Deck 20: Drugs Used for Pain Management

Question 1

Which action will the nurse take when a patient receiving morphine sulfate via PCA has a shallow, irregular respiratory rate of 6/min?

A) Elevate the patient's head of bed to facilitate lung expansion.
B) Increase the patient's primary IV flow rate.
C) Complete the FLACC scale.
D) Notify the health care provider and prepare to administer naloxone (Narcan).

Answer 1

Notify the health care provider and prepare to administer naloxone (Narcan).

Question 2

When teaching a patient who is starting therapy with NSAIDs, the nurse must be sure to mention drug interactions with which of the following? (Select all that apply.)

A) Warfarin (Coumadin)
B) Lithium (Eskalith)
C) Hydroxyzine (Vistaril)
D) Insulin
E) Diuretics
F) Digitalis (Digoxin)

Answer 2

Warfarin (Coumadin)
Lithium (Eskalith)
Diuretics

Question 3

What is the best way for the nurse to evaluate the effectiveness of the patient's opiate agonist?

A) Ability of the patient to tolerate more activity
B) Increased sleep time throughout the night
C) Reduction of respiratory rate from 24 to 18 breaths/min
D) Verbal report of 2 on a 1 to 10 scale

Answer 3

Verbal report of 2 on a 1 to 10 scale

Question 4

Which information is most accurate regarding the nurse's understanding of pain management?

A) Older patients have difficulty describing their pain level.
B) Encourage patients to report pain before the pain becomes too severe.
C) Use the smallest dose of medication possible to control pain.
D) Pain medication administration ordered PRN will maintain a constant blood level.

Question 5

The nurse is completing an assessment on a nonverbal adult patient. Which type of pain scale assessment tool is the most accurate to use?

A) TPPPS
B) FLACC
C) POCIS
D) MOPS

Question 6

Which conditions may be managed by salicylates? (Select all that apply.)

A) Migraine headache
B) Swollen joints
C) Fever
D) Muscle aches
E) Myocardial infarction

Question 7

Which are common adverse effects associated with opiate agonists? (Select all that apply.)

A) Dizziness
B) Orthostatic hypotension
C) Respiratory depression
D) Confusion
E) Diarrhea
F) Urinary urgency

Question 8

Which statement is true about neuropathic pain?

A) This pain is the result of a stimulus to pain receptors.
B) Patients describe it as dull and aching.
C) It commonly originates in the abdominal region.
D) The pain is a result of nerve injury.

Question 9

Which additional nursing intervention(s) would be effective with pain management in the pediatric population? (Select all that apply.)

A) Provide diversional activities such as coloring, puzzles, and games.
B) Allow uninterrupted sleep and rest.
C) Perform hygiene measures.
D) Encourage parental participation with caregiving to diminish the child's anxiety.
E) With the health care provider's approval, encourage the child to drink 8 to 10 8-ounce glasses of fluid daily.

Question 10

An 86-year-old patient who was admitted with gastrointestinal bleeding secondary to salicylate therapy is being discharged. As the nurse reviews the discharge medication list, the patient states that she doesn't understand why Tylenol doesn't work as well as the aspirin she had been taking. What would be the nurse's best response?

A) "Tylenol and aspirin are chemically the same drug."
B) "Tylenol is appropriate for only minor pain."
C) "Tylenol does not help with inflammatory discomfort."
D) "A therapeutic blood level must be established with Tylenol."

Question 11

Which patient assessment would indicate to the nurse that salicylate toxicity is occurring?

A) Gastrointestinal bleeding
B) Increased bleeding times
C) Tinnitus
D) Occasional nausea

Question 12

A surgical patient is being discharged on propoxyphene (Darvon), a synthetic opiate agonist. Which discharge instructions will the nurse include? (Select all that apply.)

A) Greater pain relief may be obtained if taken with acetaminophen or aspirin.
B) There is no danger of physiological or psychological dependency.
C) This drug should be taken when pain becomes intolerable.
D) Dizziness and gastric irritation are common adverse effects.
E) Uncontrolled pain should be reported to the physician.

Question 13

How long after the administration of a parenteral pain medication will the nurse complete the next pain assessment to evaluate the effectiveness of the medication?

A) 10 minutes
B) 30 minutes
C) 1 hour
D) 2 hours

Question 14

The nurse is assessing a patient's pain. When the patient describes his pain as cramping and burning, which component of the pain history is being addressed?

A) Depth
B) Location
C) Quality
D) Severity

Question 15

Which medication would the nurse administer to a patient who is rating the pain at 8 on a 0 to 10 scale?

A) Acetaminophen (Tylenol)
B) Morphine (Roxanol)
C) Oxycodone (OxyContin)
D) Oxycodone and aspirin (Percodan)

Question 16

What term is used to define an awareness of pain?

A) Tolerance
B) Threshold
C) Perception
D) Sensation

Question 17

What is the advantage of taking an NSAID that is a COX-2 inhibitor?

A) The medication is cheaper than aspirin.
B) There are fewer gastrointestinal adverse effects.
C) They are more effective than COX-1 inhibitors.
D) They have no known adverse effects.

Question 18

Which medication is contraindicated when a patient is taking warfarin (Coumadin)?

A) Aspirin
B) Acetaminophen (Tylenol)
C) Propoxyphene (Darvon)
D) Morphine (Roxanol)

Question 19

In which case would the nurse be correct in withholding an opiate agonist?

A) Evidence of postural hypotension
B) Presence of constipation
C) Pain rating of 7 on a 0 to 10 scale
D) Respiratory rate of 10 breaths/min

Question 20

Which sign or symptom displayed by a patient would be indicative of opiate withdrawal?

A) Bradycardia
B) Diarrhea
C) Lethargy
D) Hypothermia