Chapter 26: Nonopioid and Opioid Analgesics Nursing School Test Banks

Kee: Pharmacology, 7th Edition

Chapter 26: Nonopioid and Opioid Analgesics

Test Bank

MULTIPLE CHOICE

1. A client is ordered to receive a nonopioid analgesic. The nurse knows that the client is experiencing _____ pain.

a.

acute severe

b.

visceral (deep)

c.

acute mild

d.

superficial moderate to severe

ANS: C

Nonopioid analgesics are used for mild to moderate pain and may be available over the counter.

DIF: Cognitive Level: Application REF: pp. 362-363 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

2. The client is complaining of severe pain. The nurse anticipates that the client will be ordered treatment with:

a.

aspirin.

b.

acetaminophen.

c.

diflunisal.

d.

morphine sulfate.

ANS: D

Morphine sulfate should be used for severe pain.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

3. A 5-year-old client has an elevated temperature as a result of a viral respiratory tract infection. What nonopioid drug should be given to decrease the childs body temperature?

a.

Aspirin

b.

Acetaminophen

c.

Diflunisal

d.

Sodium salicylate

ANS: B

Medications containing salicylates are not recommended because of the possibility of developing Reyes syndrome.

DIF: Cognitive Level: Application REF: p. 364 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

4. An adolescent client tells the nurse that she takes acetaminophen (Tylenol) a few times every day because of stress headaches. The nurse advises her to see a primary healthcare provider because overuse of the medication may result in:

a.

nausea and anorexia.

b.

gastrointestinal irritation.

c.

hepatotoxicity.

d.

diaphoresis and fluid loss.

ANS: C

Tylenol is metabolized by the liver and, with extended use, may be toxic to liver tissue.

DIF: Cognitive Level: Application REF: p. 364

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

5. A client takes aspirin regularly to deal with the pain of arthritis. Which symptom may be indicative of a serious side effect of the medication?

a.

Intense abdominal pain

b.

Frequent constipation

c.

Excessive perspiration

d.

Excessive fatigue

ANS: A

ASA may cause gastric irritation and lead to ulceration. Abdominal pain may indicate this and may be a medical emergency.

DIF: Cognitive Level: Analysis REF: pp. 362-363 TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

6. A client is ordered to receive ibuprofen (Motrin) for dysmenorrhea. The highest priority instruction that the nurse should give the client is to take the drug:

a.

with fluid or food.

b.

on an empty stomach.

c.

upon arising.

d.

nightly before sleep.

ANS: A

Ibuprofen may cause gastric irritation, so food or fluid will decrease this effect.

DIF: Cognitive Level: Application REF: p. 365

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

7. A client is prescribed morphine sulfate for management of severe pain. The client tells the nurse that he takes several herbal preparations. Which herbal preparation will be of most concern to the nurse?

a.

Garlic

b.

Ginger

c.

St. Johns wort

d.

Saw palmetto

ANS: C

Opioids such as morphine sulfate may increase sedation when taken with St. Johns wort.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

8. A nurse is planning the care of a client receiving opioid analgesia. What is considered a priority in planning this care?

a.

Monitoring respiratory rate

b.

Listening for adventitious breath sounds

c.

Assessing for speed of pupillary reaction

d.

Increasing the IV fluid flow rate

ANS: A

Assessing respiratory rate is a priority with medications that may cause respiratory depression.

DIF: Cognitive Level: Analysis REF: p. 366 TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

9. A client requires an opioid antagonist after receiving an overdose of an opioid agent. The nurse anticipates that the client will be ordered:

a.

pentazocine.

b.

ibuprofen.

c.

naloxone.

d.

probenecid.

ANS: C

Narcan is a opioid antagonist used with overdose or oversedation caused by opioids.

DIF: Cognitive Level: Application REF: pp. 366-367 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

10. The client is ordered methadone. The client is most likely experiencing:

a.

opioid overdose.

b.

acute or chronic pain.

c.

opioid addiction.

d.

sleep apnea.

ANS: C

Methadone is used to assist in detoxification and monitoring of people with drug addiction.

DIF: Cognitive Level: Application REF: p. 372 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

11. A nurse is assessing a postoperative client who received morphine sulfate for severe pain 1 hour ago. What common side effects are associated with this medication?

a.

Constipation and pruritus

b.

Diarrhea and lethargy

c.

Tachycardia and hypertension

d.

Coughing and wheezing

ANS: A

Constipation and pruritus are known to occur with morphine use and should be assessed in patients.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

12. A patient receives nalbuphine (Nubain) for intense pain related to a fracture. Which nursing intervention is an important part of the plan of care 1 hour after administration of this medication?

a.

