Nursing 1141- Pharmacology » Fall 2022 » Mastery EAQ Ch. 10
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Question #1
A patient diagnosed with cholecystitis reports pain in the back and scapular areas. The nurse infers that the patient has which type of pain?
A.
Referred pain
B.
Neuropathic pain
C.
Phantom pain
D.
Vascular pain
Question #2
Which phrase describes the primary indication for the administration of morphine?
A.
To treat ischemic pain
B.
To relieve acute and chronic pain
C.
To diminish feelings of anxiety
D.
To induce a state of unconsciousness
Question #3
Which medication is used to treat a patient experiencing severe adverse effects of an opioid analgesic?
A.
Flumazenil
B.
Acetylcysteine
C.
Naloxone
D.
Methylprednisolone
Question #4
Which characteristic aligns with chronic pain?
A.
Sharp
B.
Sudden onset
C.
Sympathetic nervous system response
D.
Persistent
Question #5
Which opioid is used to relieve coughing?
A.
Fentanyl
B.
Hydromorphone
C.
Codeine sulfate
D.
Meperidine
Question #6
Transdermal fentanyl is indicated for which type of pain?
A.
Lower back pain related to lumbar strain
B.
Pain after abdominal surgery
C.
Severe pain resulting from cancer metastasis
D.
Acute migraine
Question #7
A patient with ulcers in the mouth is complaining of pain. Which type of pain is the patient experiencing?
A.
Deep pain
B.
Somatic pain
C.
Visceral pain
D.
Superficial pain
Question #8
Which condition is a contraindication for the administration of acetaminophen?
A.
Severe liver disease
B.
Anemia
C.
Asthma
D.
Joint pain
Question #9
A patient is admitted to the emergency department with a diagnosis of "acetaminophen overdose." Which lab value is essential for the nurse to assess?
A.
Blood urea nitrogen (BUN) and creatinine levels
B.
Platelet count
C.
Neutrophil count
D.
Aspartate transaminase (AST) and alanine transaminase (ALT) levels
Question #10
The nurse is caring for a patient who is receiving 20 mg of hydrocodone orally every 4 hours. The drug is to be changed to intravenous (IV) fentanyl. Calculate the equivalent dose of IV fentanyl for a period of 24 hours.
A.
0.4 mg
B.
1 mg
C.
0.5 mg
D.
0.8 mg
Question #11
A patient has started on a fentanyl patch. After 3 hours, the patient continues to complain of pain of "8 on a scale of 0 to 10." Which action would the nurse take?
A.
Change the patch.
B.
Call the primary health care provider.
C.
Add a second patch.
D.
Administer naloxone.
Question #12
A patient has taken an excessive dose of acetaminophen for pain management. Which adverse effect associated with acetaminophen is likely to be found in the patient?
A.
Blurred vision, Decreased hearing, Elevated liver enzymes
B.
Nausea, Blurred vision, Decreased hearing
C.
Blurred vision, Vomiting, Decreased hearing
D.
Nausea, Vomiting, Elevated liver enzymes
Question #13
A patient is prescribed sufentanil for the treatment of acute pain. The nurse instructs the patient to increase fluid intake up to 3000 mL per day to prevent which side effect of sufentanil?
A.
Crystalluria
B.
Constipation
C.
Electrolyte imbalance
D.
Mucosal irritation
Question #14
Which assessment is essential for the nurse to monitor in a patient who is receiving an opioid analgesic?
A.
Blood pressure
B.
Heart rate
C.
Mental status
D.
Respiratory rate
Question #15
The nurse cares for a patient on the second day after major abdominal surgery. The patient is receiving morphine via patient-controlled analgesia (PCA) and currently reports pain as a 2 on a scale of 0 to 10. The patient tearfully says to the nurse, "I’m so worried that I won’t be able to go back to work. How am I going to manage my bills?" Which statement is the best response by the nurse?
A.
"The disability benefit of your insurance plan will help pay your bills."
B.
"Everything will be fine. You will be back to work in about 6 weeks."
C.
"Your pain is well controlled now. Why are you so worried?"
D.
"Tell me more about your fears."
Question #16
Which response would the nurse give to explain why codeine has been prescribed for a patient admitted to the hospital with a chronic nonproductive dry cough?
A.
"This medication helps open up your airways."
B.
"This medication will help you get rid of mucous."
C.
"This medication is used as a cough suppressant."
D.
"This medication will help your immune system."
Question #17
A patient is prescribed levorphanol to treat chronic pain. The nurse instructs the patient to increase fluid to reduce the risk of which adverse effect of levorphanol?
A.
Diarrhea
B.
Dizziness
C.
Miosis
D.
Constipation
Question #18
Gallstones produce which type of pain?
A.
Deep pain
B.
Superficial pain
C.
Visceral pain
D.
