Question 1

An adult client with migraine headaches is ordered sumatriptan (Imitrex). What information disclosed in the client history does the nurse share with the physician?

Accepted Answer

Sumatriptan is contraindicated in patients with a history of peripheral vascular disease due to its vasoconstrictive effects, which can exacerbate vascular conditions.

Question 2

A client is being switched from abortive therapy for migraines to preventive therapy. The client asks the nurse to explain the difference between the two types of therapy. What is the nurse's best response?

Accepted Answer

Preventive therapy is aimed at preventing headaches from occurring in the first place, while abortive therapy is designed to treat migraine attacks once they have started.

Question 3

The nurse is teaching a group of student nurses the role of naloxone in treating opioid toxicity. How should the nurse explain the mechanism of action?

Accepted Answer

Naloxone competes with the opioid at the receptor sites, which results in the reversal of the opioid's effects, including respiratory depression, sedation, and analgesia.

Question 4

The nurse should question an order for tramadol (Ultram) for which client?

Accepted Answer

Tramadol can cause respiratory depression, which can be particularly dangerous for a patient with COPD (Chronic Obstructive Pulmonary Disease).

Question 5

The nurse is interviewing the client before minor surgery. The client is worried about pain management: "I have a history of addiction; I have to be careful what I get for pain." What is the best response from the nurse?

Accepted Answer

Nonopioid drugs are a safe choice for clients with a history of addiction. They have a lower risk of dependency and can still effectively manage pain. It is important for the nurse to address the client's concerns and offer safe pain management options. Options A and B are not appropriate as they do not offer a solution to the client's concerns. Option D is incorrect as there is no specific time frame for being drug-free that guarantees the use of opioids without risk of addiction.

Question 6

A student is administering an opioid( morphine) IV to a post operative client. Her instructor asks her why she should have naloxone available for administration. What is the best response of the student

Accepted Answer

Naloxone is a medication used as an antidote for opioid overdose. One of the adverse effects of opioids, including morphine, is hypoventilation, which can lead to respiratory depression and even death. Naloxone can reverse this effect by blocking the opioid receptors in the brain and restoring normal breathing. Therefore, having naloxone available is essential for the safety of the post-operative client receiving opioids. Naloxone is not used to treat nausea and vomiting, hyperventilation, or hypovolemia.

Question 7

Which objective method should the nurse use to assess the client's pain level?

Accepted Answer

Using a pain rating scale such as the numeric rating scale is an objective method that allows the client to rate their pain level using a standardized numeric scale. This provides a measurable and quantifiable assessment of pain level, as opposed to relying on subjective descriptions or observations.

Question 8

The nurse is performing medication teaching for a client after surgery. The nurse explains that the client will go home on tramadol, a nonopioid analgesic, for pain management. The client states, "I can't take that, I'm allergic to NSAIDs." How should the nurse respond?

Accepted Answer

Tramadol is not an NSAID, so the nurse should clarify this for the client. Option A is incorrect because tramadol is not an NSAID. Option B may cause the client to doubt their own knowledge of their allergy, which is inappropriate. Option D is incorrect because if the client cannot take tramadol, then an alternative nonopioid should be discussed, not simply continuing the opioid.

Question 9

The client is experiencing mild pain secondary to a minor ankle sprain. Which is the drug class of choice for the client's pain?

Accepted Answer

Nonopioid analgesics, such as nonsteroidal anti-inflammatory drugs (NSAIDs) or acetaminophen, are the drug class of choice for mild pain like a minor ankle sprain. They have fewer side effects and are less addictive than opioid analgesics. Adjuvant analgesics and patient-controlled analgesics are typically used for more severe pain management.

Question 10

For which client should the nurse question an order for tramadol?

Accepted Answer

Tramadol can lower seizure threshold and is contraindicated in patients with a history of seizure disorders. Therefore, the nurse should question an order for tramadol for the 50-year-old male with a seizure disorder. The other clients may receive tramadol as an appropriate treatment option for their conditions.

Question 11

What benefits of non-opioid analgesics vs opioid does the nurse consider when planning care for her client?

