Chapter 26 Narcotics, Narcotic Antagonists, and Antimigraine Agents

Chapter 26  Narcotics, Narcotic Antagonists, and Antimigraine Agents

Complete Chapter Questions And Answers
 

Sample Questions

1.
A geriatric patient received a narcotic analgesic before leaving the post-anesthesia care unit to return to the regular unit. What is the priority nursing action for the nurse receiving the patient on the regular unit?
A)
Administer a non-steroidal anti-inflammatory drug.
B)
Encourage fluids.
C)
Create a restful, dark, quiet environment.
D)
Put side rails up and place bed in low position.
Ans:
D

Feedback:

Older patients are more susceptible to the central nervous system effects of narcotics; it is important to ensure their safety by using side rails and placing the bed in the low position in case the patient tries to get up unaided. Postoperative patients are allowed nothing by mouth until bowel function returns so an oral medication or encouraging fluids would not be appropriate. This patient will require careful observation for respiratory depression, so a dark room would be unsafe.

2.
A patient who is experiencing severe pain is administered a narcotic. What would the nurse write in the plan of care as a desirable and measurable outcome for this patient?
A)
A shorter period of time between requests for medication
B)
Reduced complaints about limited movement
C)
Lack of restlessness and ability to sustain one position
D)
Increased autonomy in providing AM care
Ans:
D

Feedback:

Monitor patient response to the drug (e.g., relief of pain, sedation).When pain is being adequately managed with opioid therapy, a desirable and measurable outcome would be that the patient is able to be more autonomous in providing care in the morning. Shorter periods between requests for medication would not be a desirable outcome because it is not an indicator of pain control given that some patients are reluctant to ask for medicine even though they are in pain. Patients in pain tend not to move for fear of exacerbating the pain, so lack of movement can be an indication the patient is in pain. Just because the patient does not complain of pain doesn’t mean he isn’t experiencing pain.

3.
The health care provider orders oral (PO) codeine as an adjunctive therapy to pain control medication. What order would be appropriate for the nurse to administer?
A)
Codeine 5 mg PO every 6 hour
B)
Codeine 10 mg PO every 4 hour
C)
Codeine 15 mg PO every 2 hour
D)
Codeine 20 mg PO every 4 hour
Ans:
D

Feedback:

The correct dosage for codeine administered for pain by mouth is 15 to 60 mg q 4 to 6 hour. The other options are incorrect oral dosages because they are too low a dose or give an incorrect dosing frequency.

4.
A patient with migraine headaches is changed from an ergot to a prescription for a triptan. The nurse has completed teaching related to the drug. What statement would indicate she has a clear understanding of the new drug?
A)
“My life is over. I can’t function not knowing when I’m going to have a headache.”
B)
“I will not have to avoid driving because this medication isn’t sedating.”
C)
“I should not experience as many adverse effects from my new medication.”
D)
“I take my medication every hour when I have a headache.”
Ans:
C

Feedback:

Triptans are a new class of selective serotonin receptor blockers that cause vasoconstriction; they are not associated with as many systemic adverse effects experienced in ergot therapy. Triptan therapy will enable her to live a near normal life even during headaches. Although adverse effects are fewer than those associated with ergot therapy, triptans can still cause dizziness, feelings of strangeness, and vertigo, so the patient should not drive while taking the drug. Medications are often only taken once due to prolonged half-lives, but some may be repeated in 2 to 4 hours if the headache does not subside.

5.
The nurse receives an order for a triptan for a patient diagnosed with cluster headaches. What drug would be indicated for this purpose?
A)
Almotriptan (Axert)
B)
Frovatriptan (Frova)
C)
Naratriptan (Amerge)
D)
Sumatriptan (Imitrex)
Ans:
D

Feedback:

Sumatriptan, the first drug of this class, is used for the treatment of acute migraine attacks and for the treatment of cluster headaches in adults. No other triptans are approved for treatment of cluster headaches.