N2,5 analgesic test

Lilley: Pharmacology and the Nursing Process, 4th Edition
Multiple Choice Review Questions Chapter 10

1.
When assessing a patient for adverse effects related to morphine sulfate, which of the following would the nurse NOT expect?
A. Decreased peristalsis
B. Diarrhea
C. Delayed gastric emptying
D. Common bile duct spasm

2.
A patient needs to switch analgesic agents secondary to an adverse reaction to the present regimen. The patient is concerned that he will not receive an effective dose of a new agent to control pain. The nurse responds based on knowledge that potencies of analgesics are determined using an equianalgesic table comparing doses with that of:
A. meperidine
B. fentanyl
C. codeine
D. morphine

3.
A patient is admitted to the psychiatric unit for treatment of narcotic addiction. The nurse would anticipate administration of which of the following medications?
A. morphine
B. methadone
C. meperidine
D. naloxone

4.
A patient has been admitted after overdosing on acetaminophen (Tylenol), with a total ingested dose of 14 g. The nurse plans to monitor this patient for development of which of the following signs and symptoms related to the overdose?
A. Renal failure
B. Kidney stones
C. Acute hepatic necrosis
D. Metabolic alkalosis

5.
While admitting a patient for treatment of an acetaminophen overdose, the nurse prepares to administer which of the following medications to prevent toxicity?
A. naloxone (Narcan)
B. acetylcysteine (Mucomyst)
C. methylprednisolone (Solu-Medrol)
D. vitamin K

6.
Massage therapy is ordered as adjunct treatment for a patient with musculoskeletal pain. The patient asks the nurse how “rubbing my muscles” will help the pain go away. The nurse responds based on the knowledge that:
A. Massaging muscles decreases the inflammatory response that initiates the painful stimuli
B.Massaging muscles activates large sensory nerve fibers that send signals to the spinal cord to close the gate, thus blocking painful stimuli from reaching the brain
C. Massaging muscles activates small sensory nerve fibers that send signals to the spinal cord to open the gate and allow endorphins to reach the muscles and relieve the pain
D.Massaging muscles helps relax the contracted fibers and decrease painful stimuli

7.
When assessing for the most serious adverse reaction to a narcotic analgesic, the nurse is careful to monitor the patient’s:
A. Respiratory rate
B. Heart rate
C. Blood pressure
D. Mental status

8.
Which of the following medications is used to treat a patient suffering from severe adverse effects of a narcotic analgesic?
A. naloxone (Narcan)
B. acetylcysteine (Mucomyst)
C. methylprednisolone (Solu-Medrol)
D. protamine sulfate

9.
A patient admitted to the hospital with a diagnosis of pneumonia asks the nurse why she is receiving codeine when she does not have any pain. The nurse’s response is based on knowledge that codeine also has what effect?
A. Immunostimulant
B. Antitussive
C. Expectorant
D. Immunosuppressant

10.
In monitoring a patient for adverse effects related to morphine sulfate, the nurse assesses for stimulation of:
A. Autonomic control over circulation
B. Cough reflex center
C. Vomiting center
D. Respiratory rate and depth

11.
The nurse is preparing to administer an injection of morphine to a patient. Assessment notes a respiratory rate of 10 breaths/min. The nurse should:
A. Administer a smaller dose and record the findings
B. Notify the physician and delay drug administration
C. Administer the prescribed dose and notify the physician
D. Hold the drug, record the assessment, and recheck in 1 hour

12.
A patient receiving narcotic analgesics for chronic pain can minimize the gastrointestinal (GI) side effects by:
A. Taking Lomotil with each dose
B. Eating foods high in lactobacilli
C. Taking the medication on an empty stomach
D. Increasing fluid and fiber in the diet

13.
The nurse teaches a patient prescribed the fentanyl (Duragesic) transdermal delivery system to change the patch:
A. When pain recurs
B. Every 24 hours
C. Every 72 hours
D. Once a week

14.
The nurse plans pharmacologic therapy for a patient with pain based on the knowledge that:
A. Narcotic analgesics should not be used for more than 24 hours secondary to the risk of ad iction
B. Analgesics should be administered as needed (prn) to minimize side effects
C. Pain relief is best obtained by administering analgesics around the clock
D. Patients should request analgesics when the pain level reaches a “6” on a scale of 1-10

15.
In developing a plan of care for a patient receiving morphine sulfate, which of the following nursing diagnoses is a priority?
A. Alteration in comfort: acute pain
B. Risk for injury related to central nervous system (CNS) side effects
C. Impaired gas exchange related to respiratory depression
D. Constipation related to GI side effects