Somatic pain
Question #19
The primary health care provider prescribes intravenous morphine to a patient who has been receiving oral oxycodone 80 mg every 12 hours. If a 15-mg dose of oxycodone is equivalent to a 10-mg dose of parenteral morphine, calculate the equivalent intravenous dose of morphine.
A.
100 mg
B.
107 mg
C.
125 mg
D.
150 mg
Question #20
Which action of naloxone binding on the opioid receptor causes reversal of respiratory depression?
A.
Binds in place of the agonist and causes no response
B.
Binds and causes a response opposite to that of an agonist
C.
Binds and causes less pain response than an agonist
D.
Binds instead of the agonist and causes analgesia
Question #21
How would the nurse respond when a patient asks how to use a fentanyl patch at home?
A.
"Dispose of patches by melting them with a flame."
B.
"Keep new and used patches away from children."
C.
"Store the patches in the bathroom medicine cabinet."
D.
"Apply heat over the patch to increase absorption."
Question #22
Which outcome is an adverse effect of Chrysanthemum parthenium?
A.
Skin rashes, Muscle stiffness, Blurred vision
B.
Joint pain, Skin rashes, Blurred vision
C.
Skin rashes, Blurred vision, Nausea
D.
Nausea, Joint pain, Muscle stiffness
Question #23
A patient admitted to the unit is prescribed oral naltrexone hydrochloride daily. Which admission assessment would the nurse include for the patient?
A.
Questions regarding the date of the last flu vaccine
B.
Questions regarding past history of drug and alcohol use
C.
Assessment of chronic diseases causing pain
D.
Assessment of culture reports
Question #24
The nurse assesses a respiratory rate of 6 breaths/min in a patient receiving fentanyl. Which action would the nurse take?
A.
Assess the patient’s electrocardiogram (ECG).
B.
Assess the patient for pain.
C.
Administer naltrexone hydrochloride.
D.
Administer an amphetamine.
Question #25
The nurse is assessing a patient who underwent surgery and is prescribed oxycodone. Which assessment finding requires the nurse to take action?
A.
Heart rate 90 beats/min
B.
Respiratory rate 12 breaths/min
C.
No bowel movement in 72 hours
D.
Vague feeling of anxiety
Question #26
When monitoring a patient for adverse effects related to morphine sulfate, the nurse assesses for stimulation of which response?
A.
Respiratory rate
B.
Cough reflex
C.
Circulation
D.
Chemoreceptor trigger zone
Question #27
Thirty minutes after surgery the nurse in the postanesthesia care unit (PACU) notes that a patient has a respiratory rate of 6 breaths/min. Which action is the nurse’s priority?
A.
Administer flumazenil.
B.
Assess the patients’ responsiveness.
C.
Prepare intravenous naloxone.
D.
Initiate resuscitative measures.
Question #28
Which assessment finding indicates that the patient may have received an overdose of morphine sulfate?
A.
Pinpoint pupils
B.
Respiratory rate 28 breaths/min
C.
Heart rate 110 beats/min
D.
Blood in urine
Question #29
The nurse administered oral codeine sulfate to a patient as needed (PRN) for suppression of a nonproductive dry cough. When would the nurse assess to determine whether the medication has been effective?
A.
In 8 hours
B.
In 4 hours
C.
Within a half hour
D.
Within 2 hours
Question #30
A patient is prescribed high-dose acetaminophen for long-term treatment of pain. Which medication may be part of the patient’s treatment plan to prevent complications associated with acetaminophen toxicity?
A.
Nalbuphine
B.
Acetylcysteine
C.
Naloxone
D.
Naltrexone hydrochloride
Question #31
The nurse cares for a postoperative patient receiving epidural analgesia. The patient is resistant to the nurse’s encouragement to turn, cough, and breathe deeply. The patient says, "I’m afraid the needle will stick in my spinal cord and paralyze me." How would the nurse respond?
A.
"If you don’t turn, cough, and breathe deeply, you may get pneumonia or other complications."
B.
"There’s no needle. It’s a thin plastic tube in the protective covering of your spinal cord."
C.
"I can understand your fears, but there is no risk of paralysis from epidural analgesia."
D.
"Tell me more about your understanding of how epidural analgesia relieves your pain."
Question #32
Before the scheduled dose of opioids, the nurse assesses the patient’s vital signs. The respiratory rate is 8 breaths/min, pulse rate is 80 beats/min, and blood pressure is 108/60 mm Hg. Which action would the nurse take first?
A.
Withhold the scheduled opioid dose.
B.
Administer an opioid antagonist.
C.
Administer the scheduled opioid dose.
D.
Inform the primary health care provider.
Question #33
A postoperative patient is receiving an epidural infusion of morphine sulfate. The patient’s respiratory rate decreases to 8 breaths/min. Which medication would the nurse administer after attempting to have the patient respond to verbal and tactile stimuli?
