenance therapy on methadone
must continue to receive methadone when hospitalized. Male clients are not prescribed
higher doses than females.
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11
29. After teaching a group of nursing students about opioids, the instructor determines that
additional teaching is needed when the students identify which of the following as a
natural opioid?
A) Meperidine
B) Morphine
C) Codeine
D) Opium
Answer: A Response:
Meperidine is a synthetic opioid. Natural opioids include morphine sulfate, codeine,
opium alkaloids, and tincture of opium.
30. A client is prescribed a transwerdermal opioid. After teaching the client and family how
to administer this drug, the nurse determines that the teaching was successful when they
state which of the following?
A) ―The drug should be reapplied every 24 hours.‖
B) ―We should try to apply the patch to about the same site each time.‖
C) ―The site should only be cleaned with water before each application.‖
D) ―A hairy area, like the forearm, is an appropriate place to apply the patch.‖
Answer: C
Response:
Only water is used to clean the site because soap and other substances may irritate the
skin. The patch is applied for 72 hours and sites should be rotated. Any site that is used
should be free of hair.
31. A client is receiving an opioid analgesic following abdominal surgery. The client has
been out of bed to the chair and is encouraged to ambulate with assistance. The nurse is
also encouraging the client to increase his fluids. He reports that his appetite is good
and he has been finishing most of his meals. His bowel sounds are active but he is
having difficulty passing stools. A laxative is ordered. Which nursing diagnosis would
be most appropriate?
A) Imbalanced Nutrition: Less Than Body Requirements
B) Constipation
C) Risk for Injury
D) Deficient Knowledge Answer: B
Response:
The client is most likely experiencing constipation from the opioid therapy as well as
from the lack of ambulation and activity. The client is eating, so imbalanced nutrition is
not necessarily a problem. He is at risk for injury if he is experiencing adverse reactions
related to the opioid therapy, but this is not apparent. Although he may have deficient
knowledge about the drug, this, too, is not seen in this case.
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