Chapter 10: Analgesic Drugs
MULTIPLE CHOICE
1. A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This
pain has been gradually increasing
...
Chapter 10: Analgesic Drugs
MULTIPLE CHOICE
1. A patient was diagnosed with pancreatic cancer last month, and has complained of a dull ache in the abdomen for the past 4 months. This
pain has been gradually increasing, and the pain relievers taken at home are no longer effective. What type of pain is the patient experiencing?
a. Acute pain
b. Chronic pain
c. Somatic pain
d. Neuropathic pain
ANS: B
Chronic pain is associated with cancer and is characterized by slow onset, long duration, and dull, persistent aching. The patient’s symptoms are
not characteristics of acute pain, somatic pain, or neuropathic pain.
2. An 18-year-old basketball player fell and twisted his ankle during a game. The nurse will expect to administer which type of analgesic?
a. Synthetic opioid, such as meperidine (Demerol)
b. Opium alkaloid, such as morphine sulfate
c. Opioid antagonist, such as naloxone HCL (Narcan)
d. Nonopioid analgesic, such as indomethacin (Indocin)
ANS: D
Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to nonopioid analgesics such as nonsteroidal antiinflammatory drugs (NSAIDs). The other options are not the best choices for somatic pain.
3. A patient is recovering from abdominal surgery, which he had this morning. He is groggy but complaining of severe pain around his incision.
What is the most important assessment data to consider before the nurse administers a dose of morphine sulfate to the patient?
a. His pulse rate
b. His respiratory rate
c. The appearance of the incision
d. The date of his last bowel movement
ANS: B
One of the most serious adverse effects of opioids is respiratory depression. The nurse must assess the patient’s respiratory rate before
administering an opioid. The other options are incorrect.
5. A patient will be discharged with a 1-week supply of an opioid analgesic for pain management after abdominal surgery. The nurse will include
which information in the teaching plan?
a. How to prevent dehydration due to diarrhea
b. The importance of taking the drug only when the pain becomes severe
c. How to prevent constipation
d. The importance of taking the drug on an empty stomach
ANS: C
Gastrointestinal (GI) adverse effects, such as nausea, vomiting, and constipation, are the most common adverse effects associated with opioid
analgesics. Physical dependence usually occurs in patients undergoing long-term treatment. Diarrhea is not an effect of opioid analgesics.
Taking the dose with food may help minimize GI upset
9. The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
a. Muscle aches
b. Migraine headaches
c. Leg cramps
d. Incision pain after surgery
ANS: B
Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever. Possible adverse effects include muscle stiffness
and muscle and joint pain.
10. A patient is to receive acetylcysteine (Mucomyst) as part of the treatment for an acetaminophen (Tylenol) overdose. Which action by the
nurse is appropriate when giving this medication?
a. Giving the medication undiluted for full effect
b. Avoiding the use of a straw when giving this medication
c. Disguising the flavor with soda or flavored water
d. Preparing to give this medication via a nebulizer
ANS: C
Acetylcysteine has the flavor of rotten eggs and so is better tolerated if it is diluted and disguised by mixing with a drink such as cola or flavored
water to help increase its palatability. The use of a straw helps to minimize contact with the mucous membranes of the mouth and is
recommended. The nebulizer form of this medication is used for certain types of pneumonia, not for acetaminophen overdose.
11. A patient is receiving gabapentin (Neurontin), an anticonvulsant, but has no history of seizures. The nurse expects that the patient is
receiving this drug for which condition?
a. Inflammation pain
b. Pain associated with peripheral neuropathy
c. Depression associated with chronic pain
d. Prevention of seizures
ANS: B
Anticonvulsants are often used as adjuvants for treatment of neuropathic pain to enhance analgesic efficacy. The other indications listed are not
correct.
12. The nurse is assessing a patient who has been admitted to the emergency department for a possible opioid overdose. Which assessment
finding is characteristic of an opioid drug overdose?
a. Dilated pupils
b. Restlessness
c. Respiration rate of 6 breaths/min
d. Heart rate of 55 beats/min
ANS: C
The most serious adverse effect of opioid use is CNS depression, which may lead to respiratory depression. Pinpoint pupils, not dilated pupils,
are seen. Restlessness and a heart rate of 55 beats/min are not indications of an opioid overdose.
13. The drug nalbuphine (Nubain) is an agonist-antagonist (partial agonist). The nurse understands that which is a characteristic of partial
agonists?
a. They have anti-inflammatory effects.
b. They are given to reverse the effects of opiates.
c. They have a higher potency than agonists.
d. They have a lower dependency potential than agonists.
ANS: D
Partial agonists such as nalbuphine are similar to the opioid agonists in terms of their therapeutic indications; however, they have a lower risk of
misuse and addiction. They do not have anti-inflammatory effects, nor are they given to reverse the effects of opiates. They do not have a
higher potency than agonists.
15. A patient arrives at the urgent care center complaining of leg pain after a fall when rock
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