Chapter 48 Drug Therapy With Opioids

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Chapter 48  Drug Therapy With Opioids

 

 

Complete chapter Questions And Answers
 

Sample Questions

 

 

1. A surgical patient has highly elevated AST and ALT levels. Standard orders specify that she is to receive morphine sulfate 10 mg postoperatively. What action should the nurse take prior to administering the medication?

  1. A)  Draw up half of the medication for administration.
  2. B)  Notify the physician for a reduced dosage.
  3. C)  Assess the patient’s respiratory status.
  4. D)  Assess the patient’s pain tolerance.

Ans: B

Feedback:

Morphine and meperidine form pharmacologically active metabolites. Thus, liver impairment can interfere with metabolism, and kidney impairment can interfere with excretion. Drug accumulation and increased adverse effects may occur if dosage is not reduced. The nurse cannot administer half of the medication without a physician’s order. It is important to assess the patient’s respiratory status before administration, but this action is not the primary intervention in this case. Narcotics prior to surgery are administered to increase pain tolerance during the surgical procedure, not during the preoperative phase.

2. An outpatient has been prescribed hydrocodone for back pain related to a compression fracture. Which of the following interventions should the patient be taught regarding the medication administration?

  1. A)  Consume a diet high in fiber.
  2. B)  Decrease activity due to pain.
  3. C)  Elevate the lower extremities.
  4. D)  Take aspirin with the medication.

Ans: A
Feedback:
Hydrocodone is an opioid, which, in the gastrointestinal tract, slows motility. To prevent constipation, the patient should consume a diet high in fiber. A decrease in activity due to pain will increase constipation. Elevating the lower extremities will not increase or decrease pain. Hydrocodone should not be routinely combined with aspirin unless prescribed by the physician.

3. A hospice patient has been ordered morphine (Roxanol) 5 mg sub-Q every 2 hours. Roxanol contains 10 mg/mL. How many milliliters will be administered?

  1. A)  0.25 mL
  2. B)  0.5 mL
  3. C)  1 mL
  4. D)  2 mL

Ans: B
Feedback:
5 mg/X = 10 mg/mL. The calculation results in 0.5 mL. The administration of 0.25, 1, or 2 mL is incorrect.

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4. A patient who suffers from cancer pain is receiving morphine every 2 hours. For which of the following should the family be taught to assess while the patient is on morphine?

  1. A)  Diarrhea
  2. B)  Respiratory depression
  3. C)  Lung sounds
  4. D)  Urinary incontinence

Ans: B
Feedback:
The administration of morphine can result in respiratory depression. The family should be taught to assess the patient for respiratory depression. Morphine sulfate can be administered to treat severe diarrhea. The patient’s lung sounds are important to assess, but only after the nurse assesses for respiratory depression. Morphine does not cause urinary incontinence.

5. A patient is admitted to the surgical division after a mastectomy. The patient has a PCA pump and states to you that she is fearful she will overdose on morphine. Which of the following interventions is most appropriate to teach the patient?

  1. A)  “The pump will administer all of the doses, so you don’t have to worry.”
  2. B)  “If you follow the instructions, that won’t happen to you.”
  3. C)  “The device is preset, so you cannot receive more than you need.”
  4. D)  “The device will give you a placebo when you press it often.”

Ans: C
Feedback:
PCA pumps deliver a basic amount of analgesic by continuous infusion, with the patient injecting additional doses when needed. The amount of the drug is preset and limited. The pump will administer a basal rate, but the patient can administer the medication at preset intervals. Telling the patient not to worry is not effective teaching or use of therapeutic communication. Telling the patient to follow the instructions is not effective teaching or use of therapeutic communication. Instructing the patient on a placebo is not effective teaching or use of therapeutic communication.

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