Accepted Answer

Non-opioid analgesics have a lower risk of dependency compared to opioids, making them a safer option for long-term pain management.

Question 12

An adult client with a history of migraine headaches tells the nurse that in the past six months, she has needed to use her medication to abort headaches on the average of 5 to 6 times a month, despite avoiding her migraine triggers. The nurse explains that the next step in her therapy might be to take which action?

Accepted Answer

The client has already attempted to avoid triggers, and trying a different abortive medication may not guarantee better results. The next step in therapy would be to try a medication specifically designed for the prevention of migraines.

Question 13

The client asks the nurse why he is receiving combination therapy of opioid and nonopioid drugs to manage his pain. The nurse should explain which benefit of combination therapy?

Accepted Answer

Combination therapy helps to relieve pain synergistically and decreases the risk of side effects. Opioid and nonopioid drugs can work together to produce a greater analgesic effect than either drug alone, while reducing the dosage needed for each drug and therefore reducing the risk of adverse effects from either drug. This can lead to better pain control and improved quality of life for the client.

Question 14

A client who is being treated for cancer tells the nurse that she is still having trouble getting to the toilet without experiencing significant pain. The nurse plans care for this client based on which goal?

Accepted Answer

The goal of allowing the client to perform activities of daily living is most applicable in this scenario, as the client is experiencing pain during a necessary activity. The other options (eliminating all pain, preventing addiction, assessing treatment success) may also be important goals, but they are not as pressing in this particular situation.

Question 15

A client arrives unconscious in the emergency department in respiratory depression from an unknown drug overdose. To help diagnose the overdose, the client is given small doses of naloxone (Narcan). What is the purpose of this action?

Accepted Answer

Naloxone (Narcan) is an opioid antagonist that works by blocking the effects of opioid drugs on the body. If the client shows signs of improvement after receiving small doses of naloxone, it is likely that the overdose was caused by an opioid drug. This information can help guide further treatment and management of the client's condition. The other options (A, C, and D) are not the primary purpose of giving naloxone in this situation.

Question 16

The nurse is teaching a client who is prescribed sumatriptan therapy for treatment of migraine headaches. The nurse instructs the client to take the drug at which time?

Accepted Answer

The nurse instructs the client to take sumatriptan at the first sign of aura or headache. This helps to provide maximum effectiveness of the drug in treating the migraine headache.

Question 17

The client is being treated for severe neuropathic pain with opioid analgesics. The nurse chooses a prn order for which type of analgesic to aid the client's pain management?

Accepted Answer

Adjuvant analgesics, such as anticonvulsants or antidepressants, are often used to enhance pain relief in neuropathic pain when opioids are not fully effective.

Question 18

The nurse monitoring a client receiving morphine therapy would be watchful for which common adverse side effects?

Accepted Answer

Morphine is known to cause respiratory depression, which can lead to hypoventilation and hypoxia. It can also cause constipation due to its effects on the gastrointestinal tract. And finally, it can cause hypotension, especially in clients who are already hypovolemic or susceptible to changes in blood pressure. Therefore, the nurse should monitor the client for these adverse effects while on morphine therapy.

Question 19

What is the mechanism of action that differentiates opioid agonists from opioid agonist-antagonists?

Accepted Answer

Opioid agonists activate both mu and delta receptors, while opioid agonist-antagonists occupy one receptor (usually the mu receptor) and partially activate it while also blocking the other receptor (usually the delta receptor). This results in less pain relief and a lower risk of addiction and respiratory depression.

Question 20

The nurse is teaching the client how to use sumatriptan (Imitrex) to treat migraine headaches. Which common side effects should the nurse include in this teaching?

Accepted Answer

Common side effects of sumatriptan (Imitrex) include dizziness and nausea. Hypotension and irritability, constipation and sedation, anxiety and agitation are not common side effects of sumatriptan.

Quiz 5: Pharmacology of Alterations in the Central Nervous System

An adult client with migraine headaches is ordered sumatriptan (Imitrex) . What information disclosed in the client history does the nurse share with the physician?