NUR 378: EXAM 3
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?
Acute pain
Chronic pain
Somatic pain
Neuropathic pain - ANS Chronic pain
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.
A 16-year-old field hockey player fell and twisted her ankle during a game. The nurse will expect to
administer which type of analgesic?
Synthetic opioid, such as meperidine
Opium alkaloid, such as morphine sulfate
Opioid antagonist, such as naloxone HCL Nonopioid analgesics, such as indomethacin - ANS
Nonopioid analgesics, such as indomethacin
Somatic pain, which originates from skeletal muscles, ligaments, and joints, usually responds to
nonopioid analgesics such as nonsteroidal anti-inflammatory drugs (NSAIDs). The other options are
not the best choices for somatic pain.
A patient had abdominal surgery this morning. The patient is groggy but complaining of severe pain
around the incision. What is the most important assessment data to consider before the nurse
administers a dose of morphine sulfate to the patient?
The patient's pulse rate
The patient's respiratory rate
The appearance of the incision
,The date of the patient's last bowel movement - ANS The patient's respiratory rate
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.
A 78-year-old patient is in the recovery room after having a lengthy surgery on his hip. As he is
gradually awakening, he requests pain medication. Within 10 minutes after receiving a dose of
morphine sulfate, he is very lethargic and his respirations are shallow, with a rate of 7
breaths/minute. The nurse prepares for which priority action at this time?
Assessment of the patient's pain level
Immediate intubation and artificial ventilation
Administration of naloxone (Narcan)
Close observation of signs of opioid tolerance - ANS Administration of naloxone (Narcan)
Naloxone, an opioid-reversal agent, is used to reverse the effects of acute opioid overdose and is the
drug of choice for reversal of opioid-induced respiratory depression. This situation is describing an
opioid overdose, not opioid tolerance. Intubation and artificial ventilation are not appropriate
because the patient is still breathing at 7 breaths/min. It would be inappropriate to assess the
patient's level of pain.
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?
How to prevent dehydration due to diarrhea
The importance of taking the drug only when the pain becomes severe
How to prevent constipation
The importance of taking the drug on an empty stomach - ANS How to prevent constipation
,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.
DIF: Cognitive Level: Applying (Application)
A patient has been treated for lung cancer for 3 years. Over the past few months, the patient has
noticed that the opioid analgesic is not helping as much as it had previously and more medication is
needed for the same pain relief. The nurse is aware that this patient is experiencing which of these?
Opioid addiction
Opioid tolerance
Opioid toxicity
Opioid abstinence syndrome - ANS Opioid tolerance
Opioid tolerance is a common physiologic result of long-term opioid use. Patients with opioid
tolerance require larger doses of the opioid agent to maintain the same level of analgesia. This
situation does not describe toxicity (overdose), addiction, or abstinence syndrome (withdrawal).
A 38-year-old man has come into the urgent care center with severe hip pain after falling from a
ladder at work. He says he has taken several pain pills over the past few hours but cannot remember
how many he has taken. He hands the nurse an empty bottle of acetaminophen (Tylenol). The nurse
is aware that the most serious toxic effect of acute acetaminophen overdose is which condition?
Tachycardia
Central nervous system depression
Hepatic necrosis
Nephropathy - ANS Hepatic necrosis
Hepatic necrosis is the most serious acute toxic effect of an acute overdose of acetaminophen. The
other options are incorrect.
A 57-year-old woman being treated for end-stage breast cancer has been using a transdermal opioid
analgesic as part of the management of pain. Lately, she has been experiencing breakthrough pain.
The nurse expects this type of pain to be managed by which of these interventions?
, Administering NSAIDs
Administering an immediate-release opioid
Changing the opioid route to the rectal route
Making no changes to the current therapy - ANS Administering an immediate-release opioid
If a patient is taking long-acting opioid analgesics, breakthrough pain must be treated with an
immediate-release dosage form that is given between scheduled doses of the long-acting opioid. The
other options are not appropriate actions.
The nurse is reviewing herbal therapies. Which is a common use of the herb feverfew?
Muscle aches
Menstrual cramps
Joint pain
Incision pain after surgery - ANS Menstrual cramps
Feverfew is commonly used for migraine headaches, menstrual problems, arthritis, and fever.
Possible adverse effects include muscle stiffness and muscle and joint pain.
A patient is to receive acetylcysteine as part of the treatment for an acetaminophen overdose.
Which action by the nurse is appropriate when giving this medication?
Giving the medication undiluted for full effect
Avoiding the use of a straw when giving this medication
Disguising the flavor with soda or flavored water
Preparing to give this medication via a nebulizer - ANS Disguising the flavor with soda or flavored
water
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