Deck 19: Drugs for the Control of Pain

Question 1

The client has a patient -controlled analgesia (PCA) pump following surgery. The nurse keeps naloxone (Narcan) in the client's room as per protocol. What does the nurse recognize as the rationale for this protocol?

A) Naloxone (Narcan) is the antidote if an anaphylactic reaction to the opioid in the patient -controlled analgesia (PCA) pump occurs.
B) Naloxone (Narcan) enhances the effect of the opioid in the patient -controlled analgesia (PCA) pump and increases analgesia.
C) Naloxone (Narcan) will reverse the effects of the narcotic in the patient -controlled analgesia (PCA) pump if an overdose occurs.
D) Naloxone (Narcan) is available to treat any systemic side effects, like constipation, of the opioid in the patient -controlled analgesia (PCA) pump.

Answer 1

Naloxone (Narcan) will reverse the effects of the narcotic in the patient -controlled analgesia (PCA) pump if an overdose occurs.

Question 2

The nurse provides care for several clients. For which client would the nurse assess acetaminophen (Tylenol) to be contraindicated?

A) a 19 -year -old with a bladder infection
B) a 2 -year -old with a high fever due to the flu
C) a 65 -year -old with osteoarthritis
D) a 55 -year old who socially drinks alcohol

Answer 2

a 55 -year old who socially drinks alcohol

Question 3

The client is to start on sumatriptan (Imitrex) for migraine headaches. What will the best plan of the nurse include as it relates to this medication? Select all that apply.

A) Plan to instruct the client to take the medication with food to avoid ulcers.
B) Plan to teach the client not to drive until the effects of the medication are known.
C) Plan to teach the client to avoid pseudoephedrine (Sudafed) with this medication.
D) Plan to teach the client to increase fluid intake with this medication.
E) Plan to teach the client the importance of taking the medication with protein.

Answer 3

Plan to teach the client not to drive until the effects of the medication are known.
Plan to teach the client to avoid pseudoephedrine (Sudafed) with this medication.

Question 4

The client is using a patient -controlled analgesia (PCA) pump with morphine to control pain. Prioritize the nursing interventions.

A) Instruct the client to use the patient -controlled analgesia (PCA) before the pain becomes severe.
B) Check the intravenous (IV) line for patency every 2 hours.
C) Assess the client's pain level and vital signs frequently.
D) Ask the physician is the client can switch to an oral analgesic.

Question 5

The post -surgical client has an order for morphine 2 mg IV push every two hours and propoxyphene napsylate (Darvon - N) every four hours. He received the morphine two hours ago, and is complaining of pain again. What will the best plan of the nurse include?

A) Plan to have the client do some distraction techniques.
B) Plan to assess the client's level of pain.
C) Plan to administer the propoxyphene napsylate (Darvon -N).
D) Plan to administer the morphine again.

Question 6

The client receives morphine for pain. Which comment by the client does the nurse assess to be a side effect of morphine?

A) "My ears are constantly ringing."
B) "I feel like I am going to throw up."
C) "My heart feels like it is skipping beats."
D) "I feel cold shivers all over."

Question 7

The client comes to the emergency department with a head injury, broken ribs, and internal bleeding. Opioid analgesics are contraindicated. What does the nurse recognize as the primary rationale for this?

A) Opioids can mask changes in the client's level of consciousness.
B) The use of opioid analgesics will depress the client's blood pressure.
C) Opioids will not effectively relieve pain in the client's periphery.
D) The client may not be able to communicate his level of pain.

Question 8

What is a priority assessment question to ask a post -surgical client prior to administration of an opioid analgesic?

A) "Would you like me to help you change your position for comfort?"
B) "Would you please rate your pain on a scale of 1 -to -10?"
C) "Why do you want to receive this pain medication?"
D) "Have you ever been addicted to prescription pain medications?"

Question 9

The client receives aspirin. The nurse assesses an adverse effect to this drug when the client makes which response?

A) "I have to get up a lot at night to urinate."
B) "There is a constant ringing in my ears."
C) "My stools have been gray in colour."
D) "Bright lights give me a headache."

Question 10

The client has intractable pain, and the physician has proposed a nerve block. The nurse plans to teach the client about nerve blocks. Which statement would be included in the best plan of the nurse?

A) A nerve block enhances the effect of most of the endogenous opioids.
B) A nerve block depresses the activity of the sympathetic nervous system.
C) A nerve block modifies sensory information being sent to the spinal cord.
D) A nerve block stops pain transmission along the nerve to stop the pain.

Question 11

The client, addicted to heroin, is being treated for opioid dependence. He has been prescribed methadone (Metadol). The client asks how this will help because methadone (Metadol) is another opioid. What is the best response by the nurse?

A) "Methadone (Metadol) will make you really sick if you use heroin."
B) "Methadone (Metadol) causes you to have an allergy to heroin."
C) "Methadone (Metadol) cures your addiction to heroin."
D) "Methadone (Metadol) does not cause euphoria like heroin does."

Question 12

The nursing instructor teaches the nursing students about neural mechanisms of pain. What does the nursing instructor teach about substance P?

A) Substance P controls which pain signals reach the brain.
B) Substance P stimulates pain receptors in the spinal cord.
C) Substance P is also known as an endogenous opioid.
D) Substance P modifies sensory information in the spinal cord.

Question 13

The nurse teaches clients about non-pharmacological techniques for pain management. The nurse determines learning has occurred when the clients make which statement(s)? Select all that apply.

A) "Nonpharmacological techniques are a good adjunct to pharmacotherapy."
B) "Nonpharmacological techniques may be used in place of drugs."
C) "Nonpharmacological techniques include an aerobic exercise."
D) "Nonpharmacological techniques have not reached mainstream yet."
E) "Nonpharmacological techniques are not usually valued by nurses."

Question 14

What is an important instruction for the nurse to give to the client who is taking acetaminophen (Tylenol)?

A) "Do not take any narcotics with acetaminophen (Tylenol)."
B) "Check your gums for bleeding when taking acetaminophen (Tylenol)."
C) "Do not drink alcohol with acetaminophen (Tylenol)."
D) "Do not take acetaminophen (Tylenol) on an empty stomach."

Question 15

The client receives morphine for pain. He asks the nurse how it works to relieve pain. What is the best response by the nurse?

A) "It stimulates the receptors that secrete endorphins in your brain."
B) "It stimulates a receptor in your brain that induces pleasure."
C) "It promotes the primary pleasure neurotransmitters in your brain."
D) "It inhibits the primary pain neurotransmitters in your brain."