Deck 18: Drugs for the Control of Pain

Question 1

A nurse is preparing to provide education on the use of heroin. Which information should the nurse include? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Heroin is an opioid drug.
B) Heroin is a narcotic drug.
C) Heroin causes CNS agitation.
D) Heroin is the same drug as morphine.
E) Heroin is not as dangerous as oxycodone.

Answer 1

Heroin is an opioid drug.
Heroin is a narcotic drug.

Question 2

Which information should the nurse include in the education for a client prescribed sumatriptan (Imitrex)? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Do not drive until the effects of the medication are known.
B) Avoid pseudoephedrine (Sudafed) while taking the prescription.
C) Take the prescription with a meal high in protein.
D) Take the prescription with food.
E) Increase fluid intake.

Answer 2

Do not drive until the effects of the medication are known.
Avoid pseudoephedrine (Sudafed) while taking the prescription.

Question 3

Which statement should the educator use to describe to the nurse the neural mechanism responsible for signaling sharp pain?

A) "Once the pain impulse reaches the spinal cord, the neurotransmitters speed up the signal for sharp pain."
B) "Alpha fibers are wrapped in myelin that speeds up the signal resulting in the sensation of sharp pain."
C) "Both the alpha and beta fibers in the spinal cord work together to signal sharp pain."
D) "Unmyelinated fibers carry the pain signal faster resulting in the feeling of sharp pain."

Answer 3

"Alpha fibers are wrapped in myelin that speeds up the signal resulting in the sensation of sharp pain."

Question 4

The educator is discussing pain transmission with the nurse. Which statement made by the nurse indicates an understanding of the process?

A) "The transmission process begins with the activation of substance P."
B) "The transmission process begins with the A and C fibers."
C) "The transmission process begins with the nociceptors."
D) "The transmission process begins with the sensory neurons in the spinal cord."

Question 5

A client that experienced head trauma asks the nurse why they cannot have an opioid analgesic. Which response should the nurse provide?

A) "The use of an opioid analgesic can significantly decrease blood pressure."
B) "You may not be able to notice any changes you are experiencing."
C) "Opioids are not effective for the management of pain associated with head trauma."
D) "Opioids can mask changes in the level of consciousness."

Question 6

The educator is reviewing the neural mechanisms of pain with a nurse. Which information should the educator provide about substance P?

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

Question 7

Which comment by the client receiving morphine should the nurse recognize as an adverse effect?

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

Question 8

The educator has discussed the types of opioid receptors with a nurse. Which statement made by the nurse indicates an understanding of the information?

A) "The sigma and kappa receptors have been traditionally targeted for pain management."
B) "Drugs that block opioid receptors inhibit the pain impulse."
C) "Opioid agonists will activate mu and kappa receptors, producing an analgesic effect."
D) "Opioids exert their actions by interacting with three different receptors."

Question 9

A postoperative client has a prescription for morphine 2 mg IV push every 2 hours and hydrocodone 5 mg every 6 hours. The client received the morphine 2 hours ago and is requesting hydrocodone. Which initial action should the nurse take?

A) Administer another dose of morphine.
B) Administer 5 mg of hydrocodone.
C) Encourage the use of distraction techniques.
D) Using a pain scale assess the patient's level of pain.

Question 10

Which question should the nurse ask a postsurgical client prior to the administration of an opioid analgesic?

A) "Have you ever been addicted to prescription pain medications?"
B) "Do you understand how this pain prescription works?"
C) "Would you like me to help you change your position for comfort?"
D) "Would you please rate your pain on a scale of 1 to 10?"

Question 11

A client tells the nurse he or she has a dull, aching pain in his or her lower back. Which type of pain should the nurse recognize the client is experiencing?

A) Acute
B) Somatic
C) Neuropathic
D) Visceral

Question 12

A client asks the nurse how methadone (Dolophine) can help with a heroin dependence. Which response should the nurse provide?

A) "Methadone (Dolophine) will cause illness if heroin is used."
B) "Methadone (Dolophine) does not cause euphoria like heroin does."
C) "Methadone (Dolophine) can cure an addiction to heroin."
D) "Methadone (Dolophine) causes an allergic reaction to heroin."

Question 13

Which instruction should the nurse include for a client prescribed acetaminophen (Tylenol)?

A) "Check your gums for bleeding when taking acetaminophen (Tylenol)."
B) "Do not take any narcotics with acetaminophen (Tylenol)."
C) "You may experience diarrhea while taking acetaminophen (Tylenol)."
D) "Acetaminophen (Tylenol) can cause your mouth to become dry."

Question 14

Which statement made by a client prescribed acetylsalicylic acid (aspirin) indicates the client is experiencing an adverse reaction?