A.
Naloxone
B.
Acetylcysteine
C.
Protamine sulfate
D.
Methylprednisolone
Question #34
A patient’s medication administration record has the following entry: morphine sulfate 1 mg IV push q2h PRN severe pain. Upon assessment, the patient continues to complain of pain that is 8 on a scale of 0 to 10. The patient received 1 mg of morphine an hour ago. Which action would the nurse take?
A.
Administer 1 mg of morphine and notify the primary health care provider.
B.
Consult the primary health care provider and obtain another drug prescription.
C.
Administer another 1 mg of morphine and reevaluate the pain scale in 15 minutes.
D.
Hold the drug, record the assessment, and reassess the patient in 1 hour.
Question #35
A patient who regularly takes acetaminophen returns to the clinic for a follow-up visit. Which assessment finding indicates the need for a change in the patient’s therapy?
A.
Hemoglobin 11.2 g/dL
B.
Serum bilirubin 3.2 mg/dL
C.
Random blood glucose 140 mg/dL
D.
Serum creatinine 0.8 mg/dL
Question #36
The nurse assesses a patient who is receiving methadone hydrochloride and notes a respiratory rate of 10 breaths/min. Which action by the nurse is a priority?
A.
Reassess the patient in an hour.
B.
Administer a narcotic antagonist.
C.
Assess the patient’s neurologic status.
D.
Assess blood gases.
Question #37
Which condition listed in the patients’ medical history could be a contraindication to administration of morphine sulfate?
A.
Anorexia
B.
Cancer
C.
Asthma
D.
Diarrhea
Question #38
A patient is prescribed oxycodone extended release (ER) for pain management. Which information is essential to include in the teaching plan?
A.
"Take the medication frequently." "Swallow the medication whole." "Increase the dose if you experience no pain relief."
B.
"Do not crush the medication." "Swallow the medication whole." "Do not dissolve the medication in water."
C.
"Take the medication frequently." "Increase the dose if you experience no pain relief." "Do not crush the medication."
D.
"Do not dissolve the medication in water." "Take the medication frequently." "Increase the dose if you experience no pain relief."
Question #39
Which finding alerts the nurse to the possibility that the patient is experiencing adverse effects of morphine sulfate?
A.
Insomnia
B.
Hyperactive bowel sounds
C.
Sedation
D.
Diarrhea
Question #40
A patient with respiratory depression secondary to opioid toxicity is being treated in the emergency department. Which action is the nurse’s priority?
A.
Administer naloxone.
B.
Prepare for intubation.
C.
Assess arterial blood gases.
D.
Call the respiratory team stat.
Question #41
A patient is being discharged with a prescription for morphine for postoperative pain. Which information would the nurse include in the discharge teaching plan?
A.
"Rest before taking the medication." "Take acetaminophen with the morphine."
B.
"Drink at least 3 liters of fluid a day." "Take an over-the-counter stool softener daily."
C.
"Increase the dose of morphine if there is no relief of pain." "Take acetaminophen with the morphine."
D.
"Increase the dose of morphine if there is no relief of pain." "Rest before taking the medication."
Question #42
A patient with cancer who has had adequate pain control with a long-acting opioid reports severe pain. The nurse understands that the patient is experiencing breakthrough pain, and the time of the next scheduled opioid dose is in 2 hours. Which action does the nurse take?
A.
Distract the patient for 2 hours by using alternative methods, such as music therapy.
B.
Ask the patient to bear the pain until the next scheduled opioid dose.
C.
Administer a short-acting opioid and follow the regular opioid schedule for the next dose.
D.
Administer the scheduled opioid dose early.
Question #43
After the placement of a new transdermal opioid patch, the patient reports an increase in level of pain. Which error in placement of the new patch is the reason?
A.
Placed on the same place as the old patch
B.
Placed on a hairy area
C.
Placed on a new area, with the old patch still in place
D.
Placed on an area after cleaning it
Question #44
The nurse is caring for a patient who is receiving morphine sulfate for pain management. Which assessment finding is cause for immediate nursing action?
A.
Hallucinations, Slow pupil reaction, Altered consciousness
B.
Excess urination, Hallucinations, Change in sputum color
C.
Altered consciousness, Excess urination, Change in sputum color
D.
Slow pupil reaction, Excess urination, Change in sputum color
Question #45
Which factor would the nurse consider while planning pharmacologic therapy for a patient with pain?
A.
Pain relief is best obtained by administering analgesics around the clock.
B.
Patients should request analgesics when the pain level reaches a 3 on a scale of 1 to 10.
C.
Analgesics should be administered as needed to minimize adverse effects.
D.
Narcotic analgesics should not be used for more than 24 hours.
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