Strain all urine.

b.

Elevate the head of the bed.

c.

Monitor vital signs when getting out of bed.

d.

Infuse IV fluid at a rapid rate.

ANS: C

This medication may cause hypotension, so the nurse should assess vital signs with position changes.

DIF: Cognitive Level: Application REF: p. 373 TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

13. An adult client with a head injury complains of severe pain. The nurse notes that the dose of opioid is half the normal adult dose. What is the reason for this?

a.

Head injury patients do not experience severe pain but are disoriented.

b.

Respiratory depression can lead to cerebral hemorrhage.

c.

Opioids decrease heart rate such that the brain becomes hypoxic.

d.

Respiratory depression allows for a buildup of CO2, a vasodilator.

ANS: D

If respiratory depression occurs, the respiratory rate may decrease, causing hypoventilation. This allows CO2 to build up, causing cerebral vasodilation and increasing intracranial pressure.

DIF: Cognitive Level: Analysis REF: p. 368 TOP: Nursing Process: Analysis

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

14. A client receives hydromorphone (Dilaudid) following an operative procedure. The nurse assesses the clients urine output in order to monitor for which side effect of this medication?

a.

Urinary tract infections

b.

Incontinence

c.

Urinary retention

d.

Renal failure

ANS: C

A common side effect of opioid agents is urinary retention.

DIF: Cognitive Level: Application REF: p. 368 TOP: Nursing Process: Assessment

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

15. An adult client has just received morphine sulfate for severe pain. What would indicate that the pain medication was effective?

a.

Client lies very still in bed

b.

Reduction of the respiratory rate to 8 breaths per minute

c.

Facial grimacing and verbalization of relief of pain

d.

Lowering of tachycardia to within normal limits

ANS: D

A lowering of the heart rate to within normal limits indicates relief of pain.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

16. The client is prescribed Imitrex for migraine headaches. She is nauseated and cannot take the medication by mouth. The nurse anticipates that the client will receive the medication via:

a.

subcutaneous injection.

b.

intramuscular injection.

c.

intravenous infusion.

d.

sublingual route.

ANS: A

Imitrex can be administered by mouth, by subcutaneous injection, or by intranasal route.

DIF: Cognitive Level: Application REF: p. 377 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

17. The client receiving Imitrex complains of dizziness. The nurses highest priority intervention is to recognize that this is a(n) ________ and notify the physician.

a.

adverse reaction to the medication

b.

food-drug interaction

c.

side effect of the medication

d.

life-threatening reaction to the drug

ANS: C

Dizziness is a side effect of treatment with Imitrex but is not life threatening.

DIF: Cognitive Level: Application REF: p. 377 TOP: Nursing Process: Intervention

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

18. The client is ordered Nubain intravenously for treatment of severe pain. The client anxiously asks when she can expect to have relief from the pain. The nurse anticipates that the client will have relief within _____ minutes.

a.

2 to 3

b.

5 to 6

c.

10 to 11

d.

15 to 16

ANS: A

Intravenous administration of Nubain should result in relief from pain within 2 to 3 minutes.

DIF: Cognitive Level: Application REF: p. 373 TOP: Nursing Process: Planning

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

19. The client is taking acetaminophen on a regular basis as well as oral contraceptives. The nurse tells the client that this drug interaction will result in a(n) _____ in the effectiveness of the _____.

a.

decrease; oral contraceptives

b.

increase; oral contraceptives

c.

decrease; acetaminophen

d.

increase; acetaminophen

ANS: C

When acetaminophen is combined with oral contraceptives, the result is a decrease in the effectiveness of the acetaminophen.

DIF: Cognitive Level: Application REF: p. 363

TOP: Nursing Process: Intervention/Teaching

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

MULTIPLE RESPONSE

1. A nurse has administered 8.0 mg morphine sulfate to an adult client in severe pain. What would the nurse evaluate as positive outcomes of this intervention? (Select all that apply.)

a.

Respiratory rate of 6 breaths/min

b.

Heart rate of 80 beats/minute

c.

Blood pressure 180/110 mm Hg

d.

Restlessness

e.

Absence of facial grimacing

f.

Verbalization of pain relief

g.

Ability to take deep breaths

ANS: B, E, F, G

These indicate relief of pain and represent normal vital and objective signs.

DIF: Cognitive Level: Application REF: p. 366 TOP: Nursing Process: Evaluation

MSC: CONTENT CATEGORY: Physiological Integrity: Pharmacological and Parenteral Therapies

Copyright 2012, 2009, 2006, 2003 by Saunders, an imprint of Elsevier Inc.

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