A) "My stools have been dark in color."
B) "My nose is stuffed up."
C) "Bright lights give me a headache."
D) "I have to get up a lot at night to urinate."

Question 15

A client asks the nurse how morphine will control pain. Which response should the nurse provide the client?

A) "Inhibits the primary pain neurotransmitters in your brain."
B) "Stimulates the receptors that secrete endorphins in your brain."
C) "Interacts with receptors in your body that produce analgesia."
D) "Promotes the primary pleasure neurotransmitters in your brain."

Question 16

For which client is acetaminophen (Tylenol) contraindicated?

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

Question 17

A client with an oxycodone overdose has a respiratory rate of 8 and is difficult to arouse. Which prescribed treatment should the nurse anticipate administering?

A) Administering activated charcoal
B) Administering an opioid agonist
C) Administering opioid antagonist
D) Preparing for intubation and mechanical ventilation

Question 18

The educator has discussed with a nurse the protocol for the immediate availability of naloxone for a client with a patient-controlled analgesia PCA pump. Which statement made by the nurse indicates an understanding of the information?

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

Question 19

The nurse has administered naloxone (Narcan) intravenously to a client receiving morphine experiencing respiratory depression. Which should the nurse anticipate?

A) A peak effect of 10 to 20 minutes
B) An onset of action of 1 to 2 minutes
C) An onset of action of 2 to 5 minutes
D) A peak effect of 5 to 10 minutes

Question 20

The nurse has provided client education about the use of nonpharmacological techniques for pain management. Which statements indicate the client understands the information? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

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

Question 21

The nurse has provided education for a client prescribed opioid treatment. Which statement made by the client indicates an understanding of the education?

A) "I will make sure I take stool softeners."
B) "I will use a laxative if I need to."
C) "I will increase my fluid intake."
D) "I will increase my physical activity."

Question 22

A parent asks the nurse why his or her 8-year-old child cannot have cough syrup with codeine to help the child rest. Prior to responding to the parent, which should the nurse understand?

A) The child can become addicted to the cough syrup.
B) Codeine is contraindicated in children.
C) Children are more likely to have an allergic reaction to the codeine.
D) Codeine will exacerbate the child's condition.

Question 23

The nurse is preparing to review the records of a client with cancer prescribed buccal fentanyl. Which findings should the nurse anticipate? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) The client is already prescribed fentanyl.
B) The client is opioid naïve.
C) The client is experiencing breakthrough pain.
D) The client has a history of migraine headaches.
E) The client is being weaned off of intravenous fentanyl.

Question 24

Which information should the nurse include in the teaching for a client with a prescription for migraines? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Use the medication at the first sign of migraine.
B) Overusing this medication may result in rebound headaches.
C) Instill the spray into one nostril only.
D) Increase dietary intake of tyramine-containing foods.
E) Pain relief will not begin for up to an hour after administration.

Question 25

Which selective serotonin reuptake inhibitors (SSRIs) are prescribed as adjuvant analgesics? Note: Credit will be given only if all correct choices and no incorrect choices are selected. Select all that apply.

A) Desipramine (Norpramin)
B) Fluvoxamine (Luvox)
C) Imipramine (Tofranil)
D) Sertraline (Zoloft)
E) Fluoxetine (Prozac)

Question 26

For which client should the nurse recognize a prescription for sumatriptan (Imitrex) may be beneficial?

A) A 73-year-old with angina pectoris
B) A 36-year-old female with preeclampsia
C) A 45-year-old diabetic male
D) A 27-year-old asthmatic male

Question 27

Which prescription should the nurse anticipate to be included in the treatment of a client experiencing mild migraine headaches?

A) Ibuprofen
B) Sumatriptan (Imitrex)
C) Ergotamine (Ergostat)
D) Amitriptyline (Elavil)

Question 28

A client with terminal cancer has a respiratory rate of 10 and requests a dose of prescribed morphine. Which action should the nurse take?
1) Hold the dose until the respirations are above 1
2)
2) Administer the dose of morphine.
3) Implement nonpharmacological interventions.
4) Administer the prescribed NSAID.

Question 29

The nurse has administered sumatriptan (Imitrex) to a client. Which effects should the nurse monitor the patient for?

A) Hypotension
B) Urinary retention
C) Muscle weakness
D) Decreased level of consciousness

Question 30

Which statement is accurate when prescribing acetylsalicylic acid (aspirin) for the treatment of pain?

A) High doses are necessary (1 g) to achieve anticoagulant effects.
B) Enteric-coated capsules are available to reduce GI side effects.
C) Increase consumption of herbs such as garlic and ginger to potentiate the anti-inflammatory effects.
D) Low doses (325 mg) can significantly reduce inflammation.